Colorado legistlature helps insurers by mandating wasteful preventive care coverage
January 8th, 2010 | by Brian Schwartz |From the Denver Post:
A new state law makes some forms of preventative health care more affordable to people who are insured in Colorado.
The law, which took effect Friday, assures that services such as screenings for breast and cervical cancer, cholesterol levels and colorectal cancer; childhood immunizations and flu vaccines; and programs to help manage alcohol misuse and quit smoking are available at low cost to clients, even when the insured have not met their deductibles. …
State Rep. Tom Massey, R-Poncha Springs, co- sponsored the bill with Sen. Betty Boyd, D-Lakewood.
“It’s amazing that it went so smoothly,” Massey said. “I’ll credit the fact that the insurers were all very proactive in working through this.”
They realized “the long-term benefits and savings” of catching health problems in the early stages, he said.
Rep. Tom Massey marvels at how “smoothly” the process was, and that the insurers were “proactive.” Duh! Insurers benefit from this mandate, as it forces people to buy more expensive policies, whether they want it or not.
The Post’s Colleen O’Connor does not mention that this will likely increase insurance premiums. It will also increase demand for such services, as they will appear “free” to the patient. Hence, providers won’t compete much on price and patients will have tests they may not be necessary.
Speaking of which, how useful is preventive care? Does it have “long-term savings”? An article in the New England Journal of Medicine concludes:
Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. Careful analysis of the costs and benefits of specific interventions, rather than broad generalizations, is critical. Such analysis could identify not only cost-saving preventive measures but also preventive measures that deliver substantial health benefits relative to their net costs; this analysis could also identify treatments that are cost-saving or highly efficient (i.e., cost-effective).
Also, as John Goodman notes, an article last year in Health Affairs says:
Over the four decades since cost-effectiveness analysis was first applied to health and medicine, hundreds of studies have shown that prevention usually adds to medical costs instead of reducing them. Medications for hypertension and elevated cholesterol, diet and exercise to prevent diabetes, and screening and early treatment for cancer all add more to medical costs than they save. Careful choices about frequency, groups to target, and component costs can increase the likelihood that interventions will be highly cost-effective or even cost-saving.
I bet that if patients are paying for the preventative care, or even non-trivial fraction of it, they will make sure the treatment or test is necessary. But so long as they’ve prepaid for it through “insurance”, there’s sure to be over-consumption.
tags: Colorado health care, mandated benefits, preventive care
