One aspect of growing older is that you see history repeated, in some cases over and over again. It didn't take long after passage of the health care reform legislation for the medical schools to ramp up a campaign to increase the number of physicians. I've seen this before and the increase of physicians brought more of the same; more specialty medical care, increased costs and increase in chronic health problems. You might say that I am harsh on medical care to lay the chronic health problem at their feet but medical care has not stopped or even slowed the increasing incidence of chronic diseases. The success of medical care is to sustain chronic diseases, which is preferable to death, but it robs people and society of vitality and treasure and distracts from addressing the cause of these chronic problems and preventing, as well as reversing them.
Now, none of that is to say health care and some medical care should not be expanded. By all means, increase the number of primary care physicians, train them in public health and community health and teach them to coordinate their services with other providers in the community. Create a community system to identify patient needs and bring the best level of care to address those needs in a sustained and coordinated fashion. Emphasize prevention because it is real and it is now. Callahan and Nuland
present a good concept. T. Colin Campbell presents a good basis for nutrition in his book, The China Study
. Community health initiatives are addressing lifestyles, physical activity, health promotion and prevention.