Rwanda

Ben Franklin famously said, at the end of the Constitutional Convention in 1787, that "if we don't hang together, we shall surely hang separately." That lesson of "we're all in it together" wasn't lost on Rwanda. Rwanda - a small nation in central Africa - is one of the poorest and most underdeveloped nations in the world. Nearly 60 percent of Rwandans live below the national poverty line - and in Rwanda, with an average income of just $560 per year per family - less than $2 a day - being in poverty meant bringing home and living on as little as ten cents a day. From 1990 to 1994 - the nation had a civil war - and in April of 1994 - the Rwandan Genocide began - lasting for 3 months - and taking the lives of nearly 1 million Rwandans. And yet - despite going through a civil war and a genocide - and being one of the poorest countries in the world - the tiny nation of Rwanda has something the United States doesn't - a healthcare system that works for all. Today - the new talking point coming from the Right against Obamacare is that it raises taxes. Yet, that's exactly how Rwanda went about creating a healthcare system that works for everybody. Today - only 4% of the Rwandan population is uninsured - compared to more than 16% in the United States. So how'd Rwanda do it? In 1999 - most Rwandans never had seen a doctor and even when they were really sick, couldn't get into a hospital - primarily because costs were so high that average citizens simply couldn't afford it. Knowing they had to take action - the government's Ministry of Health started a pilot project of providing health insurance in three of the country's districts. With success in these districts - the program began to spread across the country in 2004. It ran into some kinks, though. The main one was that the government set insurance premiums at $2 dollars per year - and that was too much for for most Rwandans to afford. So - then - the program shifted to a progressive tax system. For wealthy Rwandans - insurance premiums increased to 8 dollars a year - while premiums for the poor decreased - to zero. This is similar to what's in Obamacare - with poor and low-income Americans getting free Medicaid or tax subsidies to purchase health insurance at no expense. Today - the results of Rwanda's universal health care system are remarkable. Now - there is a massive network of community health workers across the country - in both cities and villages. 80 percent of AIDS patients in Rwanda are getting the treatments they need - which is really critical in a nation with one of the highest AIDS infection rates in all of Africa. Just ten years ago - before the insurance program was put in place - life expectancy was a meager 48 years at birth. Now - its 58. And - in the last 5 years - deaths of children under 5 have dropped by half - and malaria - a once debilitating and highly deadly disease in Rwanda - is now diagnosed quicker, which means life-saving treatment is provided faster.

• published: 09 Jul 2012
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