The health reform debate and you: What next?

On Wednesday night, President Obama will deliver the traditional State of the Union address. Political observers expect Obama to acknowledge that the State of Health Reform is shaky, and they will listen closely for hints that the president will scale back what he'd clearly hoped would be his post-presidential legacy and fold it into broader plans for economic improvement for the middle class.

If Obama fulfills the predictions of some political observers and "panders" to average citizens, he will have serious trouble staying true to the left-leaning, far-reaching plan of his campaign health reform proposals. Not that he has much choice left, especially after last week's stunning defeat in Massachusetts. Republicans, of course, have just gained filibuster power with the ascension of Republican Scott Brown to the Senate seat of the late health care lion Ted Kennedy. Will they use it? Certainly, if plans put forth by Obama or congressional Democrats are unpalatable. The real question in some Democrats' minds may be: Does any kind of health reform taste good to the GOP? Republicans insist they are all for reshaping our health care landscape; the plan in front of them was just the wrong tool.

Thus the balance of power has shifted, and if true overhaul of our fragmented, expensive and unequal health care system is to happen it must occur on both sides of the political aisle. Ordinary Americans make a mistake, however, if they think they must wait it out on the sidelines, content with an occasional call to their elected officials or even a trip to the ballot box. This is a national conversation, and it demands the thoughtful, intelligent participation of all.

So what can - and should - you do to be part of the progress?

• Educate yourself: not about the subcommittee or health care lobbyists, but about your own situation. How much have your health insurance premiums increased in the last five years? How much did you pay out of pocket last year when the only available anesthesiologist for your son's surgery was out of network? Document your costs and be prepared to discuss them specifically and openly to your friends, coworkers and social media contacts. Whatever you paid last year, it's certain to be less than the health care costs paid by your congressman, who enjoys exceptional coverage.


• Reform yourself. Our overindulgence has caught up with us. For the first time in our history, today's children will not live as long as their parents. Overeating and lack of exercise have led to obesity and its sister health complications. Furthermore, cover your cough. Wash your hands. Eat right, exercise and help prevent the medical problems that are a major driver in health care insurance cost increases.


• Talk to your employer about starting a wellness program. According to a recent study, for every dollar companies spend on wellness programs, they save $3.27 on medical costs. The study, published in Health Affairs, also found that absenteeism costs drop by $2.73. If employers can save on medical costs by introducing weight management, stress reduction, smoking cessation and exercise programs to the workplace, maybe they will save enough to reduce health care insurance premiums.