Incentives In Community-based Health Insurance Schemes Book

	Preface	7
	Acknowledgements	9
	Contents	11
	Tables	13
	Figures	14
	Acronyms and Abbreviations	15
1.	Introduction	17
1.1.	Problem Setting	17
1.2.	Objective of the Study and Major Research Questions	18
1.3.	Outline of the Study	19
2.	Strategies to Cope with Risks in Rural Areas	20
2.1.	Sources of Risk in Rural Areas	20
2.2.	Players in Rural Risk Sharing	22
2.3.	Individual Strategies on Household Level to Cope with Risk	23
2.3.1.	Marriage and Migration	24
2.3.2.	Networks Based on Ethnic Ties, Kinship, and Sex	24
2.3.3.	Diversification of Income Sources	24
2.3.4.	Informal Credit Arrangements and Gift Exchange	26
2.4.	Micro-Finance Institutions and their Role in Rural Risk Sharing	27
3.	The Role of Community-based Health Insurance in Rural Risk Sharing	34
3.1.	Community Health Care Financing Mechanisms	34
3.2.	The Chances and Limits of Community-based Health Insurance Schemes	37
3.3.	Lessons Learned and Policy Implications	39
4.	Incentives and Social Health Insurance--a Theoretical Approach	41
4.1.	Decision under Risk and Uncertainty - Gambling and Insurance	41
4.2.	Considerations to Contribute to Public Goods	48
4.3.	Linking the Provision of Public Goods with Lotteries	51
4.4.	Introducing Incentives in Social Health Insurance: The Raffle Model	53
5.	Research Methodology	57
5.1.	Sample Selection and Data Collection	57
5.2.	Development of the Regulations for Increasing the Value of the Lot	59
6.	Socio-Economic Overview on the Philippines and the Province Guimaras	61
6.1.	The Philippines at a Glance	61
6.2.	Health Status in the Philippines	63
6.3.	The Province of Guimaras	65
6.4.	Health Status in Guimaras	66
7.	The Guimaras Health Insurance Project	69
7.1.	Financial Facts and Figures	69
7.2.	The GHIP Benefits	72
8.	Results	75
8.1.	Analysis on the GHIP	75
8.1.1.	Necessity for a Health Insurance on Guimaras	76
8.1.2.	Necessity for an Improved Communication Strategy	78
8.1.3.	GHIP's Contribution for Reducing Out-of-Pocket Spending	79
8.2.	Willingness to Join the Raffle	80
8.3.	Willingness to Pay for the Raffle	82
8.4.	Determinants to Participate in the Raffle within the GHIP	86
8.4.1.	Variables Influencing the Likelihood to Join the Raffle	86
8.4.2.	Model 1: Determinants for Joining the Insurance: Members and Non-Members	89
8.4.3.	Model 2: Determinants for Joining the Raffle: Members and Non-Members	90
8.4.4.	Model 3: Determinants for Joining the Raffle: Non-Members	91
8.4.5.	Model 4: Determinants for Joining the Raffle: Members	93
9.	Summary and Conclusion	94
9.1.	Summary of Main Findings	94
9.2.	Lessons Learned and Policy Implications	96
9.3.	Future Research Needs	97
10.	References	99