The Hartford Courant ran a great article today that featured a MDs take on smoking cessation and quitting smoking. Here’s an excerpt: 

As the nation starts to examine how to reform our gadget-laden, overpriced health delivery system, we can find a prime example of what is wrong with American health care in a subject that is given much lip service but very little substantive action: tobacco addiction.

In my busy family practice office, I see the whole spectrum of tobacco-related disease. The middle- aged man with lung cancer; the recent retiree with worsening emphysema wheeling her oxygen tank down the hall; and the 13-year-old, trying to walk with bravado, who reeks of cigarette smoke.

The cycle of young experimentation, addiction and disease is laid out in front of me day after day, year after year, generation after generation. Having taken care of more than my share of dying smokers, I am always urging patients to quit smoking.

Cigarette addiction kills more than 400,000 Americans a year and is the single most preventable cause of disease and death of our patients.

Quitting smoking is certainly still not an easy thing, but I know that helping patients to stop smoking is the single most powerful, effective medical intervention that a physician can make anywhere in medicine.

Yet it is with smoking cessation that the flaws in our health care system are so starkly demonstrated. Patients already sick with cancer, emphysema or heart disease are supported by our system, which will pay hundreds of thousands of dollars to treat them. When it comes to helping someone quit smoking before they become ill, many of our private insurers and both Medicaid and Medicare refuse.

Medicare will not pay for a visit to help a patient quit smoking unless the person is already sick. A smoking cessation visit is labeled "medically unnecessary."

Saving a couple hundred dollars today will cost us tens of thousands in the not-too-distant future. This is absurd.

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