The vision that
drives my work in amplifying health care reform efforts is one
of seeing a convergence of several trends producing what has been
called by some a 'retail health care marketplace.' This market, subject
to dynamics more similar to retail markets than current health care
is, would see the 'demand' side (consumers) more causal in what the
'supply' side (providers and plans) produces in the way of education,
coverage products, and so on.
This vision has
'wellness' at its core, in that a fundamental change in our lifestyle
here in American must reverse the current identity of an obese, sedentary,
and increasingly ill society to be one more of being 'well,' in the
sense of a self-conception, a sense of pride, a sense of identity.
Fundamentally,
it is my view that the 'cosmology of risk' must be re-defined to
create a measurable value of wellness, not just the degree of financial
exposure through risk. Without doing so, it seems impossible to focus
the system on what truly must be the goal if it is ever to be truly
viable. Risk mitigation in a population that is seeminly unalterably
committed to broadening its risk through unhealthy lifestyle behaviors
and cultural choices seems a poor strategy.
It is this basic
subscription to a different set of values that is required, in my
opinion, for any sustainable and meaningful improvement in the 'health'
of our health care system to take place.