Historically, countries around the globe have spent more on healthcare than on preventive population health through investments in public health infrastructure. These spending patterns still persist.
Do you think it is the time for governments to put more financial resources into preventive care so that most people do not experience preventable illness?
In the United States, healthcare and public health has been two "strange bed-fellows," until recently. Healthcare industry has been focused on sick care, whereas public health has been charged with preventive population health, through assessment, assurance and policy development. Public health has been historically underfunded and still is whereas healthcare has, for the most part, done well, whereas some healthcare systems continue to work as industrial complex with fat profits. I think it is time for a paradigm change to fund public health better.
Gulzar - the answer is 'of course'. This has been the case for several decades. The paradigm change has been called for - for decades. Acute, medical services are often reactive, expensive and, while benefiting the individual, often do little for community health and development overall. The Ottawa Charter's main aim of 're-orientating health services' has championed this reform and change in direction since the mid-80s - but this has not occurred wholesale. The problem being is that health promotion is at the behest of political agendas. Public health and its underpinning health policy (aligned to preventative healthcare) requires long-term planning and resourcing - and evaluation of success is often the same. Political parties are reluctant to commit to long-term planning and resourcing (let's say 10-year plans) because they may only be in power for a few years. They are far more inclined towards shorter-term outcomes i.e. acute, medical care outcomes i.e. reduced waiting times in hospitals - that are supported by short-term medical research measurements. Compounding this is that there are different forms of public health i.e. highly medicalised that are little different to acute services - through to chronic health models (self-management) through to 'up-streaming' population health.
I asked a question on RG 6-years ago on the difference between health promotion and health education. It is still an active thread - and has had over 530 answers and over 43,000 reads. Much of the content covers this 'tension' around reactive and preventative health reform.
https://www.researchgate.net/post/What_is_the_difference_between_health_promotion_and_health_education
yes indeed.
we need to be proactive instead of reactive moreover in this era which non-communicable disease prevalence is on arise, hence the complications are the thing we need to bear if we are still in reactive mode (rehabilitative care is needed). Actually, the health financing needs to be wisely managed. In my opinion, social health insurance will cover the curative part and budget from general tax need to invest in preventive care. In addition, the provider payment mechanism needs to be correct in order to ensure no moral hazard happen. As an example, casemix need to implement in the hospital setting and capitation in the primary care setting. No more fee for service and global budget.
Both are crucially and persistently essential for national health safety and improvement; to be addressed simultaneously; and of course, preventive care warrants more finance and priority. Because, everyone agrees that "prevention is better than cure."
Both health care and preventive health care are equally important and the government has to set aside funds for both.
I believe that health care should be provided to everyone as well as excellent clinical care because they have a very strong relationship
Yes I agree with this, Already this shift has started everywhere specially in India, Govt. started concentrating on the preventive health care now with new initiative as National Programme for Control and Prevention of Non communicable diseases, Ayushman Bharath AND SO ON....
Besides Dean Whitehead mentioned, many health problems are from food additives, environmental pollution, weather, especially recent climate changing, job related stress, family issues, etc.
It needs a systematic review and it's out of current politicians' interest. Expect an across department team to be assigned to study the problem at the national level. Otherwise, all discussion is a waste.
Thank you colleagues. Your responses are very helpful in advancing this discussion.
Both are very important but they have to be balanced. According to my experience, the best way is associated with motivation. The motivation of people/patients, whole societies, and motivation of the health care system providers.
Every single person/patient must get a chance to reach the best possible knowledge of the way of keeping & achieving good health. It is not happening.
The second important kind of motivation is to give rewards to MDs for keeping patients healthy (Japan). Avoid motivation to run patients through treatments and feeding them by chemicals used to suppress symptoms instead of teaching them the ways of keeping good health.
Unluckily, we allowed huge money to enter the health system. That was a big mistake. The system got heavily distorted towards the profit. The health of single people or even of the whole populations are at the stake this way because none cares about it.
We can learn in countries where they build a system motivating GPs to keep patients healthy. GPs get money for healthy patients. It is a very effective, highly distributed motivation.
Sadly, chemicals and weapons are high profit for the rare manufacturer, but high cost paid off by the general public. Again, the minority dominates the majority. Until one day, after there are too many people died, the revolution happens.
Is there any chance that our understanding about health is faulty? Some general practices that we have believed to be "health-promoting" for centuries are actually the main causes of our sickness?
From childhood, we all have been told that personal hygiene is very important to our health. We never think that this cleanliness-pursuing habit will destroy our microbiome, and may cause sickness:
https://www.researchgate.net/post/Is_hygiene_cleanliness_really_good_for_health
More and more people notice about the current health is faulty. As my experience, people like to change themselves to become healthy is far less than people rely on the others to make them healthy. This majority people think that they supposed "to be taken care" and they also not fair and do not care if they are fairly treated their health care giver. I think, it's the moral be neglected problem.
