Medical progress and rationing of cardiological services

Due to the financial restrictions imposed on all national health services, the problem of allocating medical resources has gained new economical and p olitical dimensions. Although each patient expects optimal treatment, the r ationing of medical services make it increasingly difficult to provide the most adequate therapy. Health politicians and medical doctors have all advocated that health expen ditures can be reduced by effective prevention of coronary heart disease, o ne of the main cost factors for all health services. Due to the introduction of statins, primary and secondary prevention of cor onary heart disease can now be accomplished effectively. However, such trea tment does not induce cost reduction, but rather an increase in costs. This applies predominantly to primary prevention. Treatment of all who would be nefit from lipid lowering by statins would be prohibitively expensive for a ll national health care systems.