September 29, 2015

An Ode To Obamacare And Preventive Health Services

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In Hartford around the time of the Revolutionary War, one Dr. William Jepson owned a home near where South Church stands now.

logo_ColumnThe doctor was better known as an apothecary, as a nod to his main function of dispensing medicine, but for the most part in those days health care was delivered by the women of the family. Only when herbs and home remedies didn’t work were “bone-setters,” or surgeons and physicians such as Jepson, summoned. Treatment might involve bloodletting, which is exactly as it sounds.

Preventive care—the standard for today’s medicine—has a spotty history in this country. Even after medical care began more institutionalized in the 1800s, curing disease took precedent over avoiding it. Other than an occasional nod to the importance of sanitation, scant little attention was paid to preventive care, at great emotional and financial cost to the culture.

For a stark example, see the R.J. Reynolds advertisements from the ’40s that included white-coated men and the legend “More doctors smoke Camels than any other cigarette.” The ad seems tragically ironic today. In fact, the makers of Camel cigarettes, in a nod to their product’s lethality, recently banned smoking in their offices.

Until the fairly recent past—say, the 1950s—good health was considered the result of good genes and good luck.

Today, Jepson’s home is gone, and he would not recognize medical care in his state with well-woman visits, clinical screenings, and checkups performed to prevent disease.

For the most recent leap forward in preventive care, thank Obamacare. For all the arguments about its implementation—arguments that continue—President Obama’s signature health care law has reinforced the importance of good preventive medical care.

The numbers have said that for a while. The Centers for Disease Control and Prevention says that with the proper clinical preventive care, more than 100,000 lives could be saved every year. Last year the CDC released a report that said as many as 40 percent of the nearly 900,000 Americans who died from the five leading causes of death suffered from deaths that were preventable. Those five causes are heart disease, cancer, chronic lower respiratory diseases, stroke, and unintentional injuries. Together they accounted for 63 percent of all U.S. deaths.

preventive careThe takeaway? With a change in behavior, a significant number of people can live longer. Add to that regular visits for checkups and screenings, and you can add years to your life.

Since the implementation of Obamacare—known officially as the Affordable Care Act—and its mandates of certain free preventive services, young women have sought more dental care and routine checkups. Since the law’s implementation, women have saved an average of roughly $250 a year on birth control. And women continue to push for annual mammograms, despite a recent recommendation from the U.S. Preventive Services Task Force that suggested, instead, that women can get fewer mammograms.

Women’s embrace of the Affordable Care Act’s deep preventive push is stunning, in part because the idea of preventive care for women is relatively new, according to a 2011 study published in Harefuah, the Israeli equivalent of our JAMA: The Journal of the American Medical Association. In fact, including women in clinical trials is relatively new as well. For generations, studies focused on the male model.

Obamacare covers a host of preventive services when in-network providers provide them. Those services range from anemia screenings for pregnant women, mammograms, certain contraceptives, and well-woman visits for women under age 65. (For more on that, the Henry J. Kaiser Family Foundation has a nifty website that outlines all the preventive services covered by private health plans under the law.)

If bloodletting and discussion of the body’s humors are a thing of the past, perhaps preventive care—as old as medicine, as new as Obamacare—is here to stay.

On Oct. 7, the Conn. Health I-Team, in collaboration with ConnectiCare, is hosting a forum, “Get Health Wise: The Benefits of Preventive Care,” from 5:30 to 7:30 p.m. at the Artists Collective, 1200 Albany Ave., Hartford. The keynote speaker is Dr. Jewel Mullen, commissioner of the state Department of Public Health. Admission is free. You can register here.

Susan Campbell is a distinguished lecturer at the University of New Haven and the Robert C. Vance Chair for Journalism and Mass Communication at Central Connecticut State University. She can be reached at slcampbell417@gmail.com.

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