Mutual Aid in Africa

Via Adam, by way of Marginal Revolution. The sick benefit society, mainly a historic curiosity preserved in the pages of Kropotkin and E.P. Thompson, is apparently making a comeback in Africa. According to the New York Times, it's being brought about by "everyday Africans who are tired of waiting for politicians to address their needs and have begun spinning their own safety nets."

Plans in which neighbors come together and create their own makeshift health coverage are the rage in Africa, particularly in the continent's west. Here, the plans now have a significant presence in 11 countries and membership has grown beyond 200,000 people.

Some of these mutual health organizations, as they are known, include fewer than 100 beneficiaries. The tiny group negotiates with a local clinic and forges a better price for care. Others have linked dozens of community groups to produce sophisticated plans that cover 10,000 or more people and offer an array of services.

"Every day there's a new group," said Olivier Louis Dit Guerin, who helps set up these microinsurance plans as part of a program run by the Labor Organization. "They're growing and growing to fill the big gap."

Membership in one such mutual, described in the article, entitles the holder and her family to

free consultations at the clinic down the road, cut-rate medicine and peace of mind. The chances are lower now that a bout of illness will bring the family to total ruin.

The financing arrangement with an individual clinic is getting pretty close to what I wrote about earlier: the involvement of mutuals not only in the cooperative finance of healthcare, but in organizing delivery of service.