Dr. Aaron Roland, left, discusses health care reform with his patients on the eve of Obama's inauguration.

What would it take for our health care system to prioritize our wellness instead of (at best) reacting to our illnesses?

Aaron Roland, the author of “The Health Care Battle Lines” in the most recent issue of Tikkun, convincingly argues that a single-payer system is a structural precondition for a health system that prioritizes the prevention of sickness.

“Preventive health care does stop disease but it doesn’t necessarily save money,” he explained Monday night on our phone forum, a weekly opportunity for Tikkun subscribers (as well as members of the Network of Spiritual Progressives) to discuss pressing issues of the day with Tikkun authors. You can listen to a recording of this week’s call here.

I’ve never understood why insurance companies don’t invest in preventive care, so I was interested to hear Dr. Roland’s explanation of why preventive care only makes financial sense in a single-payer system:

To the extent that prevention is helpful, it’s only helpful in the long run, and insurance companies don’t care about that because clients don’t last that long with a single insurance company. But in a single-payer program, it’s a single program — they’re caring for you from the day you’re born to the day you die, so it does matter.

This is just one of the many benefits of a single-payer system, but many lawmakers and health care activists have been afraid to stand up for single-payer proposals like HR 676. Tikkun editor Michael Lerner recently wrote a blog post about religious leaders’ reluctance to fight for a single-payer system, in addition to his recent editorial on health care reform.

But even in a single-payer system, the financial incentives for preventive care are relatively small, Roland said, because people eventually get sick and need expensive services, even with good preventive care.

So here’s the real message I took away from the call: shifting to a single-payer structure is just the first step. After that we need to work to ensure that real concern about people’s wellness — not worries about cost — is at the heart of the system.