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Slash health care costs in five steps


When I started writing this column four years ago, I decided I would never use it to talk about political issues. My goal has always been to help people—many more people than I can see in my office—by giving sound, practical, common-sense medical advice.

Much to my dismay, our health care system has become a political football over the last three years. And leading up to the November election, you’re sure to hear all sorts of contentious talk about why the system is flawed, and how to fix it.

Amid all the debate, one fact stands out as true: Our health care costs will most certainly bankrupt our country if we don’t find a way to rein them in.

Each party has proposed solutions, but today, I want to let you know what you can do to help. After all, no matter what the election outcome, the most important ingredient in our health care system now, and always, is how you take care of yourself with your doctor’s help.

Below is a step-by-step guide to how you can reduce health care costs while also enjoying a better quality of life. Consider this my nonpolitical manifesto for how to radically improve our health care system.

If you don’t already exercise at least five days a week, start walking 30 minutes every day. As a nation, we spend billions of dollars a year on obesity, tens of billions more on diabetes, ever more billions on depression and arthritis.

Guess what. Thirty minutes of walking daily plays a role in preventing all of these maladies. Free to you and free to the taxpayer, walking is what was intended for humans before we moved out to the suburbs and started driving our cars and commuting back to the cities for work.

If you smoke, please stop! Smoking-related diseases and deaths cost our economy roughly $100 billion a year. If every American chose not to light up, we’d save $1 trillion over the next 10 years. (Washington politicians always speak in 10-year budget windows when passing legislation.)

The savings would come from reductions in asthma, emphysema, chronic bronchitis, cardiovascular disease and lung cancer. There would be less need for medicines and hospitalizations and fewer deaths, and our country’s economic output would improve because workers would take fewer sick days.

Cut down on calories. As mentioned above, obesity-related health care costs are rising year after year at alarming rates. Obesity is a contributor to diabetes, heart disease, reflux disease and arthritis, among dozens of other conditions.

Focus on the low-hanging fruit: cut out all sugary beverages (sodas, teas, juices) and drink more water. Eat only half of what any restaurant tries to serve you. Shop in the produce aisle, and pick up lots of fruits and vegetables long before you ever get to the snack section of the grocery store. And by all means, see the above paragraph about walking if you don’t already exercise.

Chill out! Forgive me for sounding dismissive, but it is nearly impossible to communicate the impact I see in my day-to-day practice of stress on the human body.

I have written previously about the fact that Americans use antidepressants more than people in any other nation on Earth. We use more narcotics than anywhere else on Earth—stress intensifies and amplifies physical pain. And we visit the doctor more for depression and anxiety than people on any other nation on Earth.

Meditate, practice yoga, exercise, seek social contact, but please don’t work yourself to death and please don’t ignore the importance of your emotional health.

Find a primary care doctor. This sounds self-serving, but I will be the first to admit that if you walk every day, avoid smoking, control your calories and relax, then this is also the least important piece of advice in this column.

However, once you cultivate a relationship with a primary care doctor you trust and can partner with, you can engage in cost-effective preventive screenings.


Some of the most cost-effective things primary care doctors do are dirt cheap. By checking and treating high blood pressure, countless heart attacks and strokes are prevented. By screening for diabetes and high cholesterol, countless more are prevented.

By treating diabetes early (because we found it at your preventive physical), we can use generic medications to control your sugar rather wait for your kidneys to fail, your eyesight to disappear, or your leg amputation to be scheduled.

By engaging in smart cancer screenings, we can prevent colon cancer and more easily treat breast cancer. And by maintaining your vaccines, we can prevent innumerable cases of hospitalization, disability and death.

And please—if you have a primary care doctor, call his or her office before ever going to the emergency room. The difference between the inexpensive cost of a visit to your doctor and the astronomical cost of the ER is huge.

Once you have a primary care doctor you trust, don’t be afraid to ask him or her questions! After all, the physician–patient relationship is a partnership. Questions you should ask:

  • Is there a generic alternative for this medicine? You might have Medicare or generous insurance, but collectively we are all still paying for overpriced brand named medicines.
  • Is there an alternative to this test? Nothing is free, but some tests are more expensive than others.
  • Are there alternatives to this treatment plan? Sometimes, great questions allow me to communicate more thoroughly what options lie before my patients.

So, as you are inundated with political advertising for the next two months, remember that your health is something that should transcend politics.

It might seem ridiculous, but with all the talk about Medicare, Medicaid, the costs of private health insurance and medical care, you might just see that taking good care of yourself can be a patriotic activity.

By choosing to better take care of ourselves, we reduce the health care costs of every owner of a private insurance policy and every taxpayer-funded program. Maybe you can hum “The Star-Spangled Banner” on your next 30-minute walk.

MORE INFO: For a wonderful visual about all the benefits of walking, watch this video:

For a guide to interacting better with your doctors, see this site:

Dr. Christopher Lillis is an internist with Chancellor  Internal Medicine in Fredericksburg. He can be reached at