"Health care is a complicated business and there is no right or wrong way to do it -- that is illustrated by the fact that no two health care systems on Earth are the same. Each is the product of its people, its culture, its history -- and its reform is properly the preserve of domestic political debate," Andy Burnham, the United Kingdom's secretary of state for health, said at the Urban Institute this morning (click here to listen to his full speech).

Burnham wasn't in Washington to criticize the U.S. health system or to interject his thoughts on our reform efforts (although we suspect he has many). But he did have an interesting perspective to share. Like the U.S., the U.K. hopes to move toward a system that focuses on primary and preventive medicine, less "reactive" care after a crisis occurs. And he reminds us that just as a health care system is a product of a country's people, culture and history, so is a country's health. 

The United States and the United Kingdom share a problem: we live unhealthy lifestyles. (Dr. David Kessler, in his new best-seller, The End of Overeating: Taking Control of the Insatiable American Appetite, argues that the obesity epidemic is so severe that it has emerged as the biggest public health challenge of our lifetimes.) Burnham tells us that each minute; the UK spends 3,000 pounds treating diseases that could be prevented with physical exercise. He tells us that if the Brits do not radically change their lifestyles, 4/5 of all British people could be overweight or obese by 2050 and that the associated disease burden could bankrupt the National Health Service. He tells us that the UK ranks near the bottom of the European physical activity table (go to page 9 to see the graph). Unfortunately, the U.S. cannot boast better statistics.

But, as a former secretary of state for culture, media, and sport, Burnam has had his Department of Health set for itself ambitious goals to "get people active." Burnham insists that "treating people in a hospital is not a sign of success but a sign of a failure that brought them there in the first place." He views physical exercise as an "essential part of preventing ill health."

Yeah, we know that any talk of British health care sets off all sorts of alarm bells around Washington, so we'll add our standard caveat -- the health reform bills in the U.S. Congress do not put us on a path toward a British health care system. But that doesn't mean that we -- a nation that has its share of overweight couch potatoes -- can't learn from some of the U.K. innovations meant to make widespread cultural and lifestyle changes. (What Kessler would call changing the social norms.)

For example, the United Kingdom initiated the "Change 4 Life" program. This includes "Swim 4 Life," "Walk 4 Life," "Bike 4 Life" and "Play 4 Life." As part of the Swim 4 Life program, all Brits over 60 and under 16 can swim for free in public pools. In Bike 4 Life, the government hopes to encourage employers to provide showers, on site-repair and bike subsidies to employees. The UK may introduce a law that would prohibit cigarette vending machines and ban stores from displaying tobacco products. (We've taken some steps to restrict youth access, but laws also vary among states.)

Burnham maintains that throwing more money into a health care system will not automatically create change. It takes lasting and comprehensive changes (including lifestyle ones) -- making the system more accountable to the people that pay for it -- to create a health care system that is affordable, efficient and better for the long term. He acknowledges that the National Health Service is not perfect. But during the last decade, the British have put a lot of thought (and some more money) into their health care system. He believes that it has gone from poor to good -- and hopes that over the coming decade, it will go from good to great. In light of our own national health reform, we might be able to get some ideas from our friends across the pond.