Tuesday, February 28, 2006

Rising cost of cardiac healthcare

The latest issue of the European Heart Journal carried a study by the Health Economic unit of Oxford University on the cost of cardiac care in Europe in general and UK in particular. In 2003, the European Union spend 169 billion Euros on cardiac care (about about 230 euros for every man, woman or child). This is alot. Cardiovascular disease and stroke accounted for two thirds of the Cardiovascular death and 47% of the health budget.

CVD (Cardiovascuar disease) acounted for 268.5 million working days loss with 1:100 european is hamper by CVD. 17% of UK's healthcare budget is spend on CVD.

These are very telling numbers. Unfortunately we do not have our own numbers, but we can make a few succinct observations.

Obviously, people wish to live longer, whether it is Europe, UK or Malaysia. The public must know that to live longer and better costs money. The government may not be able to pay for everything all the time. We all know that no government who hopes to be democratically elected will ever say such things. The cardiac cost to the national budget is just too high, if you want the best, the "rakyat" may have to pay something. The Malaysian National Health Insurance Scheme is so long in coming, that one wonders whether it will come during our life-time.

That the best and most cost efficient thing to do is for the government to go full steam ahead with cardiac preventive programs. We could start with a no added salt diet campaign. There could also be a label all junk food campaign, so that the calorie, fat and salt content is fully declared. Also there should be a low sugar campaign, for example reducing the amount of sugar in carbonated drinks, in an attempt to reduce obesity. Reducing the incidence of hypertension, obesity and diabetes, will reduce coronary artery disease. Of course, as with all legislation, enforcement is important, so that campaigns can bear fruit.

All males above 40 and all females above 50 should go for a cardiac checkup, including a stress ECG, paid by the company, by Socso, or by EPF. This strategy will allow us to detect cardiovascular disease early. Test early, test often. This way we catch it when treatment is easier and usually less costly.

Of course we all want to live longer and better. But to expect this to cost almost nothing is unrealistic. Prevention is better than cure, and much cheaper too.

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