Despite evidence suggesting that disease prevention produces major improvements in longevity and quality of life, the role of prevention efforts in the United States health system is far from outstanding. Less than 5% of the nation's health care expenditures are for prevention of disease and injury in contrast to the nearly 80% of the nation's health care expenditures being devoted to treating people with chronic diseases. Tobacco use alone is responsible for billions of dollars in health care costs, as is obesity, including costs for the loss of productivity among those with obesity. Many in health care would suggest that prevention is a very cost effective solution to saving lives. If this is such a great concept, it would seem then, that people would embrace and practice prevention efforts more often in and effort to stay healthy. What do you think are some of the barriers and, more importantly, the "enablers" to prevention programs in managed health care plans and how do you think those barriers could be eliminated?