The #1 reason why Americans deter proactive health care is cost. No American, whether insured and unemployed or working and covered, is immune from postponing or otherwise actively managing care when they are still well.

55% of Americans say they can’t afford the cost of wellness visits out-of-pocket. This is especially true for the uninsured (81%) and the unemployed (76%).

Among the 1 in 4 Americans who did not see their physician for a wellness visit in the past year, 54% do not believe that a visit is worth the out-of-pocket expense.

You mean an 8-minute visit to hear your doctor say you should behave well isn’t worth much?

If the average family spends $15,000 per year on health insurance, is a $100 wellness visit just too cost prohibitive?

It’s not about the cost, it’s about the value and bang for your buck. Doctors are almost miracle workers for acute problems like pneumonia. People don’t have problems paying for feeling better within 24 hours. But people don’t want to pay for feeling better in 24 years. It’s understandable. Our brains aren’t wired for long term gain. The most addictive drugs in the world are those that take mere seconds to take effect. Lipitor or blood pressure medication or eating vegetables is hardly addictive.

How can we turn long term gains into addictive, short term benefits?

That’s really the only way we’ll get people to give a damn about their health in the future.

I say turn your health into a social game like Foursquare. Check in when you take your meds, go to the gym, walk to work, and eat like Michael Pollan. Tie this to your insurance premiums. In fact, I say turn life into one big game with various levels. Make the mundane fun. We’ve got the beginnings of the technology to do it. And I’m glad there are people like Dennis and Naveen who are there to show us how it’s done.

Americans don’t want to pay their doctors to be well in the future.