The original lyrics come from Pete Seeger’s song…Where have all the flowers gone…etc. At that time, it was about war. However, the same question can be asked regarding health, poverty, and education. When will we all learn that hand washing, preventive care and cleanliness, education are as requisite for good health as poverty and health illiteracy is a threat? During this recent threat from the H1N1 virus, it was not surprising that other countries had more serious outbreaks than those in the US…and that those whose lives are at a subsitence level are as much at risk today as those who lived prior to antibiotics and other medical miracles.

Florence Nightingale asked the same question: When we will ever learn that pauperism (poverty), lack of good hygiene and clean water, toxic air, and lack of good diet is why patients die who would otherwise live?

Barack Obama’s hint to wash our hands and cover our mouths remains so boringly low tech. The push is for vaccines so that we no longer have to wash our hands. My sarcasm may not be appreciated. However, there is more truth in my observation than even I am comfortable with.

Give me anything but don’t tell me to change what I am doing, how I am doing it, or when! This has become the mantra of patients, the profit margin of pharmaceutical companies, and the job description of clinicians: Diagnose and prescribe, but don’t look beyond the symptom. OR, if one looks, still do everything that can be done other than tell the patient what kind of decisions would ensure their best shot at improving their health, if not protecting it.

I am personally invested in healthcare reform. Our company rates for 8 healthy people increased 33% this year. This includes an increase in our deductible by 20%, to $2500.

Monday, the New York Times stated “Signers of the letter (of commitment) said that large amounts could be saved by aggressive efforts to prevent obesity, coordinate care, manage chronic illnesses and curtail unnecessary tests and procedures; by standardizing insurance claim forms; and by increasing the use of information technology, like electronic medical records.” This is a start, but will not help you and I in paying for our insurance or guaranteeing that when and if we really need it, our insurance will cover what we need when we need it. The question, however, is whether we will do our part in staying healthy.

I am not going to enter the debate of whether the players now willing to participate are wolves in sheep’s clothing. Rather, I am going to offer that the healthcare system, as an institution, has created a codependent relationship with all of us, making us feel like we cannot take care of ourselves. There is clearly too much profit in sickness and hardly any in wellness. Too many make too much on the sick, those of us who fear being sick, and those of us who have come to believe that cures are there to forgive our indulgences.

I am not blaming any of us for this. However, as Dr. Leland Kaiser said years ago, if we do not begin to re-frame our healthcare systems to invest in health rather than illness, offering another sickness-based system in any form will be rearranging the chairs on the deck of the Titanic.

When will we ever learn that have had health care rationing ever since doctor’s treated for money, that most vaccines will fail if we fail to use them; that the miracle of the antibiotic died at the age of 40 with the advent of HIV; that the current spread of the H1N1 virus points to the need for us to own our collective health as being all of our business. We live globally if one child in Mexico can get a virus and within days it spreads to many countries.

Florence Nightingale would have told us all to wash our hands, clean our sick homes and offices, and that the best way to deal with illness is prevention. Clearly, how this one young child in Mexico is, so how the world is.