When you think about health insurance, what comes to mind? For many people, it’s not something they think about every day—until they need it. Then it becomes everything. A broken arm, an unexpected diagnosis, or even the need for preventive care reminds us why we invest in coverage in the first place. It protects us from risks we can’t fully anticipate and gives us the confidence to live life without being paralyzed by fear of the unknown.

Psychological safety works much the same way in organizations. It doesn’t guarantee nothing will go wrong—just like insurance doesn’t prevent illness or injury. It provides a buffer, a system of trust and coverage, that ensures when something does go wrong, people are supported, heard, and encouraged to act.

The metaphor is powerful because both health insurance and psychological safety are investments in resilience. Both are about preventing bigger problems, spreading risk, and creating peace of mind. Both are often overlooked until the absence becomes painfully obvious.

Let’s unpack why psychological safety is the workplace equivalent of health insurance, why your organization can’t afford to be “uninsured,” and what leaders and teams can do to ensure the right level of coverage.

1. Coverage When You Need It Most

Health insurance protects us when life throws curveballs. Whether it’s a trip to the emergency room or ongoing treatment for a chronic condition, coverage means we don’t face risk alone.

In the workplace, psychological safety offers similar protection. It creates space where employees can:

• Admit mistakes without fear of punishment.
• Raise concerns about risks or ethical issues.
• Ask for help without being labeled incompetent.
• Share ideas that might challenge the status quo.

Harvard professor Amy Edmondson (1999), who brought psychological safety to the forefront of organizational research, defines it as “a belief that one will not be punished or humiliated for speaking up with ideas, questions, concerns, or mistakes.” Just as people without health insurance delay or avoid medical care, people without psychological safety delay or avoid speaking up. The result in both cases is often escalation: small issues that could have been addressed early spiral into crises.

Case in point: Google’s Project Aristotle (2015) analyzed what made teams effective. The number one factor wasn’t technical skill, seniority, or even workload. It was psychological safety. Teams with strong “coverage” thrived because people spoke up early, while teams without it underperformed, much like patients without insurance who avoid care until it’s too late.

2. Preventive Care: An Ounce of Prevention

Health insurance isn’t just about emergency care. Preventive services—like annual checkups, screenings, and vaccinations—help us stay ahead of problems. Studies show preventive care reduces long-term costs and improves quality of life (Maciosek et al., 2010).

Psychological safety is preventive care for organizations. Leaders who encourage questions, create feedback loops, and respond constructively to dissent stop problems before they metastasize.

For example, when engineers feel safe flagging potential risks in a new system design, they act as an early warning system. When nurses speak up about unsafe staffing levels, patient harm is prevented. Without safety, people stay silent until “disease” spreads throughout the organization.

Edmondson’s research in healthcare found that units with higher psychological safety reported more errors—not because they made more mistakes, but because people felt safe admitting them (Edmondson, 1999). This mirrors preventive health data: catching an issue early looks like “more diagnoses,” but it actually saves lives.

3. Shared Investment, Shared Benefit

Health insurance works because of risk pooling. Everyone pays premiums, but not everyone needs care at the same time. By sharing resources, the group creates a safety net.

Psychological safety works the same way. It’s not just about leaders creating the conditions—it requires ongoing contributions from everyone:

• Leaders invest trust. They model humility, admit mistakes, and respond to feedback constructively.
• Employees invest openness. They share ideas, take risks, and listen to each other.
• The organization benefits. Innovation flourishes, turnover decreases, and trust spreads.

Think of it like paying monthly premiums. Each small act—asking a clarifying question, thanking a colleague for raising a concern, inviting input in a meeting—contributes to the pool. Just like insurance, you may not always need to draw on it personally, but someone else will.

Paul Zak (2017), in The Trust Factor, demonstrates that high-trust cultures—those built on psychological safety—see 106% more energy at work, 76% more engagement, and 50% higher productivity. Everyone benefits from the collective “coverage.”

4. Peace of Mind = Performance

Health insurance doesn’t just save you money—it gives you peace of mind. You don’t wake up every morning wondering if a single accident will bankrupt you. That mental freedom allows you to focus on living.

Psychological safety provides the same peace of mind at work. Employees don’t waste energy calculating the political costs of every word. They don’t live in fear of being embarrassed, retaliated against, or ignored. Instead, they focus on solving problems, innovating, and collaborating.

Neuroscientist Matthew Lieberman (2013), in Social: Why Our Brains Are Wired to Connect, shows that social pain—like exclusion, fear of embarrassment, or rejection—registers in the brain in the same regions as physical pain. When employees don’t feel safe, it literally hurts. Conversely, when they feel secure, cognitive resources free up, enabling higher-level performance.

That “coverage” translates into healthier, more resilient organizations.

