Universal health insurance is a desired objective entertained by countries all over the world but very few have been able able to achieve coverage of the majority of population under their national insurance program. While life insurance which is becoming popular and affordable to many provides security to a family on the death of the insured, health insurance is a means of helping the family to fight against unanticipated contingencies due to many life threatening diseases. With medical and hospitalization expenditure becoming increasingly cost prohibitive, those with low surplus income are finding it difficult to keep away the threat of health afflictions. In a country like India government hospitals and health centers do provide some solace but the quality of the facilities and the medical staff is at best tolerable. Those who can afford high premiums charged by the insurance agencies have access to some of the best privately run hospitals with state of the art facilities. The Rwanda model is some thing unique, especially for a country considered one of the poorest in the world.
"The little prince is the first in his line to be delivered in a clinic rather than on the floor of a mud hut. But he is not the first with health insurance. Both his mother and grandmother have it, which is why he was born here. Rwanda has had national health insurance for 11 years now; 92 percent of the nation is covered, and the premiums are $2 a year. Sunny Ntayomba, an editorial writer for The New Times, a newspaper based in the capital, Kigali, is aware of the paradox: his nation, one of the world's poorest, insures more of its citizens than the world's richest does. He met an American college student passing through last year, and found it "absurd, ridiculous, that I have health insurance and she didn't," he said, adding: "And if she got sick, her parents might go bankrupt. The saddest thing was the way she shrugged her shoulders and just hoped not to fall sick." For $2 a year, of course, Rwanda's coverage is no fancier than the Mayange maternity ward. But it covers the basics. The most common causes of death — diarrhea, pneumonia, malaria, malnutrition, infected cuts — are treated".
For any country it is a choice between building hospitals for free treatment of the low income population needing medical attention or a universal insurance scheme that covers the entire population, leaving the running of hospitals in the private hands. Whether at low premium rates such a universal system can work efficiently may be a matter of concern for the planners. Probably the money spent on establishing and running the health centers and district hospitals under government aegis which do not inspire much confidence any way, can be better utilized in subsidizing insurance premium for poor people. One can also consider PPP mode for running medical facilities currently owned by the governments with adequate provisions for treating low income people under the universal health insurance scheme while others with adequate income can be charged as per normal norms.