Live healthy, pay less.

President Obama has stated that his number one domestic agenda priority is a radical overhaul of our health care system. The various proposals being discussed are projected to cost well in excess of $1 trillion over the next ten years.

It should be obvious that we can’t afford such “reform.”

But the debate over costs misses what I think is a very important point.

If you listen to KTBB at all, you hear segments we produce for the University of Texas Health Science Center at Tyler called ‘Health Connection.’ It recently struck me how often the doctors whom we feature on Health Connection will say, in response to a question on this or that health problem, that proper diet and exercise constitute the best prevention and the best treatment.

And that got me thinking.

You would never expect State Farm to pay a claim for a burned up engine because you never changed the oil. But we somehow expect Blue Cross to pay for a heart bypass when you have allowed yourself to be 70 pounds overweight and addicted to tobacco.

You have no problem with State Farm pricing your auto policy based on your driving record but you don’t want Blue Cross to price your health coverage based on your 44-inch waist and your pack-a-day smoking habit.

If you have a job with employer-paid health coverage or if you are on Medicare, there is no economic penalty for poor health habits in the same way that there is an economic penalty for bad driving habits.

When your co-worker’s arteries plaque up and cause heart disease, it’s no skin off his economic nose.

But that has to change. We have to get over the idea that it’s unfair to make those who don’t take care of themselves suffer the resulting economic consequences.

But Paul, what about those poor people who are just not healthy and can’t help it?

Well, to that I say those born with health problems constitute a manageable minority of cases. The vast majority of people are born with bodies that, given reasonable “maintenance,” will last an actuarial lifetime. The non-smoker who gets lung cancer can be affordably priced into the premium for cancer coverage, particularly if the smoker is made to pay for his/her disproportionate contribution to the aggregate risk.

It is diabetes and heart disease that lie at the root of most of our runaway costs. Lung, breast and colon cancers are up there, too. The majority of these problems are avoidable through good nutrition, good exercise, avoidance of known risk factors and good preventive care. (Yes, they have established a dietary and exercise link to the dramatic increase in breast cancer).

I think it’s really this simple Live healthy and we can afford health care. Keep eating like pigs while doing no exercise and a $1 trillion health care overhaul will accomplish nothing.

The collectivist approach has a terrible record. We are way too collectivist with respect to health care already and it’s not working. On the current trajectory, health care will simultaneously become ruinously expensive and unacceptably scarce.

Put people back in charge of the decisions that affect the cost of health care and we’ll end up with a much more competitive provider environment on the supply side and a much higher quality consumer on the demand side.

And we’ll all feel and look a lot better in the bargain.