VISION 2020
A POSITIVE FUTURE FOR HEALTHCARE

It is 2020. Over the past 20 years, our healthcare system has come to embrace a much broader definition of health and wellness. Health and wellness are not just a long life and the absence of disease. Rather, to be healthy and well means to be physically, emotionally, mentally and spiritually whole.

In 2020, we realize that to be healthy and well is to live from your heart. It is to love yourself, to accept yourself, to be flexible and strong in the face of life's challenges. A healthy person is grounded, compassionate, and centered. And a healthy individual is not an island: connectedness and community are pillars of both healthy people and healthy societies.

Moreover, in 2020 we better appreciate a core paradox of healthcare: that in order for us to healthfully embrace our lives, we must accept our eventual death. In this way, we now see not only health but also disease as an opportunity for growth, even a gift. Health and wellness are a life well lived and a death well died.

As a result, by 2020 our healthcare institutions have undergone a sea change. Hospitals that 20 years before were dedicated to eradicating disease have broadened their mission to promoting a high quality of life.

This has necessitated many basic changes in healthcare delivery. We started by acknowledging that our healthcare system was making its own clinicians sick. As a result, by 2020, healthcare institutions are less stressful environments, and a high emphasis is placed on healthcare workers living balanced, healthy lives at home and at work.

By 2020, at the center of healthcare is not the doctor, not the hospital CEO, not the researcher, nor the insurance company nor the government nor business, but the individual. It the individual's life, so it is up to the individual to set the course for improving their quality of life. In this patient-centered, choice-based system, caregivers play a vital yet secondary and facilitative role, providing expertise, easy-access information, and therapeutic assistance when requested.

Primary care is now delivered by interdisciplinary teams of caregivers who represent a broad range of modalities, from conventional methods such as surgery and pharmaceuticals, to older local healing traditions and faiths, to more foreign traditions such as Oriental medicine, ayurveda and Tibetan healing. In 2020, high touch has married hi-tech: a brain surgery operation may be preceded by massage and prayer and followed by homeopathy and music therapy. In the event of illness, these teams are mobilized to care for the patient physically, emotionally, mentally and spiritually. In these circumstances, the patient's loved ones are invited to join the team.Primary caregivers are peer-approved and experienced at collaborating as a team and recognizing the strengths and limitations of their particular specialties.

With such a strong emphasis on prevention, personal responsibility, and simple procedures such as acupuncture and mind-body therapies, healthcare costs have actually declined over the past 20 years, to everyone's surprise. Malpractice lawsuits have become rare. Moreover, employers and the public health system offer financial incentives to live healthfully. A patchwork of fiscal innovations has spread across the healthcare industry, in some cases eliminating the insurance "middleman," in other cases providing entirely taxpayer-funded care. The cutthroat competition of the 90's has been replaced by a more cooperative spirit and sense of common purpose. Access to affordable, appropriate healthcare is universal and considered a basic human right.

Of course, the changes of the past 20 years have not been exclusive to healthcare institutions: society's view of health had fundamentally changed. By 2020, we see less sharp a distinction between personal and societal health, so we are willing to accept the costs of living in a healthy society. We have realized that to some extent we are all healers, and that when we fall sick it is our family and community who often are in the best position to help us. As a result, by 2020, opportunities for healing are everywhere: at home, at work, in community centers and churches, in the parks. And our refreshing, newfound frankness and acceptance of death have made advance directives commonplace and the dying process a much easier one.

By 2020, we have made great strides in addressing the healthcare crisis that had once plagued our country. We have healed our healthcare system, and in doing so we have healed ourselves.

(From the Integrative Medicine Alliance's March 26, 1999 Vision/Mission Development Workshop)