Bradymck
commented
4 years ago Hey! Thanks for dropping the proposal. This is an angle a lot of people in and out of crypto are trying to re-imagine. I think it's hard with health insurance and a bit easier to do with a lower stakes model either for a specific smart contract (In crypto) or looking outside crypto, some form of low income assistance (Like Data Dividend and Andrew Yang's experiments). I think there is a lot of room for experimentation here.
You also run into the issue of KYC for anything insurance related. KYC locks out a huge chunk of the world where there is simply no "legal rails to run on".
So you are stuck with two choices. Go with KYC (limiting who can participate) and try to compete with the for profit industry and lobbyists. Or you go with a decentralized route and face Sybil attack vectors.
It's not straight forward but I do see a reputation based system on a smaller scale that is possible. Just "spit balling" here but, a place to start could be insuring Ethlance 2.0 (Coming soon) arbiter roles, jobs, or bounties.
For example, lower reputation arbiters who are just starting out could offer lower percentage fees (to actually get started) for dispute resolution and you could have an insurance option as a buffer for any loss of funds. There are a lot questions in this model too but it lowers the stakes so you can experiment with larger use cases like income assistance, health insurance, and other markets.
FYI, if you do write this up with a stronger focus on "sandboxing" this concept with lower stakes like I mentioned, please do hit me up. Also, you would be eligible for the bounty if you choose to submit this to the actual registry in a more fleshed out model: https://registry.district0x.io/
Here's the current bounty campaign: https://blog.district0x.io/district-registry-bounty-campaign-d6206c28c929
Name:
0x41and140x (to be read as "ox/all for one and one for all"). A community driven health insurance DAO.
I recon that it might not have the best name (I just like the word play) so I am open to change it, to something like Insure0x (read InsureUs :))
Purpose:
Allow communities to care, fund and support their members' access to health services while at the same time cultivating the values of cooperation and care for the other.
Value proposition:
A healthier more caring community can do so many more things and it's members are going to be overall happier and even wealthier.
Description:
Members:
There are two main types of members in this district. Subscriptors aka Beneficiaries and Healthcare Providers.
Beneficiaries will pay a one time entry fee and a monthly fee that will warrant access to health care services by the Healthcare Providers.
Healthcare providers will appear in the marketplace and will be contacted by the beneficiaries when the need arises. They will be reviewed and their tariffs should adhere to a certain range (depending on specialty or type of service provided)
Additional participants:
Maintainers (developers) of the district should receive payment whenever their services are required.
Mathematicians and financial experts are invited to contribute models for optimizing the fund's behavior. If accepted their contributions would be rewarded in the forms of bounties.
Smart contract auditors for preventing fraud and ensuring that contracts evolve in such a way that all members of the community are equally benefited.
External verifiers are also required for preventing fraud and approving expenses in certain cases (e.g. medicine).
Recruiters of healthcare providers could also be rewarded bounties.
Funding and service coverage:
Entry fees and monthly fees will be kept in a fund. The services coverage, that is, the costs that the fund will be able to cover per member will be calculated in relation to the amount of funds in the pool and the liquidity of the community, basically meaning that the more the community grows the better the coverage and quite possibly the lower the fees (more about this on the governance chapter).
Ideally the service coverage maximum amount for any given member should grow the longer that person has been participating in the community, but the base coverage should be good enough for basic medical attention.
Fees, however, should be accessible for people of different income levels, this is a district that will provide access to health services not only for those that currently can, but also to those that can't have it otherwise. The coverage and strength should come from the increasing amount of members and the network effect.
Whenever a member needs to use a service they can contact a healthcare provider through the marketplace in order to get the attention they need. Afterwards the fund can be billed the costs of the service (up a maximum). The rest of the beneficiaries will then be notified (in a privacy respecting way) that they have contributed to another person's well-being (this is important so that every member of the fund realizes the positive impact of their participation in this district), and will receive tokens that will represent the amount of times their contributions have been used.
Treatment costs (such as medicines) should also be covered if/when possible.
In principle, all members will contribute the exact same amount each time, so if there are 1000 beneficiaries and someone has a $1000 bill, then each member will only contribute $1. However it may be worthwhile to explore the possibility that members can choose to contribute more than the monthly fee in which case they can use the excess to cover their own expenses when necessary, but also, they will then contribute to increase the service coverage maximum (a mathematical model is necessary for understanding how this would exactly work).
Cashing-out
Unlike traditional insurance companies, members would be able to exit the service and get back part of their contributions to the community (if they so decide). The amount of money they would be able to cash out, should of course be less than the difference of their contributions and service usage, plus a goodwill fee for the community.
Locality
Because medical services do not cost the same in different regions of the planet, it is reasonable and most simple for communities to start as geographically localized. Eventually, as local communities in the district grow and become stronger (both economically and in recognizing the value of caring for the other) they may choose to establish relationships with other communities (e.g. an indigenous community in a third world country). Therefore governance should allow for changes in this aspect.
Another possibility is for guild-like communities to form, independent of geography. Examples of this could be communities that support independent artists, freelancers, farmers in third world countries, migrants, etc. This would be possible and recommended for communities that are already empathically bonded in some way.
Ideally however, the district will become strong enough (large and with very low monthly fees) and will value so much the support that the local communities give to their members, that the communities will choose to support each other, across the globe, in (perhaps) leveraged ways. Although this is something that would not be attempted in the starting phases of the district.
Starting a community
Communities should be started when a minimum of members have staked an entry fee to show their commitment to it. Also enough healthcare professionals should be already available. This is an aspect that should be determined by a mathematical model.
Governance
The fund should be intelligent enough to allocate resources wisely by optimizing liquidity (while keeping a reserve) so that if the fund grows too large a few scenarios become available:
Members will be allowed to vote on these aspects of the fund on a quarterly basis, or when deemed necessary (also through a participatory mechanism).
Token
The district's token would mainly be used for governance, but could perhaps be used for things such as increasing the person's maximum service coverage.
Challenges