The writer is president and CEO of Blue Cross and Blue Shield of North Carolina. This is adapted from remarks made at the March 19 annual meeting of Moore County Partners in Progress.

This is a great time to talk about health care. We're certainly hearing about it from the presidential campaigns, and many of us are talking about what should be done to deal with rising health-care costs.

Much of what we're hearing consists of "sound bites," where it's always someone else's fault. In many cases, it's insurers and pharmaceutical companies that are taking the blame.

But nothing is ever quite that simple in health care.

We've developed a health-care system in which we focus on the symptoms, not the underlying problems. For example, there's always discussion around how we should deal with the nation's 47 million uninsured. Without question this is a serious problem, but it's symptomatic of the fundamental problems we face in health care.

To set the stage, let's look at one of these problems. The costs related to physical inactivity, poor nutrition and smoking are threatening the financial viability of our health system. The costs of unhealthy lifestyles are a leading reason that more and more businesses and individuals are finding health care unaffordable.

Consider these statistics:

-- Medical care takes up an ever-increasing amount of the national economy. In 2004 and 2005, medical spending accounted for 16 percent of gross domestic product, according to the Centers for Medicare and Medicaid Services (CMS), up from 13.3 percent in 2000.

-- Chronic, often preventable diseases cost at least $300 billion to treat and result in an estimated $1 trillion a year in lost productivity, according to a report last year by the Milken Institute.

-- Roughly half of premature deaths in the U.S. are related to modifiable lifestyle factors, according to the Centers for Disease Control and Prevention.

-- In North Carolina alone, physical inactivity and poor nutrition cost $24 billion a year, according to a study by Be Active North Carolina.

Among Blue Cross and Blue Shield of North Carolina customers, nearly 80 percent of our medical costs are incurred by about 22 percent of our membership. These customers have one or more chronic conditions such as diabetes, asthma, high blood pressure, high cholesterol, heart disease or obesity.

If you were to guess what percentage of our nation's medical costs stem from chronic diseases related to lifestyle, you'd probably guess too low. It's actually 70 percent, according to the U.S. Centers for Medicare and Medicaid. That means most of our health-care dollars are spent on health conditions that are often preventable.

All of that may sound scary. We all know that health-care costs are rising at historic rates, and poor employee health is having a profound impact on the bottom line for all of us. Is there anything we can do about it?

Yes, there are a number of things we can do to make a difference in health care and in keeping rising costs in check. And it all starts with each of us taking some responsibility, which isn't often an easy sell. Here are some steps we should take:

-- Live healthy lifestyles. We don't all have to work out for hours on end every day. By simply walking 30 to 45 minutes on most days of the week, and by reducing our caloric intake by just 100 calories a day, most people can start to improve their health significantly.

-- Make sure that employers take action to engage their employees in health and wellness. Businesses large and small can change their culture to embrace healthy living -- and, for little cost, provide incentives to help their workers. A good example is to start a lunchtime walking group. Employers that don't embrace health and wellness must understand that an unhealthy work force hurts the bottom line.

-- Provide greater transparency on the quality and cost of medical services. For too long, consumers have been kept in the dark about the quality of the doctors, hospitals and other providers that they receive medical services from. And they've been insulated from the true cost of health care. We're beginning to see movement in this area as the health care industry is making more data available to consumers, but we still have a long way to go.

There are some additional actions that will help, such as fixing the tort system, taking a hard look at drug costs, and providing simplification in health insurance. Taking all of these steps means hard work and making tough decisions.

The 30-second sound bites you're hearing these days may sound enticing. But keep in mind that it took us 35 years to develop these problems in health care, and they won't get fixed tomorrow.

No one company or individual has all the answers when it comes to making health care more affordable and improving our health as a nation. If we work together, however, we can make real progress in fixing our nation's health care system.