Comments

Dear Mr. Peters,
As a personal trainer you are preaching to the choir.

I became a trainer some 11 years ago after I worked in a hospital as an E.M.T.

I got so frustrated doing compressions on obese guys who came in with heart attacks.

For them, the idea of health was too late.

After seeing numerous heart attack victims, I got out of the hospital and got my certification as a trainer.

I'm much happier now. I can prevent the problem, rather than take the body to the morgue.

I always tell me clients, "you can pay me now, or you can pay for medications and hospital bills when you get older".

With compassion,
Stephen

Posted by Stephen Cooper at January 30, 2006 6:40 PM

Dear Tom,
Simple, Clear, Graceful, and Beautiful!

I am in the eLearning industry and, as with many other industries, a similar "Aha"! can be had. I find it delightfully refreshing to engage in LEARNING conversations as apposed to the E-Learning ones. Sure we still discuss technology, but that's just a given in today's world. Discussing LEARNING opens up the conversation to so many more possibilities and brings in a more diverse set of opinions.

I'm guessing the same applies to discussions around health instead of healthcare.
Cheers!
Brent

Posted by Brent Schlenker at January 30, 2006 8:01 PM

"Healthcare" focuses on those who do it. "Health" focuses on the reason they do it, and whom they do it for. Great insight. I 100% get it.

Posted by Steve Yastrow at January 30, 2006 11:47 PM

Tom,

You sound like my dad. He was very interested in improving health and encouraging others to. He started about 46 or 47 and died of a heart attack at 51. I'm now 54 and decided a couple of years ago maybe I'd better start walking. And I'm going to.

The answers are obvious. The execution seems to fall apart from the early 30's when you slow down and loose some of that 20's edge. At least for most of us. How are ya gonna motivate me and my dilapidated cronies to actually do it? Until you do, we're stuck with "healthcare."

P.S. As a manager in healthcare, I could be out of a job if this idea picks up steam.

Posted by Donald Brown at January 31, 2006 12:45 AM

This is brilliant! Healthy TP "followers" will outlive their opponents! As Max Planck said: "An important scientific innovation rarely makes its way by gradually winning over and converting its opponents. What does happen is that its opponents gradually die out and that the growing generation is familiarized with the [new] idea from the beginning."

Posted by Mike L at January 31, 2006 12:56 AM

Tom - how about calling it "Caring (a lot) about Health."

Posted by Mark J Foscoe at January 31, 2006 2:39 AM

In 1992 the British Government published a document ‘The Health of the Nation’ where the emphasis was on ‘health’ rather than ‘care’ in the UK. The problem has been getting political 'will' to actually shift resources from the ‘care’ to 'health'.

Targets introduced in that document to reduce coronary heat disease, stroke, cancers, mental illness, accidents, HIV/Aids, smoking etc., have concentrated the minds of all managers in the NHS since 1992 and have proved a useful focus. And there have been significant reductions.

BUT

If we are serious about ‘health’ rather than ‘care’ we have to overcome the Pareto effect – 20% of investment in ‘health’ and 80% in ‘care’ while 80% of health ‘care’ is provided by ‘self care’ or primary health care services and 20% - (probably less) actually happening in hospital or other 'clinical care' settings. When people become ill the first port of call is family and friends. Second it is the local pharmacist. Third it is the family doctor and if you are really unlucky FOURTH is the hospital.

The report I highlighted yesterday elsewhere on this Blog http://news.bbc.co.uk/1/hi/health/4655514.stm gives the latest Government intention to actually shift resources from the hospital to community which in essence is the same thing and I wish the government well with that. It is an ambitious ten year plan.

HOWEVER ….

In the end it is down to us all as individuals to make the most of our own health. We can all do something and it is not good enough to expect any government to do the work for us. We can all exercise; we can all improve our diet; we can all drink less;

And by the way I don’t go along with the saying “If you do these things you won’t live any longer – it will just feel like it’ :-)

Stay passionate Tom about raising this – we all know it makes sense

Posted by Trevor Gay at January 31, 2006 5:02 AM

This caused me to remember that in the old days doctors were paid by how many healthy people they looked after. They then had to concentrate on prevention, care etc... does it make sense that the health community earns more if patients are unhealthy ?

Posted by Anna at January 31, 2006 5:49 AM

Be careful here, you don't know who you're going to provoke! If you focus on health, there are going to be lots of targets (companies/lobbies) whose profits come from promoting disease (unhealthy 'foods', 'drinks' and of course, tobacco). Have you also seen the research on British Civil Servants that points to hierarchy as a cause of serious ill-health?

Posted by Chetan Dhruve at January 31, 2006 6:15 AM

You are wise Obi-Wan...

Posted by davidcoe... at January 31, 2006 6:39 AM

I don't disagree at all but at some point we must put more emphasis/metrics on education and prevention - and the politicians etc have a serious role to play here. It just feels to me that the system does not promote health it promotes ill health - we need a revolutionary approach rather than the same old thing. I agree any new approach would probably never go through as it would be too radical in terms of lost funding for the politicians !!

Posted by Anna at January 31, 2006 6:47 AM

Health, wealth and happiness. People should manage it and be extremely skeptical of big pharma "solutions".

