The findings of the study can and should provide a blueprint for everyone — the public, the medical profession and government agencies — to achieve this vitally important money-saving and health-saving goal. But it is a goal that depends heavily on preserving a critical component of the Affordable Care Act: full coverage, without co-pays, for “an array of counseling and screening interventions relevant to tobacco use, diet, hypertension and exercise; statin preventive medication and aspirin preventive medication; depression; and cancer (breast, lung, colon, rectal, skin, cervix),” Drs. Koh and Parekh wrote.

Do people with pounds to shed for the sake of their health know that, under Obamacare, they are now covered for many sessions of weight-loss counseling? Or that diabetes prevention programs are being supported in many locations like YMCAs by the government’s Centers for Medicare and Medicaid Services?

“Everyone needs insurance to access health care services, that’s an essential part of health,” Dr. Koh, a professor of public health at Harvard’s T.H. Chan School of Public Health, told me. “And preventive services covered by the ACA are needed to give everyone the opportunity to achieve the highest attainable state of health,” a goal established by the World Health Organization.

“Dr. Murray’s study shows that too many people are not enjoying that opportunity,” Dr. Koh said. “It should be a call to action for the country. As a clinician who cared for patients for more than 30 years, I saw too much suffering and death that should have been prevented.”

For example, enormous progress has been made in curbing tobacco use in the last half-century. “Yet there are still 35 million adult smokers and more than half a million deaths from tobacco-related causes each year,” Dr. Koh said. “Lung cancer, 85 percent of which is preventable, remains the leading cause of cancer deaths. Why are we tolerating this?”

Dr. Murray pointed out that in the quarter-century covered by the study, smoking rates dropped by 60.5 percent in California, far greater than the 40.8 percent decline in smoking for the country as a whole, not to mention the meager 11.2 percent decline in West Virginia.

“There’s nothing to stop other states from mimicking what California has done,” he said.

Also needed is a greater commitment from the food industry to provide healthier foods and beverages that people can afford, along with easy access to such products for people in all parts of the country. There are far too many food deserts where wholesome foods like fresh fruits and vegetables at affordable prices are hard to come by.


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