Medical Care Is Not Health Care
The "political season" generates pressure to propose innovative
solutions to problems that rank high for public attention. This season
health is on that list. If the goal is improved health status at lower
cost, then health promotion, preventive health care, early detection
of disease and more consistent care for chronic health problems are
good ideas.
The concept of preventing health problems has been around for a long
time. The greater part of improved health and increased life span that
occurred during the 19th and 20th centuries is directly or indirectly
due to public health and prevention. Think of sanitation, housing,
safe drinking water, adequate nutrition, refrigeration, personal
hygiene and immunizations. To say the least, improved health status is
a broad, complex area that requires active participation of
individuals and populations with social and government institutions.
If it is to be done at a lower cost, the implementation cannot be
within the medical care system.
During the 20th century, America redefined health care as medical care
and, then, equated medical care with medical insurance. It has been a
lethal and costly mind-set. When health promotion and preventive
health care are defined in terms of medical care, the costs become
prohibitive and the effectiveness is lost.
The politicians have a good idea. Now, they have to rethink how to
implement it. I suggest they define and refine medical care to study
and treat serious illnesses and diseases. Stop equating medical
insurance with improving health status and recognize it as an economic
risk tool to protect against financial ruin. Create a health care
program for all citizens and implement it through the public health
and educational systems at the community level.
I believe the Director of the National Center for Disease Control and
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