Video 2 Transcript and Hyperlinks.
Please watch video number 1 first - the introduction to this series, if you haven’t done so yet. Thank you.
Coronary artery disease is the number 1 killer of adult Americans - regardless of gender, race and ethnicity. Unfortunately, there is not enough public awareness of this fact.
Unlike COVID-19, the media made us very aware how many people were dying from COVID-19 on an ongoing basis especially in 2020. At the peak of the COVID-19 pandemic, these photos had become ingrained in our mind. That is not the case with heart attacks.
In this second video, we will try to answer the question that you raised while watching video number 1.
Today is July 16 - day 16 of our Save Your Heart Campaign.
Since we started our campaign, 26,304 had suffered a first heart attack.
As part of raising awareness, we will keep an ongoing tally of first heart attack cases, starting from day 1 of the campaign.
The question we will try to find answers for is why the over 600,000 largely preventable first heart attacks every year since
- 1. We have the readily available $100 accurate noninvasive diagnostic test that doctors need in order to identify those with silent heart disease before they are stricken by a heart attack,
- 2. We have generic cost effective medications to stop disease progression and stop a heart attack before it happens, and
- 3. and we have a large volume of scientific data from multiple landmark clinical trials demonstrating that heart attack is definitely preventable.
Let us examine this slide.
On the left side are millions of Americans with silent plaque build up in their coronary arteries.
They don’t know they have silent heart disease. Their doctors don’t know either and do not prescribe the optimal medical therapy to stop their first heart attack from happening.
One by one, about 1,600 every day are suddenly sucked into this first heart attack faucet.
One the other side of the wall, different cardiac specialists get busy. That’s our current cardiovascular healthcare system - busy mopping the floor.
Wait… is the medical system so busy mopping the floor that someone forgot to turn off the faucet? Is that the case?
Or it is the insurance system telling the medical system - keep mopping the floor - more patients are coming - we will keep you busy mopping the floor. We are paying interventionalists to put stents, electrophysiologists to put defibrillators, heart surgeons to perform heart bypass and everything else you need - it is a lucrative deal.
But we are not paying for coronary calcium scoring test to detect coronary plaques earlier and identify those who are more likely to have a first heart attack and we are not paying preventive cardiologists to stop first heart attacks before it happens.
This is why the cardiovascular healthcare system is broken? Is this why our healthcare system is the most expensive in the world while only ranked #11 among richest industrialized nations.
In 2004, Dr. Michael Wolke, the president of the ACC, the largest professional organization of board certified cardiologists in the world, in the the President’s Page raised his concern with this title: The Promise of Prevention: So, Why Aren’t All Cardiologist?
He said many cardiologists have much invested in the interventional treatment of CV disease, yet the evolution of a more preventive approach is inevitable. It is not come painlessly…
That future time is here.
In 2015, another ACC president Dr. Kim Williams said: “It is time to turn off the faucet instead of mopping the floor.”
Before I proceed further, let us watch video clips from The Widowmaker.
[Show The Widowmaker documentary video clips.]
Is what you just watched illuminating? It was for me when I watched this documentary for the first time about 8 years ago.
The insurance system has significant control over doctors and hospitals since it decides what services to pay for and how much - and indirectly, one can say that the insurance system employs the medical system.
Device manufacturers - like those that make stents and pacemakers, will not manufacture their products unless they know that insurance companies will pay for them.
The same is true with drug manufacturers - they will not manufacture drugs unless they know the insurance companies will pay for them.
Doctors and hospitals do the same - they will not provide services that the insurance companies will not reimburse them for.
Look at this diagram and trace the sources of the healthcare funding. The money comes from the employers, federal government and from you, the policyholders.
The insurance system administers the fund and as a for profit company, foremost in the mind is increasing shareholder’s value, not saving lives.
This statement that you heard in the video clip explains a lot why there are over 600,000 largely preventable first heart attacks every year - “On the average, our policyholders only stay in our plan for 5 years. The cost savings benefits only goes to our competitors.”
Insurance companies clearly are not in the business of saving lives - just the business of making money.
This business decision of the insurance system - not preventing first heart attack because it only benefits competitors causes a lot more heart attacks - it leads to chronic illnesses that could have been prevented or delayed.
It keeps healthcare expenditures high but people are not healthier. It becomes a vicious cycle perpetuated by profit motive. More chronic illnesses - leads to more healthcare expenditures - which leads to higher and higher premiums. Yes, they see a profit in not preventing chronic illnesses.
Medicare is a victim of that business decision since the majority of heart attacks occur after age 65.
Medicare should have started paying for coronary calcium scoring at least 10 years ago when the ACC and AHA officially approved and recommended the test. The rest of the insurance system usually follows Medicare’s lead.
Medicare has the most to gain when Americans with still silent heart disease receive heart attack prevention medical treatment before age 65.
Not preventing heart attack is also a double whammy. Why? Because the same medical treatment that prevents heart attack also prevents stroke. Heart attack is the number 1 killer of adult Americans; stroke is number 3, after cancer.
So, what is the answer to the question we stated in the beginning of this video. Why the over 600,000 first heart attacks every year?
First - I think the insurance system is to blame. What do you think?
This insurance business thinking - the benefits of first heart attack prevention goes only to their competitors since policyholders only stay in their plan for 5 years - that needs to be challenged.
This type of thinking is false because the primary benefit goes to you, the policyholders - saves your life since 1 in 4 just drop dead without reaching the hospital, keeps you healthier, and after 65, Medicare benefits as well.
A simple solution is to level the playing field - require the insurance system - Medicare and all commercial insurance to pay for coronary calcium scoring. Presidents and astronauts get calcium scoring routinely - so you know it is an important and proven test. Saving their life is important. And for $100, isn’t your life worth saving too?
Second - The medical system carries some of the blame as well - for not heeding to the advice of the two previous presidents of the ACC - Dr. Michael Wolke and Dr. Kim Williams.
The healthcare system is broken and can’t stay broken indefinitely - to fix it presents an overwhelming challenge
but it is not impossible.
We need to start somewhere and that somewhere could be the cardiovascular sector of the healthcare economy because it is ripe for innovative disruption.
Preventing 1 million first heart attacks in just 5 years is possible. We have everything we need except the right policies. Let us begin to turn off the faucet instead of just mopping the floor. That’s innovative disruption.
Let us have a forum discussion at the www.HeartAttackPreventionChannel.com.
The next video is about what happens to communities without access to resources to turn off the faucet and there are no cardiac specialists to mop the floor. Do you live in such a community? Join us next time.
I will leave you with another story from the Widowmaker being shared by Otto Bos’ son Danie that their story does not become your story.
[Show video clip from the Widowmaker documentary.]
The Save Your Heart Campaign does not want you to have the same story.
Our goal is to help you stop your heart attack before it happens and knowing your calcium score is the first step.
If you are 45 and older and have at least one of the above risk factors - more so the older you are and the more risk factors you have, get a coronary calcium scan and know your calcium score.
Don’t settle for the crude guesstimation method called 10 - year ASCVD Risk Estimator - it is free and it is just guessing. Frankly, it should be called cardiac palmistry.
This method can’t answer two basic questions that you want answered before you start to take long term medications that you may not even need if your calcium score is zero.
The first question is: Do I have coronary plaques or not? The second question is: If I have plaques, how much plaques do I have?
So know your calcium score and don’t settle for less.
Here is your prevention dial - the next step. You can decide how much prevention you want - from the minimum to the maximum possible. While 100% is not possible, you can get as close to it as science will allow with the help of an experienced preventive cardiologist.