Tanzania pins its hopes on new universal health insurance law

Reuben Thomas, 29, lies motionless in Tanzania’s largest orthopaedic hospital, the Muhimbili Orthopaedic Institute (MOI). A bodaboda (motorcycle taxi) driver, he had been navigating Dar es Salaam’s chaotic traffic in pursuit of a potential passenger when he collided with a minibus. His left leg is now fractured and held together by costly intramedullary nails, as his hospital bill mounts.

With no daily income and his meagre savings swallowed by the initial costs, his future remains uncertain. He is not covered by any health insurance scheme. Some 9-10 people who have been in motorcycle crashes arrive daily at MOI for emergency treatment—and, like Thomas, 80% of them do not have any health insurance.

“I was brought to the hospital by friends, but they can’t afford to help me foot the bill. My sister has been going from family member to family member, asking for contributions,” says Thomas, whose average daily income of around £3 is what his family relies on for survival. If he can’t find a way to pay the bills, he—like many others—may be forced to forgo care. Alternatively, many in this position turn to crowdfunding to pay for treatment or end up heavily in debt.

Millions of Tanzanians like Thomas struggle to make ends meet. More than 80% of the population are on low incomes. They have minimal access to healthcare services and are outside of the country’s existing health insurance system. Only 15% of the country’s 64 million people …