In late December 2008, a group of 25 science, health, and policy
experts assembled in Washington, DC, to offer the Obama transition
team their thoughts on health-care reform and to comment on a white
paper developed by the Samueli Institute (Alexandria, Virginia).
Approximately 125 people participated in the discussion through
a national conference call. Considering the time of year –
many people were celebrating the holidays with their families –
it was a surprising and hopeful sign to have so many people considering
the best ways to improve our health-care system.
The Samueli Institute was founded in 2001 by Wayne B. Jonas, MD,
who had previously served as the director of the Office of Alternative
Medicine at the National Institutes of Health.
The institute's vision is a world in which healing processes
are the formative concept for achieving and maintaining wellness
and ameliorating chronic disease. The mission of the Samueli Institute
is to transform health care through the scientific exploration of
healing. At present, the institute has several initiatives under
way, including research on "Optimal Healing Environments";
integrative medicine in the military; and the brain, mind, and healing.
WIN: A Wellness Initiative
for the Nation
In collaboration with leaders in the fields of health policy, health
promotion, and integrative health-care practices, the Samueli Institute
has drafted and is promoting a "Wellness Initiative for the
Nation," which suggests several important tools that could
help us prevent chronic illness and move towards a productive self-care
society.
The first and most important step: to create an executive or congressional
office, with a director and staff, who would focus on developing
policy related to lifestyle-based chronic disease prevention, health
promotion, and integrative health-care practices. These policies
and programs "would be grounded in the continuity of health
and the prevention of illness throughout the human lifecycle,"
the WIN document emphasizes.
"The point here is that the policymakers need broad authority
to coordinate activities across various departments that are relevant
to health promotion," explains Matthew Fritts, MPH, senior
research associate at the Samueli Institute. "Our key proposals
relate to many different aspects of the government; they would include
economic incentives and technological support for wellness. Creating
an office focused on these issues could potentially have a strong
impact."
Four Key Proposals
In addition, the wellness initiative includes several proposals
that would make an enormous difference for all of us if they were
implemented. They would function like yeast to slowly transform
both our culture and our institutions surrounding health and health
care.
They include:
- A network of national and local leaders in health promotion,
disease prevention, and integrative practices to maintain a wellness
vision and guide policies in implementing this new paradigm. These
"Systems Wellness Advancement Teams" would work to translate
prevention and health promotion practices into local delivery
options and policy changes.
"We picture a network of transdisciplinary teams across the
nation that would look for ways to actualize recommendations on
health promotion," Fritts says. "In coordination with
the Wellness Office, these teams would help implement and carry
out recommendations and policy efforts, in collaboration with
community health centers and state and local public health departments."
- Professional training for health and wellness coaches. This
training will qualify individuals to focus full time on prevention,
creating health and healing, and enhancing productivity. It would
facilitate state-licensed health-care practitioners' gaining specialist
certification in prevention, health, and wellness delivery. This
would offer additional training to providers already in practice,
on how to offer increased health education and emphasize wellness.
"It would also develop new health and wellness coaches, as
an additional discipline," Fritts explains. "People
who are not currently licensed clinical providers could pursue
appropriate training and eventually be certified as health and
wellness coaches. They might work within traditional care settings,
or in schools and workplaces."
- An advanced information tracking and feedback system (a health-promotion
technology tool kit) would deliver personalized wellness education,
customized to each person's level of readiness, computer capabilities,
and stage of life. This wellness tool kit could interface with
electronic health records, and would be a valuable tool for health
and wellness coaches, the health-care delivery system, and the
general public.
"In this proposal, we're looking for ways to leverage information
technologies to improve health," Fritts says. "For example
you could use your cell phone or a handheld device to help monitor
healthy behaviors. People could receive reminders, or enter data
on how much they exercised. Just having some easily accessible
interface could help increase self-awareness and monitoring of
lifestyle choices that cause or exacerbate chronic disease."
- Economic incentives for individuals, communities, and public
and private sector institutions to create and deliver self-care
training, wellness products, and preventive health-care practices.
Intellectual property protections to reward wellness innovations.
Incentives for personal and community activities that create and
promote public wellness values.
"The new administration has a strong interest in reducing
health-care costs, since they are working to stave off a looming
financial disaster in our health-care system," Fritts explains.
"We believe that by using an integrative approach and emphasizing
true prevention and self-responsibility for health, we can reduce
costs. We might even see positive economic incentives such as
lower insurance premiums for people who adopt healthy behaviors."
The WIN proposal emphasizes that "The
United States is first in spending for healthcare but 37th in health
status among industrialized nations. If applied in concert, these
recommendations could be a 'triple multiplier' of health,
productivity and economic stimulus for our nation."
Next Steps
The proposal, as well as supporting documentation and a formal report
from the national group discussion, has all been forwarded to the
Obama team.
In addition, the Samueli Institute is presenting this information
to open-minded legislators in the House and the Senate. They are
working together with like-minded organizations such as the Integrated
Healthcare Policy Consortium (IHPC) and the Academic Consortium
for Complementary and Alternative Health Care (ACCAHC) to generate
public support for the Wellness Initiative for the Nation.
Elaine Zablocki is the former editor of CHRF
News Files.
Resources
The Samueli Institute: 703-299-4800; www.siib.org.
Wellness Initiative for the Nation: www.siib.org/news/news-home/press-releases/112-SIIB.html.
The Integrated Healthcare Policy Consortium: www.ihpc.info.
The Academic Consortium for Complementary and Alternative Health
Care: www.accahc.org.
On February 23 Wayne B. Jonas, MD, president of the Samueli Institute,
testified on "Principles of Integrative Health: A Path to
Health Care Reform" before the Senate Committee on Health,
Education, Labor, and Pensions. His testimony is archived, in video
and written formats, at http://help.senate.gov/Hearings/2009_02_23/2009_02_23.html.
The site also includes testimony from other notable speakers at
the hearing, including James S. Gordon, MD; Mary Jo Kreitzer, PhD,
RN; Herbert Benson, MD; Brian M. Berman, MD; and Kathi J. Kemper,
MD, MPH.
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