Some of our nation's largest health-care spending problems can be addressed by the most fundamental of solutions. Take, for example, the link between the future of America's economy and an inexpensive blood test. The director of the Congressional Budget Office, Peter Orszag, has been telling lawmakers and editorial boards that rising health care costs pose a fundamental risk to our economic future. He noted accurately that Medicare and Medicaid, if they continue growing at their current rate, are on a path to exceed 20 percent of the gross domestic product.

This is not an insurmountable dilemma, as long as policymakers embrace a core, fundamental truth in their work to shape the future of public heath programs. It is this: It costs less to keep people healthy than to treat them when they become seriously ill. Despite that, the very sad fact is we spend only about 5 percent of our national health expenditures on preventing disease and promoting health.

That fact carries enormous significance as millions of baby boomers make the transition to retirement, possibly bringing with them years of unhealthy eating and lack of exercise. One of our most serious chronic health conditions is obesity. Obese children become obese adults. More than half of the adult Utah population, 57 percent, is considered overweight or obese.

According to the Utah Department of Health, the number of overweight or obese people in Utah is greater than the entire population of Montana. And obese adults suffer disproportionately from heart disease and diabetes, among other diseases. In fact, a 2004 Utah Health Status Survey found that about 1 in 25 Utahns had been diagnosed with diabetes.

A more disturbing trend, however, is the increase in childhood obesity. An estimated 22.5 percent of Utah elementary school students are overweight or at risk of becoming overweight. Also growing is the rate at which children are developing type 2 diabetes, once considered exclusively an adult disease. The American Diabetes Association estimates that almost one-half of all new childhood diabetes cases are classified as type 2. A likely cause of this increase is the childhood obesity epidemic. Our federal and state budgets are facing a ticking time bomb in the form of chronic disease and lengthy, expensive hospitalizations.

This brings us to the importance of that inexpensive blood test.

Diabetes, for example, is a very costly disease, in both human and economic terms. It causes blindness, kidney failure, stroke and, all too often, premature death. As a nation, the total cost of diabetes is more than $130 billion each year. A hemoglobin A1c blood test costs about $13. It measures a patient's blood-sugar control over time. The test serves as an early warning system for the potential onset of diabetes complications, enabling preventive steps that can avert years of misery. Having that test done can reduce the likelihood of a heart attack (which costs roughly $28,000 to treat), amputation ($27,000) and peripheral artery disease (about $6,000 annually per patient) by making patients and physicians aware of the need for better blood-sugar control.