WebMD Health - Healthy Seniors

Mar 4, 2011 2:54 PM

Medical Cost of Heart Disease

When we think of heart disease, we tend to imagine a sudden event: a heart attack. But usually, that's only a small part of the story.

In fact, most people recover after their first heart attack. That's the good news. The bad news is that a first heart attack is often the start of something new: life with heart disease. The risks aren't only medical. Heart disease could wipe out your family's finances and limit your ability to work.

Here's a rundown of the costs of heart disease -- along with some advice about how you can protect yourself.

The High Medical Costs of Heart Disease

In the U.S., all cardiovascular disease costs $273 billion each year, including heart conditions, stroke, peripheral artery disease, and high blood pressure. In fact, of all the money spent in the U.S. on health care, 17% goes toward treating cardiovascular disease, says Paul A. Heidenreich, MD, a cardiologist at the VA Palo Alto Health Care System in California and associate professor of medicine at Stanford University. Heart conditions such as heart failure, heart attack, bypasses, etc., account for nearly $96 billion of that total.

What are the costs per person? One study estimated that over the course of a person's lifetime, the cost of severe coronary artery disease -- the most common form of heart disease -- is more than $1 million. That includes both direct and indirect costs.

  • Direct medical costs. These can rack up quickly. After a heart attack, there are immediate charges: ambulance transportation, diagnostic tests, hospitalization, and possibly surgery and a pacemaker or implantable defibrillator. Long-term maintenance of heart disease is also expensive, including medications, testing, and cardiologist appointments.
  • Indirect costs. It's harder to grasp the indirect costs of heart disease, but they can be enormous. The biggest are lost productivity and income. Many people might be able to return to work a few months after having a heart attack. But even losing income for a few months can cause grave financial problems. Surveys show that most people would be only 90 days away from bankruptcy if they stopped getting paid. People with more severe disease may never able to return to work full time, or at all.

Those who don't have good health insurance, or no insurance, can be financially ruined by heart disease overnight. That can also be true for people who do have decent health insurance. The lost wages alone can be crippling.

Even if you don't develop heart disease, it's still costing you. "You're paying for cardiovascular disease whether you have it or not," Heidenreich says. "You're paying for it in your taxes and your health insurance premiums." He estimates that the average person in the U.S. is paying $878 per year for the societal costs of heart disease.

Why Are the Medical Costs of Heart Disease Rising?

Projections show that the direct costs of cardiovascular disease will triple in the next 20 years, rising to $818 billion.

The medical costs of heart disease are rising for several reasons. One is obvious: More people are developing it. In part, it's the result of an aging population and the increasing incidence of high blood pressure and obesity.

Another cause is less obvious: Treatment is better and saving more lives.

"In the old days, people used to die after a heart attack," says Matt Tassey, past chairman of the nonprofit Life and Health Insurance Foundation for Education (LIFE). "Nowadays, people are back to work in three to five months." More people who survive means more people who need ongoing treatment.

Protecting Yourself from the Medical Costs of Heart Disease

What can you do to protect yourself and your family from the financial costs of heart disease?

  • Look into cheaper medication. Is it difficult to afford the medication for managing your heart disease? Ask your doctor or pharmacist if there are generic substitutes that might work as well but cost less. Many drug companies also offer assistance programs that will get you discounted medication.
  • Check your health insurance policy. "The most important thing you can do to protect yourself is make sure that you have adequate health insurance," says Heidenreich. Learn exactly what your policy covers.

If you already have heart disease and don't have insurance, it will be difficult to get it on your own. Insurers may limit or refuse coverage for people with preexisting conditions. If you can get a group plan through an employer, you can probably still get coverage. There will likely be a waiting period before it takes effect.

The health care reform law will prevent insurers from declining coverage because of heart disease or other preexisting conditions. This will be enforced beginning in 2014.

  • Consider disability Insurance. If you're healthy now, getting disability insurance could be a smart idea. It will replace some of your lost income if you ever become disabled by heart disease or another condition and can't work. If you've already had a heart attack or heart disease diagnosis, getting disability insurance will be more difficult and cost more. Some policies could still be available, but they might exclude any health problems related to heart disease.

Preventing and Treating Heart Disease

One way that can help reduce your risk of heart disease -- and the suffering and medical costs -- is to improve your lifestyle. Even if you've already developed heart disease, it's not too late. Lifestyle changes can still have a big impact, Heidenreich says.

Try these 5 tips:

  • Get more physical activity. Regular exercise can improve blood pressure and cholesterol levels, control weight, and reduce your risk of heart disease. The American Heart Association recommends at least 150 minutes of moderate physical activity each week, which could be 30 minutes of moderate to vigorous physical activity -- such as brisk walking or biking -- five days of the week.
  • Improve your diet. Eat more foods from vegetable sources and fewer foods from animal sources, Heidenreich says. It's a simple way of decreasing the unhealthy fats in your diet. Practice moderation too. "It's not just what you eat, but how much," Heidenreich tells WebMD. No matter how healthy a food might be, eating too much of it will make you gain weight.
  • Eat less salt. Sodium directly contributes to high blood pressure, which in turn leads to cardiovascular disease. One 2010 study estimated that if everyone in the U.S. reduced the amount of salt they ate each day by teaspoon, it would prevent between 54,000 and 99,000 heart attacks each year.

Cutting out salt isn't easy. Start by gradually reducing the amount you add to food, Heidenreich says. Pay attention to sodium on nutritional labels too. Packaged or processed foods account for 75% to 80% of the salt we take in.

  • Reduce stress. Researchers aren't sure how chronic stress contributes to heart disease, but the two are linked. Do what you can to reduce tension in your life. Trying breathing exercises, meditation, or yoga to calm yourself.
  • Control other risk factors. If you have risk factors for heart disease -- like high blood pressure, high cholesterol, or diabetes -- work with your doctor to get them under control. If you smoke, you need to quit. "Stopping smoking is the most important way of reducing your risk of cardiovascular disease," Heidenreich says.

Of course, many of us have seen -- and ignored -- the suggestions for heart disease lifestyle changes before. Yet they really can make a difference. Heidenreich estimates that if everyone made some sensible lifestyle changes, the number of heart attacks in the U.S. would drop by 63% in the next 30 years.

To protect your health -- and protect your finances -- making changes to how you live can be a good idea. That $50 a month for a gym membership might seem a little pricey for your budget. Compared to the $1 million that a lifetime of treatment for coronary artery disease could cost, it's a good deal.