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Fixin' Healthcare

Saturday, January 14, 2006

Trophic Cascade

The Australian Commonworth Government launched a preventive health program to encourage doctors to advise patients on how to change their lifestyles to improve their health. The US Government proposes financial mechanisms that place medical choices and decisions in the hands of the consumer (patient). And, US corporations require employees to take a greater share in the financial obligations of medical care.

Good public policy should represent the values and priorities of the people it serves. Australia is taking steps to improve health status. In the US, Healthy People 2010 is the program to improve health status and it needs to be the top priority of health reform. Otherwise, change will be a financial manipulation with deterioration of health status.

Change in health care is a complex and difficult concept. Achieving concensus will be unlikely. There is need to seek the change that will create a trophic cascade. An example can be found in nature with the change in the ecology of Yellowstone Park after the introduction of wolves. Ten years later, the number of elk has decreased and they moved to higher ground. This has changed the vegetation in the park and increased the number of smaller animals, birds and fish. It is expected the change will continue and the number of factors involved will increase.

Health care reform in the US must be approached with the goal to improve health status of all citizens. Currently, this does not appear to be the case but the opportunity is there.

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