Health and Well-Being or Healthcare?

JULY 1, 2021, rev. 1-18-23

Why This Project?

The current U.S. healthcare system is producing inferior health outcomes and not effectively improving the health status of the citizenry. In business financial terms the ROI (Return on Investment) on the “healthcare spend” is a losing proposition when it comes to the overall health status of American citizens. There is an “unhealthy relationship” between healthcare spending and the overall health of U.S. citizens (Case & Deaton, 2020; Edington, 2009; Tamber, Carroll, & Kelly, 2015).

As a result of multiple factors and dynamics, the U.S. healthcare system is “…Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, (and) Error Prone…”  (Emanuel, 2014, p. Title). At the core of these factors and dynamics is the healthcare system’s established disease-based, “wait-for-sickness” level of thinking, diagnose and treat paradigm. Despite continued advances in medical technology and treatment, the current paradigm is too expensive, all too often achieving less than desired overall health results, sometimes with significant unintended harmful consequences.

The current healthcare system has received an “on again – off again spotlight” on multiple levels, including individual, family, community, population, state, region, and national. But two issues seem to consistently receive focus when in the spotlight – tragic human outcomes and high cost. Rebecca Onie, co-founder, and Chief Executive, Emerita of Health Leads, (as quoted in Weintraub, 2018), tells a story that illustrates what is wrong with America’s healthcare system. She shares a

…story of a teenage boy who was mysteriously losing weight. His doctor, stumped, huddled with several other caregivers to decide which medical tests to run. Then someone asked the boy a simple question: Are you hungry? It turned out that the teen had been homeless for weeks and had eaten almost nothing. He had been too embarrassed to speak up but was relieved someone had finally asked.

This story demonstrates how the current American healthcare system is so intensely focused on a medical model that solely diagnoses what is wrong and then reacts with treatment to fix what is wrong that it overlooks other issues and factors that drive health and well-being. Weintraub (2018) concludes from this story that the current American healthcare system “can be so focused on medicine that it misses the social issues that really drive health.”

The Problem

We will present a precise, evaluative definition of the problem. We will clearly establish that the current state of the healthcare system is complex, and convoluted, and presents both a public and private concern. In addition, the unintended consequences of the state of the current system have far-reaching impacts in areas not typically considered.

The History

We will provide a historical overview of health care services, the healthcare system, and the state of health of US citizens and residents. Included will be the significant dynamic forces that have played a role in our health care services, the healthcare system, and the state of health of US citizens and residents. The intended purpose of this is to provide a foundational understanding of where we started and how we got to the place we are now.

The Current State

We will provide a description of the current state of the US healthcare system, health care services, and the state of health of US citizens and residents. This will serve as a foundation for an examination of the results and outcomes of the current state.

The Results/Outcomes of the Current State

We will describe the results and outcomes that are realized by our current health care services and the healthcare system. This section will not only chronicle the obvious but also the typically not considered results and outcomes that often remain hidden.

A Paradigm Shift

We will explore and describe the paradigm shift required to address the deficiencies of the current health care services and the healthcare system in order to move toward and ultimately realize an improved state.

The Challenges

We will identify and describe the challenges that will be faced in changing the paradigm. Again, doing so in a manner that reveals both the obvious and not-so-obvious.

On the Path – Mid-Term Goals

We will map out how to start and get on the path of paradigm change and mid-term goals to provide meaningful guideposts.

Realizing a Health and Well-Being System – the Ideal State

We will provide a description of the ideal state of a Health and Well-Being System.

Next Steps – Call to Action

We will provide an overview of the next steps and a call to action.

HOLISTIC ECOSYSTEM OF HEALTH AND WELL-BEING

This graphic is our current vision for the ideal state of a transformed US health care and healthcare system  We call this ideal state the Holistic Ecosystem of Health and Well-Being. There are four components that combine to make up the graphic as follows.

First, the orange-colored center and outer ring represent the whole of the Holistic Ecosystem of Health and Well-Being. It is in the center, and the outer ring to represent that while there are distinguishable items in the graphic, they are all part of the whole.

Second, working out from the center is the purple ring that represents Health.

Third, continuing out from the center is the blue ring that represents the Social Determinants of Health.

And fourth, continuing out from the center is the green ring that represents Well-Being

The following are the working definitions of each of the words that combine as representing the graphic, i.e., Holistic Ecosystem of Health and Well-Being.

Holistic is defined as follows:

A whole that is comprised of interdependent and interconnected parts that affect all other parts. The pieces within the whole can be understood on their own and within each other’s interaction in the context of the whole.

Ecosystem is defined as follows:

A set of components that function in an orchestrated manner within a design based on mutuality of purpose and the interest of the whole. The nature of the ecosystem dynamics can be viewed as a complex network or interconnected system of interacting and interdependent relationships.

Health is defined as follows:

A positive concept involving four main dimensions (physical, mental, emotional, and spiritual), each of which has multi-factors.

Well-Being is defined as follows:

Multiple factors, which interrelate, creating balance and quality in our lives and relationships, as individuals, communities, and societies, and how sustainable and secure that is in our future.

