Solidarities for Speculative Future Sickness: EthiopianƎddərsas Health Insurers?
Abstract
In this paper, we explore the potential for integrating the əddər—an Ethiopian approach to social solidarity and form of social organization that in the contemporary period has most commonly seen people collectively pooling money to defray costs of burying loved ones—into the federal government’s population health planning. Specifically, while the state is investigating whether or how to initiate a national health care system, the issue of how to subsidize it is a central problem. Our work emerges from a literature review and fieldwork in Ethiopia. The former was structured to answer questions about how əddərs have been used to offset burial and health care costs from 1958 to 2013. Exploratory fieldwork was shaped by two lines of questioning: how do əddərs organize and sustain activities related to financing or insuring members’ health care costs, and how do əddər members characterize their relationship with the state’s health care system? Results from both of these inquiries demonstrate that əddərs have been and continue to be key actors in healthcare financing over time. Since Ethiopians possess both the knowledge and experience in collective pooling of monies for mutual benefit, and since there is not yet a federal tax redistribution system able to benefit all, a pressing question remains: might əddərs be useful insurers to offset costs related to speculative future sickness? We conclude that əddərs are contextually relevant thus strong sites of practice from which to situate community-level health insurance programming, either as alternatives to or as part of the Ethiopian federal health care system.
