Rescuing profits from politics seems like a luxury compared to the real crisis facing health insurers. Looming much larger is a question of value — as in, remind us again why we need you at all.

The industry’s challenge, analysts say in Sunday’s The New York Times (”Health Insurers, Poised for Round 2“), is to prove it is “more than a middleman.” To do so, health insurers will need to reconsider their purpose, their essential value, and re-connect in fundamentally new ways with a growing chorus of voices finding it all too easy to imagine a world without them.

”The health plans are going into a very dangerous time because many of them have destroyed the perception of value they were trying to create,” says one analyst.

While insurers “say they are innovating,” corporate customers have become increasingly critical, saying “the industry is not helping to provide care that is more cost-effective in helping their workers live longer and more productive lives.”

Why the disconnect? Maybe it’s a matter of framing (see March 1 blog post).

Aetna, which is profiled in the story, says it’s betting on innovation that will make a “profound impact” on the existing delivery system. I haven’t read the company’s purported 2,000-page strategic plan, but according to the Times this focuses on patient informatics to better manage care through a more complete understanding of a person’s clinical conditions and treatments.

UnitedHealth Group, the other insurer profiled, is going the route of diversification, buying and morphing into as many health care businesses as it can.

Seems to me that both of these responses play within the existing system and within the existing set of assumptions about value. Probably good examples of what IBM’s Dr. Paul Grundy means when he says that insurers “don’t have a clue about providing what we really want to buy.”

So, what do we really want? A better system of care? Better health?

What if health plans began looking more deeply at the root causes of health? What if this became a collaborative process? What new roles might emerge? And in what ways might we begin to see that we need each other when we come together to reconsider what we most value?