I'm convinced that 6 hours of sleep is more normal for adults - big pharma claims 8-9 so one craves their products like Ambien ... caveat emptor - especially with addictive pharma like "sleep aids and painkillers" ...

Posted by Sean at January 31, 2006 9:28 AM

Often, we re-package concepts semantically with no practical change occuring. That said, sometimes a simple shift in semantics makes something more understandable - more identifiable - and more relevant to individuals/customers/patients.

Granted, we can improve our 'health' by adjusting our nutritional intake, exercise regimens and stress-coping mechanisms - but there will always be bacterium, virus strains, genetic dispositions (to Cistic Fibrosis, etc.) and natural wear and tear on our complex biological systems that will require 'health care'.

Call them what you want. We'll always need both.

Posted by Tom O'Leary at January 31, 2006 11:47 AM

I always like your realism Tom O' – I suspect you are like me - an idealistic realist :-)

You are right of course we will always need both but hey – let’s just get the thing in proportion is all I am saying.

‘Care’ (by which I mean treatment) is the ‘hard’ end of health

Prevention/promotion is the ‘soft’ end

When it comes to allocating money from government too much goes to the ‘hard’ end and yet we all know that most health care is actually self care or family provided care. I have said elsewhere that if family carers stopped providing care today the UK National Health Service would be bankrupt tomorrow. Family Carers save the government 35 billion pounds per year at the last count!!!!

This is a great topic and I am delighted TP is rattling the health cage so strongly. If only we had people with his passion running health services over here the sparks would surely fly in a very positive way.

Posted by Trevor Gay at January 31, 2006 12:33 PM viagra cheap overnight

I once participated in discussions following focus group work on healthcare. It turns out that when you ask a group of people what "health" means to them, they say things like wellness, mind-body, prevention, living well etc. When you ask what they think of when you say "healthcare" they say - hospitals, bills, hassles, dying, sickness, illness etc.

Posted by Helen at January 31, 2006 3:01 PM

I don't think many people disagree with the fact that a focus on prevention is a good thing... in fact it is the area of influence where the greatest amount of improvement for our society's health can occur. The issue is how? How do we make mass enviornmental, behavioral and cultural changes that can push our perspective of health care to health maintenance?

Having gone through graduate school, studying health promotion, it seemed like "we" can make a difference by changing how people view their health. But after working a brief period for a large health promotional campaign / program. I was somewhat let down by the lack of progress.

People are primarily concerned about the moment in many venues of their lives. Health, finance, etc... only when you take it away is there a desperation for change. So health care is a need in those moments.

The worst part (in my view) is that those that probably need to think in terms of health (the poorer population) rarely think about health due to their mindset of trying to "make it." And then when they do need health care... they're are stuck with even the worst of health care.

I've since moved back to one-on-one health focusing (as Stephen Cooper), because you can see progress... but I'm not fooling myself thinking that society is benefiting from the few that can afford my services.

Tom, I hope your right. I hope we are moving even further to the prevention side of the spectrum, but many strides in innovation need to be seen before this message has much impact.

I'd love to work in a innovated movement around this theme. I just haven't seen one yet.

Posted by Gary Ditsch at January 31, 2006 3:34 PM

Perhaps one of the reasons that people rely on 'healthcare' is that it does not usually represent an out-of-pocket cost, so effectively it seems 'free'. Out of pocket spending on health care as a percent of national health expenditures (U.S) has decreased from 46% (1960) to 21% (1980) to 12% (2004) [second-hand source: Center for Medicare and Medicare Services]. The majority of healthcare costs are covered by employer programs and Medicare/Medicaid.

Because the real cost of health care is hidden from consumers, there is no incentive to ration consumption.

Which reminds me, why does health "insurance" cover maternity and child birth? That's like my home insurance covering the cost of building an addition, or my car insurance paying to add a new supercharger. That has nothing to do with insurance, and has everything to do with spreading costs among the population (aka social welfare).

Posted by wolske at January 31, 2006 8:26 PM

I just re-read my post -- I meant to say "why people rely on 'healthcare' rather than focus prevention" -- I know that the majority of people that rely on healthcare do so because they are truly sick and it's too late to think Health. I'm not that evil/dense...

Posted by wolske at January 31, 2006 8:32 PM

Couldn't agree more - "health" IS the point. But simply removing a word doesn't transform an industry or change the people in the industry.
How about the term "health caring"? Making a noun a verb means you are doing something about it. Isn't that what we need - providers and patients CARING about HEALTH?

Posted by Tom H. at February 4, 2006 10:46 AM

The whole system from insurance providers to hospitals and every "healthcare" provider in between including the pharmaceutical companies is focused on the care side(reactive/prescriptive) not the health side (proactive/preventive). We are a tremendously over medicated society because all the links in the chain find it easier to prescribe than to prevent which takes more time and effort. If I took every drug or medication advertised during a typical few hours of primetime television I would not be a very lucid or healthy person. Yes drugs are necessary and life saving and life prolonging but not meant as part of the normal human beings daily diet. To take the path of health vs. healthcare will take a major paradigm shift for most people, politicians and industries. But that doesn't mean it can't be done one person at a time who is committed to making it happen. The sooner we reach critical mass the sooner the world will change.
Good health to all,
Steve

Posted by Steve at February 4, 2006 3:57 PM