As it happens, in an another article published this week, Leonhardt hints at one of the possible reasons Americans pay the most for health care but don’t live the longest:

We’re fat.

According to the results of a recent study published The New England Journal of Medicine, the U.S. is on the verge of a first-ever drop in life expectancy. “Looking out the window, we see a threatening storm — obesity —that will, if unchecked, have a negative effect on life expectancy,” said S. Jay Olshansky, PhD, one of the researchers involved in the study. The study concludes that obesity could end up chopping 5 years off the average American’s life.

Why are Americans fat? Well, a possible explanation is that we prefer to exercise our cars more than ourselves, and, further, we like to exercise our jaws on fast food while we let our cars do the heavy lifting. Sure, the rest of the world shares our fondness for salty, fatty food and motorized transportation, but because of cultural differences, budget constraints or lack of access, they can hardly keep our pace.

Yes, I know, fast food is an easy target. With all the bad press fast food companies get these days, you almost have some sympathy for them. Almost. But then you learn that obesity is blamed for 300,000 deaths annually and costs upwards of $100 billion dollars each year. And of course there’s heart disease, the leading cause of death for men and women over 35, which costs $300 billion each year. Heredity and smoking habits factor into those stats, but diet is huge component.

To look at it one way, our system of health care is weighed down by people who are suffering from the effects of fast food. Then think about the fact that according to Karen Davis of the Commonwealth Fund, 10 percent of the population accounts for 70 percent of health care expenditures.

But how do you get people to change their habits? Well, education is one way. It may seem like most people don’t need to be told that fast food is unhealthy, but according to recent study by the Annals of Internal Medicine, many people underestimate the calorie content of various fast food items.

Recently a Bronx city councilman named Joel Rivera proposed a zoning ordinance against fast-food restaurants. Some towns have zoning restrictions against fast food chains for aesthetic reasons, but what’s motivating Rivera is a concern about public health. While the idea has been derided by some as “nanny-state nonsense,” it has also picked up quite a few supporters.

The idea seems draconian at first, but when you read about rising obesity, ballooning health care costs and shrinking life spans, it starts to seem less extreme.

Late addition: Incetives to shed a few pounds: live longer, save at the gas pump