Dr John M

cardiac electrophysiologist, cyclist, learner

A simple, safe, inexpensive treatment: Let’s cut its funding…

By Filed Under: General Cardiology, Health Care, Health Care Reform

The new MacBook was scrolling fast but this headline grabbed the eyes…

“Self-discipline, perseverance needed for successful cardiac rehabilitation, cardiologist says.”

The story of cardiac rehab acts as a metaphor for the entire cardiac health quagmire.  Cardiac rehab following a stent, coronary bypass, or heart attack is indeed scientifically proven to improve outcomes. Problematically though, it requires self-motivation, self-discipline and perseverance form the patient.  Here lies an enormous hurdle.

Cardiac rehab teaches that good health is about balance.   There is education to the benefits of exercise, nutrition, stress reduction, but most importantly, the patient is immersed into a cocoon of health shared with their peers who struggle with the same issues.

For the past number of years the reimbursement for cardiac rehab is on the decline and thus, there are fewer patients doing it.  It is human labor and time intensive but from a global health care expense viewpoint is cheap. A building, air conditioning, personnel and exercise equipment comprise the main requirements.  Compare this capital investment to a modern OR suite or electrophysiology lab and cardiac rehab looks really cheap.
If the goal is to reduce health care expenditures by incentivizing healthy behaviors then it seems OBVIOUS to increase monies to programs like cardiac rehab.   The cynical could say, if there was more money in rehab the cardiologists would have rehab centers all over the place.  For sure, but while the cardiologist benefited, so would both the individual patient and society as a whole.
What if cardiac rehab was free but stents and surgery cost the patient more?  Not that much more, how about the same as a root canal?
Everyone agrees money is the ultimate motivator.  The wisdom of a former senior partner who told me, “whenever they say it is not about the money, it is always about the money,” comes to mind.   The solution is right there in plain sight:  increase funding to doctors and hospitals for programs like cardiac rehab and make it inexpensive to the patient.  The science supports this as does common sense.
We, society, the taxpayers, pay so much for the treatment of disease after the fact.  We should shift more emphasis (dollars) to prevention.  Really, we should.
Obviously.
JMM

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