“One key reason that Rwandans are so much healthier today is the spread of health insurance. In 1999, Rwanda’s health facilities sat unused, as the vast majority of people couldn’t afford them. In response, the Health Ministry began a pilot project of health insurance in three districts. In 2004, the program began to spread across the nation. Now health insurance — called Mutuelle de Santé — is nearly universal. Andrew Makaka, who manages the health financing unit at the Ministry of Health, said that only 4 percent of Rwandans are uninsured.
Mutuelle is a community system — premiums go into a local risk pool and are administered by communities. Until last year, Mutuelle’s premiums were about two dollars a year. This system turned out to be untenable — even two dollars a year was too much for a lot of people. (If you are a rural farmer with an income of some $150 a year, you have to spend every penny on food.)
Last year Mutuelle adopted a sliding scale. For the wealthiest, premiums essentially quadrupled, to about $8 a year. Each visit to a clinic has a co-pay of about 33 cents. If you need to go to the hospital, you pay a tenth of your hospital bill.”
(Source: The New York Times)