AHRQ Summit—Improving Health Care Quality for All Americans

Quit Digging Your Grave With a Knife and Fork

The Honorable Mike Huckabee
Governor of Arkansas

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Improving the health care of the people of Arkansas, and our Nation, has become a personal passion and pilgrimage—one I have translated into public policy goals for reducing poor health behaviors among the children and adults of my State.

The State of Arkansas is one of the unhealthiest in the Nation. This is a threat not only to the personal health of each child and adult in our State but also to the financial health of Arkansas, because the costs related to treating the health problems associated with unhealthy behaviors are enormous.

As a result, we have instituted the Healthier Arkansas Initiative, targeting unhealthy behaviors that put our children and adults at risk. The initiative includes:

• Payments for preventive services, such as body mass index measures for school children.
• Information for parents and children on the health implications of unhealthy behaviors.

We have also developed a new set of health goals for our State. By 2006, we aim to:

• Reduce the rates of smoking in adults by one-half.
• Reduce the rates of obesity in children and adults by one-half.
• Double the rates of exercise and physical activity in adults.
• Increase the rates of exercise among children by one-third.

Our Nation Is Creating an Epidemic of Obesity and Poor Health

Our Nation is facing a terrible health crisis, and it is one of our own making. We are digging our own graves with a knife and fork—and creating an epidemic of obesity and poor health that threatens to bankrupt our Nation and reduce life expectancies for the first time in history.

As a person who grew up in the South and in a poor family, I understand the cultural, economic, and religious norms that drive our eating behaviors:

• Food is at the heart of social interactions.
• Food choices are dictated by limited choices.
• A thin piece of meat is battered, fried, and covered in gravy to stretch it further.

I was a product of those norms—of poor eating habits and a total aversion to exercise that had me in such bad physical shape that I could not walk up a flight of stairs or go a city block without being in pain and covered in sweat.

At 280 pounds (110 pounds more than today) with high blood pressure, chest pains, and a diagnosis of diabetes, my doctor warned me I would not live to see my 50th birthday.

Today I am living proof that a person truly can change his or her health, starting from a point of terrible shape and health habits and making his or her way to completing a marathon race. I know that you can replace the bad habits of a lifetime.

It is not just about going on a diet. I have tried them all, and they are not sustainable. It is about changing behaviors regarding food and physical activity and understanding that while every diet ends, health and fitness can last a lifetime.

We Need To Develop a Culture of Health

We need to develop a culture of health, not one that infringes on personal rights but one that helps us make choices that can improve individual lives as well as the financial and health conditions of our Nation.

Our health care system is broken. It throws money at treating chronic and preventable diseases but does not invest in preventing those conditions. For example, my insurance plan will pay for the enormous costs of a quadruple bypass surgery, but it will not cover the cost of a 30-minute appointment with a nutrition counselor.

We cannot sustain a system that is built on just finding and treating disease. We must attack the causes of disease, such as obesity, tobacco addiction, and lack of exercise. We must build positive incentives into our system—for example, changing the Food Stamp Program to associate monetary value with food value, thereby offering more money for healthier foods.

Poor Health Habits Are a Huge Economic Burden

One way to get policy leaders involved in promoting a new culture of health is to present it to them as an economic issue. States like Arkansas are currently being overwhelmed by health care costs and Medicaid budgets. If we can get Americans to change to healthier habits, we can change the economy of the United States.

To Implement Changes That Lead to Improvements, We Must Set Measurable Goals

Each State needs to develop a plan for improvement and establish measurable targets. Then it needs to analyze, measure, and announce the results of where it stands regarding health goals.

We must keep score. We expect to know the score in sports events—we cannot accept not to know the score in something as important as the health of our citizens.

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