ECONOMICS FROM THE HEART

Healthy human beings make a healthy society and every society has its share of unhealthy human beings. The promotion and protection of health of the people is important to sustain economics and social development. It should be a national objective to attain the highest possible standard of health, as good health is the basic foundation for the promotion of creativeness, self-discipline,self-confidence and dynamism in people, which are necessary to increase the productive capacity of the nation. In fact, Health is an important input in any process of development (Chaparwal et al 1999). Health is both an input and output linked with development and therefore, should not be viewed in isolation from the overall goals of development. Either directly or indirectly, individually or collectively, consciously or unconsciously, health is linked with all aspects of daily living.

In this context, Cardiovascular diseases form the major component of chronic diseases and therefore contribute most to the economic impact: these strike individuals in their productive ages, need high treatment costs and result in premature deaths. Thus, macroeconomic consequences of cardiovascular disease are mainly assessed through calculations of years of productive life lost due to deaths and disability from cardiovascular disease in a particular population group. In addition, direct costs of health care devoted to treatment are calculated, and in conjunction with life years lost, give an estimate of the economic burden of cardiovascular disease. The other indirect costs in terms of orphanhood, widowhood and other changes in household consumption patterns are equally important, albeit difficult to cost, and considered whenever possible, to get a complete picture on theeconomic impact of cardiovascular disease. Various estimates exist on the economic impact of cardiovascular diseases from around the world: the consensus seems to be that the increasing prevalence of cardiovascular disease is going to put a huge economic burden on a country, both in terms of medical costs of an increasing array of technologically advanced treatment, and productivity losses due to premature deaths and disability (Indrani Gupta et al., 2006).

Cardiovascular Diseases (CVDs) have now become the leading cause of mortality in India. A quarter of all mortality is attributable to CVD. Ischemic heart disease and stroke are the predominant causes and are responsible for >80% of CVD deaths. The Global

Burden of Disease study estimate of age-standardized CVD death rate of 272 per 100 000 population in India is higher than the global average of 235 per 100 000 population. Some aspects of the CVD epidemic in India are particular causes of concern, including its accelerated buildup, the early age of disease onset in the population, and the high case fatality rate. In India, the epidemiological transition from predominantly infectious disease conditions to Non Communicable Diseases (NCD) has occurred over a rather brief period of time. Premature mortality in terms of years of life lost because of CVD in India increased by 59%, from 23.2 million (1990) to 37 million (2010). Despite wide heterogeneity in the prevalence of cardiovascular risk factors across different regions, CVD has emerged as the leading cause of death in all parts of India, including poorer states and rural areas. The progression of the epidemic is characterized by the reversal of socioeconomic gradients; tobacco use and low fruit and vegetable intake have become more prevalent among those from lower socioeconomic backgrounds. In addition, individuals from lower socioeconomic backgrounds frequently do not receive optimal therapy, leading to poorer outcomes. Countering the widespread disease requires the development of strategies such as the formulation and effective implementation of evidence-based policy, reinforcement of health systems, and emphasis on prevention, early detection, and treatment with the use of both conventional and innovative techniques.

Since the past two decades, there has been a phenomenal surge in acceleration of healthcare costs. This has compelled individuals to have a look on their actual monthly expenditures, spending patterns and simultaneously allocate a proportion of their income towards personal healthcare. This has resulted in individuals availing healthcare insurance coverage not only for themselves but also for their family members including their dependents. In short, healthcare insurance provides a cushion against medical emergencies. The concept of insurance is closely concerned with security. Insurance acts as a shield against risks and unforeseen circumstances. In general, by and large, Indians are traditionally risk-averse rather than risk lovers by nature. The health insurance in the country presently covers only two per cent of the population. The share of health insurance in health financing accounts for a mere 1.2 per cent of the total expenditure on health. It is obvious that apart from the disease burden, Cardiovascular disease exerts a life long financial burden for treatment and also the recurring costs of ongoing laboratory investigations and hospitalizations also add to the financial burden of an individual. Thus

there is a need to prevent the complications of Cardiovascular Disease at the earliest not onlyto increase the life span but also to reduce the financial burden of the family and self.in this background, the present study examined the choice of healthcare services, the cost and source of treatment for the cardiovascular patients in Coimbatore. This study found that

Cardiovascular disease now the leading cause of death strikes Indians early and kills many in their productive mid-life years. In India, the projected death rates from cardiovascular disease are much higher than the death rate caused by communicable diseases like Human Immuno Virus/Acquired Immuno Deficiency Syndrome, Tuberculosis, and malaria. It is more likely to affect middle-aged adults than the elderly; it also affects both genders equally. The current research analyses the prevalence, causes, burden and the source of finance for treating the cardiovascular disease. The researchers synthesizes knowledge from various research studies and conducted their own survey in Coimbatore City.