"Is Health Insurance More of an Economic Game Than Patient Support?"
- Fysiobasen
- 14. nov.
- 3 min lesing
In today’s world, health insurance has evolved into a massive global industry — involving both private corporations and public systems.While the original purpose of health insurance was to protect patients financially and ensure access to medical care, it has increasingly become an economic system driven by profit motives rather than patient welfare.
This article explores how health insurance operates, the financial mechanisms behind it, and whether it truly serves patients — or primarily functions as an economic game.
The Origins and Purpose of Health Insurance
Health insurance was created to protect individuals from the financial burden of illness or injury.Its goal was simple: to ensure people could access medical care without facing overwhelming costs.
Global variations:
In many European countries, such as Norway, healthcare is largely funded through public taxation — meaning access to medical care is not dependent on private insurance.
In countries like the United States, however, private health insurance plays a dominant role, and individuals often rely on their policies to cover essential healthcare expenses.
The Economic Game Behind Health Insurance
Despite its humanitarian purpose, health insurance has also become a profitable business model.Private insurance companies are often more focused on maximizing profits than improving patient care — a dynamic that can lead to conflicts between financial interests and medical ethics.
1. Rising Premiums and High Deductibles
One of the most visible aspects of this economic structure is the escalating cost of insurance premiums and deductibles.In many systems, patients must pay increasingly high premiums — and still face significant out-of-pocket costs before coverage begins.
Impact on patients: High costs can force individuals to delay or avoid necessary treatments altogether.In some cases, patients who pay for insurance still find themselves unable to afford care due to high deductibles or coverage limits.
Effect: Limited access to care despite paying for insurance.
2. Treatment Limitations and Reimbursement Policies
Health insurance companies often impose restrictions on the types of treatments, medications, or procedures they will cover.This can result in patients being denied optimal care, having to wait for pre-approval, or being offered less effective alternatives simply because they are cheaper.
Impact on patients: Delays in authorization can worsen health outcomes, and restrictive reimbursement policies can prevent patients from receiving evidence-based or specialist treatments.
Effect: Reduced access to optimal care and slower recovery times.
3. Cost Control Over Patient Health
Insurers frequently prioritize cost control over patient well-being.Physicians may be pressured to follow cost-saving protocols, use generic drugs instead of newer options, or limit referrals to specialists to keep expenses down.
Impact on patients: When financial metrics override clinical judgment, patients risk receiving substandard care.Healthcare professionals can also experience moral conflict, torn between insurer requirements and patient needs.
Effect: Patient health becomes secondary to economic efficiency.
Is Health Insurance Still About Helping Patients?
Unfortunately, in many modern systems, the answer leans toward no.While insurance is essential for protecting people from catastrophic costs, it has become a commercialized enterprise, where shareholder profit often outweighs patient care.
Are there better models?
Public healthcare systems — such as those found in Scandinavia — demonstrate that it’s possible to provide broad access to care without profit-driven barriers.While not perfect, these systems ensure that health, not wealth, determines access to treatment.
Summary
Health insurance was designed to protect patients, but it has increasingly evolved into an economic game where financial interests often take precedence.Rising costs, restrictive coverage, and profit-based decision-making all contribute to a system where patients may struggle to get the care they’ve paid for.
To make health insurance a true instrument of patient support, the focus must shift back to
health outcomes, transparency, and equitable access — not shareholder returns.
Sources
Pauly MV, et al. Health insurance and health care access in the United States: A critical review of the literature. J Health Econ. 2014;35:105–120.
Reinhardt UE. The economics of health insurance: A national and global perspective. J Health Policy. 2003;27(6):865–873.
Buntin MB, et al. The economics of health care insurance: An overview of the key issues. J Econ Perspect. 2012;26(4):15–34.
Ginsburg PB. The impact of health insurance on patient care: Evidence from the United States. Health Aff. 2016;35(5):832–839.
Dranove D, et al. The role of market forces in health insurance: A review and analysis. Health Econ Rev. 2011;9(4):1–13.
