At least 10 percent of health insurers‘ costs are attributable to smoking-related illnesses. Therefore, any form of treatment for tobacco dependence is not only extremely beneficial from a healthcare perspective, but is also economically advantageous. However, if a smoker does not want to give up cigarettes, even after several heart attacks, he should not receive fully funded healthcare, according to Professor Petr Neužil, head of the cardiology department at the Homolka Hospital. The economics of prevention were discussed at the Healthcare Daily’s conference by experts from the ranks of politicians, doctors, insurance company representatives and top athletes.
Despite preventive measures, cardiovascular diseases cause half of all deaths in the Czech Republic. Cardiovascular prevention therefore still has much room for improvement. „Total investment in the European Union in the treatment of cardiovascular diseases amounts to around EUR 210 billion per year. It is logical that we need to kick-start prevention,“ says Petr Neužil at the conference.
According to him, the big problem is the current perception of the lifestyle of young people. „The trend (modern, current, fashionable – editor’s note) for the population should be things like not smoking. People start smoking at an adolescent age with a classic cigarette, they don’t start with a substitute, which is a paradox,“ Neužil outlines, adding that the current „lifestyle“ for most is sitting at a computer rather than playing active sports.
According to Neužil, investing money in prevention and lifestyle changes must come proactively. „Although we have increased the life expectancy of the population, we have not increased our healthy life expectancy. We need to change our lifestyle and it is worth investing money in that,“ he appeals.
Although the Czech healthcare system is top-notch and accessible to almost everyone, experts say that the availability of prevention in the Czech Republic is somewhat lacking. In Sweden, for example, the average life expectancy is four years longer than in the Czech Republic, while in our country we spend an extra 5 years in illness. „This means that the Czech healthcare system treats and spends money on each of us for five years longer than in Sweden,“ Neužil explains, adding that compared to the Swedes, Czechs have twice the consumption of cigarettes and alcohol, and half the consumption of vegetables. The same levels of healthy population can then understandably be somewhat difficult to set.
On the other hand, Neužil appreciates the fact that younger people consume more healthy foods than previous generations of people currently in their fifties and sixties. Yet obesity numbers are still high. „Obesity is a tragedy. People are overeating, eating red meat and other nonsense,“ Neužil criticises, pointing out that even exercise, which is quite good for Czechs in international comparison, is not enough.
Smokers shorten their lives by up to 15 years
The finding that twenty percent of patients continue to smoke even after a serious heart condition such as a myocardial infarction is not very positive either. „Smoking is a phenomenon that everyone is able to control. Food is a nutritional need, but smoking is absolute nonsense,“ Neužil lists the negative aspects of inhaling smoke into the lungs. What’s more, second-hand smoking, to which people are exposed unwillingly, is also a major problem.
Will the insurance companies help?
The reduction of cholesterol in the blood also helps to reduce the risk of cardiovascular disease, which can also be achieved in modern medicine thanks to biological treatments. „We can talk about a significant shift in this treatment. Lowering LDL cholesterol by 1 mmol per litre significantly reduces the incidence of coronary events, by up to 25 percent, which is a fantastic figure. But if a person quits smoking, in a year’s time, their risk is as much as 35 per cent lower,“ he points out, adding that it costs significantly less to cut out cigarettes than biological treatments.
In the Czech Republic, 23 percent of the population over the age of 15 smokes, which is an estimated 2.2 million people. Those who gradually reduce their use of cigarettes will reduce their potential cardiovascular and cancer risk. I think that is the way to go,“ Neužil said of cigarette use, which causes 16,000 deaths in the Czech Republic every year.
In his presentation, Professor Neužil also pointed out that any form of treatment for tobacco dependence is not only extremely beneficial from a healthcare perspective, but is also economically advantageous. At least ten percent of health insurance costs are attributable to smoking-related diseases, he pointed out. All smokers should always be given education and offered help to quit smoking. According to Neužil, products with reduced or modified risk can then be introduced to those who are unable or unwilling to quit smoking.
Nela Slivková
Photo by Radek Čepelák
We would like to thank the General Health Insurance Company, National Sports Agency, RBP, Health Insurance Company of the Ministry of Interior of the Czech Republic, Military Health Insurance Company, EUC Medical Group and Sprinx for their support of the conference.
