The Truth About Healthcare Reform

 An article by Christina Pirello, an advocate of natural foods nutrition and professor of culinary arts at Drexel University, on Huffington Post states the uncomfortable truth about healthcare reform that the mainstream media consistently fails to report:

“Healthcare reform is irrelevant until Americans improve their lifestyles.”

The fact is, our healthcare costs are out of control because the diet and lifestyle that has become the societal norm in this country causes disease.  As Ms. Pirello mentioned in her article:

“We are willing to tolerate this revolutionized food because it's cheap. But it comes at a high price to our health. We spend less on food today than any other people at any other time in recorded history. And the less we spend on food, the more we spend on health care.”1

 Here are some numbers:

- Overweight and obesity rates are at an all time high – 73% of Americans are either overweight (38.8%) or obese(34.2%).2 In 1980, 15% of adults were obese – over the past 30 years,that number has more than doubled.3

- According to the CDC, U.S. obesity-related health costs totaled $117 billion in 2000, and if current trends continue, that figure is projected to reach $344 billion per year by 2018.3,4

- Coronary heart disease costs are estimated at $177 billion for 2010, costs for stroke at $74 billion, costs for hypertension at $77 billion. 5

- Health insurance premiums have gone up 131% in the last 10 years.6

- Over 50% of insured Americans take prescription drugs for a chronic condition – the majority of these drugs are for blood pressure or cholesterol.7

These costly diseases are caused by poor lifestyle choices, and they are also preventable by positive lifestyle choices.

The problem is not the fact that there are so many uninsured Americans – the problem is that there are so many unhealthy Americans. Do we need a better health care system? Of course. But not as desperately as we need better health. Better health through improved lifestyle choices is also fiscally responsible. Vegetables are cheaper than statin drugs. A gym membership is cheaper than bypass surgery.

Health care costs are the symptom, poor lifestyle choices are the cause. If we want to improve the situation, we need to address the cause. The only way to reduce these costs is to reduce the prevalence of these devastating (but preventable) diseases.

No matter how many confusing messages the American public gets about nutrition, there are some very simple truths. Fruits and vegetables are healthy, processed foods and fast food are not. If you follow a nutritarian diet, it will cost less to keep you healthy. 

Ms. Pirello suggests a healthcare system in which individuals are rewarded for having healthy habits – sounds like a great idea to me. She also mentions Whole Foods Market’s new Health Starts Here program, for which I provide nutritional guidance.

“They are about to implement a program that encourages their employees to get and stay healthy. Beginning with a simple blood test and survey, each employee who chooses to participate will receive a diet plan. Each benchmark they hit (lower cholesterol and blood pressure, healthier BMI, etc., will result in a greater discount on their groceries purchased at Whole Foods Market. Imagine a health care plan that does the same thing.”1

No matter what the outcome of healthcare reform in Washington D.C., if enough of us develop and practice healthy habits, it will be to the benefit of our healthcare system.




2. Ogden CL et al. Prevalence of High Body Mass Index in US Children and Adolescents, 2007-2008. JAMA. 2010;303(3)

Flegal KM et al. Prevalence and Trends in Obesity Among US Adults, 1999-2008. JAMA. 2010;303(3)






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Comments (16) Read through and enter the discussion with the form at the end
Emily Boller - February 4, 2010 3:44 PM

"Ms. Pirello suggests a healthcare system in which individuals are rewarded for having healthy habits – sounds like a great idea to me." -Dr. Fuhrman (from the above post)

Yes. Absolutely. Yeah, Ms. Pirello!

We need a reformation of the health and care of our BODIES.

Also, way to go Whole Foods for blazing a trail! May America follow such a great example of reformation!

Ruth - February 4, 2010 3:47 PM

Well said! I work in health care and seldom see teaching around disease prevention. For every symptom there is a drug, and for every drug symptom another drug...

Sally - February 4, 2010 4:29 PM

Having been eating a Nutritarian diet for most of my adult life has kept me free of medications at age 55 although with a family history of high cholesterol and blood pressure, all my siblings are on medication and eating SAD food.My primary doctors don't even know me because I never get sick...I plan on keeping it that way!
Thank you Dr. Fuhrman for your work in educating the public!

bruce goodchild - February 4, 2010 8:50 PM

I've been athletic all my life, very slim and fit, a veggie for 35 years (I'm 62).
Always taken care of myself, always had access to good medical facilities.

