Walker Duncan, walker.duncan@nashvillepost.com

As the debate about healthcare reform continues ad nauseum, it seems that what is perhaps the most primary question in the ongoing debate keeps getting lost in the rabble. How do you go about fixing the fact that so many Americans are simply unhealthy people? Not sick, unhealthy.

In an interview on the Health Business Blog last month, Healthways co-founder Bob Stone touched on this subject, making the simple but astute observation that, in dealing with reforming the health system, one must consider more than just the medical care received by patients.

It is a given that our system can fix sick people. But where it continues show its impotence is in the seemingly simple task of getting people to take a more active role in their own health and wellness.

Describing the various factors combining to affect the health of individuals, Stone noted that the "medical home," as he termed his hypothetical and utopian-sounding medical system, while playing a significant role in the process, does little to effect change in other areas of patients lives.

Issues arising from lifestyle choices and work environments obviously play major roles in our collective health, but can any sort of politically charged reform possibly address those issues?

The rise of the electronic health record and the greater focus on evidence-based outcomes is all for the best. But Stone very correctly pointed out that an improved medical system still does not get at the whole problem.

No one can deny that a healthier populace is a more productive and less costly one. But it is difficult to see today if government-driven healthcare reform will actually cause us to make smarter decisions about our health — or if it even can.

With all of these debates and buzzwords and proposals, one must still ask: Are we creating a more broadly focused, healthier system or merely fixing a sick one?


Walker Duncan is a reporter at NashvillePost.com, a sister publication of Nashville Medical News. You can reach him at
walker.duncan@nashvillepost.com.