Wednesday, March 4, 2009

100 Billion Wasted Dollars?


This document courtesy of Julie Harabedian of FSB associates. To see my review of the book, The Great American Heart Hoax, click here.


100 Billion Dollars We Don't Need to Spend on Healthcare

By Michael Ozner, M.D., Author of The Great American Heart Hoax: Lifesaving Advice Your Doctor Should Tell You About Heart Disease Prevention (But Probably Never Will)


Cardiovascular care in America is spiraling out of control. We are now spending more than one hundred billion dollars a year for treatment and management of cardiovascular catastrophes (heart attack, stroke and diseases of the vascular system). This extraordinary amount of money is spent on victims of a disease that is largely preventable. The problems of cardiovascular care in America are draining our healthcare dollars and contributing to our financial collapse. In addition, I point out key areas of wasteful spending on expensive and risky diagnostic studies as well as procedures that are of no benefit to the millions of Americans who fall prey to the cardiovascular intervention industry. What may surprise you is what you believed to be the ultimate of cardiac care in this country is often unnecessary and dangerous. Examples of inappropriate cardiovascular care are summarized below:


Coronary angioplasty and stent insertion: While coronary angioplasty (the opening up of a blocked artery with a catheter device) and stent placement can be indicated and potentially lifesaving in acute coronary syndromes such as heart attacks, utilizing this technology in stable patients who have coronary blockages is inappropriate and has never been shown to reduce the risk of future heart attack or prolong life as compared to more conservative therapy (lifestyle changes and medications as indicated). Indeed balloon angioplasty and stent placement can often lead to an increase in cardiovascular morbidity and mortality compared to an intensive prevention approach. Despite this well-researched fact the cardiovascular intervention industry continues like a freight-train out of control. This year over one million stents will be inserted in patients across America and many of these procedures are clearly not indicated.


Heart bypass surgery (also called coronary artery bypass graft surgery): like catheter-based intervention, heart bypass surgery is clearly indicated in select unstable patients, however bypass surgery is over-utilized in the majority of patients with obstructive coronary artery disease. Major clinical trials have failed to show a benefit in clinical outcome in the vast majority of stable patients treated with bypass surgery.


CT-Scans: While CT scans are often necessary in unstable patients in the emergency room as a diagnostic modality, the proliferation of this technology to screen Americans for coronary artery disease is inappropriate and leads to a depletion of our valuable health care dollars. There is no evidence that subjecting yourself to a CT scan will lower your risk of having a heart attack or prolong your life. Most disturbing is the fact that these procedures subject unsuspecting men and women to excessive radiation exposure which stays with them for a lifetime and increases their risk of cancer. At the end of the day ask yourself the following question: do I need to pay a large sum of money and be bombarded with a significant dose of radiation just to be told to do what I should be doing anyway? Follow a healthy-lifestyle with optimal nutrition, regular exercise, stress management and smoking cessation.


Stress-nuclear studies: As with CT scans, stress nuclear studies are expensive and lead to significant amounts of radiation exposure via intravenous radioisotopes. These tests should be avoided in the stable population. If a stress test is recommended with imaging why not choose a stress-echo study which is less expensive than a stress-nuclear study and utilizes harmless sound waves to provide similar information?


Cardiac catheterization: Another expensive diagnostic tool that carries a multitude of significant risks. These risks are justified in unstable patients however this procedure should not be performed indiscriminately on stable individuals.


At this critical juncture, we have to decide what is best for the health and wealth of the citizens of this country. Will it be business as usual with indiscriminate utilization of diagnostic and interventional procedures that cost billions and don’t improve the overall health of Americans or do we want a health care system that is affordable and delivers preventive care that gives us the biggest bang for our buck? I think the answer is clear. The Great American Heart Hoax chronicles all that is wrong with our current health care system for cardiovascular treatment and it also delivers a concise, practical and clinically proven 10- step approach that can lead us to the promise land of affordable health care, fewer heart attacks and strokes and freedom from a misguided cardiovascular intervention industry that is sabotaging our financial and medical well-being.


Copyright © 2009 Michael Ozner, M.D., author of The Great American Heart Hoax: Lifesaving Advice Your Doctor Should Tell You About Heart Disease Prevention (But Probably Never Will)Author BioMichael Ozner, MD, FACC, FAHA, author of The Great American Heart Hoax: Lifesaving Advice Your Doctor Should Tell You About Heart Disease Prevention (But Probably Never Will), is one of America's leading advocates for heart disease prevention. Dr. Ozner is a board-certified cardiologist, a Fellow of the American College of Cardiology and of the American Heart Association, medical director of Wellness & Prevention at Baptist Health South Florida and a well-known regional and national speaker in the field of preventive cardiology. He is the medical director of the Cardiovascular Prevention Institute of South Florida and symposium director for "Cardiovascular Disease Prevention," an annual international meeting highlighting advances in preventive cardiology. He was the recipient of the 2008 American Heart Association Humanitarian Award. Dr. Ozner is also the author of the BenBella Books title The Miami Mediterranean Diet.
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Julie Harabedian
Publicist
Main line (908) 204-9340
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FSB Associates180 Mount Airy Road, Suite 205Basking Ridge, NJ 07920
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