For many uninsured Americans looking forward to the opportunity of no cost health care, ObamaCare offers them a land of opportunity. The premise of free or low cost subsidized health care as a way to reduce the overall cost of medical care in this country is rooted in fantasy. Access to health care does not equal healthy Americans. In fact, one could argue just the opposite. Too much low cost access removes a sense of urgency in making lifestyle decisions and gives folks a way to take the easy way out.
The most effective way to be healthy is to live a healthy lifestyle.We know we can cut our risk of diabetes, heart disease, stroke and cancer by 80% if we practice healthy lifestyles. This NEJM study released yesterday, Post-Myocardial Infarction Free Rx Event and Economic Evaluation (MI FREEE), offered free heart medications to heart attack survivors. Led by Dr. Niteesh Choudhry of Brigham and Women's, the results were presented to the Florida American Heart Association meeting on Monday, November 14th, 2011.
Some people can't afford heart medications. For those smokers out there, we know that quitting smoking after heart attack is better than any pill. However, even for the economically fives pack a day smoker, it turns out even free medications are not enough to entice people to take their heart medications.
Only 10% of these post heart attack patients in the study continued to fill all their scripts at the end of one year, a study which had difficulty filling patients. This data suggests that giving free beta-blocker, statin, ACEi and ARB to post heart attack victims is simply not enough to entice patients to take their medications.
So, what does that mean for ObamaCare? It means catastrophic failure in their rosy predictions of cost control with universal access. If we insure everyone, we will simply be asking hard working Americans to pay their hard earned tax dollars to subsidize insurance companies for people who won't take care of themselves, even when given the opportunity for free heart medications after heart attack.
It makes me wonder why I spend so much time on discharge medication reconciliation when heart failure 30 day readmission can't be prevented without Medicare medication cops in every kitchen and bathroom. Perhaps Obama could fix that with an executive order addending the Patriot Act.



