Although many Mainers enjoy good health and excellent health care, too many do not. Some have chronic diseases that might have been avoided with early screening and prevention. Others live where health care is hard to get or expensive. These are tough issues that result from a fragmented system.

There are no quick fixes, but there are ways we can all work together to improve health and health care. Our state health plan is a roadmap of tasks and activities for all of Maine, not just government, to undertake to make us healthier. The state health plan is the foundation for Dirigo Health reform.

The U.S. is facing a health care crisis. Costs are too high, and Maine is not immune. The reasons are complex and not easily solved. Insurance premiums rise in large part because we are not as healthy as we could be; our health care system isn’t always as coordinated and efficient as it needs to be; and our culture doesn’t always support disease prevention.

Current health care spending in Maine is over $8.3 billion. Almost forty percent of spending increases in recent years is for four chronic diseases – heart disease, cancer, lung disease, diabetes – and mental health issues. We know that many of these diseases can be prevented and all of them are more effective to discover and treat early.

In Maine, we are working to do something about our health. The plan is not just for state government or health professionals. It’s for all of us, working together toward a common vision of healthy people living in healthy communities.

What can each of us do to participate? Create a culture of health in our families, our schools, our workplaces. Commit to exercising more, eating smaller portions of healthy food and quitting risky health behaviors. If you have a chronic condition, such as diabetes or asthma, work with your health care providers to manage it effectively.

Know the signs of a heart attack – they can differ for men and women – and call 911 immediately if you even think you, or someone you love, might have symptoms. If you have children in school, be sure they are getting enough exercise and that they have healthy choices at lunch time.

What can we do as part of our community? We can work together to encourage healthy behaviors, support prevention activities, and adopt environmental changes that support health. Local government can develop safe routes to schools. They can support the healthy energy by purchasing green power. They can improve air quality by switching to biodiesel and adopting no-idling policies.

Communities can continue to support recreational activities for people of all ages. Schools can offer health promotion activities for staff and students and adopt strong policies to assure buildings are maintained to keep the air healthy.

What can our health care system do? Health care providers can continue to do the great job they do in helping Mainers be healthy. They can insist that “best practice” is standard practice and advocate that those paying for care reinforce this policy. They can continue to provide the hours of volunteer work to address some of our most pressing problems.

What can Maine’s government do? State government can build a culture of health by identifying state programs that support health (mental health, public health and environmental health). It can, and must, assure that programs work more closely together to improve efficiency and impact. It can lead the way in paying for prevention of problems, not just for fixing them once they occur.

These are just some of the things that can improve our health. The Governor’s Advisory Council on Health Systems Development traveled around the state and to listen to the ideas and suggestions of hundreds of Maine people. These were incorporated into a State Health Plan.

As a member of that council, I believe the plan is consistent with what people want to happen.

Since so many plans sit on shelves and collect dust, we have established short term measures and long term benchmarks to evaluate our progress. With over $8 billion being spent on health and health care, we certainly need some accountability for results. With Maine’s 60 percent drop in youth smoking over the past decade, we have evidence of what can be achieved when we set specific goals and work together.

It is within our power to make Maine the healthiest state in the nation.

Edward F. Miller is chief executive officer of the American Lung Association of Maine.