08/21/2010 09:32 pm ET | Updated Nov 17, 2011

The Real Health Care Reform Program

It's starting to happen.

Slowly, a growing number of voices from establishment medicine are beginning to sound a different -- and much overdue -- theme in their writings on the health care crisis.

They're starting to talk about -- wait for it -- prevention.

What's gotten lost in all the shouting in Congress about the costs of universal health care and the costs of revamping the existing (and quite broken) system, is this simple message: untold millions could be saved by keeping people out of the damn system in the first place.

About which, let me just say two words: Diabetes and Obesity.

Writing in the June 23 edition of the Wall Street Journal, Mark Sklar, MD, writes:

We have unparalleled levels of obesity in our country. If we could prevent even a small percentage of people from becoming obese and developing these conditions, the costs of health care could go down far enough to cover everyone's insurance.

Sklar recommends incentive programs to encourage healthy eating and exercise. First step: Ban vending machines and fast food from our schools. (Good luck with that one, but at least he's talking about it!)

"It's really stunning how the percentages for type 2 diabetes are going up in younger and younger Americans. Clearly, diabetes is following obesity, and both have huge ramifications on long-term health," says Siri Atma Greeley, a pediatric endocrinologist at the University of Chicago Medical Center.

"The health insurance system is just horrible for these kids as they age. They get kicked out of their cozy pediatric health care systems, knocked off their parents' health plans, then stop care and suffer the consequences," says Rebecca Lipton, associate professor in pediatric endocrinology at the University of Chicago. "We are already seeing some 20- and 25-year-old kids now on dialysis for kidney failure. It's chilling."

Indeed. And this might just be the perfect teaching moment. We're all learning (painfully) about what happens when you overspend, overcharge, take an "interest only" mortgage and hope for the best later on. Now it's time to apply those economic lessons to the way we eat and the way we live.

No one said it would be easy, but it's doable. Both diabetes and obesity can be largely prevented and their staggering costs -- physically and financially -- can be substantially reduced.


We need to do exactly what we're being forced to do with spending: Cut back.

It's really not that hard -- and even if it is, so what? We've lived under the illusion that we can have whatever we want and eat whatever we want and folks, it was a big, fat, ugly lie. We spent on our credit cards and worried about the bills later, even though most of what we pay is interest on a principle that never seems to decrease and we've been doing the exact same thing with our health.

And forgive me for ranting, but I'm tired of hearing about "deprivation" as if having to turn down a Krispy Kreme is in the same class as poverty, hunger, or living on $2 a day (which is what half the world does).

Get over it.

It's time for some tough love. You're not deprived if you can't eat all the chocolate and cake and crappy cereals and supersized fries and Olive Garden sized portions of pasta you want.

I don't call that deprived -- I call it smart.

You can start your own health care reform program right now by following these four simple rules:

• Take your desired weight, multiply by 10 and eat that number of calories a day. (You can add a couple hundred if you exercise at least ½ an hour on that same day). And no, you won't starve.

• Do something that gets your heart rate pumping for at least 30 minutes a day

• Take omega 3 fatty acids.

• Don't smoke.

That may not keep everyone alive out of the health care system, but it'll sure make a profound difference in the amount of time you spend there.

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