Transcript Uplift Mutuals Governance

Social Protection for the Informal Sector…
…A Local Infrastructure.
Looking for the opportunities for an inclusive social
security system in the current Indian situation…
1 Billion people without social protection
• Only 100 millions people have some kind of social protection
94% of the total labour force is part of the informal economy sector
• Small/micro businesses, Rural agriculture, 92% two years ago.
GoI has money for financing social protection , is interested in equitable basis, wants
a certain visibility of the action.
• Gvt Health Expenditures to evolve from 1% to 3% of GDP
• Co financing strategies per product or for BPL.
NGOs, MFIs, SHG Federations, Cooperatives, Trade unions, Gram panchayats are the
only organizations reaching the informal sector.
• Only 10 million people have access today to some social protection through such entities
Free insurance market, innovative microinsurance, lack of information balance
Challenges
• How to bring social protection to the informal sector through an
inclusive mechanism?
• How to ensure an effective risk management system that involves
developing local ownership and responsibility?
• How to build communities management capacities or resilience
when facing micro or macro risks?
• How to finance a social protection sustainably even in the health
domain?
Risks
Health,
Lifecycle
Accidents,
Death,
Frequency
Monsoon
failure,
Fires, Floods
Epidemic,
Riots,
Floods,
Landslide
Tsunamis,
Earthquakes,
Cats
Costs
Risks and mitigation strategies
Education, Information, Prevention
Savings
Assets
accumulation,
small pooling
Frequency
Insurance
Local Pool
ReInsurance,
Big Pooling
Costs
The basic social security product for basic rights
• Individual benefits requiring a whole group solidarity
• Solidarity sustainability requiring individual responsibility
Indian CHALLENGE:
Setting up a sustainable social security system in a context
of free and competitive insurance market
Social Security Markets logics between
responsibility and solidarity
Tough not
to exclude
Profit Logic
Social Logic
Tough to
sustain
financially
Which entity to enroll while respecting individual
freedom and social inclusion?
1.
2.
3.
4.
Which group type includes a sample of the whole age pyramid of the
population?
Which group of individual may decide to contribute together and get it done?
Which group size can control its individuals when they have a claim ?
Which group type may be able to consider social security as another type of
infrastructure to be handled with a subsidiarity Principle?
From Self Help Group to Village Social Security Fund:
Exploring the analogy from finance to insurance
VSSF
Subsidiarity principle
Agregator
VSSF
Insurer
VSSF
Agregator
VSSF
Frequency
Costs
VSSF is the decision point & offers various solutions
Enrolment Strategy
Health Products choice
1: Village Mutual + high insured layer
2: Insurance only
 Everybody or Nobody, No exclusion, no age limit,
 Pre existing diseases covered
 Co financing from government for the BPL
 Various quality of service for various contributions under study.
Model Operations Highlights
•1-Village Security Fund
En-bloc Enrolment
•7- Social Protection Service Provider
•6- Risk
Bearer / TPA
•2- Implementing
Organization
•3- Federal Organization
Social Security Fund
•3- Federal Organization
Social Security Fund
•4- Co financing
Partners
Model Organizational Highlights
•2- Collecting/Servicing
Field Agents
•3- Representative to
Federal Security fund
Tender and
Contract
•1-Village Social
Security Fund
•3- Federal Social
Security Fund
Representatives
•6- Risk Bearer
•7- Social Protection
Service Provider
•4- Co financing
Partners
Public Private People Partnership
•4- Co financing
Partners
•3- Federal
Organization
Representatives
•1- Communities
Choose, contract,
control at their level
Transparency, Audits,
profit sharing
•2- Collecting/Servicing
Agents (NGOs, MFIs..)
•6- Risk Bearers
(Insurer…)
•7- Social Protection
Service Provider
(hospitals…)
SWOT
Roles…
Participation,
Solidarity,
Health risk
Contribution,
claim Control,
Communication
, negotiation
with HCP
Governance,
Administration
services,
Negotiation
with HCP
Data
Consolidation
Negotiation
framework,
negotiation
with insurers
training,
reporting,
Policy Advocacy,
Data
Consolidation
Negotiation
framework,
negotiation
with insurers
toolbox sharing,
Contact
• GTZ HSS New Delhi B5/1 Safdarjung Enclave +91 11 4603 6677
– FX Hay: [email protected]
– Nishant Jain: [email protected]