First, we know that prevention is more cost-effective than treatment. Emergency-room visits are more expensive than routine maintenance. Chronic disorders such as diabesity, hypertension, heart disease, strokes, and renal failure consume an inordinate share of health-care dollars. Smoking cigarettes is bad. Obesity and nutritional deficiencies are epidemic. Narcotic and substance abuse are rampant and rising. Fruitless, futile care at the end of life dominates a large proportion of the Medicare allocation. Reckless behaviours are responsible for much loss of productive and functional young lives. Cure and precision diagnosis are much more desired than mere control, maintenance, or palliation.
We also know that waste and multiplicative, superfluous, unnecessary redundancy whether in a paper-based or dys-integrated electronic information non-system have extraordinary costs both in real dollars and in time that could be allocated much more effectively. A systematized, constantly updated, searchable, linkable database with knowledge coupled to need and integrated problem lists (Lawrence Weed MD) and available at each point of care would reduce waste, repetition, redundancy, and the tendency for hand-off errors. Care could then be coordinated among all providers.
On the positive side, we know that workers who are healthy function much better with less absenteeism. Jobs, income, and reliable, portable health-insurance benefits add to security and productivity. Happy, contented people live longer and better, and many people already spend huge amounts of available income on a host of programs to improve their health and well-being. The quantified self movement is robust but, currently, peripheral to the mainstream.
We know that regular exercise, especially aerobic, improves clarity, mental functioning, and wellness. Having a meaningful, fulfilled, goal directed life of purpose and contributing to society and to aspirations larger than self also increase longevity. And meeting our basic needs, including shelter, nutrition, clothing, and security and maintaining appropriate levels of stress, balance, and moderation are essential ingredients for mental and physical well-being.
Thus, the goal is not simply to eliminate sickness or delay death. We must take a much more holistic and expansive view of health care that embraces wellness and enrichment, a view that is flexible and that adopts the best practice from moment to moment at every point of care, everywhere, everytime in the hecosystem (health ecosystem). Health and wellness are a COMMONS and the benefits of a deliberately and diligently run hecosystem accrue to us all globally.
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