THE FIRST PRIVATE-SECTOR HEALTH-INSURANCE COMPANY IN GHANA

This article analyses the development of Ghana's first private sector health insurance company, the Nationwide Medical Insurance Company. Ta king both policy and practical considerations into account (stakeholde rs' perspectives, economic viability, equity and efficiency), it is st ructured around key questions which help to define the position and ro les of slakeholders-the insurance agency itself, contributors, benefic iaries, and providers-and how they relate to one another and the insur ance scheme. These relationships will to a large extent determine Nati onwide's long-term success or failure. By creating a unique alliance b etween physician providers and private sector companies, Nationwide ha s used employers' interest in cost containment and physicians' interes t in expanding their client base as an entree into the virgin territor y of health insurance, and created a hybrid variety of private sector insurance with some of the attributes of a health maintenance organiza tion or managed care, The case study is unusual in that, while public sector programs are often open to academic scrutiny, researchers have rarely had access to detailed data on the establishment of a single pr ivate sector insurance company in a developing country. Given that Gha na is planning to launch a national health insurance plan, the article concludes by considering what the experience of this private sector i nitiative might have to offer public sector planners. (C) 1998 John Wi ley & Sons, Ltd.