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Siddhartha Konda
Professor Nunan
Writing 39C
4 March 2014
Government Intervention of Cardiovascular Disease Costs
Cardiovascular disease is a rapidly growing source of death in modern America and
causes the government to allocate larger portions of its annual budget in order to prevent or treat
the disease across the nation: “U.S medical expenditures are the highest in the world and rose
from 10% of the Gross Domestic Product in 1985 to 15% of Gross Domestic Product in 2008”
(Heidenreich 934). Since America is forced to spend an increasing amount of its budget on the
medical field, it has fewer available funds to spend in other areas of the economy, causing the
whole economy to depreciate: “In the US in 2006, the cost of CVD was estimated to be $ 368
billion (two-thirds of the overall in-hospital medical assistance cost); a 25% increase over the
next 25 years would result in CVD costs increasing to $ 550 billion” (Atella 3). Multiple
interventions have been proposed to mitigate this problem including aspirin by itself as well as
the polypill, a cost-effective pill “consisting of three antihypertensive drugs, a statin, and aspirin”
(Bautista 155). An alternative proposal to the polypill is the multidrug regimen, which is based
around the assumption that combination drugs like the polypill would not work and that a
regimen consisting of multiple drugs taken separately would work better (Gaziano 679).
Meanwhile, the American Heart Association (AHA) recommends that people use “lifestyle
management” and “cardiovascular disease (CVD) risk assessment” to avoid being afflicted with
cardiovascular disease (Campos-Outcalt 89). These three solutions would hypothetically be
imposed by the healthcare system while the government has another potential solution in mind.
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The government solution would be a combination of group efforts to prevent cardiovascular
disease: “One of the analyses evaluated by the WHO-CHOICE programme was a combination of
legislation, voluntary industry participation, and mass media to reduce salt consumption”
(Gaziano 141). The government does not want to induce an additional financial burden on the
economy in the form of direct healthcare costs, so its plan is to use legislation to reduce sugar
consumption and the power of the governmental organizations and clinical services in order to
lower cholesterol as well as decrease the risk of heart disease. The best option to effectively
mitigate the problem of cardiovascular disease in the United States is for the government to
impose laws and policies to make preventative methods and treatment procedures more costeffective at a state level in order to boost the economy because it is easier for the government to
implement changes in the economy rather than the healthcare system making people change their
behaviors.
One change that the government can implement is to reduce the amount of sugar intake
of the population of the U.S by placing an excise tax on sugar-sweetened beverages (SSBs). The
government has recently planned to put this tax into effect in California. If it is put into place,
“an excise tax on 12 ounce beverages with a pre-tax price of $1.00 would be expected to raise
the price of the beverage by 12% and result in a 9.5% to 12% reduction in consumption of these
beverages” (Mekonnen 2). In other words, the increase in price of beverages in California would
lead to fewer people buying and drinking beverages. This projected decrease in the consumption
of sugar-sweetened beverages such as sodas would cause the risk of cardiovascular diseases such
as coronary heart disease (CHD) to fall: “… those who consume one drink or more per day
double their risk of diabetes and raise their risk of CHD by 23% compared to those who
consumed one SSB drink or less per month” (Mekonnen 2). If people drank beverages less
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frequently, they would be better able to prevent cardiovascular disease as well as diabetes and
other diseases. The sequence of events can be clearly shown in this flow chart:
(Mekonnen). This method can not only be applied in California, but the entire U.S as well. Since
cardiovascular disease and death occur less often because of the excise tax, the economy benefits
from the cost-effectiveness of the tax. On one hand, a smaller projected proportion of the U.S
population being afflicted with cardiovascular disease means fewer funds from the national
budget can be allocated towards medical costs relating to cardiovascular treatment:
“[Researchers] used a national version of the CVD Policy Model to project the impact of a
national excise tax on SSB on health outcomes and costs among U.S. adults and found that such
a tax is projected to could prevent … 95,000 CHD events … while avoiding $17 billion in
medical cost from 2010–2020” (Mekonnen 4). This means that over the next decade, the excise
tax would save the government billions of dollars to use on other projects to help the economy.
