Comparative Performance Analysis of Ethereum and Optimism Smart Contracts in Health Insurance

Abstract

One type of insurance that people purchase to cover unexpected medical expenses is health insurance. In exchange for premium payments, the insurance company may cover a portion of the insured person's medical expenses, such as prescription medications, hospital stays, and doctor visits. This method makes access to healthcare easier and less expensive. Health insurance systems do, however, have a number of issues, including fair insurance premium calculation, automation, data verification, privacy and security, and cost effectiveness. These issues are starting to be addressed by blockchain technology, particularly with the help of smart contracts. Using a comparison analysis between Ethereum and Optimism smart contracts, this paper demonstrates the performance of health insurance. Simulation of these BC technologies was carried out both on the Sepolia testnet and using Alchemy. Tools and metrics provided to monitor the performance of Alchemy applications, detect errors, and analyze user interactions were used in the measurements. While Ethereum's well-established ecosystem offers robust support for smart contracts, Optimism distinguishes itself as a scalable substitute that delivers quicker transaction speeds and more affordable options. According to the analysis results, the advantages and disadvantages of Ethereum and Optimism are highlighted when it comes to health insurance. © 2025 Elsevier B.V., All rights reserved.