A Hybrid Gold Backed Primary Healthcare Insurance Model for Zimbabwe: Actuarial Design and Policy Proposal

Zimbabwe’s public health system faces underfunding, inflationary erosion of cash based insurance reserves, and a rising dual burden of communicable and non communicable diseases. The proposed National Health Insurance (NHI) Bill, scheduled for operationalisation in 2026, relies on earmarked taxes – a funding model vulnerable to hyperinflation and currency devaluation. This paper argues for complementing the NHI tax pool with a ring fenced gold backed reserve. Using the Zimbabwe Gold (ZiG) currency as a foundation, we design a hybrid primary healthcare insurance scheme for Zimbabwe, starting with government employees as a pilot. The gold portion (starting at 10 %, rising to 25 %) is held in the National Gold Vault; the remainder is invested in short term government securities. Incorporating expected inflation (4 %) and nominal interest rates (6 %), the real discount rate is 1.92 % for cash and 1.44 % for the fund. The resulting real annual premium is 9,200 ZiG per family, yielding gold contributions of 242 mg in Year 1 and 605 mg by Year 6 per average employee. The model addresses exposure to risk morbidity, actuarial reserving, and premium sufficiency. It aligns with Zimbabwe’s National Development Strategy 2 (2026–2030) and may serve as a pilot for a sovereign health fund. No peer reviewed literature describes an operational gold backed NHI; Zimbabwe thus has an opportunity to pioneer an asset backed social protection model. Keywords— Actuarial modelling; gold backed health insurance; National Health Insurance; primary healthcare; ZiG; Zimbabwe.