Wednesday, if you had a pre-existing health condition, you could be flatly denied insurance coverage. If you were a young person recently graduated from college — but without a job — your parents could no longer carry you on their insurance until you got on your feet. And if you had an expensive medical condition, your insurance benefits could be cut off at a certain lifetime limit, possibly forcing you into poverty to pay your medical bills.
Starting Thursday, those things are no longer true — thanks to the much-maligned health reform bill passed earlier this year.
We are witnessing a remarkable hue and cry in this country over the new health care law, but six months after enactment, the evidence keeps growing stronger that our health system needs reform. An uncertain economic future is keeping jobs and paychecks out of reach for too many Americans. Health care costs continue to skyrocket, dominating U.S. spending and eating up 17 percent of our economic activity. Growing rates of diabetes, asthma and other chronic diseases help fuel our health spending and lead to premature disability and death.
The latest indicator that we have been on a treacherous path? Census figures released last week show that a record number of Americans — 50.7 million of us — were uninsured last year. That's a drastic rise from the 46.3 million uninsured in 2008. A smaller percentage of the U.S. population had private insurance in 2009 than at any time since we've been keeping track.
People without insurance don't see a health care provider regularly. When they do get into an exam room, they often are in the later stages of the disease process that brought them there — when outcomes are more likely to be grim and costs are far greater.
Evidence shows that a lack of insurance not only results in worse health outcomes, it too often can be a death sentence. A study published in the American Journal of Public Health reveals that 45,000 U.S. deaths are attributable every year to a lack of health insurance.
But Thursday is the beginning of a new era, and we are already starting to see real change. The new law will guarantee millions of Americans access to quality, affordable care regardless of health status; decrease rates of the nation's leading chronic diseases; control soaring health spending; and strengthen our battered public health infrastructure.
All health plans after Thursday must allow children to remain on their parents' plans until age 26. Also, a ban on lifetime benefit limits as well as on excluding coverage to young people due to a pre-existing condition will take effect. These provisions join other lifesaving measures already in place, including key investments in prevention and wellness.
Specifically, the Prevention and Public Health Fund invests in proven strategies that prevent people from getting sick in the first place — and that save lives and money down the road. It funds community-based programs that help people who use tobacco (our nation's leading preventable cause of death) to quit and prevent others from starting. It supports initiatives to reduce diabetes and heart disease, strengthen breast and colon cancer screenings, and provide adult vaccine programs.
Being healthy starts long before you need a doctor, and achieving the best health starts in our homes, workplaces and schools. Thanks to this prevention fund, money is already at work in our communities, helping to transform neighborhoods and making it easier for us to choose healthy lifestyles. By helping communities become places where people can walk or bike to work, access public transportation safely and easily, and buy fresh fruits and vegetables locally, we are at a transformational moment in our social history. The result? We'll have healthier people in healthier communities, fewer doctor visits, a lower incidence of preventable diseases and, most importantly, a higher quality of life.
There is no question that preventing disease and promoting wellness have not been priorities in our nation's health system. Fortunately, health reform provides us the opportunity to reshape the way we care for ourselves by not only expanding access to health services but shifting away from our "sick care" system.
Health reform and its historic investment in prevention will help us achieve the promise we made to give our children a higher quality of life than we have. There are those in public life today who would seek to undo these historic reforms, or at least delay their implementation. But we can't delay, and we can't turn our backs on the tens of millions of people in this country who will live longer, healthier lives because of health reform.
Georges C. Benjamin is a physician, executive director of the American Public Health Association and former chief health officer for Maryland and the District of Columbia. His e-mail is firstname.lastname@example.org.