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Fixin' Healthcare

Thursday, May 11, 2006

The Lifestyle Chronicles - Health Works For Everyone

The recent death of Jane Jacobs at age 89 years provided occasion to review her contributions to critical thought and to society (Leonard Gilroy, Wall Street Journal May 2, 2006). A working mother with no formal education in urban planning, she published in 1961 a book entitled “The Death and Life of Great American Cities”. She mobilized citizens to fight the redevelopment and highway construction plans for New York City that would have displaced 10,000 residents and workers and destroyed thousands of historic buildings.

The central theme of her work is that cities are vibrant living systems, not the product of grand, utopian schemes concocted by overzealous planners. She believed the focus should be on how cities function rather than how they look and no other expertise can substitute for local knowledge. Her ideas were born from the urban renewal efforts that resulted in isolation or destruction of previously vibrant neighborhoods and failed to realize the goals of the planners.

Other than a fascinating concept by an astute lady, how does this fit with the current situation in health care? Well, medical care is a highly engineered enterprise that treats the sick but falls short of achieving optimum health for individuals and communities. Once a person has a chronic disease such as diabetes, hypertension, arthritis or cancer, the potential for achieving good health is limited and highly inefficient. And, unhealthy lifestyles are creating chronic diseases at an alarming rate.

The tragedy of American health policy and American society is excessive reliance and emphasis upon medical care to treat people after the onset of illness and disease. The results speak for themselves in the escalating cost and deteriorating health status. This situation can be countered by increasing the emphasis upon public health and prevention as an active community enterprise and an active health care practice.

People are responding to the escalating cost of medical care and to the realization they are paying so much and feeling so lousy.

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