Beyond Health Insurance

Much of the debate about health policy in the United States has focused on the availability of health insurance coverage and the relatively large number of individuals who are uninsured. While tackling the problem of the uninsured might improve access to and utilization of health care, it would likely have little effect on the health of the population, as there is only a weak connection between health insurance coverage and health. Expanding health insurance coverage alone is unlikely to significantly improve the health of the population or narrow health disparities within the population, given that many of the major causes of poor health such as smoking, obesity, and physical inactivity are largely unaffected by health insurance. The narrow focus on the uninsured in the health policy debate comes at the expense of other policies that could improve health faster and more significantly for every dollar spent. It is well known that the United States spends approximately twice as much per