Heart disease: treat or prevent?

One of the greatest killers in the Western world is heart dis­ease. The death rate from the disease has been increasing at an alarming speed for the past thirty years. Today in Britain, for ex­ample, about four hundred people a day die of heart disease. Medi­cal experts know that people can reduce their chances of getting heart disease by exercising regularly, by not smoking, and by pay­ing attention to their diet, but Western health-care systems are still not paying enough attention to the prevention of the disease. There is an urgent need for more programs to educate the public about the causes and prevention of heart disease. Instead of financ­ing such programs, however, the U.S. health-care system is spend­ing enormous sums of money on the surgical treatment of the dis­ease after it develops.

This emphasis on treatment is clearly associated with the technological advances that have taken place in the past ten to fifteen years. In this time, modern technology has enabled doctors to develop new surgical techniques and procedures. Many opera­tions that were considered impossible or too risky a few years ago are now performed every day in U.S. hospitals. The result has been a massive increase in heart surgery.

Although there is no doubt that a large number of people ben­efit from heart surgery, critics of our health-care systems point out that the emphasis on the surgical treatment of the disease has three clear disadvantages. First, it attracts interest and financial resources away from the question of prevention. Second, it causes the costs of general hospital care to rise. After hospitals buy the expensive equipment that is necessary for modern heart surgery, they must try to recover the money they have spent. To do this, they raise costs for all their patients, not just those patients whose treatment requires the equipment. The third disadvantage is that doctors are encouraged to perform surgery – even on patients for whom an operation is unnecessary – because the equipment and surgical expertise is available. A federal government office recently concluded that major heart surgery was often performed even though its chances of success were low. In one type of heart surgery, for example, only 15 percent of patients benefited from the surgery. However, more than 100,000 of these operations are per­formed in the United States every year.

Main Idea Check

1. What is the meaning of this emphasis on treatment? Check pre­vious sentences.

2. What is the meaning of to do this?

a. to help people with heart disease

b. to buy new equip­ment for the treat­ment of heart disease

c. to get back the money that has been spent for equipment

3. Choose the sentence that best expresses the main idea of this passage:

a. People can reduce their chances of heart disease by exercising regularly, by not smoking, and by paying attention to good nutrition.

b. Modern technology is allowing doctors to perform new types of surgery on people who are suffering from heart disease.

c. In the West, especially in the United States, we tend to emphasize the surgical treatment of heart disease; this has a number of clear disadvantages.

4. Everyone is satisfied with the way Western health-care systems are attacking the problem of heart disease. T / F

5. Western health-care systems are spending too much money to edu­cate people about the causes of heart disease. T / F

6. According to the critics of the U.S. health-care system, where does more em­phasis need to be placed?

a. on preventing heart disease

b. on treating heart disease

c. on developing new surgical techniques for heart operations

d. on buying high-technology equipment for heart surgery

7. What is not true about heart surgery in the United States?

a. It helps some patients.

b. It is now being performed more often than in the past.

c. It keeps medical costs down.

8. What effect, or effects, is modern technology having on medicine?

a. It is a factor in the rising costs of medical treatment.

b. It has clearly helped save the lives of patients.

c. It makes some operations impossible.

What Do You Think?

You are a government official responsible for deciding where public money should be spent. You have $2 million to give to a project that will lower the death rate from heart disease. One project that wants the money is a program of re­search to develop an artificial human heart. The other project is a program to inform people about the connection between heart disease and the way they live. Which project do you decide to support? Justify your decision.

? VOCABULARY PRACTICE

Same or Different?

Writers sometimes express the same ideas in sentences with very different gram­mar and vocabulary. This exercise will help you identify such occurrences.

Read the two sentences in each example, and decide if they express the same ideas or different ideas. Choose S when the two sentences express the same idea; choose D when they express different ideas. Remember: You can express the same ideas with different words and different grammar!

1.

a. The patient is now recovering from her illness.

b. The patient is now getting better after her illness. S / D

2.

a. Experts believe that we can bring down the death rate from heart disease if we emphasize that exercise is very important.

b. By stressing the importance of exercise, according to experts, we can reduce the number of people who die of heart disease. S / D

3.

a. John is going to have major surgery on Monday.

b. John is going to perform major surgery on Monday. S / D

4.

a. Many people are realizing that high-technology equipment can also have disadvantages.

b. High-technology equipment can also have disadvantages. Many people are now becoming aware of this. S / D

5.

a. Instead of merely increasing the money that it is spending for hospitals, the government is also attempting to improve the nutri­tion of its people.

b. The government is not spending more money for hospitals. It is trying to provide better food for its people. S / D

6.

a. The enormously high costs of health care can be reduced if we stress the prevention of disease more than we do now.

b. We can bring down the extremely high costs of health care by putting greater emphasis on the prevention of disease. S / D

7.

a. Medical research has shown that stress, poor nutrition, smoking, and lack of exercise are all factors in heart disease.

b. According to medical research, there is a clear association be­tween heart disease and stress, poor dietary habits, cigarettes, and insufficient exercise. S / D

8.

a. After the operation, the patient's condition improved.

b. In spite of the operation, the patient did not recover. S / D

Making Connections

Each example in this exercise has a lead sentence and two sentences (a and b) that might or might not logically follow the lead sentence. Read the lead sen­tence, and ask yourself what kind of ideas you expect in the next sentence. Then read sentence a. Decide if it can follow the lead sentence and make good sense. Choose Y for "Yes" or N for "No." Do the same for sentence b. Can it follow the lead sentence and make good sense? Remember: Look for the ideas that make a logical connection between each pair of sen­tences.

This is also a vocabulary learning exercise. If you have problems with any new words, check their meaning as you work.

1. Medicine is again beginning to emphasize the prevention of disease.

a. For example, more and more doctors are stressing the impor­tance of exercise and good nutritional habits. Y / N

b. Experience with diseases like AIDS and many forms of cancer has clearly shown that we should not rely only on drugs and surgery to fight disease. Y / N

2. The new technology that is being introduced into hospitals has some major disadvantages.

a. It makes operations safer and increases the patient's chances for a successful recovery. Y / N

b. It forces hospitals to raise the cost of their services in order to recover the costs of the expensive new equipment. Y / N

3. Heart disease is clearly associated with the type of life that a person leads.

a. Modern technology allows doctors to perform surgery on pa­tients who are suffering from heart disease. Y / N

b. A poor diet, lack of exercise, and stress are all factors that play a role in the development of this disease. Y / N

4. In the United States, there has been an enormous increase in the number of people who are becoming members of health and sports clubs.

a. The increase indicates that more and more Americans are be­coming aware of the importance of regular exercise. Y / N

b. Most large U.S. companies have health-insurance plans that pay for any medical treatment their employees need. Y / N

5. Experts in health care believe that our health-care systems emphasize the treatment of disease too much.

a. There is an urgent need, they say, to stress disease prevention. Y / N

b. Merely reducing fat in people's diet, they claim, would reduce the death rate from heart disease more than all the heart surgery that is performed in the United States annually. Y / N

? VOCABULARY PRACTICE