IN ALL the ways the Obama administration and others are proposing to cut healthcare costs, including a single-payer option, limiting malpractice claims, and increased use and uniformity of electronic medical records, there is one that everyone - patients and doctors both - can utilize immediately: preventative health.
The next time you talk to a doctor, ask “How much of what you see in a day is preventable?’’ Whether the doctor is an internist, cardiologist, endocrinologist, or orthopedist, you may be surprised by the answer.
I am not suggesting that if we just took better care of ourselves we would eliminate the need for a medical profession, but preventing illness has always been less expensive and more effective than trying to treat it.
And the biggest threats to our health are largely preventable: heart disease, stroke, type 2 diabetes, and some cancers. Our lack of nutrition and exercise as well as other problems have made us into an unhealthy lot. According to recent data from the National Health and Nutrition Examination Survey, over the past 18 years, obesity has increased from 28 percent to 36 percent and regular physical activity has decreased from 53 percent to 43 percent. The World Health Organization’s healthcare ranking system, which looks at everything from our life expectancy to how well our healthcare system is working, grades the United States 37th out of 191 countries.
We cannot foot the bill anymore. Our bodies and our medical budgets are broken.
Obesity is wearing out our joints and our pancreases. Smoking is weakening our hearts and our lungs. Overconsumption of fat, salt, alcohol, caffeine, sugar, and processed foods and underconsumption of fruits, vegetables, and healthy meats and grains are wreaking havoc with our human physiology.
The medical system can no longer afford us the luxury of plopping down in front of our doctors and just saying “fix me.’’
Every day we consume twice as many calories as we need (the average American consumes just under 4,000 instead of the recommended 1,600 for women and 2,200 for men), eat 4,000 milligrams of sodium (less than 2,400 milligrams a day is recommended), smoke cigarettes (20 percent of all adults and 30 percent of adults between the ages of 18 and 29 smoke), and rarely engage in physical activity (fewer than one in five Americans exercise on an average day).
We expect the dollars and the drugs will always be available to help us.
As individuals and as a society, why are we such numbskulls when it comes to applying our world-class medical knowledge (as well as our dwindling wealth) to simply repairing the damage from our lifestyle choices? We need to put our resources toward public health research, healthcare delivery, environmental studies, and research to combat other, less preventable diseases - all the while taking better care of ourselves.
We would save money if doctors wrote more prescriptions for healthy lifestyles and fewer prescriptions for drugs to try to just “clean up the mess.’’ This preventative approach is also true for our society at large with respect to community gardens, safe areas to walk and bike, and limiting environmental hazards.
Here’s a start - instead of a bag of chips, grab a banana or an apple. Cut your portion size and your processed food intake in half and eat slower. Walk to lunch or coordinate an exercise program at work. Take the family out for a jog or bike ride after dinner. Find the stairs instead of the elevator. Limit the double espresso lattes. And save $4,000 this year (as well as your heart and lungs) by quitting the cigarettes. Your next visit to the doctor could be a well-checkup instead of another bottle of pills or a trip to the operating room.
Maybe an ounce of prevention will really be worth a pound or (billions of dollars) of cure.
Dr. Terry L. Schraeder is an internist and clinical assistant professor at Warren Alpert School of Medicine at Brown University. 
