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Taking a Bite Out of Health Care Costs

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As Congress debates how to pay for national health care reform, here in California we are showing there are ways to make coverage both universal and affordable.

In San Francisco, we are finding that one of the most effective reforms, and the most affordable by far, is simply using the purchasing and persuasive power of our city to promote the kind of healthy habits that keep residents away from costly medical interventions and prevent chronic diseases.

Many readers already know that the only existing "public option" in America is the Healthy San Francisco program that has already covered 72% of the previously uninsured residents at a dramatically lower cost than private insurance. The data is in -- and the results show that a public option like Healthy San Francisco is more affordable than private insurance.

But in San Francisco we are going far beyond the notion of health care as just a way of treating sickness. We are saving money, and ultimately improving lives, by focusing as much of our attention on how to keep people well as we do on how to treat their illness.

We are implementing cost-effective reforms that will lower the cost of health care, while raising the level of good health, through a series of common sense programs like easier access to fresh and nutritious foods, preventative health care counseling, immunizations and promoting basic exercise. Study after study reach the same conclusion: keeping people healthy saves billions and billions in health care costs. No city in America is doing more to address that simple truth by investing in wellness, from the foods we eat to the simple steps we can take like walking a little more each day.

Last week we took a big step forward when we announced the first-ever comprehensive municipal food policy that encourages San Franciscans to eat healthy, local food. It's a simple goal that can have profound consequences on public health for our city and can bring about dramatic cost savings that are associated with healthier diets.

There was a certain amount of nay saying about our efforts to promote healthy foods. But there was resistance as well when we were the first city in America to ban smoking in the workplace two decades ago and during the numerous other health "firsts" that have made San Francisco a leader in American health policy.

Our Urban-Rural Roundtable just released its final recommendations (PDF) on how San Francisco can create a vibrant regional food production system that supports local growers, promotes local health and as an important added benefit, creates local jobs.

A separate study released last week quantifies a disturbing trend: unhealthy diets cost California upwards of $41 billion a year in health care expenses and loss of productivity. If we don't take proactive steps to reduce this trend, the costs of preventable diseases like Diabetes will skyrocket to almost $53 billion a year by 2011 in this state alone.

In San Francisco, we are trying to prevent this terrible drain on our economy by focusing on healthy lifestyles. In 2006, we launched Shape Up San Francisco, to encourage city residents to be physically active within the constructs of their daily lives. We have built a partnership with Kaiser Permanente, the San Francisco Chamber of Commerce, and other important stakeholders to develop policy, programs, and research efforts to promote active living. Just 30 minutes of moderate physical activity three days a week reduces the chances of developing Type 2 Diabetes, alleviates stress, and helps prevent heart disease. And the participation of local business underlies the important lesson that healthier residents help promote a stronger economy, because businesses lose fewer days to sick time and employees are more productive.

Beyond incorporating exercise into their daily lives, San Franciscans have a demonstrated desire to eat healthier as well. To this end, we installed salad bars full of locally grown produce in more than two-dozen public schools around the City. I've seen it with my own eyes -- elementary schoolers excited about eating broccoli! We are working to promote more farmers' markets beyond our internationally famous Ferry Building. And we're requiring that city departments and agencies leverage our municipal purchasing power to encourage the consumption of fresh produce and nutritious alternatives whenever possible.

San Francisco is both a city and a county, with a municipal budget larger than many states. We are using our tremendous purchasing power to build up the market for healthy foods, to make them just as affordable as unhealthy options. We hope other local and state governments follow our lead, just as they have adopted our bold policies on banning plastic bags, or reducing the use of bottled water, or promoting local solar use.

Eating food grown within a 200-mile food shed makes our environment healthier by minimizing the carbon footprint of the meals we eat and makes us healthier because residents are more likely to consume better tasting, fresher options. It also keeps food dollars in the regional economy, a major boon to local farmers. It's a win for everyone involved.

California can no longer afford billions and billions of dollars in health care for Type 2 Diabetes, heart disease, and other medical ailments associated with unhealthy diets and inactive lifestyles. Particularly not when there's a way to transition towards a food policy that encourages locally grown, sustainable, nutritious alternatives at no greater cost. We have an abiding belief in my city in the value of preventative health care, as demonstrated by our landmark Healthy San Francisco program. Healthy eating is a critical component of all-around well being, and I'm proud we're taking the first important steps on this critical public health challenge.

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