Challenges to Our Current Health Care System

image of man on hospital bed

First of all, we pay almost double of any other country for medical and health care, and yet we’re 30th or lower in our health indices. At the current rate we will spend 25 percent of our gross national product by 2025 and almost half of it by 2082 if we don’t change what we are doing. The baby boomers have started to turn 65, which means there’s a tsunami of chronic needs and illnesses coming down the pike.

We are standing on the train tracks with the train coming straight at us; yet we don’t seem to be able to move; even to save our lives.

Health disparities are growing, not shrinking, increasing and undercutting the ability of our population to function and flourish. The Centers for Disease Control and Prevention estimates that one in three children born after 2000 will develop type 2 diabetes. We are killing our children with lifestyle–related diseases.  And for the first time in 100 years, our life expectancy is declining compared to other countries, especially in women and people of color.

I was taught that infant mortality and low birth weight occur mostly in places like India or Sub-Saharan Africa and we’ve got a modern system that’s really solved that problem, right?  


We have the highest infant mortality of all of our peer countries. If you look at other birth outcomes, such as low birth weight, stillbirths, preterm birth rate, we also are one of the highest in the world. In fact, the comparison is more like the rates found in Sub-Saharan Africa. We do not have an effective health system.

Where do we excel?

If you’re 75, you’re probably going to live longer than if you live in another country. If you have cancer, you’re probably going to live longer if you are here in the U.S. We are great at keeping people alive; not so great at keeping people healthy.

Einstein said that no problem can be solved from the same kernel of consciousness that created it; we must learn to see the world anew. I think the fundamental issue here is:
Can we reshape our own assumptions and perception about how health happens?

It does not happen by putting more money into a medical treatment system that was built for something a hundred years ago.


We are investing a huge amount in a disease treatment system when what we need is a health creation system. We need to build a systems focused on healing, resilience, well-being, community wellness and prevention. To me, the fundamental perceptual difference has to do with something that I call “salutogenesis,” a term originally coined by social psychologist Anton Antonovsky.  When I was in medical school, I studied from a book called The Textbook of Pathology. It’s still used. Pathogenesis is about how disease occurs. It is the process and the mechanisms whereby illness and diseases arise. In our current medical systems, everything flows from pathogenesis: diagnosis, research, and reimbursement.

At the same time, it is clear that we are always healing ourselves; constantly, continuously, often completely; that there is a process of health creation going on in our bodies, our minds, and our spirits.

Yet we didn’t have a name, much less a book, for that in medical school. I never heard the term.

Aaron Antonovsky coined the term “salutogenesis” for the process whereby health and wholeness is restored and maintained.

We need a system of healthcare that focuses on salutogenesis and frames a profession and industry around that, not just around pathogenesis.

How do you create health and wellness?

You move.
You make a social contact.
You cultivate positive intentions.
You settle your mind into the moment.
You eat right.
You do meaningful things.

All those are fundamental behaviors that create health and wellbeing and that you can teach anybody to do, anywhere, anytime. If you like chemistry I can show you studies where these behaviors generate oxytocin and dopamine in the brain; the social chemical and the happiness chemical. As the late neuroscientist Candice Pert put it these and others are “molecules of emotion.”

Surveys that periodically ask people about what they are doing and if they are happy with what they’re doing, reveal that happiness does not come from whether you’re in a good or a bad situation. It mostly comes from whether you’re doing what you want to do at the time, instead of your mind wandering off and doing something else in parallel. It comes from being fully where you are.

In other words, happiness is largely generated by being mindful of what you are doing rather than whether or not what you are doing is enjoyable.

Happiness comes from mindfulness and mindfulness can be learned and practiced. 

Wholeness and health arise from motion, from presence, and from social connectivity. That can be done by anybody at any time. We all have access to happiness, instantly and anywhere.

The question is: So what are you doing right now? Is it moving you toward greater wholeness?