ABSTRACT
This chapter identifies five overall goals involved in rethinking health: shifting the emphasis toward health, getting health care where it is most needed, reducing wasteful use of high technology by demedicalizing life experiences, shifting to lower cost, more ecologically sophisticated care, and improving the health of the planet. Health promotion involves much more than clinically focused "prevention" efforts centering around inoculations, well-baby services and early cancer detection. The Pepper Commission and the Clinton Health Insurance Reform Task Force struggled with fair ways to share the increased costs of including previously-excluded populations in insurance coverage. Health insurance reform could allow nurse-run prevention services or other appropriately staffed preventive health services to enter into flexible "managed care" contracts. Targeting the high-cost users of disease care services for consumer-oriented services that strengthen their own health-building capacity would be an excellent use of resources. Many would benefit from purchasing services for home health-care equipment and pharmaceuticals.
