Seminar | Illness as Insurance as Metaphor

How Health Insurance Damages Health Care and Beyond
(I Know What You’re Thinking…That’s Not It)

Steven Lewis

Tuesday, Feb 26, 2019
12-1 pm
Room B104, 2206 East Mall
School of Population and Public Health
University of British Columbia

Susan Sontag’s famous 1978 book, Illness as Metaphor, contends that the metaphors we use to describe various diseases constitute value judgments about both the condition and its host. Ever since Bismarck, the language of insurance has become a core element of the health care vocabulary in both privately and publicly financed systems and sectors. Universal health insurance is proclaimed a magnificent public policy triumph in most advanced nations. Insurance is part concept, part operating mechanism, and part metaphor. How and why did this happen, what are its effects, and do they reflect and promote the public interest?

Insurance thinking affects both the organization and delivery of care, and its place among other public goods. Its metaphorical grip is powerful. This presentation will describe its intended and unintended consequences and outlines the benefits of abandoning it. Liberating health care from the insurance meme is a big job. I don’t have a magic solution to this linguistic and conceptual conundrum – I’m no Gwyneth Paltrow – but I hope at least to plant the seed that the issue is real rather than the perplexing preoccupation of someone with too much time on his hands.

Steven Lewis is a Canadian health policy and health services research consultant, and Adjunct Professor of Health Policy at Simon Fraser University. He thinks, reads, writes and occasionally teaches about health and public policy, and has an abiding fascination for what accounts for individual values and choices, and what makes systems work effectively.

This seminar is jointly sponsored by CHSPR, the School of Population and Public Health, and the Centre for Clinical Epidemiology and Evaluation.

You may also join remotely via GoToMeeting: https://global.gotomeeting.com/join/297740069.