According to the International Diabetes Federation (IDF), there area 285 million people worldwide who have diabetes.

The sad fact of the IDF report is that the brunt of the epidemic is among low and middle-income countries and affecting more people of working age than previously believed.

Reforming the health care system isn’t good enough, especially if there isn’t a component addressing why more and more people are demanding improved health care services that costs lots of money. Providing incentives to people to take better care of their lives and help prevent diseases, such as diabetes, and penalizing those with higher health care premiums who fail to practice preventative health care measures, such as diet and physical fitness.

For health care reform to work there has to be a degree of personal responsibility on how people take care of themselves. Taking another pill that’s now more affordable doesn’t address the cause of the disease. In the case of diabetes, in many cases, a lifestyle change becomes a critical component to treating the cause.

IDF predicts that diabetes will cost the world economy at least US$376 billion in 2010, or 11.6% of total world health care expenditure. By 2030, this number is projected to exceed US$490 billion. More than 80% of diabetes spending is in the world’s richest countries and not in the poorer countries, where over 70 percent of people with diabetes now live. The United States accounts for $198 billion or 52.7% of total diabetes spending worldwide.

Regardlessof health care reform and accessibility to health care coverage, if you don’t address the cause of the problem, the expense is still going to magnify itself dramatically. There’s no government solution to personal responsibility. America is going to have to start looking at itself if it really wants to address health care reform. It’s all about good choices and that starts with each and everyone of us.