Changing the Arc of the History of Health & Healthcare


Since health and healthcare are two of the biggest topics in the world today, I’m going to start by defining what I mean by them.

In my opinion, health is the ability to effectively function physically, mentally, and emotionally. Healthcare is the set of approaches that help people to effectively function physically, mentally, and emotionally.

Consequently, a person’s health can be enhanced by his or her own actions and the actions of healthcare organizations. Governments can guide the flow of money of how healthcare gets paid for and who receives it, but governments cannot help a person become healthier. That is not their function or their competency.


In order to change the arc of the history of health and healthcare, the starting point is within each individual. In the era we live in there are constant complaints and suggestions about what the government needs to do or what hospitals need to do or what HMOs need to do to make people healthier.

However, if we, and I’m talking about you and me, are really serious about solving the healthcare crisis, and I’m specifically talking about in the United States, then by far and away the most important thing we can do is to eat healthier and exercise more often. This is a multi-trillion dollar problem that people constantly talk about, and yet a great deal of the solution is within our own hands.

This requires pausing and getting off the treadmill of constant activity and getting on the treadmill that involves running. It means stopping always being so busy that we eat crappy food and write it off as “I’m too busy to eat healthy.” Multiply that attitude of “no time to exercise and no time to eat healthy” by decades and tens of millions of people and you have yourself trillions of dollars in debt of the government trying to pay its way toward healthy citizens. It doesn’t work that way. There are not enough tax dollars in any country and not even enough borrowing power in any country to pay for a society’s incredibly bad attitude toward eating healthy and exercising regularly. In the end, you have a healthcare crisis of ginormous proportions.

The starting point for reversing the healthcare crisis is a massive attitude shift in personal responsibility toward eating healthy and exercising regularly. I think we all have a pretty good idea that healthy eating involves fruits and vegetables and avoiding sugar, grease, and red meat. I think we understand that exercise means getting the heart pumping and strengthening our muscles. The government can’t mandate us to do this, but politicians could certainly talk more about personal responsibility toward physical, mental and emotional well-being. All three of those are connected to each other, and they all need the attention of the individual. I think politicians spend most of their time fighting over who should pay for insurance and what hospitals should provide. Those are important financial considerations, but in and of themselves they do not help a person become healthier.

Of course, there are many diseases that affect people’s lives that are not the direct result of poor exercise or poor eating. Two of the healthiest people I know who took incredibly good care of their bodies and ate remarkably well developed cancerous cells that became brain cancer and pancreatic cancer. Millions of other people have been dramatically affected by all sorts of physical and emotional diseases that were not related to their lack of physical workouts or proper eating. These are the people for whom we need as a society to have the best possible healthcare organizations we can develop.

In summary, we need to collectively reduce the strain on healthcare organizations to the greatest degree we can by eating healthy and exercising regularly so that they can focus on people who contracted diseases and dysfunctions that were outside of their individual control.


In my estimation, the vast majority of healthcare professionals are focused on doing the best job they can to increase another person’s ability to effectively function physically, mentally, and/or emotionally. Among the many doctors and nurses and other healthcare professionals I have met I cannot think of anyone who was solely focused on their income. I have met many people who have given as much energy and focus and time to trying to help people become healthier as they can.

I think we need to develop more of a trusting relationship toward healthcare professionals with the belief that they are trying their best. I had a close friend who died shortly after a brain cancer surgery. It wasn’t the actual cancer that had killed him, but rather a pool of blood that formed in his brain after the doctor had removed more than 90% of the cancerous cells. However, there was no talk among the family members of blaming the doctor. Instead they thanked the doctor for trying his very best to help prolong the life of my friend.

I understand that this attitude of trusting and respecting healthcare professionals can be hard to implement because they are human as well and they can make mistakes that can cost a person his or her life. It’s not like making a typo in an article. However, if our attitude is to hold them to an impossible human standard of perfection or they will face the equivalent of a career-guillotine in the form of lawsuits, then we can probably expect fewer great doctors and nurses and other professionals to want to enter the field of healthcare.


In so many ways healthcare in the United States is extraordinary. There have been an incredible number of advances in every aspect of healthcare.

However, to really change the arc of the history of healthcare, I think healthcare organizations need to continue to focus on two items: reducing the cost to patients of receiving healthcare and improving the health of their own employees.

I don’t think government-imposed sanctions are the best way for any organization to figure out how to reduce the cost of delivering value to customers and consequently reducing the price of that value for the customer. I think it’s vastly more effective if healthcare organizations work closely together to learn from each other on how to deliver great value to patients at a lower overall cost. Two books I recommend on this topic are The Cleveland Clinic Way by Toby Cosgrove and Management Lessons from Mayo Clinic by Leonard Berry and Kent Seltman.

Obviously one of the hard parts of this learning might be that healthcare organizations may come to the conclusion that there are too many healthcare organizations in existence today. Consequently, money could be saved by consolidating existing healthcare organizations, which would mean that some people would lose their current jobs. This is the same challenge facing universities. There may very well be too many of them to sustain themselves in the face of ever-rising costs to students.

Ironically, the second challenge facing healthcare organizations is the health of their staff members. I have no statistics to back this up, but it seems to me that healthcare organizations tend to work some of their staff members for inordinately long periods of time. It’s not unusual at all for nurses to work 12-hour shifts and then have paperwork to fill out afterward. It’s not unusual for doctors in residency programs to put in 70-80 hours a week. It seems that the industry that should lead the way in creating healthy working situations should be the healthcare industry, and yet so often I meet nurses and doctors who look completely exhausted.


I understand the complexity of my suggestions. If doctors and nurses work fewer hours, then you need to hire more doctors and nurses, which can drive up the cost of healthcare. This is why I’m recommending all four of these suggestions simultaneously:

  • Individuals taking much better care of themselves in terms of what they eat and how much they exercise in order to significantly reduce the number of people who need a healthcare professional.
  • Individuals believing that healthcare professionals are truly trying their best and not looking to sue them for every mistake they make.
  • Healthcare administrators working together to reduce the overall cost of delivering healthcare to patients.

  • Healthcare administrators working to ensure that the health of their staff members is of an utmost priority. It’s very difficult to be there to help another person if you don’t take care of yourself.

I don’t think the U.S. government can make its citizens healthier. It can impact the flow of money in the healthcare and medical insurance industries, but that is not the same as a healthier nation. I think the physical, mental, and emotional health of our citizens is extremely important. I believe the people responsible for improving the health of America consist primarily of each individual choosing to eat healthy foods and exercising regularly and healthcare professionals working in a way that delivers the best care they can within the confines of reasonable spending. If we as a country continue to exercise poorly and not eat in healthy ways and if healthcare organizations continue to do things as they have done them in terms of spending money and charging incredible prices, we have no chance of reversing the health trends in America or the exponential expansion of the federal deficit.

The good news is a great deal of the solution is in our hands. Eat healthy, exercise regularly, and take really good care of yourself mentally and emotionally. And healthcare professionals: keep being innovative in improving the quality of the care you provide while simultaneously reducing the overall cost to patients of being cared for. Neither of these recommendations are easy, but we are talking about changing the future of the world. Who said that it was going to be easy?

Reprinting this Article

If you would like to reprint this article, please send an email to Dan Coughlin at, with “Change the Arc of the History of Education” in the subject line and he will send it to you in a word document.