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Remarks as Prepared at Prevention SummitMy wife Jackie and I had one of life’s great privileges this year. We became grandparents for the first time. In fact, it happened twice. A friend explained why there is such a strong bond between grandparents and grandchildren. He said, “They have a common enemy.” I’m going to spare you from pictures or stories of little Braden or Ava, but I want to tell you one way that it has affected me. It changed the way I feel about things. I have begun to see the passage of time in a different way. Standing at a hospital bed, I watched my son holding this tiny little soul and suddenly I realized how quickly the past 25 years have passed. It was just yesterday, yesterday that I held him for the first time. The lesson: Time passes, time passes. There is a phrase sociologists use: Demographics are destiny. Today, I want to talk about health care, and where the passage of time is leading and controlling our own national destiny. In case you were guessing, I am 55 years old. When I was born, health care occupied about 4% of the total economy. In what seemed like a very short amount of time, when my son was born in 1977, health care had climbed from 4% to 8% of the total economy. This year, when my grandchildren were born, one generation hence, our nation spent 16% of every dollar it generated in health care. Now, having experienced the rhythm of life, and begun to feel it, it is clear to me that it won’t seem long before they are in grade school. We’ll go to their soccer games and dance recitals and, though it won’t seem possible, they will turn nine years old. It’s going to happen. While that’s happening, health care costs will continue their relentless rise. By then, health care will consume 20% of the entire economy. Time passes. Demographics march forward. It won’t be long after that when I get that call, “Grandpa, I got my drivers license.” It will happen, because time passes. Before you know it, they will finish college and soon be holding babies of their own. By then, I’ll be about 80 years old, and starting to think about retiring. If nothing has changed, health care will be nearly 25% of the economy. Now if you’re like me, you are skeptical of logarithmic projections of current trends, because we all know that won’t happen. We will either have fixed it, or our nation will have been eliminated from the economic playing field. In a global economy, there’s no place on the leader board for a nation that spends 25% of its entire economy on health care. Why? Because any nation that devotes that much to health care will undoubtedly and unavoidably have neglected education and all the other things it takes to maintain economic leadership. The human body has a warning system. It’s called pain, and when it occurs, we are motivated to do things we otherwise might not be willing to do. The economy has the same warning system, and people are feeling economic pain. Consumers are feeling it in their paychecks. I keep track of events in my home state, and I recently saw that the teachers there were given the biggest salary increase in many years. A few weeks later, I read that their take home pay had actually gone down because of rising health care costs. A recent survey of employees reported health care costs were the second biggest concern of employees, exceeded only by losing their job. Employers are feeling it. They are finding it more and more difficult to compete with companies from other industrialized nations who devote less than half what they do. You have all heard General Motors complain that the cost of a U.S. automobile contains more for health care than steel. I recently talked with the CEO of Starbucks Coffee and he confided in me that they pay more for employee health care than coffee. This is a serious problem. Intuitively everybody here knows the biggest reason health care costs are going up: We don’t take good care of ourselves. Until we approach prevention and staying healthy with the same rigor we have for treatment after we are sick, a significant part of this problem will persist. We own that problem, every one of us. The President is pressing hard for progress on obesity prevention and treatment, and emphasizing the importance of exercise and eating healthy. There’s no better model of fitness than our President. An increasing amount of our total health care costs as a nation are from preventable and manageable chronic diseases. Progress on those two alone would not only reduce suffering, but it also would change the economic equation of our nation. Obesity is an epidemic and the chronic diseases that follow have become quiet killers. More than 50% of American adults do not get enough physical activity to get the benefits of it. One quarter of adults are not active at all in their leisure time. During the past 20 years, obesity among adults has risen significantly in the U.S. About one in three U.S. adults aged 20 years and older are obese, according to the latest data from the National Center for Health Statistics. That’s about 66 million people. Obesity is not only itself a serious chronic condition, but it can also play a role in many others. In total, more than 90 million Americans live with chronic diseases, according to the Centers for Disease Control and Prevention. Chronic diseases cause seven out of 10 deaths every year. The cost of chronic diseases is almost unimaginable: Treating people with chronic disease accounts for about 75% of the $2 trillion America spends on health care each year. Twelve percent of our Nation’s Gross Domestic Product goes to treat diseases that are largely preventable and manageable. We all bear the brunt of those costs, and hence, government has a compelling national interest in promoting healthy life choices. Each of us has a personal responsibility, as well. Prevention is the key. Let me mention a powerful tool of prevention we are urging all Americans to get today: A flu shot. More than 36,000 people die from flu and its complications each year, losses that