Commentator David Frum.
Commentator David Frum. - 
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Kai Ryssdal: The House and Senate aren't even back at work yet, but the health-care debate got kicked up a notch today all the same. The buzz around Washington -- widely reported but not yet confirmed by the White House -- is that the president will make an address to Congress next Wednesday.

Speculation is that he's ready to drop what's known as the public option. That is, a government insurance program, as part of a deal to get some kind of bill passed. Policy is often largely about the politics of an issue. But commentator David Frum suggests that for health care, it's personal too.

DAVID FRUM: How much does health care matter, really? The numbers suggest that for most of us individual behaviors matter more than anything doctors do.

The U.S. spends 60 percent more of national income on health care than the other advanced countries. Yet American life expectancy ranks below Italy's and Portugal's.

Let me suggest four simple actions to extend and improve American life and save hundreds of billions of dollars.

1: Everybody wear a seatbelt. Even now, one-fifth of American motorists go unbelted. The National Highway and Traffic Safety Administration projects that more than 1,600 lives could be saved and more than 22,000 serious injuries prevented every year if Americans wore their seat belts as often as Germans and Brits do.

2: Smokers: please quit. One-fifth of Americans currently smoke, and almost 9 million Americans suffer a smoking-related disease. We spend $75 billion per year treating those who will die from smoking. Those who live will incur costs of tens of billions more.

3. Everybody lose weight. Obesity is not nearly as lethal as smoking, but its health consequences are much more costly -- about one health dollar in nine for everything from type 2 diabetes to premature hip and joint disease.

4. Above all: If you're a woman of childbearing years, please: take extra care of yourself. Our infant mortality statistics are awful, worse than Cuba's. It's these infant deaths that pull down American life expectancy overall. Once Americans reach 65, American life expectancy ranks a respectable 9th in the world.

Why so many infant deaths? The shockingly high American incidence of premature birth: about one baby in eight. And the most important causes of premature birth are controllable: smoking during pregnancy, drinking, drugs, maternal overweight, and sexually transmitted diseases.

We all want wider health access and a more rational health-care system. But a big obstacle to a better system is our expectation that doctors, hospitals, and machines will save us from the harms we do to ourselves.

RYSSDAL: David Frum is a resident fellow at the American Enterprise Institute.

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