America needs to rethink its entire health and wellness system, from the workplace on down to the elementary school level, in order to rein in runaway health-care and insurance costs, former Arkansas Gov. Mike Huckabee said yesterday during a visit to Pittsburgh.

But it's up to the corporate world -- not Congress and the new president -- to find solutions to chronic problems such as obesity and poor eating habits, which will in turn help to ease health-care costs, he said.

"The reason that I don't have a whole lot of faith that Congress is going to make the decisions and do the things that need to be done [is] politicians do not typically engage in policy changes that aren't going to be realized within their reelection term," he said. Health care reform is "not on fire in D.C. ...

"Don't look for Congress to fix this. It's going to be fixed in the private sector when companies start showing a better profit, and a better return, because they have healthier employees," he said.

Mr. Huckabee, who rose to national prominence in 2007 and 2008 during his failed bid to capture the Republican presidential nomination, was one of the headline speakers at a "health and productivity" summit organized by health insurer Highmark Inc. He spoke to a crowd of about 200 business representatives from around the region, all of them Highmark clients looking for ways to reduce health costs and promote workplace wellness.

Now an analyst for Fox News, Mr. Huckabee also is sought as a public speaker on health issues -- he once weighed nearly 300 pounds, and was diagnosed with adult-onset diabetes. Health issues were a major focus of his gubernatorial and presidential campaigns, and he once said he would support a federal smoking ban.

Yesterday, he said workplaces need to offer incentives -- cash, prizes, or vacation days -- to get employees to take their own well-being seriously.

Beyond the workplace, prevention must replace intervention as the primary goal of health providers. But doctors, for the most part, are still reimbursed by insurers for office visits and for procedures, not for having healthy patients. And insurers rely too heavily on actuarial tables, and not enough on common sense.

"We won't cover things like maybe a fitness program, or visit to a nutritionist, but we'll pay for a $100,000 quadruple bypass," he said. "Which is the most cost-efficient?"

Prevention needs to start at a young age -- he noted that gym classes have it all wrong, and he recalled his own gym class days when, like many students, he sought to avoid the dodgeball games and sit in the bleachers.

"P.E. is only important if it's actually physical education that's training students to be fitness-minded. If all it is is an extension of competitive athletics, it is worthless," he said.

Societal changes like these can take a generation or two, but Mr. Huckabee pointed to other health-related shifts as examples of what can be accomplished over several decades -- campaigns against drunk driving and cigarette smoking, and campaigns promoting seat belts. Forty years ago, every table in the Sheraton Station Square hotel ballroom (where the conference was held) would have had ashtrays on it, and most cars didn't come standard with seat belts until the 1960s.

The Highmark summit came a week after President Barack Obama met with health care industry officials and lobbyists, who promised to cut the rate of growth of national health care spending by 1.5 percentage points each year, amounting to more than $2 trillion over a 10-year period.