Can we ever bring the sharing economy to health care coverage? If you are not using your insurance, give it to someone else. @yeohsiewhoon— Filip Filipov (@Filipov) May 23, 2014
The idea of sharing unused insurance has a lot of assumptions baked in, and to be frank, I am no expert on emerging economies (referenced in a later tweet). However, let's unpack this.
Let's start with our goal. Can we assume, for the sake of argument, that it is to provide both protection of the individual against ailments and collective protection of the 'herd' against transmissible diseases ? To keep this simple, let's assume this is provided in the scope of a single country i.e. we don't attempt any cross-border solution.
The choices for a solution come down largely to what degree collective versus individual responsibility is assumed. At one end of the scale we have the USA, where the individual largely expects to have to pay a company for insurance, and then claim on this per usage. The government covers some collective responsibility in the form of disease control, and Obamacare is changing things, but the assumption is largely that you have to look after yourself.
At the other end is the UK where we still pay insurance, but it is a largely flat payment and we don't tend to pay a significant amount per usage. It is a hybrid in that private insurance also exists but that is typically used as an add-on rather than for primary care. Disease control is solidly in the domain of the government.
The notion of "sharing" what you individually have only arises on the USA end of the scale. The implication is that since you've paid for something but not used it, why not enable altruism and allow it to be passed on? In this light, maybe it does make sense to enable this in some way.
At the UK end, individual sharing makes no sense, since there is nothing for you to pass on. In fact, you're already sharing it with others by giving money to the government who does it on your behalf, except you have no control over who it's shared with (unless indirectly via elections).
However does re-sharing even make sense at the USA end of the scale? To be exact, do you actually own your lack of a claim? I suspect insurance companies would say no. The insurance has been sold to you at a particular price on the basis of actuarial data about likelihood of a claim. You have been sold an option to claim healthcare at some future point. That option is not transferable because it would upset the model of expected claims.
Now there is nothing stopping an insurance company from changing the way they sell it at the beginning so that it is transferable in some way. However, I suspect you'd then pay more for that and there would still be restrictions (e.g. only shareable amongst family members). An insurance company would not allow a very open interpretation of sharing because they make a lot of their money on people who pay but don't claim.
I'm reading between the lines here a little and assuming you mean "sharing economy" in a very open sense. Given this interpretation, we're already doing it in the UK, just not under our individual control, in the form of the NHS. At the USA end of the scale, it would only be possible in a very circumscribed form. This implies that more sharing is possible in a Healthcare system like the UK.
When it comes to how this applies to emerging economies, I really don't know. I suspect the level of sharing of unallocated resource depends on where it falls on the spectrum between USA and the UK.