Hope Cook: A practical health care approach
August 21, 2011
Steamboat Springs — Whether you agree with the Affordable Health Reform Act, there is a part of it that has finally put common sense into how we as a society look at our present and future health care approach. As of 2012, the deductibles and out-of-pocket cost sharing for screening procedures will be no longer be required in health plans. This was announced Aug. 1 by the Department of Health and Human Services. As a public health professional, that was music to my ears and hopefully will be to my fellow Americans. Let me tell you why.
Since I entered nursing decades ago, there have been untold cases that I have personally seen of individuals who waited to go to the doctor for screenings because they were afraid of the results and they waited until symptoms had advanced and were beginning to impact their lifestyles. Then something that was very treatable became more costly and complicated to treat. Health plans enabled this thinking by providing coverage for care without the myriad restrictions we have now. It seemed then that this was counter-intuitive — wouldn't you want to encourage your clients to seek help when a problem started rather than waiting for it to get bigger?
A report that was written by the Commonwealth Fund found that from 2007 to 2009 there was a 25 percent increase in women delaying seeking care due to the out-of-pocket cost sharing or co-pays that they would have to pay. For example, if a woman found a lump in her breast but waited until it became more noticeable before seeking treatment, she could then face a much more complicated treatment plan that would be more painful and more costly.
Enter the new rules and thinking that preventative care is more cost-effective and sustainable than our current practice of treating illnesses after the fact. Targeting women for certain health benefits and coverage will begin in August 2012. The areas of focus will include:
■ Well-women visits, which can be thought of as the annual visit, but with emphasis on wellness practices and preventive services.
■ Gestational diabetes, which will be for women 24 to 28 weeks pregnant to insure that mom and baby remain healthy during the remainder of the pregnancy and minimize mom's risk of Type 2 diabetes later in life.
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■ HPV DNA testing for women 30 and older. Women will have access to this test regardless of pap smear results every three years. Early detection of HPV can reduce the prevalence of cervical cancer.
■ Yearly STD counseling and HIV screening and counseling. Currently, only about 28 percent of women ages 28 to 44 discuss sexual health issues with their health providers.
■ Contraception and contraceptive counseling will be covered. This will allow women access to all FDA-approved contraceptive methods, sterilization procedures and education. Family planning services are key to healthy spacing of pregnancies that increase maternal health and better birth outcomes.
■ Breastfeeding support, supplies and counseling will be provided. This will promote breastfeeding as best practice for newborns and their mothers.
■ Domestic violence screening, which can be so effective in detecting and intervening in an abused woman's intimate partnership and improve her safety.
These services already are available to many Americans through their current health plans and to members of Congress. Including them in the Affordable Health Care Act increases the access to many more citizens and encourages thinking in the terms of achieving and maintaining good health. The old adage of an ounce of prevention is worth a pound of cure will hopefully take on a 21st century meaning — and that's good for everyone.
Hope Cook is a longtime nurse in Routt County.