James H. Rimmer, Ph.D., Director

The other day I was dreaming about having a conversation with President Bush before he took to the air for his State of the Union message. In my dream, he had gotten wind from one of his staff members that there was this lone voice in Chicago who had dreamt up this extraordinary idea for a health promotion plan - that's health promotion, mind you, not health care - that would meet the needs of all Americans, including people with disabilities.

I would begin by telling the President that the nation is in a "deep freeze" regarding innovative ideas and strategies for helping people connect to the extraordinary physical, and more importantly, psychological benefits that can be attained by practicing good health promotion, which of course includes lots of opportunities to participate in indoor and outdoor physical activity. People with and without disabilities alike would meet in neighborhood parks, community centers, malls, gyms, etc., to engage in one of the most important and essential aspects of human existence - movement. After this brief introduction, I would furnish the President with the grim statistics regarding the health of our nation's citizens: millions with heart disease, diabetes, obesity, arthritis, back pain, kidney failure, cancer, lung disease, limb loss, blindness, and neurological conditions. And this doesn't include the millions more with severe and uncontrolled depression; young children heading down a dangerous path consuming large quantities of high-fat/high-salt/high-sugar foods and finding solace in sedentary behaviors in front of TV sets and computers in place of climbing monkey bars, playing kickball and sleigh riding; and the elderly with disabilities ignored and neglected by society, living in social isolation with little or no access to any type of movement or physical activity.

As the President sat across his desk listening intently, my dream continued: "Jim, do you have any ideas on how we can get people with disabilities to think about good health promotion practices? In my State of the Union message, I am going to propose a new health care initiative that provides coverage to the uninsured and underinsured, but I am only focusing on providing more medicine and better hospitalization." This is the point in my dream when I turn on the juice - using the remaining 3 minutes of my time to explain to the President that we must "turn off the faucet before we empty the bucket." With a bewildered look, he asks me to explain.

"Mr. President: There is an old Cornish test of insanity that goes something like this: A doctor comes into the room where a patient is sitting on a chair in front of a bucket hanging over a faucet and is handed a ladle. The doctor explains to the patient that he is going to turn on the faucet and begin filling the bucket with water. The patient is instructed to remove all the water from the bucket. As the story goes, if the patient begins ladling before turning off the faucet, he is declared insane. Mr. President, that's what our health care system is like - we're ladling before we turn off the faucet. We are providing more and more services to treat chronic conditions that are associated with an unhealthy lifestyle, but no one is "turning off the faucet." And so, we are ladling frantically, using limited health care dollars to treat various emergencies and more serious health matters such as open heart surgery, renal failure and lung cancer, and in the meantime, the water is rushing out of the bucket. Life can't exist without good health management and that starts with having access to fitness and recreation.

"And so, Mr. President, what we must begin to do is teach people how to turn off their own individual faucets by providing them with access to quality health promotion, and that starts with physical activity. For you and me, it's easy. Get the urge to exercise, and off we go for a run or walk. But it doesn't work like that for millions of people with disabilities who cannot run or walk, or who have no access to home exercise equipment or a health club membership. We must provide transportation and fitness club memberships to all people with disabilities. Both you and I are avid runners. How fortunate we are that we can run on a treadmill when it's raining or snowy outside. But how can we expect someone with a severe disability who is unable to walk or run, has no exercise equipment in their home, no access to transportation, and no money to purchase a fitness membership to turn off that gushing faucet that is flooding their lives with disease and hardship? Mr. President, one fitness membership per disabled person with a little transportation thrown in would be an enormous contribution to improving the lives of people with disabilities and would likely reduce other health care costs associated with physical inactivity. Thank you for listening, Mr. President."

You know what they say about dreams: Sometimes they come true.

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