Bush administration officials said Tuesday they have sent out tens of millions of guides to Medicare beneficiaries touting the plan’s pending coverage of some preventive health services.

They say they want to use the new payments, passed by Congress last year as part of the Medicare bill that also provided for prescription drug coverage starting in 2006, to help shift spending in the U.S. health care system from treatment to prevention.

The program, which pays most health costs for 40 million elderly and disabled Americans, is set to begin offering preventive services in January. The policy targets chronic diseases that cost the U.S. economy billions of dollars, including diabetes, heart disease, and osteoporosis.

Health and Human Services Secretary Tommy G. Thompson told reporters that 99 percent of all Medicare spending is on treatment for people who are already sick. Meanwhile, 70 percent of all U.S. health spending is on chronic diseases, which can be lessened in severity with early detection or sometimes prevented with good individual health choices.

“This has to change,” Thompson says. He added that he expects Medicare to “be the driver” in redirecting more of the nation’s $1.5 trillion in annual health spending toward prevention.

Medicare chief Mark B. McClellan, MD, declined to specify how much Medicare spending would shift to preventive counseling and tests after the policy is implemented.

The program is set to begin covering a range of services including blood tests to screen for high cholesterol and other signals of heart disease risk and fasting blood glucose tests to screen those at risk for diabetes.

Medicare is also scheduled to begin covering comprehensive physical exams for new beneficiaries in 2005. The program expects doctors providing the exams to offer patients counseling on weight control, smoking cessation, and other practices.

“People may fear the worst if they go in for these tests,” McClellan says. “The costs of not taking advantage of preventative medicine are higher than ever.”

By Todd Zwillich, reviewed by Brunilda Nazario, MD

SOURCES: Tommy G. Thompson, secretary of Health and Human Services. Mark B. McClellan, MD, administrator, Center for Medicare and Medicaid Services.