Before you move into a new home, what do you do to avoid unexpected risks? You'd probably call a home inspector to check it out to make sure there are no nasty surprises-mold in the walls, or faulty plumbing, for example. If you're knowledgeable, and well read, you might inspect the home yourself. When you move in, ongoing, preventive maintenance, and  improvements will keep you from entailing unexpected costs. You get the furnace ducts cleaned out, you repair roof shingles, and do a whole range of daily, weekly, monthly, and yearly chores necessary to keep your home ship-shape. The one thing you should not do if you want to prevent nasty surprises is ignore early signs of deterioration-doing so is a recipe for disaster.

The rules that apply to keeping a home in good shape and preventing nasty surprises and high  costs also apply to your health. Following a decision to look after yourself, get a doctor to check you out and inspect yourself as well-that's easy. The more difficult and important part comes with doing the daily, weekly, monthly and yearly things that keep your body and mind healthy. If you do, your body, your personal "home," will probably last a long time in a state of good health.

Unfortunately, our societal approach to health has not been based on these common sense rules. In fact, it's a great irony that we use the term "healthcare" at all, because the system isn't interested in you unless you already have a disease! Imagine going to your doctor and saying, "I feel wonderful! What can I do to stay this way?"

The "system" pays attention to you most when all your options for physical, mental or social health are used up. That's like shoring up your house when the first joist in your basement collapses with dry rot-by which time it's already spread through the entire house! At that stage a home needs to be completely rebuilt; similarly, when you're diagnosed with diabetes or angina or chronic lung disease, you're poised to head over the brink, and sometimes only heroic efforts can keep you from doing so.

Statistics show that 90 percent of medical expenses in a person's life occur in the last five years before death. Wouldn't it be better to spend half that amount on active and vigorous efforts to preserve good health throughout one's life? A number of groups, including HANS and another organization of which I am a part, the Association of Complementary and Integrative Physicians of BC (ACIPBC), agree that it's time for us to build a true healthcare system. We need a recipe for change.

Make being healthy easy
We need the government to make health maintenance and enhancement easy. For example, give people who exercise tax breaks, or provide rebates on health-enhancing purchases. Give tax breaks to gym owners, exercise trainers, restaurants that promote healthy eating, organic farmers, athletics facilities, and amateur sports facilitators. Create lots of walking and biking trails. Encourage arts and cultural activities that inspire audiences and  participants alike, and support social dancing, art classes, and community theatre. Make counseling services available to people who are emotionally upset or highly stressed, without stigma or financial penalty.

Put healthy food in schools and make physical exercise a significant part of the curriculum,  encouraging mass participation rather than elite achievement. Put big taxes on gas-guzzling cars, and remove them from less polluting vehicles; take taxes right off bicycles. Support those responsible for rearing and teaching young children, whether parents, or day-care staff, so that this critical period of development is maximally supported.

Make being unhealthy difficult
We need our healthcare system to make ruining your health difficult. For example, the government should raise taxes on cigarettes. Make places to smoke even more restricted (and offer really good support for people who want to quit). Get rid of junk food in and near schools. Cut down on the number of liquor store outlets, particularly near highways. Make driver training very stringent, with an emphasis on "defensive" practices. Increase taxes on cosmetic pesticides and on any other non-essential chemicals that have poisonous qualities.

Make healthcare whole
We need the delivery of health-related services to be balanced, seamless whole. For example,  we need complementary and alternative approaches, which are of proven value, accessible to all in a fair way. We need the government to link treatment, preventive services and interventions, so that no-one who seeks treatment fails to hear about simpler, safer, more efficient, preventive practices or opportunities.

Ask the government to set up demonstration projects, where prevention as well as all modalities of treatment are available in close proximity. Health needs to be marketed with all the energy, zeal and intelligence that is now poured into marketing beer, cars, laundry soap and drugs. Drug therapy should be de-emphasized, with all its inefficiencies, risks and  high costs.

Make it holistic and patient-centred
Let's train doctors and other health care practitioners to adopt a holistic, patient-centred  approach for example, model holistic patient-centred relationships in all training programs.  Teach medical and nursing students about healthy nutrition, exercise physiology, good mental hygiene, and motivational techniques.

Give everyone in healthcare an understanding of the social determinants of disease, and make it clear that addressing them carefully is just as important as starting IVs and prescribing treatments! Give all health professionals a rational, unbiased basic introduction to a full range of therapeutic techniques and approaches, both conventional and complementary.

Seem complicated? It's not. It's just plain old common sense. As the old saying goes: "An ounce of prevention is worth a pound of cure," when it comes to home care and healthcare.

Warren Bell, MD, is a physician in the heart of the Okanagan Valley. He is also President  of the Association of Complementary and Integrative Physicians of British Columbia.

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