The Grameen Bank started with a loan of $27 to 42 people - surprising that such a small amount was needed. He was surprised and gave the money to people to get them away from moneylenders.

It’s important to have patients to pay for their services - how it happens may vary, but it must not be free - that makes people feel small, payment makes it into a two-way relationship and therefore empowering to the patient. Doesn’t matter how it happens, pay now, pay later, pay in kind but important that patients feel they have contributed.

They are doing cataract operations - and adjusting the price according to the ability to pay, but still they are able to make money and create a “social business” - not primarily to make money, but to provide a service to people. This is a wonderful example - you recover your costs, but everyone gets what they need.

Health insurance is an effective way of bringing services to everybody. They have insurance for all their employees etc. but a differentiated system. They are dealing with 35 million people, so an insurance scheme can raise a lot of money, so that’s what they are moving towards - he believes it’s very important especially for poorer people.

Trying out the handheld devices….

Q: Should the patient always pay at the point of service? Several people say yes, but there’s a little issue about how the question’s being asked - will come back to this later.