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An ounce of prevention
Health care plan isnt perfect or cheap, but more preventive medicine can only help in long run
0926VP.Phaedra Corso
Phaedra Corso, a Gainesville resident, is an associate professor and head of the Department of Health Policy and Management at The University of Georgia.

On Thursday, a host of new measures associated with the Patient Protection and Affordable Care Act took effect to increase access to health services.

One of the key provisions that is of particular interest to the field of public health is the removal of patient co-pays for many preventive services. Prevention is the centerpiece of public health, and the services that are included in health care reform have been reviewed and recommended by a multitude of clinical and public health experts in the field, based on evidence of effectiveness.

As such, the preventive services that those with health insurance will now be able to access without any additional out-of-pocket expenses are wide-ranging.

Some examples of these preventive services include: mammographies for the early detection of breast cancer, immunizations to prevent against childhood diseases, and screening and counseling for drug and alcohol addictions.

Without a co-pay, it may be likely that people will take advantage of preventive services more frequently. This is a "good" thing from a public health perspective because if barriers to effective preventive services are removed, people may actually use these services more - ultimately resulting in improved health and reduced long-term costs because disease will be prevented or detected before costly treatments are required.

Yet with all policies, and particularly with health care systems that are complex and interconnected, the multitude of changes coming into play has the potential to have not only intended benefits, but also unintended consequences.

For example, just because your co-pay is going to disappear doesn't mean those preventive services are going to be free. The former cost-sharing system brought in some revenue to the insurance companies, thus enabling them to offset some of the costs of those services.

Speaking realistically, when that revenue stream dries up, the insurers will need to find another way to cover their expenses. And if more preventive services are being used, more revenue will be needed in the short-term to cover these additional expenses. As a result, it may be the case that insurance companies will have to increase their premiums to offset their losses in co-pays for preventive services.

You could try to make a financial case to an insurance company that they should be willing to make an investment in providing preventive services because of the long-term benefit of lower costs for treating less disease. However, in a society where individuals change insurance plans frequently, many insurance companies will likely only focus on the short-term economic pinch, not the long-term savings.

Thus, as public health practitioners, with a stated mission to improve the health of the population, it is our job to argue that from a societal perspective, increasing access to preventive services is still the right thing to do even if it means a short-term bump in our health care costs.

Utilizing better preventive services means a healthier population, improved health-related quality of life and lower long-term costs that could outweigh the increase in short-term costs.

Sometimes the biggest challenge in implementing anything new is actually getting over that first hurdle, and the passage of health care reform achieved that. If the process of change can continue to move forward on some level, it's important to remember there is an effort to address the flaws in the system, learn from them and try to improve them.

It's not a perfect process or an ideal system, but it is better than sitting back, wringing our hands and saying that too many people are uninsured or that the system is not effective.

Phaedra Corso, a Gainesville resident, is an associate professor and head of the Department of Health Policy and Management at The University of Georgia and co-host of "Public Health Impact," airing at 6:30 p.m. Wednesdays on WNEG-TV.

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