The negative effect of the clinical model of "health": implications for health care policy.
America has no overall health policy agenda that provides direction for improving the health of the nation. Historically, policies have focused on financing medical care. However, the philosophical model underlying that care is disease, not health, oriented. Health is only implicitly conceptualized and then only as the absence of disease. While the clinical model has provided for technological excellence and sophisticated medical care, it has also led to many problems within the health care delivery system. Skyrocketing costs; decreased access to care; poor health outcomes; and significant disparities in health among groups in America are the result of policies based on the model's limited conceptualization of health. This article describes the pervasiveness of the clinical model in influencing health policy. It analyzes both the health and economic outcomes of such policies, and explains the necessity of developing policy from a broader perspective of health. Using a nested model of health is encouraged. This allows policy makers to clearly visualize both the level of client and the focus of care that is being addressed. Delineating the focus of care may help in the development of policies that are truly aimed at improving the health of the nation.
Medical College of Ohio School of Nursing, Toledo, USA.
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Peters
D006291:Health Policy / Q000191:economics / Q000639:trends; D006293:Health Promotion / Q000639:trends; D006801:Humans; D017146:Models, Organizational; D009341:Negativism; D014481:United States