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Health Department

Dr. Paul's Tennessean Guest Column - January 14, 2009
Health Care Reform

Despite spending over $2.3 trillion annually on medical care, the U.S. ranks poorly on most measures of health. For example, we rank 30th among nations in life expectancy at birth.

Medical care is important, but surprisingly it can prevent only about 10 percent of premature deaths. Unhealthy behaviors - often shaped by unhealthy environments - cause about 40 percent. Tobacco remains the number one cause of death, with obesity not far behind. Smoking rates have improved a little, but most smokers are unsuccessful when they try to quit, and obesity rates continue to soar.

Effective, widespread strategies to help smokers quit and to make our environment less conducive to the development of obesity could save millions of lives and billions of healthcare dollars.

As the new administration moves ahead with health reform, the conversation will focus on insurance, drugs, procedures, hospitalizations, and technology. ‘Health’ as a concept apart from "health care" might not seem like a natural part of the conversation, but it should be. This is a great opportunity to make our nation's health the ultimate goal of our health investment, so it is encouraging that President-elect Obama’s health plan includes a commitment to improving public health and prevention.

William S. Paul, MD, MPH
Director of Health
Metro Public Health Department of Nashville/Davidson County