House Speaker Nancy Pelosi commented recently on the need for additional savings in health care in the government's ongoing overhaul plan: "There's, I believe, more to be squeezed out...from hospitals, pharmaceutical companies and docs."

Yet these potential targets comprise three rich historic sources of health care innovation.

Current health care reform rhetoric places much of the blame for our healthcare woes at the feet of hospitals, providers, and pharmaceutical and medical companies. How else could solutions coming out of Washington include reduced reimbursement, government sponsored drug re-importation, and weakened patent laws? One element that is consistently missing from these "solutions" is the most egregious cost driver in health care: patient compliance.

How is it the fault of insurance or drug companies that obesity and related conditions (diabetes, hypertension, heart disease, stroke) are at historic highs, and growing at epidemic rates?

America's diet and commitment to exercise is equally weak, yet over the past century, U.S. life expectancy has nearly doubled from 47 to 78 years. This improvement is largely the result of innovations by the US healthcare industry; innovations that have continued in the face of increased government interference and reduced patient trust, compliance and cooperation.

Consider just one mostly avoidable disease facing Americans today--but one growing at epidemic rates: diabetes.

According to the American Diabetes Association, there are currently 24 million diabetics in the U.S. This group has been growing at approximately 5 percent per year since 1990.

Unfortunately, the failure of diabetics to either modify their life styles or comply with proven treatment regimens costs the US billions of dollars. Consider the following statistics from the American Diabetes Association website:

The total annual economic cost of diabetes in 2007 was estimated at $174 billion. Medical expenditures totaled $116 billion comprised of $27 billion for diabetes care, $58 billion for chronic diabetes-related complications, and $31 billion for excess general medical costs. Indirect costs resulting from increased absenteeism, reduced productivity, disease-related unemployment disability, and loss of productive capacity due to early mortality totaled $58 billion. This is an increase of $42 billion since 2002.

The 2007 per capita annual costs of health care for people with diabetes is $11,744 a year, of which $6,649 (57 percent) is attributed to diabetes.

One out of every five health care dollars is spent caring for someone with diagnosed diabetes, while one in ten health care dollars is attributed to diabetes.

The overwhelming majority (>90 percent) of diabetics suffer from the acquired form of the disease, type 2. Type 2 diabetes is caused when years of excess sugar in the bloodstream overpower the body's ability to metabolize it. While there is some genetic component to the disease, this excess sugar is almost exclusively the result of poor diets and aversion to exercise. That is why, with rare exception, diabetes afflicts the obese. In the past, this disease struck people in their 30s and 40s. Now it is not unusual for endocrinologists to see pre-diabetes in teens.

Pharmaceutical companies have spent billions in dollars and man hours developing innovations to improve diabetics' ability to deal with their disease. These innovations, coupled with life-style changes, provide the opportunity for diabetics to lead nearly symptom-free lives. These treatments were developed, produced and distributed by pharmaceutical companies, not government laboratories. Pharmaceutical sales representatives, not the government, helped educate physicians and provided samples of new products for doctors to evaluate.

Pharmaceutical companies profited from solving a public issue, much as Boeing profited from solving the problem of how to transport people from one place to another. Yet healthcare companies are pilloried for following the same business model. Unfortunately, even with these life-saving products are available, it is amazingly difficult to ensure patients to take the drugs as directed. How will universal health care improve people's health when they refuse to exercise or change diets?

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