This article examines the utilization of a simulation exercise known as Choosing All Health Insurance (CHAT). As a decision tool, this exercise allows variably educated resource-poor populations who are inexperienced with health insurance to select health benefits that they perceive to be relevant. CHAT was adapted to developmental context of India through the project "Strengthening Micro Health Insurance Units for the Poor" (2005-2006). The primary beneficiaries of this exercise were poor communities at the "bottom of the pyramid" given that such populations previously lacked an accessible mechanism to engage in the rationing of health benefits. The need for such a mechanism arose from the gap between benefit packages available on the market (from both private and public insurers) and those reflecting the priorities of the poor. Using a sample population of some 200,000 persons, the aforementioned study proposed a premium of INR 500 (about 10 Euros) per household per year, derived from actuarial calculations of local prices and willingness to pay. Group decisions were reached by consensus, reflecting the Indian cultural setting. A subsequent survey of participants indicated high levels of satisfaction with the overall CHAT process and resultant health insurance packages.
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