Jessica Mulholland is the associate editor of GOVERNING, and is also the associate editor of both Government Technology and Public CIO magazines.E-mail: email@example.com
Health care won't cost less until people get healthy.
On Sunday, March 21, the House of Representatives passed the health-care reform bill, and President Barack Obama signed it into law just two days later. According to healthreform.gov, the Obama administration believes "that comprehensive health reform should reduce long-term growth of health-care costs for businesses and government."
But during national coverage of the landmark vote, Dr. Delos "Toby" Cosgrove, CEO of the Cleveland Clinic, which ranks No. 1 in the U.S. News and World Report's Best Heart & Heart Surgery Hospitals, said that unless citizens become healthier -- ridding themselves of obesity and the addiction to smoking, to name a few root causes of severe health problems -- this health-care reform bill will not curb the rising costs related to health care.
And he echoed that sentiment on PBS Nightly Business Report about a week later: "We need to have the U.S. public understand that they are, in large measure, responsible for their health. And they have to begin to take responsibility for their health in terms of obesity, in terms of smoking and getting enough exercise. All of those things will help drive down health-care costs."
In a recent interview with CNN Money, Cosgrove said obesity accounts for 10 percent of the cost of our nation's health care. "We will never be able to control the cost of health care until we begin to control the epidemic of obesity," he said. "Two-thirds of the U.S. is overweight, and one-third is obese. We are the fattest nation in the world."
According to Cosgrove, our rate of obesity is increasing so much that half the U.S. will likely be obese in the next 20 years-but there are plenty of things we can do to change our fate.
First lady Michelle Obama is already doing something-she's targeting kids with her Let's Move! initiative to end childhood obesity.
And in Florida, the Miami-Dade County Health Department will target everyone: As part of $372 million being awarded to 44 communities nationwide to support overall public health efforts, the department will receive $14.7 million for obesity prevention. Lillian Rivera, administrator of the Miami-Dade County Health Department, says the funding will allow the community to expand access to fresh fruits and vegetables through community gardens and farms to institutions, promote healthy options in vending machines, and invest in activities that promote physical activity, among other items.
"This is the first time we've been granted a considerable amount of money to deal with chronic disease," Rivera says, "and that's very significant for public health officials around the nation. I bet everyone would say the same thing -- that we want to make really good use of this money, and that we do great interventions so we can make a difference in people's lives."
But is giving healthy options to citizens enough to actually make them change their ways? Rivera says yes, adding that the health department's philosophical and conceptual framework includes personal responsibility as an important component. But ultimately, she says, no person who's overweight or obese wants to be that way.
The problem is changing behavior, according to Rivera. Another challenge to cutting obesity rates is that eating can become an addiction for some. But unlike addictions to drugs or alcohol, which are substances people can do without, you can't stop a food addiction by not eating.
With the funding it will receive, Miami-Dade's health department will not only increase access to fresh fruits and vegetables, but it also will support anti-obesity programs in its Parks and Recreation Department and at local nonprofit organizations.
In addition, the county is working with the University of Miami to look at a range of weight-reducing programs and practices, including the use of bicycle paths and other forms of exercise. "All of these interventions we have delineated in our plan we submitted to the federal government, they're going to eventually make us successful," Rivera says, "so we can say we made a difference in people's lives."