Opinion: Get Moving for True Health Care Reform

(Feb. 12) -- With health care reform ailing, President Barack Obama is, like a good doctor, looking to save the patient if he can. Some proponents have gone back to the initial diagnosis, asking what all this was supposed to accomplish anyway. Here's the answer: People would get healthier and health care would cost less.

Most Americans don't believe the Obama health care plan would do that. But here's an idea that just might: rather than create an individual insurance mandate that requires everyone to have health insurance -- a core element of Obamacare -- Congress could pass an individual exercise mandate.

Oh, I know it sounds crazy, but let me explain.

Medical researchers are accumulating piles of studies showing just what exercise can do to combat expensive health problems. People with mild depression improve as much with regular exercise as they do on antidepressants. Those at risk of diabetes are much less likely to develop the disease if they start walking several times a week. Pregnant women who exercise have lower-risk pregnancies and healthier babies. Regular exercise lowers blood pressure, may prevent osteoporosis and senility, and helps people sleep better.

There's no need to train for marathons; you can accumulate the recommended 150 minutes (2.5 hours) per week by raking leaves, vacuuming or walking around the parking lot.

Clearly, exercise won't keep you out of the hospital forever -- or you might be the unlucky guy who gets hit by a bus while you're out for a jog. But unlike many other health care "innovations," exercise is cheap and it works.

Well, it works if you do it. Many Americans don't, and they have a vast arsenal of excuses why. Many center on being busy, which is bunk. If Americans watch more than 30 hours of television per week, according to Nielsen, we have time to walk 2.5 hours or -- if desperate -- jump rope during commercials.

So we have a situation where we know something is good for us, yet we don't do it. According to the philosophy known as "libertarian paternalism" -- best articulated by White House Office of Information and Regulatory Affairs administrator Cass Sunstein -- when people persist in making choices they wish they wouldn't, government should step in and make it easier for them to make the right choice.

In this case, that could mean requiring all of us to exercise 2.5 hours per week. Some could opt out, either by convincing a judge that they had a really good excuse, or else by demonstrating that they had such generous health insurance that they would never wind up costing the public a dime despite their sloth. But the default would be to work up a sweat.

Oh, I know it would seem difficult to enforce, but much of our taxation is based on the honor system, too. And it would seem incredibly invasive, though many states require school children to take phys-ed, with few protests. Indeed, many Americans support mandatory gym class for kids. Why not for grown-ups too?

In any case, an exercise mandate would be far less invasive than requiring people to buy health insurance. The average family policy now costs upwards of $1,000 a month. If you figure each family has two workers, each earning $20/hour, that translates into six hours per adult each week to pay the premiums -- far more time than is necessary to get the health benefits of exercise.

So what's not to like? At first blush it seems ridiculous, but no more ridiculous than many of the ideas tossed around in the health care debate. I think Obama, who gets his exercise playing basketball, should give it a shot.