Preventive care is any medical service that protects against health emergencies. It includes doctor visits, such as annual checkups, medical appointments, and teeth cleaning. Some medications are preventive, such as vaccines, contraception, and allergy medications. Screening tests, such as skin cancer tests, high cholesterol, and colonoscopies, are effective preventive measures.
Preventive care also keeps people productive and allows them to continue to earn a good income into old age. Health problems forced 35% of retirees to retire early before they were financially prepared.
How Preventive Care Lowers Health Care Costs
Preventive care helps reduce health care costs in America by preventing illnesses before they require emergency room care. Why is this a problem? Hospital care is very expensive, accounting for one-third of all health care costs in the United States. In 2010, 21.4% of adults went to the emergency room one or more times. By 2017, that had decreased to 18.6%.
One reason is that many adults use the emergency room as their primary care physician. In 2014, 7.0% of adults ages 18-64 went because they really had no other place to go for health care, regardless of health insurance status. 77% went to the emergency department due to the severity of the problem, which included those sent by the doctor. 15.4% of the uninsured are likely to use the emergency room due to lack of access to other service providers.
The cost of emergency room care for people without insurance can be very high. When the uninsured can't afford it, the cost rolls over to their health insurance premiums and Medicaid.
These diseases are heart disease, cancer, chronic lower respiratory diseases, and strokes. Heart disease and stroke are mainly caused by malnutrition and obesity. Lung cancer, the most common type, and CLRD are caused mainly by smoking. Obesity is also a risk factor for other common types of cancer.
Even before they reach the emergency, treating these chronic diseases is prohibitively expensive. In the United States, 90% of the $ 3.5 billion in annual health care expenditures are for people with mental health and chronic conditions.
Many patients are tired of taking too many medications or cannot afford them. When they regress, they end up in the emergency room with heart attacks, strokes, and other complications.
The ACA relies on preventive care to keep costs down
The Affordable Care Act requires insurance companies, Medicare, and Medicaid to provide preventive care services for free. Not all actions recommended by the US Preventive Services Task Force have a single commitment. Obamacare requires these to be included as part of its Top 10 Benefits.
The strategy seems to be working. In 2018, a Health Affairs study found that the expanded Medicaid program saw a 40% increase in the number of prescriptions filled with diabetes medications. Countries that did not expand Medicaid saw no increase.
The ACA's preventive care provisions include maternity care, mental health treatment, and enhanced drug benefits.
Maternity and newborn care
This includes quality women's visits, domestic violence checks, and support for breastfeeding and contraception teams. This is cost-saving preventive care because it is cheaper to provide the mother with good nutrition and alcohol / drug advice than it is to treat preterm births and fetal alcohol syndrome. All are detailed as preventive care provisions.
Treat mental and behavioral health
Many of the homeless in America suffer from mental and behavioral health problems that go untreated. In a June 2015 study, 564,708 people became homeless on any given night in the United States, and of those, 250,000 or 45 percent had some kind of mental illness. Left untreated, they cost society more than emergency rooms, police procedures, and prisons.
A chronically homeless person costs taxpayers an average of $ 35,578 a year.
Coverage for disabilities and chronic cases
Most plans cover services and equipment to help you recover from temporary injuries, like a broken leg. The ACA requires coverage of goods and services to help you maintain a standard of living if you develop chronic diseases, such as multiple sclerosis.
Diagnostic lab tests
It should be covered 100% if diagnosed as it is considered preventive. If you've already been diagnosed with a disease, standard subscriptions and discounts apply.
Take care of children
Dental and vision care must be covered.
Prescribed medication
All of the plans listed will include coverage for at least one drug in each category in the US Pharmacopeia. Regardless of what you pay out-of-pocket for the drugs, it will also count toward the deductible amount. This is not true for all pre-ACA insurance plans. They also offered this at a cost.
Example: Parkland Hospital's "frequent flyer program"
Parkland Hospital is located in the low-income department in Dallas, Texas. About 85% of its patients are uninsured or receive medical care. The hospital spent $ 871 million on unpaid care, more than half of its budget. It also accounts for 2% of all unpaid hospital care in the United States. One reason is that only two-thirds of the citizens of Dallas have health insurance.
The Parkland program focuses on patients who have visited the hospital at least 10 times in the past month. Most of them were homeless at some point in the past year.
Parkland Center for Clinical Innovation refers its frequent travelers to homeless shelters and grocery stores. Private donations paid for a computer system that tracks the care these patients receive outside of the hospital. It connects the fire department, the school system and the community colleges. For example, the school system can ensure that parents carry asthma medications for their children.
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