Dear Frieda Mah ,
Agree with you that each personal should take the responsibility of his own health. Ultimately, it is our own body that can do the curing, not any medicine. If ourselves don’t take care of our own health, no other person can help. Just as The Yellow Emperor's Classic of Internal Medicine says: “病不许治, 病必不治, 治之无功. (If the patient is reluctant to be treated, there is no way to cure the illness. Any treatment will be no effect)”. Most of the contemporary diseases are lifestyle related, and when disease occurs, one has to make lifestyle change. Otherwise, the same disease will occur again and again. One needs to equip himself with the right health knowledge, and ignorance is deadly.
My personal experience shows that eating plenty of raw fermented foods containing live microbes is very good for health. It can prevent any essential nutrients deficiency with the microbiome inside it. So try to prepare fermented food by ourselves, and consume it in raw.
Similar to the Question thread from Ligen Yu:
"The medical community need to carry out more research on the self-healing capacity of the organs in human Body"
There my answer was:
Yes, we need!... But the biggest part of the 'medical system' is not interested in! One of the main reasons of illness in general is dis-connection from the source (the absolute) within this mind set we belief in needings. To need more Health, Food, Money, Love and so on... By needing this we consume others (people, our planet etc) because we fear of having to less.
This cascade is working in many systems as well as in the 'medical system': physicians consume patients, patients consume physicians, the pharma industry consumes the physicians and the patients, no one is interested in harmony, only in the opposite of harmony: consumption.
In my opinion is this the "faulty" Frieda Mah has mentioned.
Moreover it is the unawareness of these facts:
The most doctors believe that they 'heal', they try their very best but they can not really do because the fault described above is immanent in the system. Old chinese tradition systems 'payed' a doctor when the village was in a good health, this doctor worked preventive so in very old traditions the people had access to things like inner force, chi, prana, power of breath and so on, they knew about their field (today we rediscover the morphogenetic field) and mind over matter was selv-evident.
Nowadays the system teach us that mind (consciousness) is an accidental product of accidental connected and accidental developed organic matter (Darwin). Within this mind set a common physician is just one-dimensional so we think for example that an Active Pharmaceutical Ingrediant (API) works for example by blocking a specific receptor in the body and we treat with pills in which an API is mixed in. But how the API is mixed in, the habbits of the patient and all the factors influancing the way of the API to his target is not well understood. No one is interested in, because the industry just wants to sell a drug, a docter just wants to do a prescription and a patient just wants to loose the symptom. (see also thread of Raja Kahn "what is reward"). In this way they all consume each other...
Population Health should be seen as many other essential issues like sexuality, energy gain, food, etc.: the key is self-empowerment
This must be the goal of all education, science and research. The more people are empowered and independent, the more people do not need to consume others! This is finally a producrt of love in contrast to the actual mind-set of the political and philosophical and even religious systems all around the world: the mind set of fear.
Dear Ligen Yu and Christian Jost,
Your answers perfectly resonate with me. My life started quite early with heart disease due to a medical error of a physician who did it recognized tonsillitis at my seventeen. Initially, for less than 10 years with cardiomyopathy, I was fully following medical instructions and procedures.
After it, while seeing that there is obviously something missing, I started to learn about my disease, how to achieve better health and slowly started to incorporate various healing modalities in my life: meditations, walking meditations, Yoga, and finally started to work with Qi, Qi Gong, and medical Taiji Quan.
That all led to the ability to perceive, see, and manipulate vital energy in my body. Doors to resolve various kinds of blockages of energy in my body opened. I cannot say that I know & understand all about energy and diseases but things started to be revealed gradually.
It is a process, which goes in steps of sharp improvement followed by plateaus of accommodation & understanding, that is revealing new truths.
It all helps me to decide which medical drugs are beneficial for me or not, now after the heart transplantation. It helps me to find ways to decrease inflammation, and repair constantly insulted digestion due to immunosuppressive drugs.
It helps me to see the overall dynamics of the energy in the body of a transplanted person. This is rather an unusual situation to look for a new equilibrium of living with a transplanted organ.
It is ways more difficult when compared to intact, non-transplanted patients. Less difficult than to compensate failing organ (heart) for twenty years before the transplantation.
These are all the reasons why I decided to start working on the heart and prediction of all ventricle located arrhythmias: VTs, VFs, and Torsade de Pointes. There is an avenue towards mathematized medicine working at the level of preventive and predictive medicine.
We must do everything possible to create more advanced approaches in current medicine.
Some healthcare for all is always better than all healthcare for some.
Yes, it is time to invest more resources to strengthen preventive measures than to invest in clinical care. That is especially true for non-communicable diseases.
Ancient Chinese medicine is the solution for COVID-19. It has successfully beaten every epidemic episode in Chinese a couple of thousand-year history. It's humanity and economics.
Article Clinical Population Medicine: Integrating Clinical Medicine ...
Clinical Population Medicine is the conscientious, explicit, and judicious application of population health approaches to care for individual patients and design health care systems.