The president of the Iowa Nurses Association says health care reform must include efforts that encourage Americans to take steps to avoid obesity which can lead to diabetes and heart disease. Iowa Nurses Association president Ginny Wangerin of Clive says nurses value a "wellness perspective" that focuses on better eating habits and more exercise to prevent the onset of some chronic diseases.

"It’s critical that we understand what’s driving the increased costs in health care and a significant piece of that is the prevalence of chronic disease and the high costs of treating those chronic diseases,"she says. "And we’ve not done enough in terms of health promotion and disease prevention over the years."

Wangerin sees 2009 as "different" from 1993, the last time an effort was undertaken to enact major health care reform at the national level. "If nothing else, the efforts at that time really started people thinking and very often before we really embrace the need for change, we have to sort of struggle with those concepts and decide that the status quo really isn’t good enough," she says. "And so I think that we are definitely in a different time."

Wangerin says Americans are "acutely aware" of where they’re spending their money during this economic downturn, and the skyrocketing cost of insurance has built broad support for action on health care reform. "The willingness of people to say, ‘We need to do something and, even though the economy is tough, we need to make that investment or we will end up being worse off than we are,’" Wangerin says.

Senator Tom Harkin invited Wangerin to speak at a hearing in Washington, D.C. on Thursday. Wangerin, a part-time professor in the University of Iowa College of Nursing, holds a masters in nursing. Her term as Iowa Nurses Association president ends in October.