Models of Health Insurance?

Hi Edgeryders,

I was wondering there were any examples of alternate models of health insurance that aren’t based on total pooling of collected dues? In the US, our insurance system is provided by a few companies that sell packages, which penalize people who are unemployed or in freelance/ non-traditional modes or employment. Universal healthcare is quite a political spectacle, and not many people are holding their breath up for something to pass soon.

Do people know examples of where health insurance is based on small scale local pooling of monetary resources, which then is accepted by sympathetic health care professionals? Or something similar?

Also if you know of even more creative models I’m all ears.


Haven’t said hi yet, so hi! :slight_smile:

I heard of two ones… something in Peru I think @jean_russell do you remember that guy who was at the retreat in Thailand with us? I don’t have the catalogue with description of participants…maybe @christina_jordan knows?

Another one is the Amish, Alberto wrote about it here.

Then there is the Greek network of shadow clinics.

Also @woodbinehealth might know of some? Maybe also @markomanka ?

1 Like

This a great starting point. Thanks @nadia Nadia! Gonna dive deep~

Hi :slight_smile:

I am not sure if I have put the question in the right mental frame… I think I understand until the part about pooling local resources… and as instance even CERN utilizes schemes of mutuality for social security, and health insurance…

However, I may be missing the part about sympathetic health care professionals…? I understand most mutual insurances would cover costs for care with some “capping” mechanism, which is calibrated on the best offers they have been able to negotiate in advance: providers A and B would do it for the amount X, and if you go to another, and the amount is higher, you will be reimbursed up to X, or only Y% of the cost you incurred…

As long as you pay in a valid currency, no sympathy by the providers really enters the picture… it’s usually the mutual insurance that sets the policies.

It may be different if you were discussing of an alternative currency here, but that requires an entirely different setting… I imagine if a LETS exists, then this would not be a problem?

…have I made sense to you @aquamammal?

Hi @markomanka, by “sympathetic” I meant like, health care professionals who were cool taking money from a group of people instead of a middle agent like an insurance company at a comparable rate with which they charge insurance companies.

So if say 150 people pooled together a health fund, a doctor would take their money as payment at a negotiated rate as opposed to that uninsured rate. (I’m also in the US where prices vary wildly and people go bankrupt all the time due to lack of insurance or insurance company litigation.

And yes, I agree, would love to explore like alternate forms of compensation for health care, haha, but let’s keep it simple~

Hi @aquamammal, thank you for the clarification.

I cannot draw any truly general considerations here, but this boiling down essentially to a business decision, I would say that once the collectively instituted pool has a clear enough governance, any doctor should be at least willing to negotiate such a deal.

This boils down to the size of the pool, its stability over time (and the possibility by an affiliated provider to check its current status), and the terms of payment (whether the “pool” would pay immediately, or with fixed delays, etc)… nothing formal I can think of further than this.

Of course, this being a negotiation with a huge human and ethical dimension to it, having front people that can truly communicate the case for this arrangement, and explain and defend its purposes, would greatly impact the chances of landing an agreement.

…but in general, as a doctor myself, I see not a single reason why my category should reject a deal anywhere in the world (at least for those countries with whose professionals I have interacted with…)

Have you encountered specific barriers that you would feel comfortable sharing with me, either here or privately, to analyse them together?

1 Like