Public Health

Most Americans are not getting recommended preventive care: why?

As of 2015, only 8 percent of US adults ages thirty-five and older had received all of the high-priority, appropriate clinical preventive services recommended for them. Nearly 5 percent of adults did not receive any such services.

This is from a recent Health Affairs paper by Borsky et al. (2018).

This is despite the Affordable Care Act making most preventive services free.  Just because preventive care does not cost insured patients any money, however, does not mean that getting preventive care is not costly.  Patient’s have other costs associated with receiving preventive care.  First, there is the time costs to get to the doctor in terms of arranging getting off of work, plus the  transportation costs to and from the doctor.  In addition, there is the mental cost of keeping track of all of the many preventive care items that are needed.

Further, you can think about going to the doctor like going to the mechanic.  You may go in for an oil change but the mechanic may find other mechanic issues that need fixing that you’ll have to pay for.  Similarly, you may go to the doctor’s for preventive care or screening.  However, if the screening find a problem, you will have to pay for the treatment.  Further, 28% of Americans are enrolled in high-deductible health plans.  Although preventive care is free, navigating the bureaucracy to figure out what exactly a health plan defines as preventive can be tricky and take time.

Thus, while preventive care may not have any direct cost to patients, there are significant costs that patients incur to receive these services.  These additional cost hurdles may need to be overcome if we are to increase the use of high-value preventive services among American adults.

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