On the other hand, the excise tax helps the government by bringing in extra funds to use as a
means to boost the economy. This tax is meant to be put into effect at a state level, so all the state
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governments within the U.S can implement it in order to mitigate the problem of cardiovascular
disease harming the economy.
The U.S government can also benefit the economy by preventing cardiovascular disease
across the nation through the US Preventive Health Services Task Force and its goals. The US
Preventive Health Services Task Force has a framework called Healthy People 2020 is meant to
improve the health of America by using preventive services on a variety of afflictions from
diabetes and stroke, to heart disease and tobacco use. It uses the recent passage of the Patient
Protection and Affordable Care Act (PPACA) to provide clinical services to people with health
insurance: “Among the CVD-related A or B services are aspirin counseling, blood pressure
screening, cholesterol screening, healthy diet counseling, obesity screening and counseling, and
tobacco cessation counseling” (Weintraub 967). These methods are effective when offered
throughout the U.S and executed at a state level. The A and B Services are the highest ranked
procedures as shown by this chart:
(Weintraub). By following these procedures, cardiovascular disease risk can be lowered and a
larger portion of the U.S budget can be retained to use towards other necessities of the nation and
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the economy. These preventive services were ranked well based on their impact on people’s
health as well as their cost-effectiveness by the National Commission on Prevention Priorities:
“The PPACA also strengthens the Community Guide, which addresses health improvement and
disease prevention at the community level by conducting systematic reviews to determine
effective program and policy interventions and grading the interventions” (Weintraub 967). The
Community Guide is the manner by which the U.S government controls and monitors the spread
of cardiovascular disease through review procedures. Another strategy that the US Preventive
Health Services Task Force can enforce through the PPACA is to reduce overall health spending
is by lowering the patient copayments for cardiovascular treatments: “Reducing patient
copayments for highly effective, evidence-based therapies has been proposed as a method of
stimulating greater adherence that may also reduce health spending” (Choudhry 1817). If
patients paid less for copayments, it would correlate to reduced health care resource use and
patient out-of-pocket spending (Choudhry 1817). This would result in an overall decline in
medical spending and increase the amount of money state budgets can spend in other areas as a
means to improve the overall economy.
The government can also reduce the burden of cardiovascular disease in the U.S is by
implementing a solution that was recently used in India through the Framework Convention on
Tobacco Control (FCTC): “Major FCTC provisions include smoke-free laws, brief cessation
advice by health care providers, mass media campaigns, a tobacco advertising ban, and increased
tobacco taxes” (Basu 2). These provisions by the FCTC were controlled and enacted by the
World Health Organization (WHO) which means that they can also be enacted in the U.S.
Although the U.S already has tobacco control laws in place, it should follow the standards in
place by the WHO in order to ensure that the provisions affect the cost-effectiveness of
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cardiovascular disease in a positive way. By reducing the use of tobacco in the country, fewer
people will be afflicted by cardiovascular disease and the economy will improve due to the extra
budget retained by the U.S government. This is because there is a positive correlation between
high tobacco use and high frequency of cardiovascular disease and that leads to more money
spent on treatment procedures.
Overall, having the government implement changes within the U.S is a better option for
mitigating the problem of cardiovascular disease rather than instituting drugs through the
healthcare system. This decision benefits the economy in a more cost-effective manner because it
prevents cardiovascular disease among the patients, saving them treatment procedure costs. As
less money is required in the area of medicine, larger portions of the federal budget can be put
into other areas to nurture and boost the economy. The goal of the government should be to put
money into preventive methods through organizations like the USPSTF so that treatment costs
can be saved and the surplus in the government budget can increase. As long as cardiovascular
disease costs remain high or continue increasing over the years, the government will have less
available funds each year to use to develop the nation and the economy will suffer as a result of
it. Cardiovascular disease costs will decrease if preventative measures are pushed through in the
form of taxes, organizations, and clinical services because treatment costs will be saved.
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Works Cited
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