Ensuring Wellness vs. Insuring Against Sickness

May 14th, 2021

It’s hardly controversial to say that the American healthcare system has a lot of room for improvement. We have the best research universities, the best hospitals, the best doctors, and yet, compared to most wealthy countries, healthcare in the United States is more expensive and results in worse health outcomes. 

Looking at indicators such as infant mortality, life expectancy at birth, or heart attack mortality, the US falls surprisingly short compared to other nations who spend far less on “health” per capita.

There are a few factors contributing to this unfortunate reality. One is the fact that prices, for everything from prescription medications to surgical supplies, tend to be higher in the United States than in other countries. The consolidation of hospital systems and pharmaceutical companies, which leads to a lack of competition, enables these prices to rise without constraint.

Then there’s the inefficiency that is a result of the inherent complexity of our healthcare system: Compared to other wealthy countries, which spend an average of $173 per capita per year on administrative costs, the US spends $937

But perhaps the most glaring issue in our healthcare system is the fact that it is inherently not designed to keep people healthy. No one makes money when patients are healthy. We spend more on administrative costs per capita than we do on preventative care. 

Meanwhile, it is becoming increasingly expensive for individuals to afford medical care of any kind: Preventative or otherwise. Even with health insurance, the rising costs of health insurance premiums and out-of-pocket expenses are making it more difficult for the average American to afford wellness visits, diagnostic tests, and other medical expenses that could help to avoid larger, more catastrophic health outcomes. 

If not our health, it begs the question of what we are really paying to insure. 

Course Correction

In order to correct the course of our healthcare system, we need to align the incentives of healthcare providers, insurance companies, and patients. We need to rebuild a system that is focused on ensuring wellness, not insuring against sickness. 

This is, of course, a monumental shift, one that will require a complete overhaul of long-standing cultural, systemic, financial, and bureaucratic structures. To truly see this shift happen might take decades, but there are indications that change is coming. 

Tech companies are finding innovative ways to make healthcare more accessible, more affordable, and more focused on creating positive health outcomes. 

How Employers Can Affect Change Now

In an article titled, ‘How Tech Companies Can Help Fix US Healthcare,’ the Harvard Business Review highlighted the importance of working within the existing systems to affect change. In an employer-sponsored healthcare system, employers often feel powerless in protecting their employees against rising insurance premiums. However, there are strategies employers can employ to make healthcare more accessible and affordable. 

Offering Paytient as a benefit is one way that employers can help to ensure health in a system that is only designed to insure against sickness. Paytient gives employees greater flexibility in how they pay for their medical, vision, dental, and veterinary care, making it more likely that they will get the care they need.

And there are several reasons why employers should be incentivized to do so: Employees who are able to afford their medical bills are healthier than those who cannot. And healthier employees are better employees: Less likely to be distracted at work, less likely to miss work, and less likely to suffer from the many physical conditions exacerbated by financial stress.

Then there’s the more tangible, financial benefit: When employees can afford to get the preventative care they need, employers are more protected against large, catastrophic claims, helping to keep costs down for both employer and employee. 

Although a large-scale shift toward preventive medicine will take time, employers can work within existing systems to encourage employees to take charge of their health. One thing is clear: Ensuring wellness, instead of insuring against sickness, is a better system for all. 

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