Some affordable health care benefits effective in September

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by Dr. Regina Benjamin

We need to change the way we think about health in this country, I want us to move from a system based on disease and illness to one based on wellness and prevention. We need to prevent people from getting sick in the first place, to stop illness and disease before it starts. During my 23 years as a family physician, I saw too many missed opportunities for prevention.

That’s why I’m excited to tell you about the Affordable Care Act and some very important new benefits that took effect last week. These measures will make it easier and more affordable for people to practice the preventive care that will help keep them healthy.

Beginning Sept. 23, new health insurance plans are required to cover recommended preventive services and will not be allowed to charge a deductible, co-pay or coinsurance. This applies to services like children’s checkups, mammograms, pap smears, colon cancer screening, vaccinations, and blood sugar testing.

These are services that help people stay well and help us detect illnesses early. In spite of this, as a doctor I have too often seen patients put off getting preventive care—even if they have insurance—because they can not afford the co-pay.

For instance, if a 58-year-old woman who is at risk for heart disease is recommended to have a mammogram, a colon cancer screening, a Pap test, a diabetes test, a cholesterol test, and an annual flu shot. Under a typical insurance plan, these tests could cost her more than $300 out of her own pocket. Under the new law, new health plans must offer these tests at no out-of pocket expense to her.

Expanding access to preventive services will reduce health disparities for 41 million African-Americans by helping to identify and prevent many of the diseases that have a disproportionate impact in our community. We have some of the highest rates of chronic illness in the nation including heart disease, kidney disease, diabetes, and obesity.

Eliminating co-pays and deductibles for preventive care will also help Americans when it comes to detecting cancer early, ensuring healthy pregnancies, and treating HIV/AIDS. While the cost savings for these treatments will be significant for all Americans who take advantage of this free preventive care, African-Americans will gain even more, since we already spend a higher percentage of our income on health care.

The preventive benefits that became available on Sept. 23 are just the latest reforms in the Affordable Care Act that will help Americans stay healthy. The new law also created a prevention council, of which I am chair, to develop a national prevention strategy for the first time ever and coordinate prevention efforts across the federal government.

We need to use a more holistic approach to community health, from safe highways and work site wellness programs to clean air and healthy foods. It’s especially important in many communities that often have less access to healthy foods and fewer opportunities for exercise. We want to make it easier for kids and parents to make healthy choices. With this council, I hope to move us from a system of sick care to a system based on wellness and prevention.

At the same time, we know that the best solutions are often innovative, local programs that are developed and implemented by the local people who know their communities best. That’s why Congress provided funding through the Recovery Act for a program called, Communities Putting Prevention to Work.

This program provides communities with the resources to create healthy choices for residents, such as increasing availability of healthy foods and beverages, improving access to safe places for physical activity, discouraging tobacco use, and encouraging smoke-free environments. So far, this program has provided $500 million to such initiatives across the country.

By increasing access to preventive care and a moving us towards a more community-oriented approach to prevention, the Affordable Care Act will help fight chronic disease in this country and dramatically improve the health of all Americans. We still have a long way to go, but this is a big step toward making us a healthy and fit nation.

(Dr. Regina Benjamin is surgeon general of the United States. Reprinted from the Afro American.)

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