Quality & Equity Health Care

This book contains a health insurance model that aims to provide affordable premiums for low-income populations in countries with different levels of development and economy. In many situations, low-income people work hardly to come up from poverty and become sick accidently. Despite all their efforts, all the investments they have suffered to acquire are spent to cover medical treatments. When reviewing why health insurance does not cover those with a low income, the high level of premiums is ranked as the main reason. The economy of scale boosts businesses constructed with lower prices to obtain many clients. In business, a low price is far from enough. The quality of a product or service is equally or even more important. Quality in health insurance means many things, but an essential parameter is the benefits package of the healthcare services covered. The idea of the model is to say, let us focusing on a limited number of expensive healthcare services, as the prevalence is usually low and cost sharing should work. The proposed attractive benefits include major surgeries, complicated birth deliveries, and cancer treatment. The services include medical consultations, diagnostic exams and drugs. To make the model more attractive and sustainable, the quality and efficiency of healthcare services and the efficiency of the health insurance administration were added. The model is proposed as a profitable social business that aims to attract investments for the reduction or prevention of the impoverishment of low-income populations due to expensive healthcare services.