Health Reform in Action: 5.5 Million on Medicare Take Advantage of Free Preventive Services

obama-approved-health-reforOn Sunday, I wrote about the new National Prevention Strategy that was made possible by last year's heatlh reform legislation. Thanks to the Affordable Care Act, Americans on Medicare have been receiving the benefits of no-cost sharing preventive care for a while now. The Center for Medicare and Medicaid Services is now reporting that 5.5 million Americans have already taken advantage of free preventive care under traditional Medicare. Why was preventive care even more essential than usual for Medicare beneficiaries?
This new emphasis on prevention is centered on the fact that we know that we can reduce many of the highest cost chronic diseases, such as diabetes, heart disease, chronic obstructive pulmonary disease, stroke, hip fracture and several cancers. This is especially critical in the Medicare population, where the average beneficiary with a chronic condition sees three primary care physicians and six or seven specialists.   
Given that no-copay preventive care has only been available under traditional Medicare since the beginning of this year, the numbers are all the more impressive.
As of June 10, 2011, approximately 5.5 million people with traditional Medicare used one or more of the preventive benefits including, most prominently, mammograms, bone density screenings, and screenings for prostate cancer.  This is 16 percent - almost one in six - of the more than 33 million Americans who had traditional Medicare in June 2011.
Health reform also added a new benefit to Medicare, the Annual Wellness Visit - a benefit created and crafted to encourage seniors to get their annual checkups without any cost sharing. Since its beginning at the start of this year, it too has seen excellent growth, with nearly 800,000 people taking advantage of it by its fifth month of availability.

Annual Wellness visit utilization

All of these things help demonstrate two things: First, though an old adage, it cannot be emphasized enough: an ounce of prevention is worth a pound of cure. If you make preventive services easy to get and without a copay, more people will take advantage of it. This means early detection and treatment of illnesses, including chronic ones. It also means stopping certain diseases before they even happen. In their report, CMS notes that they are working through the outreach efforts of the National Prevention Strategy to reach underserved and at-risk communities who are covered by Medicare.

The second thing the early success of preventive services under health reform demonstrates is that reform is working, regardless of the detractors of reform, no matter where on the political spectrum they came from. These types of benefits are not only good for beneficiaries, they are also good for establishing the essential liberal idea that a social safety net is not only necessary for a civil society to function, but that a social safety net can improve with the time and respond to changing realities and needs. Despite all the bru-ha-ha you heard from the Right about "death panels," I doubt the Republicans want to seriously face the awkward question that if they mess with "ObamaCare," they will be cutting benefits for people on Medicare.

And despite all the jumping up and down on the Left about the public option (and the lack thereof in the final legislation), I do not see how any self-respecting liberal cannot be proud of what Medicare - our model single payer system - is doing in terms of delivering free preventive services to our seniors under health reform.

At the bottom line, any and all reform is about one thing and one thing only: does it work to make people's lives better? If you look at health reform, that is certainly the case. 5.5 million people on Medicare have already gotten free preventive care, thanks to health reform. The prescription drug doughnut hole under Part D has begun to be closed, with a 50% discount on brand name drugs, and the doughnut will shrink each year until it goes away completely in 2019.

Medicare is of course not the only thing to benefit from health reform. Because of health reform, young adults up to age 26 can stay on their parents' plan. Because of health reform, children can no longer be denied coverage due to a pre-existing condition (it expands to everyone in 2014). Because of health reform, insurance companies can no longer kick you off as soon as you get sick. Because of health reform, some premiums in the individual market are actually going down! Because of health reform, a Pre-existing Conditions Insurance Program in each state is now in place to cover people with pre-existing conditions, the premiums of which, by the way, were just cut by as much as 40% in federally administered cases.

Each day, little by little, health reform is working. Each day, person by person, health reform is making a mark in the real lives of real people. Everyone who pushed to make health reform happen should be proud. It was difficult, it was hard, it almost did not happen. But Barack Obama stood up and said we must do the right thing, the political consequences be damned. Nancy Pelosi stood up and said she was going to do the right thing, despite taking plenty of heat from her own caucus for not-good-enough-ism. Harry Reid stood up and carried it through the Senate despite an unprecedented Republican commitment to obstruct everything. And now, it's working. Hurrah!

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