We will spend about 17.6 percent of our GDP on health care expenses this year in America, primarily because we are not healthy in some very key areas.
We have the highest rate of diabetes in the world. We have nearly the highest rate of heart disease.
Because we are hugely overweight and we are so collectively inactive that large numbers of us are almost inert.
One third of all the expenses of the Medicare program go to people who are diabetic. It is the fastest growing disease in America. If our rate of diabetes was only at the average level for every other western country, we would not be facing a governmental financial projection right now that Medicare will be broke within a decade.
This problem can be addressed. Chronic disease can be prevented or significantly delayed. Most cases of diabetes do not have to happen.
What can we do? It's actually very simple.
Walk -- and eat right.
That seems too simple to be true -- but if people who are pre-diabetic walk half an hour a day four days a week, the likelihood of becoming diabetic goes down by 40 percent. Losing 15 pounds (from any weight) and then walking that same amount of time can reduce the rate of new diabetics by almost 60 percent.
Sixty percent is a big number.
The opportunities are huge and the problem is huge.
Seventy-five percent of the costs of care in America come from chronic disease -- and the incidence of each of these diseases can be hugely reduced by physical activity and healthy eating.
So any overall health care reform agenda for America that by-passes that opportunity is a reform strategy with a major plan flaw and an even bigger tactical deficit.
Childhood obesity in this country is growing. We have the heaviest kids in the world. We bemoan that fact -- and then we sadly do very little to deal with it. We don't even have good and basic exercise programs in our schools or our communities.
This set of problems isn't a secret. These facts are widely known. We should be ashamed of ourselves as a nation for not simply recognizing the problem of obesity and inactivity and then beginning to address those issues.
It can be done.
Finland used to be the country with the worst health in the western world. The Finns were overweight and had the highest heart disease mortality rate in the world. The Finns decided to face that issue head on and create a national culture of health -- with better eating, better food, more physical activity and a generic sense on the part of the government, employees, unions, communities and cities that health should be a goal and a value.
The Finns, a decade later, are 20 percent below the European averages for both obesity and heart disease.
They created a Finnish culture of health.
An American Culture of Health
We need an America culture of health. We need our leaders in Washington to make health a priority -- and we need our schools, employers, unions, communities and community organizations to get on board with that health improvement agenda.
Diabetes is the number one cause of kidney failure, blindness and amputations in America. The personal consequences of diabetes ruin lives and shorten lives. We need better and more coordinated team-based care for diabetes -- so that we have half as many people in the kidney dialysis units. We also need a culture of health so that we have half as many people getting diabetes in the first place.
These are achievable goals. This is not an idealist dream. It is purely practical and tactical advice. What we are doing now is functionally bad for America. We can do better. Employees, government agencies, schools and unions in America should all embrace our nation doing what we need to do to create a culture of health.
We can make health care much more affordable in this country if we have half as many heart attacks and half as many strokes. We also need to help our people understand more clearly the real consequences of less healthy behaviors.
Fat Creates Dementia
Good research from the Kaiser Permanente database shows that people who have both high cholesterol levels and high levels of body fat in their mid 40's are more than twice as likely to have Alzheimer's in their 60's and 70's. Mid-life fat increases late life Alzheimer's and dementia by 360 percent. Dementia is another rapidly growing health problem for America. It turns out that excess weight and high cholesterol issues accelerate the risk of diabetes, heart disease, cancer, stroke and dementia.
That combination of facts should be widely shared -- and it should make people think very hard about how we can each be healthier.
The dementia data is chilling, all by itself.
Let's be honest.
It can be hard to do health improvement activities alone. We need to support each other in improving our collective health. The Finns have proven that health improvement is easier to do together... and that people can encourage, support and reinforce each other's healthy behaviors -- and the Finns have shown that is more likely to happen when a country is mutually and collectively committed to creating a culture of health.
Why is that relevant to health care reform?
Let's include actual health in our overall congressional agenda to reform health. We need to cover everyone. Then we need to make the care we need more affordable by reducing the amount of care we need.
That's an absolute win win outcome.
It's a two-track agenda -- both tracks should be tightly linked.
Let's cover everyone -- and then let's create a national culture of health so we can afford to cover everyone.