The out of pocket payment is a real financial barrier or burden for low and middle income. The causes of out of pocket payments are multiple, including absence of cost sharing systems like social security and health insurance systems that are able to protect efficiently the low-income. It is either a total payment or high partial payment. The technologies, approaches, systems used by the health insurances include deductibles, co-insurances, etc. There are situations when health insurance co-payments can reach 15,000 US Dollars a year per person. Pooling one dollar per person per month mobilizes far beyond the need, except the United Sates of America and Germany that it requires ten dollars a month.