These 5 health care culprits cost $1 trillion

While insurers, doctors, employers are criticized for making care increasingly expensive, experts say consumers also have to share some of the blame.

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By Parija B. Kavilanz, senior writer

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NEW YORK ( -- As the nation tries to deal with its annual $2.2 trillion health care pricetag, there's a way you can help save as much as $1 trillion: Take better care of yourself.

Experts say simple lifestyle changes such as cutting back on certain foods and not smoking could substantially shrink our medical bills.

"There's no way that we are going to halt the upward spiral of health care costs until we attack the causes rather than apply the fixes," said Dr. Margaret Lewin, medical director of insurer Cinergy Health and clinical assistant professor of medicine at Cornell University.

"Prevention is key but it is also very expensive," said Lewin.

"When it comes to health care dollars, preventive medicine won't help save money," said Dr. Kent Holtorf, an endocrinologist and founder of the Holtorf Medical Group in Torrance, Calif. "Preventive medicine just delays the onset of medical problems. It won't actually 'prevent' them." spoke to health care experts about hidden health culprits that are adding billions of dollars to our medical bills.

We love salt. Americans love their salty snacks so much that sales of stuff from the potato chip aisle of the supermarket have risen by about 20% during the downturn, according to research firm Mintel.

Mintel's research shows that 50% of kids, teens and adults say they eat salty snacks five times or more per week.

Excessive sodium consumption is a leading cause of hypertension, high blood pressure and other cardiovascular diseases in the United States.

The Institute of Medicine recommends that adults consume no more than 2,300 milligrams (mg), or about a teaspoon of salt, daily. The Centers for Disease Control and Prevention (CDC) estimates that most Americans age two and older consume about 3,436 mg of salt, about 1-1/2 times the recommended level.

Research group Rand Corp. said in a report in September that lowering sodium intake to recommended levels could save the nation $18 billion annually in health care spending.

"Heart disease and strokes are the first and third leading causes of death in the United States," said Lewin. "We estimate that the total cost to health care to treat both these diseases is as high as $475 billion a year," she said.

We love sugar. The CDC estimates that obesity and physical inactivity are the second-leading cause of preventable death after smoking.

Obesity is dangerous and expensive. According to an report earlier this year in industry publication Health Affairs, obesity accounts for 9%, or almost $150 billion, of all medical spending. That's up from 6.5% in 1998.

"National data show that physical activity levels [in the United States] have been fairly stable over the past 20 to 30 years. But in that same period, we're also consuming more calories," said Dr. Gilden Tsai, an assistant professor of medicine at the University of Colorado in Denver. Tsai said about 32% of adult Americans are obese.

Tsai said diet is the most common cause of obesity. "Sugary beverages, higher percentage of calories from fat, larger portion sizes are all contributors," said Tsai.

And obesity can also result in diabetes. The American Diabetes Association said the annual health care costs associated with the disease is $174 billion, an increase of 32% since 2002. That total includes a direct medical cost of about $116 billion and an indirect cost of $58 billion when people have to miss work due to health problems.

While some states are debating controversial polices such as a soda tax to address the problem, Tsai said consumers can take simple steps to at least prevent weight gain.

"Cut sweetened beverages, reduce portion size, avoid high-fat foods, eat more fruits and vegetables, and be more physically active," he said.

Dangers of alcohol. Excessive alcohol use is the third leading lifestyle-related cause of death in the United States every year, according to the CDC.

"Nearly a quarter of general hospital admissions in the country are either directly or indirectly related to alcoholism," said Lewin, who added that alcohol is responsible for 50% of all liver-disease related deaths in the United States.

The total direct cost to the health care system from alcohol-related health problems is about $45.5 billion, according to industry reports. "On top of that is the indirect costs to society from lost work productivity and driving fatalities," Lewin said.

Smoking. Tobacco use is the number one preventable cause of disease, disability and death in the United States, according to the CDC, which estimates that about 44 million American adults smoke cigarettes.

Each year, an estimated 443,000 people die prematurely from smoking or exposure to secondhand smoke, the agency said.

Although industry reports show that tougher smoking restrictions in the United States has reduced cigarette smoking, with the prevalence of cigarette smoking among adults declining over the past decade to 18.5% from 24.5%, past smokers may still have to deal with long-term health consequences.

"Even if somebody quit smoking ten years ago, they could still be facing health problems," said Lewin. The overall health care cost associated with smoking, according the CDC is $96 billion a year and another $97 billion in indirect costs to the society.

Pollution. "One of the biggest hazards to our health is pollution. This can be in the form of pesticides or other gases that we're breathing in," said Holtorf

A report last month from the non-profit National Academy of Sciences sought to quantify the "hidden" costs of energy production and use, such as the damage air pollution has on human health.

The committee estimated that air pollution associated with electricity generation and vehicle transportation contributed to $120 billion in health care problems in the U.S. in 2005, the most recent data available.

"Health damages, which include premature mortality and morbidity such as chronic bronchitis and asthma, constituted the vast majority of monetized damages, with premature mortality being the single largest health-damage category," Sara Frueh, spokeswoman with the National Academy of Sciences, said in an e-mail. To top of page

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