“The body is a temple, that’s what we’re taught. I’ve treated this one like an old honky-tonk. Greasy cheeseburgers and cheap cigarettes, one day they will get me if they ain’t got me yet.”
Kenny Chesney song lyrics from Living in Fast Forward
National healthcare expenditures in the U.S. will exceed $2.8T in the current year. This means that we will spend an average of more than $9,000 per individual in just one year! For adults with chronic conditions, we will spend nearly $30,000 for each with heart failure, $23,000 for each with COPD, and $17,000 for each with diabetes. Sadly, 80% of these national healthcare expenditures come from individuals with these and other chronic conditions. Even more disheartening, 80% of those costs are derived from hospitalizations and ED visits.
The reality—training, reimbursement and focus of healthcare professionals has been predominately based on pathogenesis, or the origin and treatment of disease. We train these individuals to treat the ill, minister to the sick and fix the broken. Then we take it a step further and pay those professionals almost exclusively for services, interventions, treatments and medications built for the ill and those with disease. Seldom do we reward healthcare professional substantively for actually building health. The result is a seriously unbalanced system.
Looking again at national healthcare expenditures of $2.8T, it is significant to note that we spend 94% of that total on fixing what is broken, addressing symptoms and treating chronic disease. In contrast, we spend only 6% of that total on prevention, wellness and screenings. U.S. medical care and sick care may be top drawer yet our health status has been declining and health risks increasing.
The truth—a transformational shift from fixing what is broken to building and maintaining health is long overdue. The World Health Organization (WHO) stated in 1946 that “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This was an early planted seed of a profound idea. To truly play forward this powerful idea we need a wellcare system—an entirely new strategy, a new path, built around a new concept. It is a health system designed to build, support, foster, create and maintain health.
In the 1970’s, a physician named Aaron Antonovsky, developed a concept with a vital new view of health. The term for this concept was salutogenesis. Quite the flip side of pathogenesis, it is the origin and maintenance of health, where individuals are considered more or less healthy, while being more or less ill. Rather than a dichotomy separating health and illness, Antonovsky described a continuum with health-ease at one end and dis-ease at the other. This is a logical, yet profound shift in the culture of health, and healthcare as we know it.
Salutogenesis is derived from the Latin “salus” meaning health, well-being, and happiness and the Greek “genese” meaning origin. It is an assets approach to health which focuses upon promoting, educating, preventing, protecting and curing—always with health as the true end game.
By placing the emphasis upon health as the defined intention, we contribute to the stabilization or improvement in our health status concomitant with reduction in health risk regardless of age, or present condition. This concept takes a bold step beyond simple prevention. By reclaiming focus upon health, we are more likely to improve our health, reduce our utilization of heath care, and reduce health care’s cost to society, all at once. What a wonderful world that would be!