Ain't Nothing "Free" In Health Care, Mr. Pear...

Robert Pear has been writing about health care policy and politics for The New York Times for a couple decades, and is surely one of the most respected voices in mainstream media on the subject of health care and insurance reform.

But this article in last week's Times (http://www.nytimes.com/2010/07/15/health/policy/15health.html?th&emc=th)contains a real whopper...or at least, a cynical oversimplification of an important issue.

The article begins with a dramatic statement:"The White House today issued new rules requiring health insurance companies to provide free coverage for dozens of screenings, laboratory tests and other forms of preventive care."

What?...

The body of the article clarifies the issue somewhat: effective September 23rd, many health plans, both for groups and individuals, will be required to provide their customers with access to a pretty wide range of diagnostic and preventive services at no out-of-pocket cost; that is, not subject to deductibles and co-pays.

But that ain't "free."

Now, there are some pretty good policy reasons to impose such a condition on health plans. Americans in general use diagnostic and screening services at about half the rate of other countries. And since the introduction of high-deductible health plans, there has been ample evidence that patients in such plans avoid "non-emergency" services because of high deductibles, often at risk of their own health. And the earlier illnesses such as heart disease, cancer, and diabetes are diagnosed, the easier they are to be treated successfully.

Still, Mr. Pear's reporting reflects a dangerous half-truth: treatment which is not subjected to deductibles and co-pays is not "free;" instead of being paid for directly by the patient, the cost is covered indirectly through the health plan, which leads to higher overall premiums.

And, of course, should a screening lead to a diagnosis, treatment for the health condition will still be subject to deductibles and co-pays. So you might find out you have cancer based on a "free" test, but seeking treatment will remain expensive.

It's easy to beat up on insurance companies; sometimes it's even fun. But, as is the case with so many provisions of the new health insurance reform law, it's a disservice to consumers to trumpet the introduction of "free" services on the one hand, then express shock and dismay when insurance premiums continue to rise faster than inflation. This one ain't the insurers' fault; this one's on the politicians.