Project Leadership

The two principals leading this project are –

Marge Cawley, Ph.D., Project Manager

Dr. Cawley continues to be a curious social scientist who spent several years predominantly working for Arizona State Government and in a non-profit in North Carolina. She conducted performance and audit evaluations from a policy and budget perspective for the legislature. She was a key player in the development of the State of Arizona’s strategic planning and Arizona State Administrative Office of the Courts.  She led a team effort consisting of three organizations to develop the State of North Carolina’s Department of Health and Human Services’  Mental Health and Substance Abuse performance measure system. She has conducted research and training in strategic planning and performance measurement. She also taught part-time for Western International University (Research Methods) and Northern Arizona University (undergraduate upper-level public administration courses). Currently, she is working with P2 Performance Plus on a design to transform our current healthcare system.

Jay T. Roundy, M.A., D.P.A., P2 Performance Plus Co-Founder and Chief Operating Officer

Dr. Roundy is a counseling psychologist and organizational behaviorist by training, a servant leader by nature, and a performance coach by choice.  Jay is a transformational performance expert with extensive senior-level leadership, management, coaching, consulting, and training experience with individuals, teams, and organizations in multiple sports and business areas. He has a unique ability to apply results-producing performance improvement strategies and demonstrated ability to lead others to achieve transformational performance in the midst of a demanding, complex, and constantly changing environment by inspiring a common purpose, vision, strategy, and execution.

Jay has conducted research on organizational behavior and leadership as they relate to results-oriented performance. Applying the performance and leadership strategies derived from his research, he has implemented high-performance teams, improved morale, and improved results both in the boardroom and on the field of play.

For more information, contact Jay at jayr@p2performanceplus.com.

References

Case, A., & Deaton, A. (2020, April 14). America can afford a world-class health system. Why don’t we have one? New York Times. https://www.nytimes.com/2020/04/14/opinion/sunday/covid-inequality-health-care.html

Edington, D. W. (2009). Zero trends: Health as a serious economic strategy. Ann Arbor, MI:

Health Management Research Center, University of Michigan.

Emanuel, E. J. (2014). Reinventing American health care. New York: Perseus Books Group.

Tamber, P. C., Carroll, L., & Kelly, B. B. (2015, May 5). Communities creating health: An introduction. Stanford Social Innovation Review. https://ssir.org/creating_health

Weintraub, K. (2018, May 24). Using medicine and science to improve the quality of life. New York Times Digital Article. https://www.nytimes.com/2018/05/24/science/using-medicine-and-science-to-improve-the-quality-of-life.html

JULY 1, 2021

The Health and Well-Being or Healthcare Research Project intends to make an evidence-informed case for the value of fundamentally changing the paradigm of the current U.S. healthcare system, creating societal change. This fundamental change, while extremely complex in size, scope, and nature, can best be described in brief form as follows –

Change the current U.S. “health care system” of disease-based, “wait for sickness” level of thinking, diagnose, and treatment paradigm.

To

A health and well-being paradigm that is based on raising and sustaining the health status of individuals, families, communities, and populations IN CONCERT WITH the best practices of the current U.S. “health care system.”

The following is taken from the Research Project’s High-Level Strategic Plan. The project’s full, and detailed strategic plan continues to be developed. However, the Purpose, Values, and Vision are approved as they appear below.

PURPOSE:

To make the case for the value of changing the current HEALTH CARE SYSTEM MODEL to a HEALTH and WELL-BEING MODEL

VALUES:

Science-based research methods
Evidenced-informed data and information
Inclusive processes
Integrity
Excellent storytelling

VISION:

Be the trusted science and evidenced-based source for meaningful change on all levels to a HEALTH and WELL-BEING MODEL that includes an improved HEALTH CARE SYSTEM approach.

For more information contact Jay at jayr@p2performanceplus.com.

Videos of Interest

Why Change is Necessary

Urban Institute. (Apr 18, 2018). Dr. Camara Jones Explains the Cliff of Good Health [Video].

The Cliff Analogy, by Dr. Camara Jones, briefly explains why a paradigm transformation is necessary on multiple levels to attain health and well-being. On a macro level she calls attention to the need for systemic change. On a micro level, she highlights various barriers to the opportunity to achieve good health and well-being. Systemic and barrier opportunities to attain good health she notes are Racism, Sexism, Socio-Economic Circumstances, Governmental Policies, Social Determinants of Health (SDoH), and Health Disparities, among others. Paradigm change is necessary to improve system care and to overcome barriers to provide equitable resources, access, and quality of care, and all around well-being.

A Well-Being Economy

Why Governments Should Prioritize Well-Being

In an informative TED Talk, the concept of a “well-being economy” is introduced. Nicola Sturgeon, the First Minister of Scotland, outlines the far-reaching implications of a well-being economy. It is not difficult to identify that these implications range across multiple levels, including local, community, national, regional, and global. Factors such as equal pay, childcare, mental health, and access to green space, to name a few, are integral to this well-being economy. The interest from the perspective of our Health and Well-Being Project is varied but certainly includes the role of government, public policy, and public health, among others, in relation to a Health and Well-Being System. There is more to this story, as you will hear by clicking on the link below.

Coming soon