Health care reform has to be about prevention. That's the most economical and practical answer. The answer is NOT more drugs, more doctors, more hospitals, more insurance, free clinics. Those things are all reactive. Preventative care, which include nutrition and excerise guidelines, is proactive. 

Think, for a second about what that means. Imagine that health education became a primary course in education from elementary school through college, as vital as English and Math, instead of the easy-A half-semester elective you have to take once in a while. Imagine that students were actually required to learn something in health class. Imagine that every student were required to do real exercise every day. Think about the P.E. classes today. My daughter took volleyball as her P.E. requirement in high school. This required her to change clothes and go to the gym, where she sat on the bleachers for the better part of an hour and chatted with her friends until she was called to the court for about 10 minutes. On a most days, she didn't come into contact with the ball. That was what passed for physical education. Exactly the same as it was when I was a kid. How about getting an aerobics instructor in there and have anyone not on the court do at least 30 minutes of aerobics? Imagine how much healthier our kids could be if we really gave them an education in health and fitness...instead of paying lip service and then feeding them fries and coke in the cafeteria.

Imagine a fitness test and a blood test once a year as standard care and a quick visit to a fitness center every three months to moniter health. A doctor would not necessarily need to be present, just a nurse or nurse-practitioner. Anything unusual on the tests could be flagged up for a visit to the doctor. Imagine nutritionists available to everyone...before obesity and diabetes becomes a factor.

Sure, some people simply wouldn't go, and some people won't stop eating McDonalds until they drop facedown into the secret sauce for the last time.

Maybe this kind of preventative care sounds expensive, but once you start factoring the real cost of diseases we are TEEMING with as a society - obesity, diabetes, cancer (from smoking), heart disease, ulcers, acid reflux, stress...etc, then prevention of such things with simple nutritional education support and exercise standards, the cost seems almost negligible.

I think the key to preventative care is accountability. The only thing that works to help me keep on track with diet and nutrition is knowing that someone is going to evaluate my results. And you know, the most powerful thing to me is not the guilt or the embarrassment factor, either. It's the inspiration I can give to others, and get from them. The one idea that will get me out the door to do the exercise I hate with a passion is the knowledge that someone will say. "You did it...so I know I can do it too." and the equal knowledge that they can as easily say "You made an excuse...and so it must be ok to make excuses."