In what passes for "the health care debate" in this country -- the only wealthy nation that doesn't attempt some form of universal care -- many states are forming commissions and holding hearings into how to face the two key issues of health policy: rising costs and declining coverage.

This week, a committee in North Carolina grappling with these issues heard testimony from various experts, which revealed a lot about how insurance companies view health coverage. Chris Fitzsimon of NC Policy Watch reports:

The outrage of the week comes from a presentation from an executive with Blue Cross Blue Shield of North Carolina to a legislative committee studying the cost of health insurance. BCBSNC Vice President John Friesen told the committee that lifestyle is the biggest driver of rising health care costs.

Friesen listed obesity, tobacco use and depression as the major cost items in the lifestyle category and said that 7 of the top ten prescription drugs that Blue Cross pays for are related to lifestyle.

Apparently, Blue Cross believes that mental illness is a lifestyle choice. People can choose to exercise and they can choose not to be mentally ill. That may come as surprising news to individuals and families devastated by mental illness, including depression. Folks should just choose to feel better, just like they should choose not to be poor.

This reminds me of Abbie Hoffman's classic zinger when asked to comment on then-first lady Nancy Reagan's infamous anti-drug campaign of the 1980s. Her "Just Say No" initiative, he said, is like "telling manic depressives to 'just cheer up.'" Maybe Blue Cross Blue Shield doesn't know that Abbie was joking.