Are We Insuring or Ensuring Health?

The individual mandate option, as proposed in the House and Senate, would require that every individual in America have health insurance. Such a plan would virtually eliminate the nearly 47 million uninsured, potentially reduce government health care spending and provide access to quality affordable health care. Massachusetts has done it and other states are attempting to emulate.

But is the goal of mandated health insurance to insure health or to ensure access to health care when needed? If it is to insure health, recent analysis from the RAND Corporation, a reputable research think-tank, suggests that the effect on health of mandated coverage may be modest, with only some additional benefits among infants, children and those with HIV. If it is to ensure access, strides must be made to ensure that what is accessed translates into better health. Although health insurance coverage for all is necessary, the reality is that health insurance coverage does not guarantee health, just as car insurance does not guarantee that a car will operate. Guaranteeing health is where the focus should be and expanding our thinking about what health insurance is can facilitate this.

What we think health insurance is and what it actually is are different. Health is defined as "a condition of optimal well-being," while insurance is "a guarantee against loss or harm." Together, "health insurance" is literally a guarantee against loss or harm of a person's state of optimal well-being. However, the way we understand health insurance is as a loose safeguard such that if health care is required it would not cost us our house and home. (And we know that this is not always true.) Though our current system necessitates universal health insurance coverage to cut down on costs, the best way to universally insure health is to institute mechanisms that promote healthier choices and lifestyles. Whether it is creating work-life balance and wellness programs, developing community gardens, building sidewalks in neighborhoods or having quality grocery stores in the inner city, focusing on the social and environmental factors that affect health is imperative for a healthy society. In so doing, we build the capacity of individuals and communities to make healthy choices and ensure that our nation is a healthier one.

By Chisara N. Asomugha  |  July 10, 2009; 7:10 AM ET  | Category:  Insurance
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