National Health Insurance Fund of Mali (CANAM)
BACKGROUND AND PROBLEM:
Mali’s Compulsory Health Insurance (AMO) scheme, established in 2009, is based on the principles of solidarity, contribution, risk pooling and the paying third party. The National Health Insurance Fund (CANAM) manages it in accordance with the law. CANAM, by regulation, delegates some of its functions to two delegated social security schemes that are also responsible for public service missions: the Malian Social Security Fund (CMSS) and the National Institute of Social Welfare (INPS).
The AMO concerns workers and retirees in the public and private sectors exercising a permanent and/or regular activity as well as members of Parliament. In addition, can join the AMO, the persons affiliated to the voluntary insurance scheme of the INPS, in particular the non-salaried members of the liberal, craft, commercial and industrial professions as well as the self-employed. For the categories of people mentioned above, health insurance coverage is family, that is to say, it includes the member and his dependents for the benefit of health insurance. Participation in AMO requires a contribution in the form of contributions from the member and his employer as the case may be. The contribution rates are determined by Decree.
The collection of contributions for the scheme began in November 2010. In this context, and in accordance with the provisions establishing the Compulsory Health Insurance scheme (AMO), an actuarial study was to be carried out at the end of the second year of operation of the scheme. This is how this actuarial study, which constitutes the first actuarial valuation of the scheme since its inception, was carried out.
The actuarial study of the AMO scheme, object of our service, aimed to provide relevant data concerning the impact of the technical and institutional arrangements of the AMO, to update the cost of the basket of care and to provide CANAM with real visibility on its present and future commitments.
In addition to determining short-term equilibrium parameters, the study aimed to ensure the sustainability of the system and the sustainability of its funding over the long term.
- The evaluation and updating of the care basket
- The review of the institutional and organizational arrangements of the scheme and recommendations for their improvement
- The actuarial evaluation of the scheme and recommendations on the parameters of the scheme to ensure its long-term solvency.
The results of this study allowed the CANAM to make the various adjustments necessary to the AMO regime to ensure its long-term viability. Today the AMO scheme managed by CANAM is seen as a success story in the sub-region and in Africa, and serves as a model for several other similar regimes.