![Dr. Claudio Smuclovisky shows how the cardiac CT machine works at Holy Cross Health in Fort Lauderdale. Broward County will decide Tuesday whether to put on item on the November ballot that would create a new tax to pay for residents to get free medical tests that can detect heart disease. Dr. Claudio Smuclovisky shows how the cardiac CT machine works at Holy Cross Health in Fort Lauderdale. Broward County will decide Tuesday whether to put on item on the November ballot that would create a new tax to pay for residents to get free medical tests that can detect heart disease.](https://www.sun-sentinel.com/wp-content/uploads/migration/2022/01/24/OEGVZU566FEWFIOOJ3AERM6AXE.jpg?w=535)
I oppose the proposed Broward County sales tax increase to pay for routine cardiac CT angiograms among qualifying residents.
This proposal (which requires voter approval) lacks evidence-based medical support. According to American College of Cardiology guidelines, there is insufficient evidence to warrant cardiac CT angiograms for routine screening purposes in asymptomatic people.
The risks outweigh potential benefits. They include radiation exposure; unnecessary subsequent tests; unnecessary procedures (cardiac catheterization, coronary stenting, surgery); unnecessary patient worry; and excessive medical costs. Emphasis should be on proven preventative strategies: diet, exercise, smoking cessation, weight management, blood pressure, cholesterol and diabetes screening.
Currently, cardiac CT angiograms are indicated tests for select patients with chest pain or a known cardiac condition that warrants the test. Another indicated less-invasive CT called a coronary artery calcium (CAC) test may be appropriate for select at-risk patients. Both should only be conducted after consultation and coordination with trained medical professionals.
We certainly need ethically conducted clinical trials to determine whether widespread use of cardiac CT angiograms saves lives. There is no scientific basis for this approach. Research could prove that this approach makes sense. As a cardiologist, I certainly hope that the science continues to evolve to aid in better early cardiac disease detection and prevention. Cardiovascular disease remains one of the leading causes of morbidity and mortality in the U.S.
Although we applaud the Broward County leadership for taking on public health initiatives to reduce the burden of cardiovascular disease, there are more cost-effective ways to achieve this goal. Individuals should consult with their doctors regarding appropriate vs. inappropriate health screening tests.
Joshua M. Larned, M.D., Fellow, American College of Cardiology (FACC), Fort Lauderdale
Health care is already political
Howard Tescher’s letter vehemently opposing the 0.25% increase in county sales tax raises several questions.
When he says he doesn’t want politics in his health care, does he mean we should foot the bill individually for health care and end Medicare and Medicaid? Politics is inevitably part of the equation if health care is provided by the government. How much we should spend is another question.
He criticizes this almost miniscule tax increase as discriminatory against people under age 45. Isn’t his argument like that of someone who argues that school taxes discriminate against people with no children? Is the societal benefit of potentially better health care irrelevant?
Third, he employs the “slippery slope” argument to say that tax increases to pay for sickle cell and diabetes testing at taxpayer expense are next.
We have a problem with obesity, which threatens to inundate us with diabetes sufferers in the future, and might cost billions of tax dollars to treat. Perhaps Ozempic or Wegovy will one day become a simple and cheap solution to the problem, but for now, they are not in wide use. Diabetes, like heart disease, is expensive and difficult to treat.
There may be good reasons to not have a tax-funded heart testing system, but so far, they haven’t surfaced. I hope county commissioners will consult health care providers and heart specialists, ask if screenings make sense from a cost-benefit analysis, and heed their advice.
John Countryman, Plantation
Amendment 4 is needed
As many Southern states limited abortion access in 2023, Florida saw an increase in the number of abortions.
However, the Florida Supreme Court, with its five Ron DeSantis appointees, threatened the lives and bodily autonomy of millions of Southern women on April 1 by permitting a six-week abortion ban to replace Florida’s current 15-week ban.
Though the new ban takes effect May 1, Floridians will have an opportunity in November to void 15-week and six-week abortion bans by voting for Amendment 4, which would protect the right to an abortion prior to fetal viability or when it is deemed necessary to protect the patient’s health.
Eleanor Sobel, Hollywood
The writer is a former Democratic state senator.