Although caring for one’s health is a basic human need, many people who live on less than US$1 a day don’t have access to essential healthcare services because they can’t afford to pay service fees.

In exploring alternate approaches to financing healthcare for the poor, a new International Labour Office (ILO) and World Bank publication introduces innovative solutions on how to help small health insurers overcome financial crises caused by the unpredictable and often prohibitive cost of illness.

"More than a billion of the world's poor do not have adequate financial protection against the cost of illness," says Alexander S. Preker, World Bank’s Chief Economist for Health Nutrition and Population. "Many end up becoming increasingly indebted even when seeking care from public clinics and hospitals due to the user fees often charged by providers working in these facilities".

The book, Social Re Insurance, builds on existing community-based microinsurance schemes, and considers them a first step in improving financial protection and access to health services for poor, rural, and informal sector workers.

These schemes, often the only locally accessible safety nets with little red tape and an immediate response time, were originally developed in agricultural communities and informal sector trade groups that set up their own community-level financing schemes to protect their populations against the impoverishing effects of illness.

Social Re Insurance offers strategies and public policies that countries and donors can use to mitigate the shortcomings of community-financing microinsurance. It suggests that governments could strengthen community action in securing financial protection against the cost of illness by introducing more pro-poor policies that could build on existing social capital. It also emphasizes reinsurance a mechanism for enlarging the risk pool, managing risks across larger population groups, and guaranteeing solvency of microinsurance units as well as the reinsurer.

"The ‘Social Re’ idea sets out to prove that health insurance for the poor is not only morally desirable, but financially sustainable and operationally viable," says David M. Dror, ILO’s Senior Health Insurance Specialist and "Social Re" Project.