The insurance role in workplace health promotion: a comparative analysis of the United States and the Philippines.

This article provides a comparative analysis of the role of health insurance in workplace health promotion in the United States and the Philippines, focusing on how insurance functions as a policy instrument to improve population health and reduce healthcare costs. In the US, the Affordable Care Act (ACA) mandated essential health benefits (EHBs) including preventive and wellness services, incentivizing employers and insurers through mechanisms such as the medical loss ratio (MLR) and state-level workplace wellness programs to incorporate health promotion into health plans. Conversely, the Philippines employs a Bismarck-style universal health coverage (UHC) system administered by the government through the Philippine Health Insurance Corporation (PhilHealth), which unilaterally provides promotive health benefits via the Tamang Serbisyo sa Kalusugan ng Pamilya (TSeKaP) program, emphasizing health literacy, behavioral change, and social equity without relying on private insurer incentives. While both countries aim to integrate health promotion within insurance frameworks aligned with the World Health Organization's health promotion model, differences in insurance environments, regulatory approaches, economic conditions, and socio-cultural factors influence the design, implementation, and outcomes of these initiatives. The study highlights that in the US, health promotion is largely individual-based and market-driven, whereas in the Philippines, it is more structured and universal but challenged by access barriers related to geography and resources.