Unfortunately, I was diagnosed with _atrial fibrilation_ 8 years ago, and
_non-hodgkins lymphoma 15 mos. ago. Just bad luck, I guess, but
it had nothing to do with my life style or diet.

While I agree that, on balance, society would be better off if everyone ate better and
exercised, my situation seems to indicate that it is not so simple......

Barb - February 5, 2010 6:09 AM

The problem is deep in the roots of our infrastructure. We need to stop eating junk food and driving everywhere. I lived in Europe for awhile and there were very few fast food restaurants and cars were not allowed in the suburban village centers. Local produce was sold in farmer's markets and available in the village centers.

The mass transit system was excellent and subway trains were not more than half a mile from the center of all the suburban villages. People did not need to use their cars so much. This structure does not rely on willpower but makes it mandatory for residents to walk to the farmer's markets in the little village centers. Not only does this remove the fast food but automatically provides daily exercise. (And people get a chance to know their neighbors.) In America, we are setup for this health problem as in most places, it is impossible to exist without a car. We need government help at this point to provide the mass transit.

We consumers will have to make the choices to eat better food until we are provided it and the fast food goes out of business. I did not have a weight problem in Europe but when I returned home, I put on 20 pounds in 2 months. No wonder there are 73% of Americans overweight. We are setup to gain weight in this environment.

Evelyne - February 5, 2010 10:35 AM

I love all the comments here above. I came from Europe and can appreciate what Barb said about it. Good food is more accessible and there is more of it too everywhere. Prevention would be a key to help America to do the swith. We need to help all the medical profession to make a switch from the medicated assisted method to the natural whole food market prevention. I love the idea mentioned by Dr Furhman about big corporations and insurance companies rewarding employees and families. If we could reward the the medical professions as well, things could really change. Long time ago, in China, docteurs were retributed for keeping people in good health. Prevention was very important. - Could we come back to such a way of thinking and take advantage from all the benefits that our nature has to offer.

Michael - February 5, 2010 11:31 AM


I agree with you that this lifestyle isn't going to eliminate the need for healthcare or eradicate diseases, but it would drastically reduce the major ones afflicting us today (heart disease, diabetes, cancer).


I've read that cities in the US that rely heavily on public transportation have a lower incidence of obesity. I don't think using Europe as an example would work. The US is much more spread out and trains just aren't as realistic. I do think most big cities would benefit from better public transportation. MARTA in Atlanta (where I live) could be greatly expanded on on would likely improve air quality, traffic congestion and other aspects in addition to better health due to increased physical activity.

Cindy - February 5, 2010 11:47 AM

This is it . . . Dr. Fuhrman had the vision, and it's spreading. 2010 is the year Americans start to get the message, though admittedly it will take some time. Exciting for those of us already on board.

Of course, we will always need a good health care system. As Bruce unfortunately learned, not all diseases are lifestyle related. I say, let's put our resources into taking care of situations like Bruce's rather than trying to overspend and overmedicate away our Type II diabetes epidemic. Get well, Bruce.

luc - February 5, 2010 11:50 AM

There is a actually a considerable debate which type of lifestyle causes more costs to health system, social insurance etc.:
Too simplified but a healthy long life might result in more costs than an unhealthy and shorter life. Look it up on Pubmed for example. Simply looking a the cost for diabetes treatment is a way too simple approach.

Greg Kaler - February 6, 2010 7:42 AM

I have a very negative outlook for the future health of Americans. It's going to get much worse/much more out of control. I travel across the U.S.- 47 states- as a school assembly performer. I mention Dr. Fuhrman and Eat To Live in each of my school assembly shows called Fitness For Life. Dr. Fuhrman and his staff are my heroes.
I SEE SO MUCH NEGATIVE EVERY STATE I GO, so much obesity, so many people waiting in line at the drive thru, so many milk mustache posters in school cafeterias, SO MUCH MISINFORMATION!
The problem is unhealthy food and drink addiction. When we suggest people eat and drink healthier we're messing with their "drugs". They are addicted. Try to get a loved one to stop drinking coffee, or soda, or eating meat. In the great majority of cases it is virtually impossible. It's their drugs.
I'm afraid I have a very pessimistic view for the future. As what happened with me, most people won't even consider a healthier lifestyle until they get sick. Then so many rely of pills- band-aids, not the cure.
One answer is to make unhealthy food/drink illegal. It will never happen. People will fight for the right to keep their "drug habits", with no consideration for their longevity. We're not only in a losing battle, we're in a hopeless war. I will go down trying being a good influence and soldier for getting out Dr. Fuhrman's information.

