The impact on employer operating costs of low cost health insurance including an HIV/treatment benefit: results of a study of five employers in Namibia
De Beer, Ingrid
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OBJECTIVE: The impact of low-cost health insurance on the costs incurred by Namibian employers was measured. BACKGROUND: Namibia has a relatively recent HIV epidemic and adult HIV prevalence estimated at 15.3%. AIDS-related mortality would be rising in the absence of antiretroviral treatment. (ART). Medical schemes in Namibia now offer low-cost policies that include good coverage for treatment of AIDS, including ART. In 2006-2007, a number of large Namibian employers agreed to purchase such policies for their uninsured workers. METHODOLOGY: We compared data on worker attrition and related costs for the period before and after purchase of the low cost health insurance policy. RESULTS: Worker attrition (death and medical retirement) reported by the companies declined from a range of 1.5% to 2.0% of the work force in 2005 and 2006 to 0.7% to 1.1% in 2008. When data was pooled, attrition fell from a peak of 1.7% of the combined work force in 2005 to 0.9% in 2008. Attrition-related costs at the companies were lower in 2008 than in the peak attrition years. The downward trend in attrition appears to have begun before the date when the firms purchased the new policies. The 2008 value of the savings measured was less than the annual cost of the premiums for the new policies. DISCUSSION: Antiretroviral treatment appears to reduce workforce attrition and related costs for Namibian employers. However, we cannot say if this is a result of new low-cost insurance policies or the rapid expansion of ART in the public sector.
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