These disability insurance pools were created in the wake of the Risk Retention Act of 1986, passed by Congress, to address the growing inability of small entrepreneurs to obtain liability insurance due to rapidly rising costs. «Risk-fixing groups allow companies in the same sector, such as plastics or chemicals, to reduce insurance costs by actually creating mini-insurance, to insure themselves against liability claims,» says Lynn Woods in Nation`s Business. «On the other hand, risk buying groups allow group buy liability coverage.» Kutzin J, Jakab M, Shishkin S. From the system to the system: social security agencies and the transformation of health financing in Kyrgyzstan and Moldova. In: Chernichowski D, Hanson K, editor. Innovations in health system financing in developing and transition countries. Progress in Health Economics and Health Research, Volume 21 Bingley: Emerald Group Publishing; 2009. The Mexican Seguro Popular has also moved to this principle of automatic coverage for all persons who are not part of an insurance plan for official employees in the sector [47, 48]. Peru has also made considerable progress with its integrated health system («SIS»), a budget-funded system of explicit coverage of the poor and a growing informal sector . These examples of low- and middle-income countries have in common that they have failed to bring all coverage systems together in one set, due to the opposition of official workers in the sector to a single national system. These countries had therefore decided to set up an explicit coverage programme for people outside the formal sector, while trying to gradually increase the amount of resources in order to reduce the gap between per capita spending in the various systems.
Although this pooling provision is not completely blurred by the fragmentation and segmentation of the population, it does reduce it considerably. determines how clubs can accept shipments from shipowners who wish to defer their insurance from one club to another. Some countries associate competition between insurers with the individual choice of insurer and mandatory participation. This is generally referred to as competitive social health insurance. Each insurance plan therefore constitutes a separate pooling agency. The incentive for «risk selection» under voluntary health insurance also consists of a mandatory plan with competing insurers, in which pooling and purchasing agencies attempt to declare the least risky individuals. This has a negative effect on capital in resources beyond pools. One of the key requirements of this consolidation agreement is therefore the adjustment of the revenue risks collected by each insurer in order to limit the segmentation of the population into different pools on the basis of its health risks and to address inequalities in the resources available in different pools .
Since group clubs share rights to the pooling system, they have a common interest in avoiding and controlling losses and maintaining quality standards throughout their membership.