Steve - February 6, 2010 10:28 AM

The comment by luc reminds me of similar comments I have heard over the years about how smokers would save taxpayer money because of the shorter life span. I only ever heard this from heavy smokers, usually at a time when the (Canadian) government was suggesting no medical benefits for people with abusive lifestyles.

I suspect it is a rationalization, I have no idea if it is true, but even if it is, what would you do with it? Encourage short lifespans?

Smoke, drink, butter your bacon, use crack cocaine, die young and save your government money. Selfish and altruistic all at the same time ;-)


Cindy - February 6, 2010 12:12 PM

Greg, can that possibly be your real last name?! I understand your pessimism, but in the long term I don't share it. I do fight the battles with some family members and agree (and know from personal experience) that food addiction is real. My teens get caught up in SAD peer pressure continually. But the good news is that my 20-something kids and their friends are definitely into healthful eating and fitness. Plus they are so mad about paying for all the pharmaceuticals and end-of-life care for the older folks that it seems to translate into a determination not to follow in those footsteps. So it will be a long war, with many tough battles, but I am hopeful that we have reached a turning point with more and more Americans waking up.

PS I commend you for spreading the message. You are an ETL hero yourself!

luc - February 6, 2010 10:04 PM

I guess I wanted to point out with my comment that the sad state of the SAD nutrition is NOT really an excuse to do NOTHING in regard to the financial and insurance aspects of health care reform.

Greg - February 7, 2010 12:15 PM

I agree that Americans have a terrible diet, and that a better diet will leader to healthier lives. However, it's nothing more than wishful thinking to believe our corporatist health care system would in anyway become cheaper with healthier Americans.

Our medical system costs so much because we let for-profit corporations bleed sick people dry. Most the bankruptcy in this country is related to medical bills, and most of these are people who had insurance.

"The problem is not the fact that there are so many uninsured Americans"

"The fact is, our healthcare costs are out of control because the diet and lifestyle"

"Healthcare reform is irrelevant until Americans improve their lifestyles"

English and Canadians have unhealthy life styles just like Americans, yet their health care is cheap because they have single payer health care. Their bad diet doesn't make health care impossible because they don't let corporations loot health care.

Even with a perfect lifestyle, people still get sick. Disease can be reduced, but never eliminated. You probably don't understand what it's like to be one of the 50-100 million people who have to choose between bankruptcy and going to the doctor. Even going to the doctor because you want to make sure a strange lump is nothing important can bankrupt a hard working family.

An active lifestyle leads to all sorts of physical injuries and ailments. Those of privilege can go to the doctor when they injure themselves. Those who aren't, cant.

Sydney - February 17, 2010 7:29 AM

"The problem is not the fact that there are so many uninsured Americans – the problem is that there are so many unhealthy Americans."

Amen to this comment! I am a vegan/vegetarian and feel great and rarely get sick. But I am about 30 pounds overweight and cough more than I would like. I started Eat To Live yesterday and am about halfway through. Two of your points have me wondering:

1. I only eat limes/lemons and berries because I've been convinced that other fruits are too high in sugar
2. I've also been convinced that olive oil is highly desirable and I should eat some every day

I'm not sure that you're right - but I'm going to start tomorrow and religiously follow ETL for one week and see what happens. If all goes well, I will stick to it for six weeks, as you suggest, and report back. If my notions about fruit and oil are wrong, I'm happy to change. So, off to the grocery for some fruit. :-)

Patrick Murphy - February 19, 2010 9:36 AM

Many of the quoted statistics are simply wrong. The stat for overweight is presumably the mistake of adding in morbidly obese which, in the referenced article, were included in the obese as well. The number given is 64.5%. The quoted stat about heart and cholesterol drugs is a misreading of the CBS news article given as evidence: i.e. "most widely used" does not mean "majority of". (There are no such hard stats on which drugs are the most widely used.) There are other errors. But most egregiously, this post cherry picks the very same references it misquotes, failing to mention, for example, that during the same period rates of heat disease, cancer, and stroke all fell.

Not that I expect any scientific accuracy in a blog post that claims these diseases are simply the result of bad "lifestyle choices" - a term that reminds me of right-wing criticism of homosexuality, a far more bigoted but no less fallacious description of human behavior.

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