These terms are often thrown around as synonymous, when they clearly are not. Someone’s, or some society’s health takes into consideration the freedom from illness, disease, or injury (actually from the Germanic meaning “wholeness”). Health is impacted by genetics, stress, violence, diet, laws, living standards, and health care, to name a few.

“Health care” is the interventions we perform on individuals to try to keep them healthy . Economically, “health care” is resources spent on health: not just monetary resources, but time, energy, workforce, etc.

Health insurance is a way to pay for health care . The theory behind insurance is this: big, bad, expensive things can happen to you at any time. Your house can catch fire. You can get into a car accident. You can get cancer. We pay for insurance to decrease this risk–that we pay into the system now so that it will bail us out later . The more people in this system, the better. If there’s only two people, and one gets robbed, there goes a lot of the other guy’s money! But if 100 people are in the system, there’s 99 people’s money left to even out the risk.

The goal of health policy is to make the population as healthy as possible.

The goal of health care policy is to make the health care system — only one part of the determinants of health — as “good” at divvying up limited health care resources as possible. (Lots of ways to define good. I define it as going to those who most need them.)

I would love to see a population whose health is so darn good that we wouldn’t have to worry as much about health care. Health alone could be its own blog, so I’ll simply suggest a few ways that we might be healthier, without even messing with health care :

• Reverse the subsidies for vegetables versus meat. Wonder why a salad costs more than a Big Mac? It’s not that cows are cheap. It’s that government subsidizes.
• Walking instead of driving. Afraid as Americans we screwed the pooch on this one during white flight and suburban sprawl of the mid-20th century. One of many reasons I prefer the city.
• Create a more equal society. It should be no surprise to anyone that the poor are the earliest to die and are the most obese. When your food options are canned foods or McDonald’s, the game’s already against you.

I illustrate these points only to remind you that if your goal is to make people healthier, there’s many, many more avenues that might be far more effective (and far far cheaper) than optimizing or fixing the health care system. (We just like to argue about it because it’s the most accessible and well-understood by us.)

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