In Praise of Rwanda's "Public Option"

If Rwanda's high economic growth rate, political stability and focus on women's rights have not yet convinced you that the country is a beacon of hope in Africa, perhaps this will: the government of Rwanda currently offers health insurance to 92% of its population.

Yeah, you read that right. In a nation where a majority of people live on less than $0.43 a day, nearly the entire population is covered by health insurance that costs each person just $2 a year.

Now let's be up front about this — the health care that Rwandans receive is extraordinarily basic. If a Rwandan person has a heart attack or stroke, or is stricken by a disease such as cancer, that person is unlikely to receive the treatment she would need to save her life. But for more common causes of death — diarrhea, malaria, malnutrition, infection — the healthcare system is quite adequate.

Unlike health centers in most of Africa, local clinics in Rwanda are stocked with medicines and are able to run basic blood and urine analyses. Though there's only one neurosurgeon in the entire country (out of a population of 11 million), nurses are not quite so rare, and women are encouraged to give birth at health centers instead of in their homes. These seemingly small changes have made quite an impact — since the insurance program was implemented 11 years ago, the average life expectancy in Rwanda has increased by four years, from 48 to 52.

Though the system is not perfect — $2 per year is still a hefty burden for the poorest farmers, and (like many Americans) some Rwandans are not fond of the concept of paying for something that they might not need — it's an important safety net in a country plagued by infant mortality, HIV/AIDS and a whole host of infectious diseases. Meanwhile, making everyone contribute is part of President Paul Kagame's plan of developing self-reliance across all Rwandans.

Right now, over half of the $307 million yearly health expenditure in the country is covered by international donors. While it'd be great to see the government of Rwanda in a position to take on the full financial burden of its healthcare system, for the moment, Rwanda's health plan is a success story both for national planning and international investment.

And with a 92% coverage rate, perhaps we Americans could learn a thing or two from Rwanda about national healthcare.

Photo Credit: swimboy1