A Dirt-Poor Nation, With a Health Plan

[Liberal_in_LA]

A Dirt-Poor Nation, With a Health Plan

By DONALD G. McNEIL Jr.
Published: June 14, 2010

It has no running water, and the delivery room is little more than a pair of padded benches with stirrups. But the blue paint on the walls is fairly fresh, and the labor room beds have mosquito nets.

Inside, three generations of the Yankulije family are relaxing on one bed: Rachel, 53, her daughter Chantal Mujawimana, 22, and Chantal’s baby boy, too recently arrived in this world to have a name yet.

The little prince is the first in his line to be delivered in a clinic rather than on the floor of a mud hut. But he is not the first with health insurance. Both his mother and grandmother have it, which is why he was born here.

Rwanda has had national health insurance for 11 years now; 92 percent of the nation is covered, and the premiums are $2 a year.

Sunny Ntayomba, an editorial writer for The New Times, a newspaper based in the capital, Kigali, is aware of the paradox: his nation, one of the world’s poorest, insures more of its citizens than the world’s richest does.

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For $2 a year, of course, Rwanda’s coverage is no fancier than the Mayange maternity ward.

But it covers the basics. The most common causes of death — diarrhea, pneumonia, malaria, malnutrition, infected cuts — are treated.

Local health centers usually have all the medicines on the World Health Organization’s list of essential drugs (nearly all are generic copies of name-brand drugs) and have laboratories that can do routine blood and urine analyses, along with tuberculosis and malaria tests.

Ms. Mujawimana gave birth with a nurse present, vastly increasing the chances that she and her baby would survive. Had there been complications, they could have gone by ambulance to a district hospital with a doctor.

“In the old days, we came here only when the mother had problems,” her mother said. “Now the village health worker orders you not to deliver at home.”

Since the insurance, known as health mutuals, rolled out, average life expectancy has risen to 52 from 48, despite a continuing AIDS epidemic, according to Dr. Agnes Binagwaho, permanent secretary of Rwanda’s Ministry of Health. Deaths in childbirth and from malaria are down sharply, she added.

http://www.nytimes.com/2010/06/15/health/policy/15rwanda.html?src=me&ref=general

[jody]

1. Rwanda has 1 physician and 4 nurses per 10,000 to serve its 10 million people. n/t

[hobbit709]

2. Amazing how it works everywhere else

But here the pukes, teabaggers and Blue dogs say it won't

[stray cat]

3. Would you settle for treating only the conditions they treat?

if so - we can have national health care cheaper than Medicare for all. Just don't get sick with anything other than diarhea, tuberculosis, or cuts - and hope you don't mind 3 to a bed and a copay! We have it good even if your uninsured in comparison.

[hobbit709]

4. I think we can afford to pay more than $2 a year here

So we ought to be able to get more.

We don't really have it any better than that if you're uninsured.

and obviously cutting down on their major killers has made a difference.