A new report out this week shows many people will face higher out-of-pocket costs for prescriptions if they stick with what they’ve got.
A new report out this week shows many people will face higher out-of-pocket costs for prescriptions if they stick with what they’ve got. - 

Sarah Gardner: Congress is celebrating a rare "bipartisan agreement" to shore up Medicare for another year. But there's one group not celebrating -- public health folks.

That's because in order to pay for an extension on Medicare reimbursements to doctors, Congress cut programs aimed at helping us not need a doctor in the first place. They call it preventive care.

From the Marketplace Health Desk at WHYY in Philadelphia, Gregory Warner explains.

Gregory Warner: Here’s a short list of the stuff San Antonio did with federal prevention money. Maggie Thompson is with the city’s health department.

Maggie Thompson: Put in walking groups, farmer’s markets, initiatives in schools like salad bars.

Anti-smoking groups for teens, and in city parks in low-income neighborhoods, fitness classes and workout stations.

Thompson: Activities so that people can work out and not have to pay a gym membership.

And hopefully, save the country’s health care dollars by keeping themselves healthier.

There is now less federal money for those prevention programs. As part of a bipartisan agreement on Friday, Congress made a deal: Medicare will keep paying doctors at the same rates, to be sure doctors will still treat their elderly patients. To pay for it, lawmakers cut $6 billion out of the $15 billion Prevention Fund established by the health care law.

Rich Hamburg: What in essence are additional payments for medical care, using a fund that was supposed to save money and reduce the medical burden, doesn’t make any sense.

Rich Hamburg is with Trust for America’s Health. He says if you help people lose weight they’ll need less expensive care.

But economists like David Cutler at Harvard say its still not proven that prevention funding saves money.

David Cutler: One of the great questions in health care is does prevention save money or does it just save lives.

In the end, it didn’t matter. Prevention money was cut to avoid a steep drop in doctor’s pay.

As for the $9 billion left in the fund, Rich Hamburg worries about other hands reaching into the pot.

Hamburg: We could very well see another effort to use the remaining part of the fund for an offset for -- fill in the blank!

And in this economy, there are a lot of blanks to be filled.

In Philadelphia, I’m Gregory Warner for Marketplace.

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Follow Gregory Warner at @radiogrego