Summary: Implementing healthy practices seem straightforward. Solving them seems to be not “rocket science.” But then why are we having such difficulties? A public-private Healthy Nation Partnership and a section of proposed federal health reform legislation each suggest the dimensions of brilliance we must draw upon to lay a foundation for a healthy society. The former initiative, recently announced, is led by the Institute of Medicine (IOM), the AARP and the Bravewell Collaborative; the latter by US Senator Tom Harkin, the Samueli Institute and others. Wellness entrepreneur James Strohecker, CEO of HealthWorld Online suggests the nation needs another “Manhattan Project” such as was created to develop the bomb. But might not the key to establishing Harkin’s “wellness society” be nothing less than unraveling what was sown by that earlier project?
I was struck by the use of two military references in a
recent conversation about what our nation needs for true health reform. These wartime
metaphors may be useful, if surprising guides amidst some recent, national
rumblings toward health and wellness.
Jim Strohecker, CEO of HealthWorld Online and the co-creator of an
online tool to help people toward what he calls “a higher level of wellness”
used the terms. Strohecker comes by military references naturally. He grew up in
Oak Ridge, Tennessee, which was a “secret city” built by the U.S. military in
the early 1940s as part of the war effort.
We spoke of what it takes to be healthy. The wellness
program Strohecker offers to individuals, integrative medicine centers,
hospitals, and employers is based on a dozen dimensions of wellness that create
a foundation for healthy living. He asserted: “It’s not rocket science.”
The phrase struck me. Over the years I’ve probably heard it
used a dozen times in exactly this context, suggesting that something about health
creation is easy. But then why is it we are not making much headway?
Clearly, while it might not be exactly rocket science, we
need some of the brilliance, inventiveness and insight associated with that
term. I challenged Strohecker.
An emerging Healthy Nation Partnership
He responded with a second
military reference, straight from his boyhood: “What we need in order to create
a culture of wellness and to transform the health of the American people is a national
commitment on the order of the Manhattan Project.” This project was a massive
federal government initiative, of which the secret Oak Ridge community was an
integral part, to build an atomic bomb to end World War II.
Strohecker’s reference to that wartime initiative came
within days of an announcement that leaders of the Institute of Medicine (IOM),
the AARP and the Bravewell Collaborative of philanthropists for integrative
medicine had formed what they are calling the Healthy Nation Partnership. This
partnership is to be “a campaign that would empower and encourage individual
behavior modification designed to promote health and wellbeing and at the same
time, inspire American society to make the changes needed to support
individuals in their efforts to improve their own health.”
The goal is nothing less than “to inspire a broad social
movement by linking government, education, the food industry, agriculture,
religious institutions, media, health care, and major employers.”
Sounds like a kind of Manhattan Project for a healthy nation.
Certainly any major initiative might include such partners. Note that health
care is not mentioned first. Positioned thusly, the Partnership tacitly
acknowledges the public health view of the determinants of health. Medical
interventions are minor players.
A parallel whole system wellness effort in Senate reform
The release from the Healthy Nation “public-private partnership”
mentions government first among stakeholders. Fortuitously, a federal
infrastructure on which to flesh out a massive initiative such as this is
inside the US Senate reform bill that has been promoted by US Senator Tom
Harkin. The bill would establish a National Prevention, Health Promotion and
Public Health Council. Harkin is the Senator who speaks regularly of his
passion for creating a “wellness society.”
The envisioned Council make-up, like that of the Healthy
Nation Partnership, reflects a whole system view of health creation. Involved
would be heads of agencies ranging from education and energy to agriculture,
transportation, health and human services, defense and the Veteran’s
Administration. Like the Partnership, the proposed legislation does not place
medicine in the driver’s seat. The Council is not located in, or necessarily
chaired by anyone from Health and Human Services. Health is not principally
about medicine. (More on the Council here.)
Yet the Council’s powers and finances are limited in the
proposed legislation. The funding and reach are less than wellness advocates
such as the Samueli Institute and the Integrated Healthcare Policy Consortium
wanted. Even Harkin wasn’t ready to propose the Manhattan project-like
dimensions of the Wellness Initiative for the Nation (WIN) that these
It will take rocket sciences (and arts)
Yet observing these green shoots in U.S. healthcare gives
more hope for true reform than the current national debate allows. Perhaps we
are seeing the public-private staging for a next, more fundamental round.
If so, let’s get it right and leave no elephants out of the
room. Notably included in the government list of stakeholders, but left out of
the Healthy Nation Partnership group, is the military.
Here’s where the rocket science comes in. The Manhattan
Project that will most effectively “encourage individual behavior modification”
will include smaller classrooms, transforming farming, greening energy and
transitioning industry toward healthier practices. Such an effort will require
hundreds of billions in investment. Spending some $1-trillion a year on
the military is an obstacle. Never mind the fear-mongering, local economy
dependencies and arms selling that go along with these priorities.
As of this writing, the IOM-AARP-Bravewell group has not
made public the concept paper for their Healthy Nation Partnership. Assessment
is yet impossible of how much their strategic plan for modifying individual
behavior will include modifying the behavior of industries, economies and
Yet the overwhelming question begged by both these
initiatives is whether moving the nation to Harkin’s wellness society and
Strohecker’s vision will require us to break from the militarized economy the
United States has promoted since the original Manhattan project.
How do we end these dependencies and habits of mind?
This despairing loop only reminds us how deeply and
powerfully our private sector is invested in practices in the agriculture,
energy and medical sectors – not to mention those that are directly military-industrial
– that are either willfully blind or shamelessly conscious of their negative impacts
on health and wellness.
Yes, it will take rocket sciences and arts – rocket social
science and rocket communication and rocket economic transformation and rocket
vision and even rocket cajoling – to forge the coalitions and partnerships we
need to create a healthy nation.
for inclusion in a future Your Comments Forum.