A very important reason for medical care cost escalation has to do with our own personal behaviors. We are a country of people who are overweight --one-third are overweight and one-third or more are frankly obese --, under-exercised, poorly fed from a nutritional perspective and highly stressed. And it gets worse each year. Even children have progressively declining physical activity from about three hours per day at age nine to less than an hour by age fifteen. And this will correlate to obesity beginning in adolescence. Twenty per cent of us still smoke tobacco. These are some of the major reasons that medical costs will rise in the future. Diabetes will accelerate to epidemic proportions, heart disease will follow, arthritis will be exacerbated by obesity, life spans will be shortened and along the way there will be enormous medical bills to pay. We need a government that encourages good health, regardless of the economic interests that such a program will affect. It will mean less fatty food, less red meat, less whole milk and cheese on our pizza, less sodas [and everything else made with high fructose corn syrup], less prepared and take out meals and more home cooking, more whole grains (whole wheat, brown rice, oatmeal) and a real change in the cereals sold in supermarkets. We need to shop the periphery of the supermarket and leave the aisles with all the prepared foods alone. We still smoke in high numbers with all too many teenagers picking up the habit. They will incur the wrath of lung cancer, heart disease, chronic lung diseases and others in the years to come. And we must finally come to accept that weight gain is a function of the number of calories consumed minus the number expended by exercise. That’s so simple but apparently so difficult that we try all sorts of diets that ultimately don’t work but cost lots of money and frustration. Chronic stress is a cofactor in heart disease, back pain, gastrointestinal disorders and many others. Some alcohol may be good for our heart but it is never good to drink and drive yet all too many do so. At the same time many people do not wear their seatbelts. Add up all these adverse behaviors and they have a very marked effect on the diseases that occur – chronic, complex diseases that last a life time and which are very expensive to treat.