Health, health care, and health insurance “are surely connected, but they are not the same.” This is one of the myths and misconceptions brilliantly exposed by Katherine Baicker and Amitabh Chandra in a Health Affairs web exclusive. Other myths they examine deal with

  • the cost of insurance as a reason for going without
  • the ability of preventive care and insurance coverage expansions to pay for themselves
  • the link between insurance coverage and quality care
  • the advantages and disadvantages of getting insurance through our employers
  • the ability of competition and high-deductible health plans to cut costs

Baicker and Chandra conclude that the key is to reward high value care. There are a number of ways to do that and other values may come into play besides cost and efficiency, such as redistribution.


Private insurance fundamentally cannot provide the kind of redistribution based on underlying health risk or income that social insurance can.

On the other hand, a single-payer system does not automatically provide high-quality care: the provision of low-value care is as pervasive in the single-payer Medicare system as it is elsewhere. … If the goal of policy is to direct subsidies to people with high health costs, a single-payer system is just one of many alternatives–all of which represent normative preferences that are hard to justify through improved efficiency or reduced costs.