Commentary: Health care reform requires attitude change for all

Until the mindset of America shifts dramatically, no health care reform bill will ever work.

What has undermined our current health care system isn't a question of private vs. universal coverage. And it's not a question of how many diagnostic tests doctors should be ordering. It's a question of how we approach our health altogether and what we're willing to do to prevent disease in the first place.

Chronic diseases are the leading cause of death and disability in the United States. They account for the vast majority of health spending. In fact, according to the Partnership to Fight Chronic Disease, people with chronic conditions account for 81 percent of hospital admissions; 91 percent of all prescriptions filled; and 76 percent of all physician visits.

What's more, 75 percent of every dollar spent on health care in the United States is for the treatment of those patients with chronic conditions. In public programs, the numbers are even higher: 96 in Medicare and 83 percent in Medicaid.

The great irony is that most cases of chronic disease are preventable.

Yet, less than 1 percent of total health care spending goes towards prevention. The U.S. Centers for Disease Control and Prevention (CDC) estimates that eliminating three risk factors – poor diet, inactivity, and smoking – would prevent 80 percent of heart disease and stroke; 80 percent of type 2 diabetes; and 40 percent of cancer.

We already know that exercise helps prevent disease.

According to the CDC, physical activity reduces the risk of dying from coronary heart disease and of developing high blood pressure, colon cancer, and diabetes. It helps maintain healthy bones, muscles, and joints; reduces symptoms of anxiety and depression; fosters improvements in mood and feelings of well-being; and helps control weight, develop lean muscle, and reduce body fat. And physical activity can help reduce blood pressure in some people with hypertension.

If health care reform is to work for America, each of us must take the reins and affect change – change within our own lives and change within our own communities. Change must happen within households across America; within small businesses and large corporations; within industry and the medical community; within the government; within neighborhoods nationwide – and within each of us.

For the truth of the matter is that meaningful health care reform is a Rubik's cube of change. All the twistings and turnings don't spell success, and the cube isn't whole until all the parts are lined up correctly. Doctors, the health care industry, the government, the school system, the media, the hospitals, and parents all must come together in alignment around wellness, prevention, healthy lifestyles, and the promotion of exercise. And the hands that are shaping this cube have to be the individuals themselves.

Doctors can bring about change by routinely discussing and prescribing regular exercise and healthy eating for all their patients. Employers can create corporate cultures that promote stress management, exercise, and healthy lifestyles. Schools and educators can help shape future generations by creating greater opportunity for movement throughout the school day. Legislators can create supportive public policies and legislation that make exercise and healthy living affordable for all Americans, including economic incentives like appropriate tax incentives. Private health insurance providers can offer wellness incentives and cover wellness services, such as wellness programs, yoga classes, and health club memberships.

The media can use its influence by keeping health-focused headlines front and center and by providing articles for hard-working Americans on how they can fit exercise and healthy food choices into their busy lives and limited budgets. Restaurant owners can ramp up their efforts to introduce healthier food options onto their menus. And parents can join together to create healthy-living support networks and make time to play ball, hike, bike, walk, swim, and generally enjoy the company of their children while engaged in physical activity.

The time for change is about a generation overdue. America – and Americans – must reinvent how we live if we really want health care reform to work this time around. It will take all of us. And the time for action is now.


Joe Moore is President and CEO of the International Health, Racquet & Sportsclub Association (IHRSA). He is a member of the advisory board of the Partnership to Fight Chronic Disease. He leads IHRSA as a organizational member of the National Coalition to Promote Physical Activity (NCPPA);as a partner with HHS in promoting the 2008 Physical Activity Guidelines;and he led IHRSA as a primary participant in the launch of the Adult Fitness Test introduced by the President’s Council on Physical Fitness and Sports. IHRSA also is a Network Member of the Exercise is Medicine™ initiative and is an Organizational Affiliate of the National Physical Activity Plan. IHRSA recently introduced the publication, "The Economic Benefits of Regular Exercise."

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