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In a New York Times opinion piece, Dartmouth’s H. Gilbert Welch writes that since Obamacare is here to stay, it makes sense to focus on improving the program. One of its flaws, he writes, is that it favors screening over diagnosis, and thus could discourage people with symptoms from reporting them.

“While the distinction may seem arcane, it has real-world implications. Screening is what we offer to the well; it’s the effort to find abnormalities in those who do not have signs or symptoms of disease. Because screening is considered part of preventive care under the Affordable Care Act, it is provided at no charge,” writes Welch, a professor of medicine at The Dartmouth Institute for Health Policy & Clinical Practice.

“Diagnosis is what we offer to those who do have signs or symptoms of disease. Because diagnosis is not preventive care, it is subject to deductibles and co-payments.”

Read the full opinion piece, published 4/30/14 by The New York Times.