could be lessened by vaccination. This year, we have more flu vaccine than ever, and it will continue to be shipped through November. Even if it takes a while to get them in the door, people can be vaccinated well into the flu season—December and even later. But we need to start now, and tell your family and friends. The Department is engaged in many other prevention-related programs. Today, I’d like to make an announcement on new guidelines that will be developed on physical activity. For the past 40 years, many organizations have issued recommendations for physical activity. And while it’s fine to call for physical activity, it’s even better to give guidance on what people can do. So, at my request, the Institute of Medicine convened a workshop earlier this week to explore whether enough evidence exists to serve as a basis for comprehensive physical activity guidelines. But today, for the first time, those comprehensive physical activity guidelines can be created. So beginning immediately, this Department will initiate a process to develop these guidelines. It will take two years and culminate in a publication in late 2008 of the first Physical Activity Guidelines for Americans, which will describe not only what people should do, but also how to do it. I’m also pleased to announce that we are releasing two new tools to aid in prevention efforts. We will be sending more than 400,000 copies of the 2006 Guide to Preventative Services to clinicians nationwide, in cooperation with our partner, United Health Foundation. The guide is just the right size to fit into a [physician’s] white coat. Clinicians will also be able to access that information electronically, thanks to a new tool, the Electronic Preventive Services Selector, which is also being made available to primary care physicians today. It will assist physicians in selecting the right preventative service for the right patient in real time. The Department is devoting substantial resources to preventing obesity, especially among kids. The proposed budget for Fiscal Year 2007 calls for spending of about $640 million on obesity-related efforts. The HealthierUS Initiative established a framework for wellness-related activities and programs, ranging from this Prevention Summit to the President’s Council on Physical Fitness and Sports. It established pillars of wellness that guide obesity-related activities across the government including the Veterans Administration, Education, Agriculture, and Defense. The Small Step Campaign was set up to get people involved in activities to reach their personal fitness goals. The President’s Council on Physical Fitness and Sports, which is celebrating its 50 th anniversary, has created the President’s Challenge Partnerships with over 100 organizations, which encourage regular physical activity as a part of an overall healthy lifestyle. The We Can! program is also directed at children and teens. It is designed to serve as a one-stop resource for parents and caregivers looking for practical tools to help their eight to thirteen-year-olds maintain a healthy weight. We cannot create a culture of wellness through regulations and penalties. Like my friend Mike Huckabee, who’s done great work on obesity prevention as Governor of Arkansas said, “I don’t believe the government should be the ‘grease police.’” Instead of government restrictions, we need to encourage constructive engagement and allow individuals to find the best solutions to the problems of obesity and chronic disease. So, in the near future, I will be meeting with private sector organizations from industries that deal with foods and choices, including the beverage and snack foods industries, and the media and entertainment industries. My hope is that we will find innovative ways to effectively bring the private sector into the work we are already doing in creating a culture of wellness. I’d like to work on ways to lead children and families away from behaviors that lead most directly to chronic diseases, whether through better messaging or offering more palatable alternatives. HHS is also going to continue to partner with the Ad Council for the third year of the HealthierUS/Small Step Campaign. Our campaign will have Shrek joining us in January. And the Ad Council will be partnering with YouTube/Google and the National Academy of Television Arts and Sciences to launch a web-based video contest in the spring. As those programs go forward, I and the members of my staff are going to constantly be looking for ways to connect it to other efforts. For instance, prevention is tightly linked to preparedness, since the two depend on the same public health infrastructure and the same cross-government connections. Prevention also has an essential place in my goal of making the health care system more value driven. One of the four cornerstones for doing so is the creation of positive incentives for people to avoid unhealthy choices and risky behaviors, and to share in the benefits for doing so. Creating a culture of wellness won’t be easy. But it is so important. Time passes. And in health care, the passage of time is leading and controlling our own national destiny. But the culture will not change if we simply burden people with guilt or appeal only to their fears. For it’s hard to be healthy—as anyone who has ever broken a diet or skipped a week of exercise can attest. Bad habits are not easily broken. Good ones are not easily won. Achieving wellness demands the discipline and determination to take small steps each day. But the hard way is often the best way. And the benefits of wellness are significant and substantial. So changing the culture from one of just treating sickness calls for small steps and good choices to be made each and every day. Ultimately, wellness isn’t about restricting behavior but rather about pursuing happiness, about expanding horizons. That’s my vision of wellness achieved—a future of greater health, greater hope, and greater freedom. Thank you. Last revised: October 27, 2006 |
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