Our current health care system does not give us a good return on the dollar.

Have you ever bought something and then found out someone else bought the same thing for less? Maybe it was a new appliance or computer and someone else bought the same thing, or even a higher quality model, for half the price.

That wouldn’t sit well, would it? Yet in the United States, this is what is happening with health care. We pay two to three times the amount per person for our health care than almost every other country in the world.

Based on data from the Organization for Economic Cooperation and Development, we spend more than $8,200 per person per year on health care in the United States. This compares to $4,400 per year in Canada, $3,400 per year in England and $2,900 per year in Italy.

We pay more, but do we get more for our money? Do we pay more because we have Isuperior health care in this country?

Not really. The World Health Organization ranks the United States at 37th in health care performance, right between Costa Rica and Slovenia. Italy ranked second, England 18th and Canada 30th.

Another measure of health is average life expectancy. In the United States, average life expectancy in 2010 was 78.6 years. This compares to an average life expectancy of 80.6 in England, 80.8 in Canada, and 82 years in Italy.

In 1960, the annual health spending per capita in the United States was only $148, while life expectancy was equal to that of Canada, England and Italy.

Increased spending and decreased health in the United States have many causes. One of them is obesity.

The Centers for Disease Control reports the prevalence of obesity in this country is 35.7 percent. This compares with a prevalence of 22 percent for the rest of the world.

In 1980, while annual health care spending per capita in the US was only $1,100, the prevalence of obesity was only 15 percent.

Though there are other causes of this nearly eight-fold increase in health care spending over the past 30 years, we do know that obesity leads to an increased incidence of chronic disease, including diabetes, high blood pressure, heart disease and many types of cancer, all diseases with high associated costs.

Our current health care system has lost both the “health” and the “care.” It has become an “illness treatment” system, not a health care system.

Obesity is expensive.

For example, we know that coronary artery bypass surgery, also known as open heart surgery, saves lives, yet it costs from $50,000 to $100,000 and does little to prevent further blocking of arteries.

High cholesterol, high blood pressure and diabetes are not caused by a medication deficiency. Yet traditionally, health care in this country has focused on using medications to treat numbers, be it the blood pressure, cholesterol or blood sugar. The focus has been on treating the complications of diseases, not the causes.

The cause in many of these diseases is lifestyle and the resultant obesity. Many chronic diseases can be effectively prevented and treated with lifestyle changes.

For the past two years, the staff at the Richmond Area Health Center has been doing just that, working together with patients to make a difference.

Through a simple, no-cost program based on identification, encouragement, affirmation and caring, patients have been losing weight. In the past 12 months, 400 patients lost a combined total of 3,223 pounds.

In the two years since inception of this program, a combined total of more than 7,800 pounds has been lost by patients through lifestyle changes.

This is the kind of reform our health care system today needs.

While obesity is not the only area for health care reform, it is a start. Healthier lifestyles and weight loss can mean fewer medications, fewer procedures and patients who feel better and are more active in their day to day life.

Health care reform must happen.

Our system must become one that focuses less on treating the results and consequences of illness and more on treating the causes, on encouraging healthy lifestyles and on prevention.

Tom Bartol is a nurse practitioner at the Richmond Area Health Center.