Obesity is the health reform fault line

Have your super-sized fries if you want, but when you come down with diabetes don't come frying to me.

The CDC said Monday that obesity costs us $147 billion per year.

We know what causes that.

Big portions from food retailers, and heavy marketing of fat and sugar by the agriculture industry, combined with a human tendency to eat what is in front of us.

Rolling all that back won't be easy, but it can be done. Trouble is, a lot of people don't want to do much about it. They call obesity a lifestyle choice, and attack efforts to reduce it as "nanny-state" or "big brother" tactics aimed at the heart of freedom.

Freedom to smoke. Freedom to tote an AK-47. Freedom to get fat and ride around without a helmet. Freedom to die young and make an ugly-ass corpse.

This is the real fault line in the health care debate. It's the trump card Americans play in keeping you from being able to see a doctor.

If government can't act against these "lifestyle choices," then we can't have health reform. The very premise of reform is based on wellness. It's based on creating a feedback loop, using data and para-professionals, that links your "lifestyle choices" to your future illness, and breaking the cycle.

Alcoholics, rageaholics, meet foodaholics, inveterate smokers and gun nuts. Treat these people before they collapse on their own, reform advocates say, and you save a ton of money. Enough to give everyone access to wellness care and, from those savings, medical care.

Commenters here and elsewhere say, wait a minute. You want government to tell me how to live? You'll get my Twinkies when you pry them from my cold dead hand.

Fine. How is this for a compromise?

Everyone gets a work-up on their lifestyle risks, free. You like riding around without a helmet? You feel cool toting that gun in your pocket (or are you just happy to see me)? The Supersize lifestyle is just the way you are?

Fine.

Sign here and the complications resulting from that choice are excluded from any health insurance coverage you may seek, public or private. You were warned, in English, you chose to ignore the warnings, we wash our hands of you. Sayonara.

On the other hand, if you promise to work with us, we can offer a host of aids that can move you to change. We can afford to give everyone access to a nutritionist, a physical therapist, even psychiatric care to treat the emotional issues you face from changing.

Lifestyle choices are driving health care costs. Make new choices or get out of the system.

This is not just what the government is saying. It's what the health insurance industry is saying. The cost of getting care,  to those serious about cost control, is caring about yourself.

Have your super-sized fries if you want, but when you come down with diabetes don't come frying to me.

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