The emerging question in medicine today is not, "What can we do to help our patients?" but, "What can patients do to help themselves?" And the latter question is a fair one. In a project looking at the possibility of using health coaching as an effective tool for influencing better behavior in patients, Harvard and the University of Minnesota cite a startling statistic. According to the website, http://instituteofcoaching.org/index.cfm?page=healthcare, about 75% of health care costs in the U.S. are from the treatment of PREVENTABLE chronic illness.

What this means is illnesses related to overconsumption of food, drug & alcohol and/or cigarettes are responsible for much of the crushing expenses of our medical system.

I, in no way, intend to disband the responsibility of insurance companies and any other for-profit institution that seek to make cash off of sick people. Simply put, the execution of a medical model based on a capitalistic theory is less effective and more expensive than a universal health care system. The World Health Organization ranked the U.S. 37th among reviewed countries for quality of care, but thank God we're the most expensive, http://www.who.int/whr/2000/media_centre/press_release/en/index.html.

The top performing country was France, which employs a mixed system of socialized and private pay. Everyone gets basic care. Basic care plus saner lifestyle choices equal a healthier population.

Although big changes could be and will be made to our medical system over the next decade, responsibility for health must start on the individual level. Obesity expenses to our system for 2008 reached $147 billion according to the CDC (http://www.cdc.gov/obesity/causes/economics.html). Smoking doesn't help the health system or the individual much, either (http://www.huffingtonpost.com/2009/04/08/how-much-does-smoking-cos_n_184554.html). The health and social costs for drug and alcohol addiction are simply mind-boggling (http://www.niaaa.nih.gov/Pages/default.aspx). 

My point is simple: we must behave better.

Reliance on the medical system to treat preventable disease is inefficient and, frankly, not particularly effective. Medical and pharmacological treatments are expensive, time consuming and often have miserable side effects. Daily monitoring of preventable forms of diabetes is not fun for the patients who suffer with it, and, over time, extremely expensive for the system. Using this as an example, why would someone subject themselves to painful and expensive medical treatments when losing weight and staying active could significantly improve her/his health? Because it is easier to use the medical system than to change one's own behavior. If the latter were easier, we'd have parks filled with walkers instead of hospitals and clinics full of sick people.

Americans, as a whole, have shitty lifestyles. We work too hard for too little. We fill our days and the days of our children with "activities" instead of good company, good food and laughter. We do not sit still, contemplate our lives, and enjoy the moment. As a people, our mental health diagnosis would be "Obsessive Compulsive Disorder." Our minds are a constant, churning propeller stuck in neutral. 

We focus our attention on external matters such as our celebrities, our relationships, our houses, our jobs, to an unhealthy degree. The great spiritual leaders have lamented this through millennia. Those who seek the rewards of the world without the rewards of self and spirit loose themselves. In modern parlance, you go crazy.

To focus on external matters to the exclusion of internal experience leads, inevitably, to compulsion and obsession as we seek to control and manipulate a constantly changing world that has no strong interest in our thinking on how things SHOULD be. And herein lies the seeds to all addictions, be they food, cigarettes or alcohol. We have allowed ourselves, as Americans, to rely too heavily on external chemicals to control what we have become unable to control: ourselves.

Coming full circle, we then depend on our doctors and the pharmaceutical companies to treat the health effects of our addictions, yet another level of dependence on the external world to regulate the internal experience.

I am not a purest of any sort. Anyone who has spent time in Europe knows the French are not counting calories. And here's the thing, they don't need to count calories. By establishing lives balanced between the internal experience (health, joy, wellbeing) and the external (health care, socialization, and work), they do not suffer as a nation with a collective form of obsessive compulsive disorder.

The healthiest people (both physically and mentally) view life as a dance between discipline and indulgence, work and relaxation, pleasure and the unavoidable pain in life.

We are running out of options here. We, as Americans, may simply be forced to live better lives, forced to have increased health for decreased cost, and hopefully, experience deep joy instead of destructive highs.