Preventive Medicine and Health Insurance

Allen G. Brailey Jr, MD
JAMA. 1980;243(14):1423. doi:10.1001/jama.1980.03300400013016.
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To the Editor.—  In his excellent article, "A Positive Strategy for the Nation's Health," Lester Breslow, MD, MPH (242:2093, 1979), observes: "While many excellent physicians provide such services to their patients, the usual present methods of payment for medical services do not favor prevention. In fact, they often preclude it. That statement applies to governmental medical care, to plans sponsored by physicians and hospitals, and to private insurance." He concludes, in part, that a positive strategy for the nation's health should include "arrangements for medical service and methods of payment that favor prevention and health maintenance."I believe that Americans will be better motivated to adopt healthful habits when private health insurance rates are structured according to health risk factors, so that the fewer risk behaviors (smoking and overeating) a person has, the lower will be his health insurance premium. This has been done effectively with life insurance for nonsmokers


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