A Rigorous Evaluation of Micro-Health Insurance in Cambodia

• Is health insurance a good way to increase health incomes?
• Is health insurance a good way to decrease the vulnerability of poor populations?
• Is "adverse selection" (where those with high costs are more likely to buy insurance) an obstacle to a financially sustainable private health insurance market?
• What insurance prices and contracts minimize adverse selection, promote financial sustainability, and improve outcomes for the poor?

Partner organizations

GRET is a professional solidarity and international cooperation association. Based in France, GRET works in Africa, Asia, and Latin America on a variety of development issues. GRET has administered the SKY program since 1998.

Product

The SKY Health Insurance product has a premium of about USD $0.50 per household per month for a single-person household up to $1.83 per household per month for a household with 8+ members. Benefits include

• Free access and prescription drugs at contracted health centers
• Free access to out-patient and in-patient services at contracted referral hospitals, upon referral from health centers
• Free access to contracted provincial hospital, upon referral from health centers or referral hospitals
• Free transportation from health centers to hospitals in case of emergency
• Funeral grant and traditional music at funerals

Evaluation design

Experimental encouragement design. At the introduction meeting in every village, SKY uses a random drawing to give coupons to participants. 35% receive a coupon for five months of free insurance, while the remaining receive a one-month discount on insurance.

Data Sources

• Surveys: Pre-intervention baseline and follow-up surveys to be conducted over four-year period, covering health, asset vulnerability, investment and savings decisions, and risk management.

Sample size

Approximately 3,000 households with over 12,000 individuals

Project website(s)