America treats disease. We don’t prevent it. And until we create a system of health care that is built on the foundation of disease prevention, then the cost of health care never will be controlled. And all the campaigning, community discussions, blog posts, Congressional debate and legislation will yield nothing more than an additional drain on our already teetering economy. Chronic diseases are the leading cause of death and disability in the United States. Yet, most cases of chronic disease are preventable. [IMGCAP(1)]According to the Centers for Disease Control and Prevention, physical activity reduces the risk of dying from coronary heart disease and of developing high blood pressure, colon cancer and diabetes. It helps maintain healthy bones, muscles and joints; reduces symptoms of anxiety and depression; fosters improvements in mood and feelings of well-being; and helps control weight, develop lean muscle and reduce body fat. And physical activity can help reduce blood pressure in some people with hypertension.According to the Partnership to Fight Chronic Disease, 45 percent of Americans — that’s 133 million people — have at least one chronic disease. And people with chronic conditions are the most frequent users of health care in the United States. They account for 81 percent of hospital admissions, 91 percent of all prescriptions filled and 76 percent of all physician visits. In fact, chronic diseases account for the vast majority of health spending. In 2005, total U.S. spending on public and private health care was roughly $2 trillion. More than 75 percent of that spending went toward the treatment of chronic disease. In publicly funded health programs, spending on chronic disease represents an even greater proportion of total spending: more than 96 percent in Medicare and 83 percent in Medicaid. What’s more, the number of people with chronic conditions continues to grow.If we are to bring the cost of health care under control and build a health care system that works, then the discourse must start with ways for improving how we address chronic disease. Namely, we need to promote a culture and medical system that embrace preventive care. And exercise and healthy living must be at the hub. The health and fitness industry recently launched the Campaign for a Healthier America, a national grass-roots project bringing together health-conscious Americans in a movement to encourage all Americans to make smart lifestyle choices. The campaign seeks to join the fitness industry with government, employers, medical and public health professionals, insurance providers, schools and each of us individually to create a culture of wellness that supports a health care system based on disease prevention.Surveys sponsored by the International Health, Racquet & Sportsclub Association underscore just a few examples of the many areas where our current health care system, legislative system and culture have failed to support basic prevention: • Seventy percent of Americans say they had an annual physical last year, but less than a third (28 percent) say their doctor suggested exercising regularly to improve their overall health; a mere 15 percent say their doctor suggested exercising regularly to improve or prevent a chronic condition; and less than half (41 percent) say their doctor asked if they exercised regularly. • Ninety-nine percent of Americans believe exercise helps preserve good health, but most feel they have to battle current culture to exercise regularly. • More than three-fifths of Americans (61 percent) believe the government should do more to promote physical activity, and more than half of those polled (51 percent) say the federal government currently doesn’t do enough. The tenets of any successful health care system must include:• The vigorous promotion of regular exercise and healthy eating for people of all ages and physical conditions; • Intrinsic grass-roots efforts that engage Americans in making their communities healthier; and • Public policy and legislation that make exercise and healthy living affordable for all Americans. Financial barriers to exercise and healthy lifestyles must be removed by creating economic incentives, including appropriate tax incentives. President Barack Obama is right. Health care reform cannot wait, it must not wait and it will not wait another year. But if any reform has even the slightest hope of working, it must be built on the principle of prevention first.Joe Moore is president and CEO of the International Health, Racquet & Sportsclub Association.