Washington is still operating the same way it did 50 years ago when infectious diseases, which struck people fairly at random, were the leading cause of illness. Since then, heart disease and cancer, which have a much behavioral component to determine who is afflicted rather than luck of the draw, have topped the list of leading illnesses. Fifty years ago, health providers were fighting the illness. Now, the fight is against human preferences – smoking, drinking, high calorie diets, sedentary lifestyles, etc. – which in turn bring about the illness.

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