Life is full of positive and negative events. Both are necessary. The goal is to end up with more good than bad. Evolutionarily speaking we are more reactive to negative events, possibly because avoidance of those events was necessary or survival. The preference for negative events was documented by many researchers. These researchers also identified the need for positive interactions in our life to outnumber our negative events by about 3. The 3 to 1 ratio of positive to negative events was necessary to have net positive life according to Barbara Fredrickson’s and the Losada line, Corey Keyes with the Mental Health Continuum and many more. These findings replicated and documented the the original findings by Kahneman and Tversky that showed our innate tendency to be risk averse and to have what they termed loss aversion because negatives, or losing something, was more impactful and meaningful than the positives of a possible gain.
This means to create a Net Positive Life, we must cause good, do good and help many. To have a net positive life, we must consistently work at better ourselves, as we help others and our environment. In other words, the +3 life I discuss from selfish, selfless, synergistic interactions relates to how we can have a net positive life and exceed expectations:
These points were driven home again from my reading of the fantastic work by Bradley and Taylor in “The American Health Care Paradox: Why Spending More is Getting Use Less”. A book I strongly recommend you read. In the book they use powerful data to document how we are all in this together, and we do best when we help each other. With powerful clarity, they document something we all already innately know, better health cannot be achieved through medical means. They end the book with:
To that end, an ever-growing body of literature suggests that broadening Americans’ historically narrow focus on medicine in pursuit of improved national health may ultimately hold the key to unraveling the spend more, get less paradox.
While medicine is good at medical care, America does have the best emergency care, our lives and health are not linear, they have multiple causes. These multiple causes mean we need to also, if not primarily, focus on the social, behavioral and environmental non-medical determinants of health because it is more effective at improving quality of life as it also decreases the need for medical care.
Throughout history, America has made an attempt to support and improve non-medical care with community health centers, HMOs, and now ACO’s. Unfortunately, the power of the medical lobby and their concern over losing paying patients caused these efforts to be watered down to a focus on medical care. Without question, medical care is crucial for specific illnesses. Medical care is vital for acute, short term care, I am alive because of it. However a larger content is more predictive and necessary to improve public health. Bradley and Taylor also show us many successful efforts in America that resulted in better health. These attempts also were significantly less expensive and better for all involved.
America Actually Spends Less On Healthcare
With clarity, they demonstrate America does NOT spend the most on healthcare if you account for all the factors associated with health, not just medical care. Medical care and social services are interrelated. Nations that spend more on social services enjoy a higher quality of life and better health and spend much less on medical care – because it is not needed. America spends the most on treatment and rescue care because America’s system neglects the social, behavior and environmental determinants of health.
America’s neglect of social, behavioral and environmental determinants of health has resulted in very bad outcomes. Despite spending so much on medical treatment, America lags other peer nations in
- Life expectancy
- Infant mortality
- Low birth weight
- Injuries and homicides
- Adolescent pregnancy
- Sexually transmitted diseases (STDs),
- HIV Aids
- Drug related deaths
- Obesity, diabetes
- Heart Disease
- Chronic lung disease, and
- Disability rates
Quite an indictment of our current system. Medical care is good at treating disease, what it is designed to do, it is not good at creating health, it is not designed to do that, medicine is about eliminating disease. We must remember health is the PRESENCE of physical, mental and social well-being and NOT MERELY the absence of disease and infirmity. The movie, “Escape Fire: The Fight to Rescue American Healthcare” by Shannon Brownlee demonstrates this in stunning clarity.
To build a net positive life for ourselves and our nation, we must generate comprehensive improvements by engaging in more social, behavioral and environmental interactions that facilitate health for all. I look forward to hearing about your selfish, selfless, synergistic interactions that help everyone and everything benefit.
Please share your thoughts and questions below.