Total U.S. health-care spending is approaching $2 trillion a year and is expected to double in the next 10 years according to Dr. Dexter Shurney, chief medical officer of Healthways, Inc., a health-management firm based in Nashville.

So what’s underlying these increases?  For starters it’s our own personal failure to take care of ourselves.  The biggest factors driving these increases are the treatment of chronic diseases such as cancer, diabetes and heart and lung diseases. These are the four leading causes of death in the United States.  What’s truly sad about that statement is that all of these diseases are basically preventable -- 80 percent of the risk factors are behavior-related. People still smoke, most – over 66% eat too much, and 75% of Americans don't exercise. It’s that simple. These lifestyle choices dramatically increase the chances of developing deadly, costly diseases.

Although I’m a big proponent of personal responsibility, I won’t lay all the blame on our boomer and aging senior population, and there is a way to repair or even fix or system.  Imagine this, if our health-care system – that includes Medicare and the Medicare Advantage HMO managed care insurance companies would shift a small percentage of total spending into programs that help prevent people from getting sick in the first place, it would dramatically reduce the overall cost of care.

Certainly people will still get sick, but when they do, we could target more resources to helping them manage their illness.  In other words, approach health care from a proactive wellness and prevention bias rather than from a fix and cure reactive approach that is in place today, and obviously not working.   Instead of waiting for the next chronic health episode that requires hospitalization and treatment, establishing incentives for both patients and doctors to prevent problems rather than treat them could simultaneously help reduce health-care costs and create a country of healthier people.

The way our current healthcare system is set up, doctors, nurses and other care providers don't have adequate financial incentives to focus on prevention. There are approximately 15,000 reimbursement codes under our Medicare system, and only a small handful address preventive care. Under our current system, in order to make a living, doctors have to wait for patients to become sick in order to be reimbursed by insurance.  Even more health-averse, under the insurance reimbursement plan, there are few, if any, patient-education billing codes.

As ridiculous as it sounds, health providers are rarely reimbursed for helping to educate patients about the importance of exercise, proper diet or other activities that promote health. When tests reveal patients are at risk of a chronic disease, today’s physicians do not have a financial incentive to help them make the necessary changes to stay healthy, and make their money by treating the problem when only when it worsens.

Of course, convincing people to change their behavior and live healthier lifestyles is easier said than done. But it can be done and is being done by hundreds of thousands of people every day. One of the best examples of systematic behavior change can be seen in the way diabetes is now treated. When someone is diagnosed with diabetes, it is not a death sentence. Persons with diabetes can live long and healthy lives if they manage their blood glucose levels, get exercise and maintain a healthy diet. The problem is that many need a support system, a coach, an advocate to help them stay on track.

Every individual is capable of achieving his or her own optimum level of personal health and well being, even if he or she has a chronic disease. And there is a ray of hope.  There are physicians, and other healthcare providers who will provide counsel to help those who wish to take at least the majority of responsibility for their own wellness.  Prevention works. It is not a simple fix; but if we as a society make a more concerted effort to improve this approach, and continue to work carefully to support individuals in making the necessary changes to live healthier lives, we will be making an investment in people that will have a very positive impact -- on their health and on the bottom line of our population and our healthcare system nationwide.