Ounce of prevention

June 20, 1991

When half the beds at Johns Hopkins Hospital are filled with people whose illnesses or injuries could have been prevented, insurance coverage for preventive medical care seems to be common sense. Yet many insurance policies do not cover the simple procedures that can detect problems before they mushroom into serious, expensive conditions. Why? Because, too often, employers are not prepared to pay increased fees up front for savings down the line.

Even so, this week the Blue Cross and Blue Shield Association announced new guidelines for its 73 independent member plans, recommending that they provide coverage for routine screenings for such conditions as breast cancer, lung cancer, heart disease, diabetes, thyroid disease and osteoporosis. Some insurance plans already cover such routine procedures. But not enough. According to officials at Blue Cross and Blue Shield of Maryland, preventive-care options have been available to employers for a decade, but only about 10 percent choose these options for the plans they offer to workers. However, in recent months, the Blues have noticed among employers a surge in interest in preventive care.

And none too soon. To cite only one important preventive procedure, health care experts estimate that 80 percent of American women who should be screened for breast cancer do not have routine mammograms. Aside from the obvious human tragedy, it would seem that a dollar comparison of the cost of a mammogram with the cost of treating a woman for advanced breast cancer would prove the effectiveness of preventive care. Apparently, however, despite all the health care research done in this country, precious little has focused on the persuasive evidence employers need to justify the cost of adding preventive coverage to their health care plans. Surely science will have no trouble proving the old adage that an ounce of prevention is worth a pound of cure.

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