Several years ago my brother-in-law was in a small commuter plane on an LAX runway. Unfortunately, a US Air jet was given the ok to land on that same runway. The result was catastrophic. My in-laws lost their son in that crash, my sister-in-law lost her husband and her kids lost their father. It was tragic. Immediately after the crash an investigation was launched by the FAA and it was not concluded until the result of the crash was discovered and regulations were implemented nationally to avoid the same problem in the future.

According to the National Center for Healthcare Statistics, Preventable medical error and injury during hospitalization is the 5^th leading cause of death in this country. That's more deaths annually than Breast Cancer, HIV and Auto Accidents. In fact, Dennis Cortez, the CEO of the Mayo clinic says that we crash the equivalent of a 747 jet full of people every day and a half in this country due to preventable medical error. Yes, that is correct. Every day and a half. Can you imagine the outrage if that was happening to the airline industry? The public simply wouldn't stand for it and ultimately, the government would have to step in and commission ... the FAA to do something about it.

So take some of the trillions you're talking about spending and create a "Federal Healthcare Administration (FHA)" that does the same thing the FAA does in the airline industry. And when you discover what went wrong at one hospital, create a regulation, a policy or Standard Operating Procedure of some kind that has to be followed by all hospitals nationally. If they don't follow the new SOP's, yank their Medicare and Medicaid benefit! Trust me, with that as a serious consequence, hospitals will fall in line with the new and improved standards quickly.

By the way, before moving on, let's do some quick math. Some studies suggest that preventable medical error, injury and waste during hospitalization are responsible for as much as 20% of our total annual healthcare bill of $2.3 trillion. Let's be conservative and say that using an FAA equivalent, we were able to cut preventable medical error by 50%. That's $230 billion dollars in savings right there. That's a good start.

Let's get back to Denis Cortez and the Mayo Clinic again. The following is a quote from an article in the Wall Street Journal; "Research at Dartmouth Medical School suggests that if every American went to the Mayo Clinic, our annual health care bill would be 25% lower (that's more than $500 billion) and the average quality of care would improve."

Again, this isn't rocket science. Take Denis aside and say, "So Denis, what did you do to bring about such success here at the Mayo Clinic?" Listen carefully to what he has to say. Maybe even take notes (sorry for the sarcasm, I'm still burning up from this morning). After learning as much as possible from someone who's already mastered the art of quality care at affordable prices, begin creating benchmarks for other health care facilities to follow. Put consequences into place for non-compliance to the new benchmarks, or performance standards and watch the positive changes begin. Obviously, the first consequence that could easily be implemented is to publish the national results for all medical facilities on the Internet and let the free-market system dictate the ongoing viability of that health care entity. If non compliance continues after that, threaten to pull government benefits and programs like Medicare and Medicaid and then actually pull them for continued non-compliance. Either the entity will get bought out by someone who cares about quality care, or they'll go out of business and a new player will enter into the marketplace that can get the job done.

So with our math now, let's again say that this benchmarking program only yields half of the results the Dartmouth study suggests, that's an additional $250 billion in savings.

Several years ago I was on the back of a cruise ship playing basketball. The wind was playing havoc with my jump shot, but the competition was weak at best, so I was holding my own. After a few pick up games, my wife and I went up to the captain's lounge for some ice water. The lounge happened to be right above the basketball court I'd just been playing on. We looked down at the court and saw some people gathering around one of the ball players - who was now on his back on the ground. When a doctor began performing CPR, I realized that the man had just experienced a heart attack. We watched in amazement as a doctor pulled a long needle out of his bag and injected it right into the man's heart. Unfortunately, this man, who was perhaps a little older than I was, didn't make it. Apparently his body couldn't handle the extra 150 pounds he was carrying around on the basketball court. (You thought I was kidding about the competition right?). He had neglected his body and his health for decades and unfortunately, he paid the ultimate price for that.

I realize that not all heart attacks are the result of neglect and obesity. And I apologize for making light of the subject. In doing so, I am ultimately trying to send a message and prove a point at the same time. Consider the following statistics. In a 1985 study on Obesity Trends by state - among U.S. Adults, an "obese population" category above 15% didn't even exist. The 10-14% category was the highest in the study and although there were only 8 states who's population fell into that category, they were considered to be "failures" in their health education efforts. In the same study, conducted in 2007, not one state had a population lower than 15% and only 1 state had an obese population of less than 20%! 14 states fell into the 20-24% category and the rest were over 25%, with some states averaging over 30% of their population being obese. In the history of this country, there has never been a trend like this one. And it is having a tremendous impact on health care costs in America.

These statistics show what the medical community calls "Lifestyle Diseases". Illnesses brought on by our own lifestyle, or our own behavior. According to independent studies by Stampfer (2000); Platz (2000); and Hu (2001) the primary cause for the following diseases is - in a word - "Lifestyle":

Again, I don't mean to generalize too much, as my own father, who was an avid runner and mountain climber died of cancer. But the statistics are quite overwhelming when viewed as a whole.

It's easy to see why estimates show that as much as 70% of all health costs are due to preventable illnesses and conditions. Not to get ahead of myself, but that's $1.6 Trillion dollars that can be cut, by changing public perception, creating more accountability and empowering individuals and companies to demand and maintain better health.

So do I believe that because I watch what I eat, exercise and work hard to maintain good health that I should receive financial incentives, significantly better rates and upgraded health care coverage? Absolutely! In fact, I'll go so far as to say that the obese smoker should be penalized for his contribution to health care costs nationwide. My benefits should be higher, my costs lower and his should be reversed. As an employer, I have seen our company health care coverage increase at a rate of approximately 14% per year. The national average is a 39% increase in premiums over the last 5 years.  I think I'd rather have the people who are responsible for the majority of those costs, be climbing right alongside me on the StairMaster, rather than running up my health care bills.

Let's quickly take a look at the math again. Let's say that between programs and incentives that were so drastic that they actually affected health behavior, and insurance coverage that pushed health care costs over to those bringing their "lifestyle diseases" into the system, we were able to reduce preventable illnesses and conditions by only 30%. That's an additional $480 billion dollars saved.