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A dream comes true!!! The basic requirements for a world health insurance have already been developed in theory and even in practice to a certain extent. A world health insurance could solve the problem by defining rights and duties for both rich and poor states. A world health insurance would shed different light on the problem of sustainability. Several effective health interventions are branded as “unsustainable” in poor countries, because national health budgets cannot afford them. The option of substantially and permanently increasing national health budgets through international assistance is rarely considered. The creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria (“the Global Fund”) demonstrates the merits of ambitious thinking: the provision of antiretroviral therapy (ART) to people living with AIDS, previously dismissed as unsustainable, became widely accepted as soon as the Global Fund provided a long-term funding perspective. Other health interventions deserve a similar approach. A Practical Format for a World Health Insurance The underlying principle of health insurance is the willingness to share health risks and the burden of health care. In national health insurance schemes, duty-bearing individuals pay a fair contribution; rights -holding individuals receive assistance in accordance with their health-care needs. Transposed to a world health insurance, rich states would pay a fair contribution and poor states would have a right to assistance according to the health-care needs that they are unable to finance themselves. The creation of a world health insurance would therefore require: (1) A mechanism to determine the contributions from rich |
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