Healthier from health reform?

Does expanding health coverage actuall improve people’s health?

This is not as obvious an answer as you might think. Frankly, health reform is more about improving our economic health, rather than their personal health. Health care and coverage often comes after people are sick… it ensures that people get care but also that they don’t fall into medical debt or bankruptcy for seeking such care. The focus of H.R.3200 and other health reform proposals is to provide economic security to families.

That said, the Wall Street Journal Health Blog had a revealing post a few weeks ago that does give a few concrete examples of how these health reforms can actually help our health. They interviewed John Auerbach, the commissioner of Massachusetts’s Department of Public Health. He gave a few indicators he’s watching.

In particular, he cites three pieces of data as short-term indicators:

1) Smoking rates: In the first year of the effort that started in 2006 to get all residents insured, there was a surge in people covered by Medicaid, which pays for smoking cessation patches and counseling. Some 11% of smokers on Medicaid choose to take advantage of cessation tools that year. In 2007, Massachusetts saw an 8% drop in adult smokers, its largest dip in 10 years. In addition to having the patches paid for, Auerbach believes that a number of recently insured adults received a physical in that year and discussed smoking cessation with their docs.

2) Colonoscopies: There was a statistically significant increase in age-appropriate colonscopies in the state. “If you’re uninsured, you’re not going to get a colonscopy,” Auerbach said.

3) Flu vaccines: The percentage of adults who received a flu vaccine increased above and beyond the increases the state had been seeing in recent years. The largest percentage of vaccines are given in private doctors’ offices, so it makes sense that if more people are going to their primary care docs, the more likely they would be to receive a flu shot, according to Auerbach.

I have a sense there are many more health benefits to health reform–on top of the economic benefits–especially as time goes on. (And the two are intertwined–in people have less economic anxiety, and are not driven into poverty because of medical costs, that will have health benefits as well.) But those are good initial indicators about why this effort is so important.

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