Skyrocketing costs are forcing us to rethink health care practices. Heart disease remains our No. 1 killer, but Medicare is currently studying more than 1,000 heart patients participating in a non-surgical program for reversing heart disease. This program was developed by Dr. Dean Ornish of UC San Francisco, who has been featured repeatedly on PBS and appeared in a Bill Moyers program and book called Healing and the Mind.

It was long assumed that heart disease couldn't improve - that at best it wouldn't get worse - but Ornish showed that "comprehensive lifestyle changes" can shrink blockages in the coronary arteries. His careful research compared heart patients receiving standard treatment with those making numerous major lifestyle changes-a low-fat whole foods diet, stress reduction with slow stretching exercises and meditation, moderate exercise (walking), and participation in regular groups emphasizing communication and opening up with feelings.

Cardiac tests before and after the year-long study showed most of the "control group" becoming worse, while those making the changes had reduced arterial blockages, had much less angina pain, had often decreased or stopped blood-pressure medication, and felt better overall. Ornish later published a follow-up study showing that those who maintain these lifestyle patterns enjoy ongoing clearing of their arteries over several years.

Patients made all the changes simultaneously, so it wasn't known which were most important. Ornish thinks that feelings of love and interdependence are especially crucial. He cites extensive research showing "anything that promotes a sense of isolation often leads to illness and suffering [while] anything that promotes a sense of love and intimacy, connection and community, is healing." In his latest book, Love and Survival, Ornish says that "if a new drug had the same impact, virtually every doctor in the country would be recommending it for their patients [and] it would be malpractice not to prescribe it."

Some insurance companies now cover participation in the Ornish program, which can often be an alternative to traumatic and expensive cardiac bypass surgery. Medicare sets the standards, and they're now studying this program closely. If they start covering it, then all the insurance companies will-and we'll take a giant step to rein in medical costs while improving our health and nurturing the joy of living.

Brian Julian is a physical therapist. He has a website at www.humboldt.com/~bri/ and you can e-mail him at bri@humboldt1.com.