Health policy and outlook.

Health policy has great influence on the daily work of every cardiologist. The influence of progress of practical cardiology on health policy in our country on the one hand and the influence of health policy on cardiology on the other hand are discussed, In the 1970s cardiac rehabilitation in special rehabilitation clinics was developed as a consequence of the usual therapy at that time with longer periods of bedrest and late invasive diagnostic procedures. Patients got a right on rehabilitation by law. However, in the 1980s the increasing number of rehabilitation clinics in our country and their budgets caused the first controversial discussion on health policy in our society, which was primarily thought to be a scientific one. At that time one of the first guidelines of the Commission of Clinical Cardiology as to coronary dilatation demanded in necessity of immediate cardiac surgery. To get more influence on the ongoing discussion the group of chief clinical cardiologists founded their own working group which had later on considerable influence on policy and scientific work of our society. Overall, the awareness of the need for active health policy was developed relatively late. For instance, the register of nationwide heart catheterization procedures was started in the early 1980s but was not used to influence health policies, for establishment of new catheterization facilities. At present, the development of cardiology is limited by budget and total number of cardiac operations is reduced, so it is time to remember the highly effective conservative "soft" therapy of atherosclerosis with a combination of drugs and changing lifestyle which is well evaluated in prospective studies. It is time to apply and reevaluate the chances of primary and secondary prevention of atherosclerosis and heart insufficiency. New non-invasive techniques as MRT and PET and therapeutic techniques as genetic or stem cell therapy will influence cost and health policy in the near future.