Encouraging the creation of mutual health insurance programs is an initiative under Vision 2020—the Rwandan government’s detailed plan to become a middle income country by the year 2020. Mutual health insurance programs, while encouraged by national government initiatives, are managed locally to serve small areas.
Per these programs, people contribute an amount of money determined by the community, which subsidizes their healthcare costs if they become sick. In past years, contribution and participation in this program used to be voluntary, but recently it has become mandatory. The reason for this change is that in the days of voluntary participation, only people who knew they were sick would sign up for the program. Because of this, the cost of providing healthcare to the insured was more than the programs could afford.
Some people complain that because of such government programs, their earnings are swallowed up in various taxes and mandatory contributions. Others say that most people don't have the money to pay for treatment should they become suddenly ill, so health insurance is necessary.