He stated that the health care system in America is "irreparably broken" in that its focus is on disease and how to treat it, when the real challenge is how to prevent diseases. "There is a crisis," he said, and major factors are overeating, underexercising and smoking. Nationally obesity rates are up by 77-percent since 1990. In Arkansas 25-percent of citizens are completely inactive and 65-percent of the population is overweight or obese. The human and financial costs are staggering. For example, Huckabee said, when he became governor nine and a half years ago Medicaid costs to his state were $600 million; now they are $3.5 billion.
"How do we change the culture of health?" Huckabee asked. Addressing the causes of the problem, Huckabee said family plays a vital role; habits "are more caught that they are taught [in school]." Huckabee noted the "competition of portion" with "portions that are unlike anything Americans have ever consumed." As to the cure, he said that while government has an important role, unleashing "sugar sheriffs" is "probably not going to change the behavior of Americans.
In a thoughtful analysis, Huckabee cited several examples of how attitudes and the atmosphere in the country have changed and then government actions can be taken. For example, in the 1960s littering was common, then Lady Bird Johnson's beautification efforts came into play, and now most people will look askance at a litterer and there are significant fines for littering. Similarly, seat belts in cars started as an option, then were required in cars, and now people are required to wear them. Smoking is another example.
Huckabee said he favors incentives to encourage healthy behavior. For example, in Arkansas four hundred companies immediately registered for a fitness challenge program. He suggested that it might be possible to leverage food stamps so that a dollar of food stamps buys $1.25 of healthy food but only 75 cents of junk food.
Huckabee cited programs developed by governors in other states. As chairman of the NGA, he aims to use the year-long "Healthy America" initiative to raise national awareness and get Americans thinking about changing the culture of health.
