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Fixin' Healthcare

Friday, July 08, 2005

Pour A New Foundation

Health care is a large enterprise that touches everyone in one way or another. The health care system is loosely organized and difficult to manage. It has been impossible to reform. Growth is the only change the health care system has known. Yet, there are serious problems that confront health care in the United States. High cost, limited access and deteriorating health status relative to other industrialized countries top the list. Almost everyone can agree that reform is necessary but no plan of action has broad support.

Fear, hope, scientific progress, development of technology, higher education, professionalism, specialization, commercialism, competition and politics are among the factors that contribute to sustained momentum in health care. With so many vested interests, sometimes the obvious truths are overlooked or ignored. The usual result is a practical course of action that modifies the existing system to resolve specific problems. This is not an effective method for reform because the old problems often persist and new ones are created.

Changes in the health care system frequently do not lead to predictable results. The major groups directly involved or with a vital interest in health care are quite nimble in their response to gain advantage or preserve the status quo. The details may be different but the outcomes often circumvent intended reform.

Health care in the US is medical care and medical care is a highly specialized activity that functions best when treating illness and injury. Medical care has not been successful in addressing the lifestyles that cause most of the chronic diseases. It is not a matter of whether the country needs medical care but whether the country can afford so many sick people. Society needs optimum health status for the greatest number of people at the lowest cost.

American society has demonstrated an escalating trend to present a wide variety of personal and social problems to medical care described as sickness. The medical care enterprise has promoted this trend with aggressive marketing. It is difficult and expensive to distinguish between need and demand when problems are defined in the context of sickness.

Medical insurance functions as a financial tool to manage illness and injury. It has not been an effective mechanism to manage health risk and prevent health problems. The traditional role of insurance to share financial risk is indefensible in a population where unhealthy lifestyle is prevelant. It is unlikely that providing medical insurance to everyone could result in optimum health status for the greatest number of people at the lowest cost.

Hopefully, medical care reform will make the treatment of illness and injury more effective and efficient, but it is community action on health promotion and prevention that might result in optimum health status for the greatest number of people at the lowest cost. Good health depends upon healthy lifestyle and healthy lifestyle arises from communtiy commitment and personal responsibility.

Health lifestyle is not one thing; it is everything. Nutrition, nutritional supplements, physical activity, adequate sleep and management of stress determine health status. A healthy lifestyle requires public health measures that assure immunization status, clean environment, safe water and safe food supply. Spiritual lives, service to others and respect and courtesy for everyone are important components of healthy lifestyle.

Development of healthy life style for the community requires input from the community. There is urgent need for thoughtful deliberation and public debate regarding the development of programs for health promotion and prevention that apply equally to everyone and include incentives, rewards and penalties. The purpose is to formulate, evaluate, propose, promote and implement plans of action to improve health status.

The following questions are only a beginning.

Is American society oriented to health or sickness?
Does it make a difference whether society is oriented to health promotion and prevention or sickness?
Can a community develop, promote and sustain healthy lifestyle for everyone? If so, how?
What defines community?
Are people capable of the individual responsibility required for healthy lifestyle and preventive health care?
What incentives, rewards and penalties could work for health promotion and prevention?

Your responses will be summarized and used as the basis for additional articles to move the public dialogue forward.

There is no topic more important to America today than good health.


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