Making America Healthy:
Our People and Our Economy

Can We Reduce Our Federal Debt and Create Jobs
by Making the Healthy Choice the Easiest Choice?

 What is the Issue?

Did you know:

  • The Congressional Budget Office (CBO) projects that the federal debt will reach $49.9 trillion by 2035 if current trends continue. That is 187% of our Gross Domestic Product (GDP)!
  • Other economists have projected the debt will reach 314% of GDP by 2050.
  • In the long term, Medicare and Medicaid are projected to account for 52% of all federal spending, while Social Security will account for 20%.

Is it possible to reduce the federal debt by improving health?  Our preliminary analysis says, yes we can.  If we can reduce the annual increase in Medicare and Medicaid spending by just one percentage point and extend the years of productive work life by 10%, the federal debt would be reduced by a third.  Without action to reduce the deficit and reduce Medicare/Medicaid spending, it is likely that the national economy will implode before the federal debt reaches these levels.

What Can We Do?

Investing now in lifestyle changes and making the healthy choice the easiest choice, will provide long-term savings. Assuming an annual cost of $200 per person to improve health, these efforts will cost approximately $62 billion/year for the full population of 310 million people.  Our calculations show that it may be possible for the $62 billion annual cost to be offset each year by the medical cost savings achieved by employers because of the improved health of their employees and dependents, and by new income taxes paid by health promotion providers whose annual revenues would grow from an estimated $2 billion to $62 billion. Furthermore, growing the field of health promotion to this size will create an estimated 280,000 new jobs.

To achieve a level of change in the health of the US population, will require a commitment to creating work and living environments that make the healthy choice the easy choice, raising the living conditions of people with low incomes, and providing health promotion programs that train people in the skills they need to achieve the health goals they set.


You are an important part of helping drive the change that is needed in America.
Here is some helpful information to learn more about this initiative:

April 2015 Webinar


Additional Resources

Below are a few key resources that provide more details on the topic.

Michael O’Donnell’s presentation at Institute of Medicine


Michael O’Donnell’s presentation at the Institute of Medicine meeting held July 30, 2014.










Editorial by Michael O’Donnell from the American Journal of Health Promotion, titled “Can We Reduce Our Federal Deficit and Create Jobs by Making the Healthy Choice the Easiest Choice?”. This document explains the concept and key issues.


Editorial by Michael O’Donnell from the American Journal of Health Promotion, titled “A Strategy to Create Jobs and Reduce the Deficit by Making the Healthiest Choice the Easiest Choice.


Editorial by Michael O’Donnell from the American Journal of Health Promotion, titled “Compression of Morbidity: A Personal, Research and National Fiscal Solvency Perspective”


James Fries article on The Theory and Practice of Active Aging, published in Current Gerontology and Geriatrics Research, 2012. This research supports the hypothesis that people with healthy positive lifestyle habits reduce the  number of years of disability at the end of life.






Art & Science of Health Promotion Conference (April 2012).


A Health Dividend for America: Opportunity Cost of Excess Medical Expenditures


Public Health ROI: Saves Lives, Saves Money















Additional Information

Health Enhancement Research Organization project “Role of Corporate America in Community Health and Wellness”.
Project Report


Our Next Steps

Our next step is to validate the concept and determine that our economic analysis is sound.  If it is sound, we will begin crafting messages to engage health professionals, policy analysts, community leaders, the general public, and state and federal governments in supporting this approach. We hope you will be willing to help us achieve the vision of a healthy economy and healthy Americans.

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