In 21st century America, the concept of healthcare access has been conflated with health insurance coverage. Yet, this is a relatively new way of thinking. Less than 100 years ago, health insurance was not the primary conduit through which people arranged and paid for healthcare services.

Key points:

  • Employer-sponsored healthcare insurance was initially created in response to the wage freeze in World War II as employers wanted to entice potential employees with benefit packages.
  • Healthcare and health insurance have consistently been combined and confused for each other, creating the false narrative that the way for a person to get healthcare is only through the purchase of health insurance.
  • Following the current trend of government intervention in the health insurance market, the likely end result will be a single-payer system administered by the federal government.
  • If the Patient Protection and Affordable Care Act, stripped of its individual mandate penalty, is deemed unconstitutional, there may be a pathway for citizens to look outside of health insurance markets and toward other options—direct care, health sharing ministries, or health reimbursement arrangements.