5. The Cost of Being Uninsured

What happens when you don’t have health insurance? People delay care, avoid doctors, and rack up devastating bills when emergencies strike. The long-term costs—both financial and human—are immense.

The same is true for psychological safety. Organizations without it face:

• Turnover: Gallup (2017) reports disengaged employees are 37% more likely to leave.
• Ethical breakdowns: Whistleblowers often stay silent in unsafe environments, allowing scandals like Wells Fargo’s fake accounts or Boeing’s safety failures to snowball.
• Lost innovation: Deloitte’s 2020 Human Capital Trends report found that 74% of organizations see agility and adaptability as critical, yet most fail because people don’t feel safe to take risks.

The absence of safety isn’t free—it’s one of the most expensive risks an organization can take.

6. Invisible Until It’s Gone

Here’s the paradox: health insurance and psychological safety are both most noticeable in their absence.

• When you have health insurance, it fades into the background—until you suddenly need a $30,000 surgery.
• When you have psychological safety, it feels like “just the way things are”—until silence, fear, or retribution makes it painfully clear that safety is gone.

The 2017 Gallup State of the American Workplace report shows that only 3 in 10 employees strongly agree their opinions count at work. That’s a coverage crisis. Leaders may assume safety is “fine,” but the lack of visible claims doesn’t mean people are covered. It may mean they’re avoiding the system entirely.

7. Coverage Levels: From Basic to Comprehensive

Not all health insurance plans are created equal. Some are “bare-bones”—they only cover catastrophic events up to a certain dollar amount, leaving out preventive care, wellness programs, or ongoing support. They look cheaper up front, but in the long run they often cost far more when preventable problems become emergencies.

Psychological safety works the same way. A minimal or surface-level implementation might check a box—leaders say the right words in meetings, or a team is told they’re “safe to speak up.” If that safety doesn’t extend to honest feedback, tough conversations, or raising concerns that challenge authority, it’s a basic plan with hidden costs. 

True, sustainable psychological safety requires a comprehensive approach:

• Leaders model vulnerability and openness consistently.
• Teams embed listening and learning practices into daily work.
• Organizations integrate safety into systems—hiring, performance reviews, innovation cycles, and decision-making.

When safety is only partially implemented, the appearance of coverage can lull leaders into a false sense of security—until the “claim” comes due. A whistleblower case, high turnover, stalled innovation, or an ethical failure can end up costing far more than the original investment to build a truly safe culture.

In short: you get what you pay for. Basic coverage may feel like enough in calm times, but only comprehensive, embedded psychological safety ensures resilience when it really matters most.

8. What Leaders Can Learn from Health Insurance

So what does this metaphor teach leaders? Three lessons:

• Don’t wait for a crisis. Just as you wouldn’t buy insurance after the accident, you can’t wait for a scandal to create safety. Build it proactively.
• Invest in preventive care. Encourage feedback loops, listening sessions, and “speak-up” rituals before small issues escalate.
• Think system-wide. Insurance covers populations, not individuals. Similarly, psychological safety isn’t about a single leader being “nice.” It’s about embedding trust, fairness, and inclusion into systems and culture.

Final Thought: Protecting What You Can’t Always See

Health insurance protects your physical well-being. Psychological safety protects your human well-being at work. Both are investments in resilience, trust, and peace of mind.

Just as you wouldn’t go without health coverage for your family, organizations can’t afford to go without safety coverage for their teams. Psychological safety isn’t a perk—it’s an insurance policy for trust, innovation, and long-term successful high-performing, learning teams.

The difference? Unlike health insurance, psychological safety doesn’t come with monthly premiums. It comes with daily practices: listening, humility, empathy, and courage.

Coverage matters. Peace of mind matters. Safety matters.

If you want to bring psychological safety into your organization but aren't sure where to begin, start here by reading this InKNOWnative Insights: How to Use InKNOWnative’s Step-by-Step Training to Build Sustainable Psychological Safety.  

Citations

Deloitte. (2020). Global Human Capital Trends. Deloitte Insights.

Edmondson, A. C. (1999). Psychological Safety and Learning Behavior in Work Teams. Administrative Science Quarterly, 44(2), 350–383.

Edmondson, A. C. (2019). The Fearless Organization: Creating Psychological Safety in the Workplace for Learning, Innovation, and Growth. Wiley.

Gallup. (2017). State of the American Workplace. Gallup Press.

Google re:Work. (2015). Project Aristotle. https://rework.withgoogle.com/print/guides/5721312655835136/

Lieberman, M. (2013). Social: Why Our Brains Are Wired to Connect. Crown.

Maciosek, M. V., et al. (2010). Greater Use of Preventive Services in U.S. Health Care Could Save Lives at Little or No Cost. Health Affairs, 29(9), 1656–1660.

Zak, P. J. (2017). The Trust Factor: The Science of Creating High-Performance Companies. AMACOM.

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