Clinical Preventive Services and Advocacy Letter
1 Clinical Preventive Services
There are a number of reasons why clinical preventive services like lung cancer screening, breastfeeding support, and skin cancer prevention counseling should be covered by health insurance plans. First, these services can save lives. For instance, early detection of lung cancer through screening can dramatically improve survival rates (National Lung Screening Trial Research Team, 2011). Similarly, skin cancer is one of the most preventable types of cancer, and yet it continues to be a leading cause of cancer death in the United States. Second, these services can save money in the long run. Third, these services improve the quality of life for patients: patients who receive breast cancer screenings often report feeling more empowered and in control of their health; patients who catch lung cancer in time are spared a worse fate down the road; and the same goes for skin cancer. In short, these services are important, and should be equitable and accessible to all patients regardless of income or social status. All Americans should have access to these lifesaving preventive measures.
Lung Cancer Screening
It is important to note that, with early detection, patients have a higher survival rate and subsequently require less intensive and expensive treatments. Furthermore, research suggests that for every dollar spent on screening, three dollars are saved in treatment costs (Erb-Downward et al., 2011). When these cost savings are taken into account, lung cancer screening becomes a more cost-effective proposition for insurance companies. In addition to reducing treatment costs, early detection also has the potential to improve population health by reducing mortality rates from lung cancer. Consequently, insurance companies and policy-makers should consider the potential value of lung cancer screening when making decisions about coverage and funding.
The science behind lung cancer screening is well-established. Although there is some debate about the ideal screening strategy, the general consensus is that low-dose computed tomography (CT) scanning can significantly reduce mortality from the disease (National Lung Screening Trial Research Team, 2011). A recent study found that, when compared to no screening, CT screening resulted in a net savings of $333 per person (Erb-Downward et al., 2011). This is due in part to the fact that early detection of lung cancer can lead to less invasive and less expensive treatment options (Pyenson et al., 2012). Thus, both the scientific evidence and the economic data support the use of CT screening for lung cancer. Although there are other important issues to consider when making policy decisions related to health care, these data suggest that insurance companies should be required to cover CT scans for lung cancer screening.
Breastfeeding: Primary Care Interventions
Providing accurate information about the benefits and challenges of breastfeeding, as well as practical advice on how to establish and maintain a good milk supply, can make a significant difference in whether or not mothers are able to successfully breastfeed their infants. In addition, insurance companies may be willing to provide financial incentives to healthcare providers who offer breastfeeding instruction to their patients, as this intervention has the potential to decrease healthcare costs in the long run. For instance, there is evidence indicating that breastfeeding mothers are less likely to suffer from post-partum depression (Borra et al., 2015). By working together, healthcare providers and insurance companies can help to improve population health and reduce healthcare costs.
Suffice to say, breastfeeding is a low-cost, yet highly effective, primary care intervention that is grounded in science. Numerous studies have shown that breastfeeding helps to reduce the risk of certain chronic diseases, including obesity, Type 2 diabetes, and cardiovascular disease (Horta et al., 2015). In addition, breastfeeding has been shown to boost cognitive development and increase IQ scores; moreover, it has been linked to lower rates of Sudden Infant Death Syndrome (SIDS) (Stuebe, 2009). These health benefits are well-documented in the medical literature and provide strong evidence for insurance coverage of breastfeeding services. Insurance coverage would ensure that all women have access to these life-saving services, regardless of their socio-economic status. In addition, it would help to offset the costs associated with breastfeeding, making it more affordable for families. Ultimately, insurance coverage of breastfeeding services is critical for ensuring that...
…change tends to be.2
Letter to Legislator
Dear Senator Rand Paul
As a doctor, you know the importance of effective health care policy in helping to prevent the spread of disease.
As your constituent, I am writing to urge you to support coverage of three clinical preventive services for women: lung cancer screening, breastfeeding as a primary care intervention, and skin cancer prevention via behavioral counseling.
Lung cancer is the leading cause of cancer death and has taken the lives of thousands of women in the United States each year. Early detection is critical. Additionally, breastfeeding has been shown to reduce the risk of numerous chronic diseases in both mothers and children, and is an effective intervention for diabetes. Skin cancer is the most common cancer in the United States, and behavioral counseling has been shown to be effective in reducing risk factors for skin cancer.
These services are all important. They can help to improve the health of women throughout the US. And they can prevent a great deal of expensive care down the road.
I hope that you will consider my request and support coverage of these three important clinical preventive services for women. Thank you for your time and consideration.
Sincerely,
Question/Answer
Rand Paul
167 Russell Senate Office Building
Washington DC, 20510
I chose Rand Paul because he is a doctor who cares about public health. I believe he can have great impact on what I am advocating for because he is a strong advocate of health and enjoys promoting services that are sound.
When it comes to advocating for clinical preventive services, a multi-pronged approach is often most effective. For example, the letter I sent could work in conjunction with other efforts such as social media campaigns, op-eds in local publications, and meetings with key decision-makers. Each of these advocacy options can help to raise awareness about the importance of coverage for clinical preventive services. And when combined, they can create a powerful call to action that is hard to ignore. Of course, there is no one-size-fits-all solution when it comes to advocacy. But by taking a broad and inclusive approach, you can increase the chances of…
References
Borra, C., Iacovou, M., & Sevilla, A. (2015). New evidence on breastfeeding andpostpartum depression: the importance of understanding women’s intentions. Maternal and Child Health Journal, 19(4), 897-907.
Erb-Downward, J. R., Thompson, D. L., Han, M. K., Freeman, C. M., McCloskey, L.,Schmidt, L. A., ... & Huffnagle, G. B. (2011). Analysis of the lung microbiome in the “healthy” smoker and in COPD. PloS one, 6(2), e16384.
Horta, B. L., Loret de Mola, C., & Victora, C. G. (2015). Long?term consequences ofbreastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta?analysis. Acta paediatrica, 104, 30-37.
Hubbard, G., Kyle, R. G., Neal, R. D., Marmara, V., Wang, Z., & Dombrowski, S. U.
(2018). Promoting sunscreen use and skin self-examination to improve early detection and prevent skin cancer: quasi-experimental trial of an adolescent psycho-educational intervention. BMC Public Health, 18(1), 1-15.
National Lung Screening Trial Research Team. (2011). The national lung screening trial:overview and study design. Radiology, 258(1), 243.
Pyenson, B. S., Sander, M. S., Jiang, Y., Kahn, H., & Mulshine, J. L. (2012). An actuarialanalysis shows that offering lung cancer screening as an insurance benefit would save lives at relatively low cost. Health Affairs, 31(4), 770-779.
Stuebe, A. (2009). The risks of not breastfeeding for mothers and infants. Reviews inobstetrics and gynecology, 2(4), 222.
Watts, C. G., Cust, A. E., Menzies, S. W., Mann, G. J., & Morton, R. L. (2017). Cost-effectiveness of skin surveillance through a specialized clinic for patients at high risk of melanoma. Journal of Clinical Oncology, 35(1), 63-71.
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