Covering more preventive services is the right Rx for our ailing system

Regarding Merrill Goozner’s Nov. 6 editorial, (“What’s behind America’s epic fail on diabetes care,” p. 42), he astutely asks, “In our fragmented insurance system, where people are constantly changing plans or aging into Medicare, why spend money today when the benefits will accrue to some other payer down the road?” He’s exactly right about the current system.

However, here’s an idea. We know that some preventive care is truly cost-effective if you look over a multiyear horizon. Although I’m not normally a fan of increased regulation, requiring all insurance companies to cover those preventive services that are known to be not only clinically effective, but also cost-effective over time would eliminate the impact of insurance churn. If Insurance Company A pays for cost-effective preventive care for Patient 1 who subsequently moves to Insurance Company B, it is just as likely that Patient 2 might switch from Company B to Company A, thereby balancing the economic scales. At that point, it becomes a market-share issue, introducing another element of competition where insurers that achieve the highest level of patient care and satisfaction come out ahead through enrollee retention.

Of course, paying for additional preventive services would result in short-term cost increases for the overall system, but the benefits should balance out if only those preventive services that are cost-effective over the long term are covered.

Glenn Pearson Principal Pearson Health Tech Insights Marietta, Ga.