Consider the cost of food: Until it is cheap and easy to purchase fresh food compared to fast food, a majority of people without the resources will not eat healthy. As a past resident of Philadelphia, PA, I have seen the scarcity of fresh food in the inner city and children who eat daily at McDonalds because it is cheap and easy for families.

Also look at education. Physical education is a scarcity. No longer is the value of daily exercise enforced, nor the basics of exercise being taught.

All of this is forming a generation of people who may hear that a healthy lifestyle is best but the daily life does not reinforce the choice.

The commitment needs to be from all parties, not only the health care system.

I think it’s going to emanate from the workplace. Employers are starting already to clamp down on poor lifestyle choices, especially smoking. I read about one company that fired everyone who didn’t quit smoking by a particular date. I’m sure that case is being litigated, so the final word hasn’t been written. Frankly, as a healthy person who subsidizes the 20% of people who incur 80% of the cost of my employer’s plan’s claims, I say good. Besides, being healthy is just objectively better than the alternative. Unless, of course, it’s just a genetic condition, in which case lifestyle changes aren’t going to make a big difference.