Health insurance is a perk that comes along with a corporate career in South Asia. It’s a different story for the household staff employed by executives. “My driver, my maid, my gardener, my cook were all uninsured,” said Saad Amanullah Khan, CEO of Gillette Pakistan and president of the American Business Council. If one of them experienced a family medical crisis, Khan was ready to cover expenses out of his own pocket, “but that can be a huge cost.”
The situation has changed since the launch of Naya Jeevan, a social enterprise that aims to bring catastrophic coverage to millions of unskilled workers and their families in Pakistan and India. The idea is to enroll the previously uninsured as “affiliated workers” of corporations. Some, like Khan’s household staff, have personal ties to executives of multinational corporations. Others are connected through supply chains. Micro-retailers who sell its goods in small shops, for instance, can buy subsidized insurance through sales incentive programs. Gillette alone has a distribution channel of 80,000 micro-retailers.
By bringing the previously uninsured into large risk pools, Naya Jeevan gives corporations negotiating leverage to keep premium rates low. Khan now insures his entire household staff “for $3 per person per month.”
Naya Jeevan (“new life” in Urdu and Hindi) was launched in 2007 by a physician-turned-social entrepreneur named Asher Hasan. A boyhood split between the UK and Pakistan gave him an early look at the disparities of medical care. When a maid who worked for his family in Pakistan was financially ruined by a health crisis, the issue became personal. “It weighed on me,” Hasan recalls. “I wondered, ‘Why isn’t there a mechanism to provide coverage so that people are not stuck in a cycle of poverty?’”
Answering that question took time. The business model for Naya Jeevan began to take shape while Hasan was working for a US biotechnology company. “The environment in biotech was fast-paced and dynamic. I started thinking about how I could take the principles of innovation and apply them to developing world situations.” It helped that insurance underwriter Allianz agreed to share a database of real costs for insuring 30,000 low-income people. “Without that benchmark,” Hasan says, “it would have been challenging to partner with insurance companies.” Allianz is now one of four underwriters for the program.
Goals for Naya Jeevan are ambitious. Hasan wants the model to be “sustainable, scalable, replicable, globalizable.” He also thinks he might be onto an idea that could be “reverse innovateable,” providing ideas to help the West with health care reform.
Headquartered in Karachi, Naya Jeevan has enrolled about 20,000 previously uninsured adults and children in Pakistan. Hasan predicts financial sustainability by early 2014, when he expects to have 100,000 enrolled. Then it’s on to India and another massive market of uninsured.
Naya Jeevan continues to experiment with ideas to expand coverage and improve health care. Along with corporate sponsorship, Naya Jeevan is testing a self-financed community model. Capitalized by the US Agency for International Development for the pilot, the model is designed to be self-sustaining once enough people are making regular daily payments through mobile banking. Premiums are deeply discounted, averaging about $2 per person per month.
Naya Jeevan is also working on what Hasan calls a “diaspora model,” targeting markets with heavy concentrations of South Asians. “If you’re a taxi driver in New York or London, you’ll be able to pay to have your family insured in Pakistan.”
On the care side, Naya Jeevan offers a range of free wellness services, including a 24-hour medical hotline. Annual outpatient health risk assessments encourage early detection. Health education workshops emphasize prevention. Pharmaceutical companies offer differential pricing for Naya Jeevan’s lowincome market.
The flurry of innovation from Pakistan has started to attract attention from around the world. Naya Jeevan has earned recognition from the Schwab Foundation, Ashoka, TED, and the International Partnership for Innovative Healthcare Delivery. “Pakistan is a really tough country,” Hasan admits. “If we can do this here, it should be less challenging to take these ideas to other places.”