Health insurance linked to preventive care consumption


Americans with health insurance are more apt to get preventive care to cut their risk of illness, but having insurance doesn't mean people will indulge in risky behaviors since they don't have to pay as much to treat ensuing health problems, according to a recent study published in the Journal of the American Board of Family Medicine.

These conclusions debunk an old economic theory that having insurance creates an "ex ante moral hazard," which means here that coverage prompts people to play roulette with their health through habits such as smoking, as they ask themselves: Why refuse unhealthy pleasures to avoid illness that medicine can cure later with insurance picking up the tab?

Researchers compared data on more than 96,000 respondents in the Medical Expenditure Panel Survey, a source of information on healthcare costs and uses. The study focused on adults who entered the survey between 2000 and 2008, participated for two years and carried insurance at least once during their two-year participation period, according to the University of California Davis Health System. 

The team studied behaviors including smoking, weight gain and seat belt avoidance. They also focused on preventive services including flu shots, colorectal cancer screenings, mammography, pap smears and prostate-specific antigen testing. 

The findings: Changes in health insurance status were linked to preventive care consumption, which rose with coverage and fell without it. But gain or loss of health insurance had no significant connection to changes in health habits.

Despite coverage expansion under healthcare reform, 30 million Americans are likely to remain uninsured and therefore fail to receive recommended preventive health screenings. For instance, people who are exempt from the individual mandate and low-income legal immigrants will fall through preventive care coverage cracks, FierceHealthPayer previously reported.

And insured Americans who receive preventive screenings continue to be charged for them erroneously since some provider offices aren't well informed about what is and isn't billable.

For more:
- see the study abstract
- read the UC Davis Health System announcement

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