RESUMO
Health insurance planned and implemented according to the shari'at is considered a form of mutual self-help, takafulijtimae. The purpose of protecting life, maqsadhifdh al nafs, makes equitable access to the basic and necessary health services a basic right of every citizen to be fulfilled by the family, the community and the state in that order of increasing responsibility. Health services beyond the basic necessary ones are considered a privilege; they fall under the categories of needs, haajiyaat; complements, mukammilaat, and embellishments, tahsinaat, that can be provided to each according to economic ability. Health insurance helps reduce disparities in health care among various socio-economic groups but does also introduce new ones. This paper reviews empirical experiences of various aspects of health insurance from the perspectives of purposes of theshari'at and as they relate to the major ethical issue of equity. The issues reviewed are: access, coverage, type of care, quality of care, utilization of services and type of insurance. The paper reaches two conclusions: [a] health insurance improves access to health care but does not always assure equity, [b] private insurance is generally more effective but has objectionable aspects from the Islamic Law perspective. The paper recommends adopting some of the free market tools of private insurance to increase quality and efficiency of government or cooperative community insurance but making sure that the objections of jurists to commercial insurance are eliminated.