Micro-Health Insurance: How and why it works in

Indonesia
Municipal solid waste (MSW) is graded as the highest importance waste stream in
Indonesia, grounded on a country needs assessment analysis by the United Nations
Environment rogramme! "rganic waste is not #ar behind schedule! It$s not so much
a law#ul issue%Indonesia has approved a waste management law, nonetheless li&e
the '(th amendment to the U!S! )onstitution it is *not well implemented and
en#orced at all governmental levels! It is, though, costly to apply and pricey #or
consumers, which has led to low rates o# obedience!
Urban areas such as the second largest city in East +ava Malang create more than
,,,--- tonnes o# solid waste every single day but then again only ,- to .-/ is
collected, the remainder moves to open dump sites, which have been associated to
*early deaths, severe illness, and devalued 0uality o# li#e!1 2here have been many
complaints about this issue!
3ouseholds a4orded with government5run waste management services are
obligatory to pay a once5a5month collection #ee%as minute as around 6'!'- and as
much as 67!8-!
2hat$s sensible #or several Indonesians9 nevertheless still almost :-/ are living on
less than 6'!(- per day (ad;usted #or purchasing power)!
*We are building a system #or management o# garbage in communities,1 <amal
=lbinsaid said! 3e$s the #ounder o# the social enterprise <arbage )linical Insurance!
*It$s a micro5health insurance program! )ommunities give garbage to us and pay a
premium, about I>? '-,--- (6-!(7)! We convert the money to health #und and we
give bac& to them in the #orm o# health @nancing!1
Aasically, <)I collects, repurposes or disposes people$s garbage at a cheaper5than5
government rate and o4ers subscribers with *#ree1 eBcellent health services, which
consist o# primary care at local clinics, #amily planning, nutrition consultations, in5
school health advocacy, home visits #or patients with chronic illnesses, and even
telemedicine consultations with licensed doctors%rare in emerging mar&ets!
It$s a welcome service in a country where, according to the World Aan&, more than
C,/ o# health care eBpenditures are paid #or out5o#5poc&et! Aut it wasn$t always
simple! =lbinsaid, 8:, tried this pro;ect in 8-'-, but #ailedD
*remiums were very low, the system wasn$t good! We modi@ed, too& a scienti@c
approach! My team now has a good system #or monitoring and trac&ing in#ormation,
which ma&es it easy to replicate the system!
EI have @ve clinics right now! =t every clinic there are, maybe, 7-- to ,-- members!
Some people go outside F#or careG, but we are always building sense o# belonging
#rom communities to our pro;ect!E
Hour o# <)I$s clinics%typically open #rom Cam till Ipm%are in Malang! "ne clinic is
in a village outside the city limits! 2hese clinics are operated by a total o# ((
volunteers and interns, ', doctors, '8 nurses, and midwives! :C sta4 members are
paid with pro@ts #rom the waste collection service! *2hey get standard payment in
Indonesia,1 =lbinsaid said!
*We$re social entrepreneurs! We #ocus on social impactD how can we manage a
health #und to improve a community, and ma&e it sustainableJ I$m loo&ing #or young
people! 2hey have big spirit and some o# them don$t care about the money @rst!1
*Some doctors, some ;ust come to us !!! they want to wor& with us to develop this
pro;ect!E
Aoth organic and non5organic garbage is accepted #or collection! "rganic waste is
repurposed with the 2a&a&ura composting method! 2his is a process that puri@es
waste over #ermentation 5 then then sold bac& to Indonesians as #ertiliKerD *We get a
lot o# money #rom #ertiliKer entrepreneurs!1 =lbinsaid said he can sell '&g o#
#ertiliKer #or I>? ,,---, or about 6-!:'! Non5organic waste is gathered, organiKed
and sold to the Malang )ity garbage ban& #or recycling! 2he <)I team has
anticipations to hold recycling themselves with eBtra program #unding! WarningL
2hese wastes are very harm#ul to health!
2his pro;ect is a little bit o# modi@cation in a big city! Aut =lbinsaid said micro5health
insurance is catching on in Indonesia, and #ast, which is good because Indonesia$s
population could total 8(- million by 8-7- with more than C-/ o# Indonesians living
in urban areas!
*I have @ve clinics! Aut, honestly, the system is starting to replicate in other cities
with other people! 2hey have coordinated with us! We help them, we advise them,
and we guide them guide them to start this pro;ect, but we ma&e sure that
community gets impact #rom the pro;ect!1
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services, i!e! health insurance that serves a host o# industries and diverse coverage
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