The Twin Goals of Health Insurance

This was published as a Wall Street Journal Think Tank column on May 9, 2014.

A study published this week by researchers at Harvard shows that the 2006 Massachusetts health-insurance law reduced mortality in the Bay State. The big contribution was in documenting the impact insurance has on mortality in a rigorous study of a large uninsured population, but the results should be no surprise. We have known for years that the uninsured put off care and, as a result, end up sicker. They are more likely to die early than people who have insurance. But like those people in a bygone time who believed that the earth was flat, some still question the value of providing health coverage to the uninsured. Unless, of course, you don’t have insurance. Then there is far less debate.

Much less disputed is the value of insurance when it comes to economic security. One in three Americans have problems paying their medical bills, and people consistently rank paying for medical care among their top economic problems, even ahead of paying their rent or mortgage.  The Massachusetts study found that coverage there saved one life for every 800 people covered. The economic security provided by health coverage has a different kind of effect. It benefits the majority of people covered by helping people pay their medical bills and giving them greater peace of mind.

Health coverage has twin goals: better access to improve health, and economic security.  It’s always a mistake to emphasize one more than the other.