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A sick person would once have to sell land or cows to pay hospital bills, says Owen orishaba, a teacher in the Kigezi highlands of Uganda.But now "a goat can solve your problem." Four years ago he joined a community health-insurance scheme managed by Kisiizi Hospital, a church-run institution.With 45,000 members, it is the largest of its kind in the country.Its success illustrates a wider truth: to deliver services to poor, rural people, begin with the systems they have built themselves.
In principle, Ugandans can get free healthcare at public clinics.In practice, government health centres are short of money, medicine and staff.The state accounts for only 15% of health spending,with another 42% coming from donor aid.Almost all the rest comes straight out of people's pockets at private or faith-based facilities.Uninsured patients sometimes run from their beds to evade bills, says Moses Mugume, an administrator at Kisiizi Hospital.
How to reduce the burden on patients while generating steadier funding for the hospital? The answer lay in the hills.For generations, villagers had carried the sick down from the steep slopes and thick banana groves on an engozi, a stretcher made from vines and bamboo.They also pooled their savings to cover burial costs and to support bereaved relatives.As Mr Mugume tells it, the hospital went to these informal societies and asked them a question："Why do you wait for death to occur? Why don't you prevent death?"
In 1996 the hospital began enrolling engozi groups in health insurance.Group leaders register members and collect premiums, which range from 11,000 to 17,000 shillings ($3- 4.50) per person a year.Members make a small co-payment to access services, such as 3,000 shillings for a basic examination or 40,000 shillings to deliver a baby.Group enrolment is a way to enlist the strong alongside the sickly.
The impacts are not just financial.Patients with insurance are less likely to be admitted to hospital than those without.That is because they show up earlier, when their conditions are more easily treated.
The cost still puts off the very poorest.Only about a quarter of the hospital's patients are insured.But Kisiizi shows the potential to build on institutions.However, the Ugandan government's plan for a national health-insurance scheme, currently before parliament, says little about community models.Schemes like that at Kisiizi could continue alongside state initiatives, says a health official, but are too thinly spread to be the basis for it.
Owen orishaba is cited to show that community health-insurance can______
A
B
C
D
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解析：
根据文章中的描述，社区健康保险计划可以有效减轻病人的经济负担，使他们不必卖掉土地或牛等财产来支付医疗费用。因此，选项B“有效降低病人负担”是正确的答案。
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