The fundamental importance of social insurance for health equity.

Abstract

People need to consume goods and services that support health, such as nutritious food, medical care, and quality housing, throughout their lives. Many of these goods and services are allocated using markets, which means that people need income to provide purchasing power for these goods and services. However, everyone has times when supporting themselves through paid labor is not possible, so many individuals will not receive the income needed for a healthy life if income distribution is tied solely to economic production. Therefore, a key political economy of health goal is to put in place income-support policy that gets income to those unable to engage in paid labor. The 3 main forms of income-support policy-social assistance, social insurance, and guaranteed income-offer different strengths and limitations. I argue that social insurance, because of its focus on getting income to people in situations in which they cannot or should not engage in paid labor, is a fundamental part of a political economy that supports everyone's health.