Why don’t insurers cover more preventive care?

KEY TAKEAWAY: Chronic diseases, such as heart disease, cancer, and diabetes, are responsible for 7 of every 10 deaths among Americans each year and account for 75% of the nation’s health spending. These chronic diseases can be largely preventable through close partnership with a healthcare team, or can be detected through appropriate screenings , when treatment works best.  So why don’t insurers help their customers by suggesting more preventative care?

Eating healthy, exercising regularly, avoiding tobacco, and receiving preventive services such as cancer screenings, preventive visits and vaccinations are just a few examples of ways people can stay healthy. The right preventive care at every stage of life helps all Americans stay healthy, avoid or delay the onset of disease, keep diseases they already have from becoming worse or debilitating, lead productive lives, and reduce costs.

And yet, despite the benefits of many preventive health services, too many Americans go without needed preventive care, often because of financial barriers . Even families with insurance may be deterred by copayments and deductibles from getting cancer screenings, immunizations for their children and themselves, and well-baby check-ups that they need to keep their families healthy.

The debate around the relationship of health care insurance and eating healthy and exercise continues yet the fact remains that a lot of people are paying the costs for unhealthy lifestyles of others.

Although most Americans underuse preventive services, individuals experiencing social, economic, or environmental disadvantages are even less likely to use these services. Examples of obstacles include lack of access to quality and affordable health care, lack of access to healthy food choices, unsafe environments, and a lack of educational and employment opportunities. However, employers, as well as insurers, need to get in the act.

Preventive Health Care Seminar.

Last week while cycling around my hometown of Naples I say three health screening trailers parked at a large employer.  One was offering bone density scans the other two were for blood tests for diabetes and mammograms.  The employer contracted to offer these services free to employees.  When I talked to one of the nurses she said that a number of employees “were surprised” they were prediabetic.

We can talk about the cost of prescription drugs all we want, but the fact still remains that only ten cents of every health care dollar spent goes to Rx drugs. Until we are ready to enable more preventative services and mandate that they be used healthcare costs aren’t going down.

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