Health insurance isn’t built for the reality of 2026

Health insurance has historically been built to react to illness. The model is simple: once a diagnosis is made, the insurance steps in with treatment, specialists and quick access to care. This approach has worked well in a world where most health challenges were acute and well‑defined.

But that isn’t the reality health insurers face in 2026.

Today, more people live longer – and also have more years with reduced physical and mental capacity. This is a challenge for a model designed for illness but poorly suited to a gradual loss of function. Future health challenges are less about isolated diagnoses and more about loss of functional ability. Loss of function can precede diagnoses rather than the other way around. It applies to both physical and mental ability. Reduced strength, low load tolerance, impaired recovery and cognitive fatigue develop over time, long before they trigger a specific diagnosis.

For health insurers, the consequences are tangible. Loss of function means longer case histories, increased risk of repeated treatments, more complex courses and more difficult returns to work. Treatment alone doesn’t solve the problem if underlying capacity remains low. That’s why we are already seeing a shift from a one‑sided focus on treatment to a broader approach where the goal is to preserve and build functional capacity over time.

The World Health Organisation highlights functional ability as the key determinant of whether people can live independently, work longer and recover well. It is functional capacity, not the number of services provided, that determines outcomes.

Why strength is crucial

In 2026, one intervention stands out: building strength. Strength training is among the most well‑documented ways to build and maintain functional capacity, both physical and mental. Increased muscle strength correlates with lower risk of musculoskeletal disorders, fewer falls, better mental wellbeing and a quicker return to work – precisely the factors driving much of health insurance costs.

International research shows that low muscle strength and reduced functional capacity are strong predictors of a higher disease burden, earlier death and greater health expenditure – independent of diagnosis. Studies from Canada and the UK show that low levels of strength leads to significantly higher health and social costs. Recent research in trauma patients supports this: people with low muscle mass have worse functional outcomes, longer hospital stays, more days on ventilators and higher mortality. Even among survivors, courses of treatment are longer and more burdensome. Strength, therefore, acts as a biological buffer. It reduces vulnerability and increases the chances of people returning quicker and healthier after strain or illness.

It’s also an economic issue

Loss of muscle mass and strength – sarcopenia – is a major economic burden in itself. It increases the risk of falls,hospitalisation, the need for care and loss of independence, on top of the costs associated with physical inactivity. Data from Canada show that low muscle strength accounts for a substantial portion of total health expenditure and that even small reductions in prevalence could yield significant savings. In the UK, muscle weakness is estimated to cause annual additional costs in the billions, driven by the need for more treatment, care and loss of function.

It underscores the need to distinguish between general physical activity and strength training that actually builds capacity. Ordinary exercise, balance and coordination have value but are insufficient to build the muscle mass and power that protect against loss of function. Resistance training is critical.

Targeted capacity building

Loss of function often occurs long before diagnosis. This means risk groups can be identified earlier and more accurately if we measure function rather than focusing only on disease. Instead of broad prevention schemes for everyone, it makes sense to assess functional ability as an early indicator of health: what can a person actually cope with – physically and mentally – in daily life?

This provides a more accurate picture of the risk of chronic illness, sick leave and reduced work ability and allows health insurers to invest where the effect is greatest: shorter courses of treatment, fewer complications and a better return to work. It’s not about shifting responsibility to the individual but about investing in capacity earlier and more strategically.

At the same time, this field is well‑suited to digital solutions. Strength‑based interventions with high frequency and continuous contact – such as micro training – deliver high retention and lasting progress. They can be tailored to individuals, precisely dosed and integrated into busy lives. Capacity building requires continuity: not one‑off interventions but sustained effort throughout the year. This is where digital solutions can achieve what traditional healthcare rarely manages: keeping people engaged long enough for improvements to last.

A supplement, not a replacement

Developing this approach does not replace the public healthcare system. Health is a complex societal issue that no single sector can solve alone. But health insurers have the opportunity to supplement the healthcare system: by investing earlier, thinking longer term and focusing on functional ability rather than diagnosis. In Denmark, pensions and health are closely linked. This provides a unique opportunity to invest in functional capacity before problems become chronic and costly. When health and pensions coexist in the same ecosystem, long‑term capacity building pays off – for the individual and society. If in 2026 we measure health more on capacity, robustness and everyday function – and not just on treatments and services – we will take a crucial step towards a healthier society and a more sustainable healthcare system. Health insurance is built for illness. Reality requires it to be built for functional ability.

Read the article in Finans in Danish.