In Indonesia, Patients Can Trade Trash For Free Health Care

Garbage Clinical Insurance offers a smart trade-off for patients: recyclables for two free doctor visits.

A few years ago, when he was beginning his career as a doctor in Indonesia, Gamal Albinsaid learned about a young girl who died from an easily treatable disease because her parents couldn’t afford health care. It’s a common problem in the country–about 60% of Indonesians are uninsured.


“You have people who can’t go to the hospital because they don’t have money,” he says. “So I started thinking, if you don’t have money, what do you have?”

The surprising answer: Garbage. “There’s garbage everywhere on the ground,” Albinsaid says. “So we decided to use garbage as a financial resource.”

Recycling isn’t common in Indonesian villages, even though it is possible to sell cardboard and plastic to scavengers. Only about half of trash is collected. But by inviting patients to bring trash to him, Albinsaid realized he had found a simple way to help fund health care.

Every month, patients bring in a certain amount of recyclables–for example, around 4.5 pounds of bottles and other plastics, or 11 pounds of cardboard–to a health clinic. When it’s recycled, the trash earns the clinic 10,000 Indonesian rupiah, a little less than a dollar. And that’s enough to provide the patient with a basic form of insurance that covers two free monthly visits to the clinic.

For patients, it’s like getting health care for free. “They think they don’t pay anything for the insurance–they just give garbage,” Albinsaid says. “So it persuades the community. And we’re encouraging poor people to pay with their own resources.”

Albinsaid, now 26, has been running his startup, Garbage Clinical Insurance, for two years, after a few earlier variations on the idea failed to take off. The company now runs a health clinic of its own, and also works with four others. So far, it has helped 3,500 uninsured people get health care.


“We believe health is a fundamental human right,” he says. The company’s unorthodox approach is also helping solve an environmental challenge for the country, which is the second largest contributor to ocean plastic waste in the world, after China.

Now, their garbage-as-barter approach is inspiring other companies, too. “Some people want to use this idea for education,” Albinsaid says. “So people can modify the system to solve different problems.”


About the author

Adele Peters is a staff writer at Fast Company who focuses on solutions to some of the world's largest problems, from climate change to homelessness. Previously, she worked with GOOD, BioLite, and the Sustainable Products and Solutions program at UC Berkeley.