That begins in this issue, with our focus on the Wellness Initiative for the Nation and related articles on why health reform must include a major shift toward prevention, health promotion and integrative care. At a time when health finance issues often overwhelm thoughtful discussion of what is truly needed to deliver health and wellness to our population, we have a special responsibility to say what has not yet been said and to raise our voices in support of those whose proposals go to the heart of the current crisis. If you believe in democracy and see a need for change, speak out. Be part of the solution.

On many levels, our nation and our world have reached a tipping point, in which short-term-only thinking has become a luxury we no longer can afford. Crisis yields opportunity. From climate change to economic meltdown, from preventable chronic diseases to unsustainable levels of resource consumption, major change has become a necessity. We all must learn to think long-term, to ask ourselves the critical question: How will our decisions now affect the world our great-grandchildren inhabit?

Those of us in health care should start where we are, looking first at our own behaviors and working to harmonize our actions with what we know to be the most health-affirming choices available to us. Then, we can share these practiced insights with our patients. Finally, we need to imagine the world we wish to create and engage in a local, national, and worldwide conversation about how to make it happen. Small steps in the right direction matter greatly, both for their inherent value and because they set a tone, like the ringing of a beautiful bell. That tone can then resonate outward into our homes, families, workplaces and communities. We can become the change we seek. That is how transformation happens.

Wellness Initiative for the Nation

In this issue, we feature four articles on health reform. Early this year, I interviewed Wayne Jonas, MD, about the Wellness Initiative for the Nation (WIN), a groundbreaking health policy proposal he crafted with colleagues at the Samueli Institute, where he is president and CEO. Dr. Jonas was a military physician for 20 years and headed the National Institutes of Health’s Office of Alternative Medicine in the mid-1990s, its years of greatest growth and transformation. He speaks with the voice of experience, in reasoned tones but with a profound sense of urgency.

WIN embodies the best insights of the prevention and health promotion movement, providing legislators (if they will listen) with the broad directions and policy specifics needed to reverse our current epidemic-scale levels of obesity, diabetes, cardiovascular disease, hypertension, cancer, and osteoporosis. Everyone interested in including meaningful prevention and health promotion programs in a reformed health care system should read the current draft of WIN. President Obama has spoken often about the need to prioritize prevention. WIN is a program he and his team need to know about and to implement through the newly created White House Office of Health Reform.

8500 Community Health Reform Meetings

I took part in a conference call hosted by the Samueli Institute to discuss the WIN proposal. This was one of the 8500-plus Community Health Care Discussions held in the final two weeks of December 2008, in response to the Obama-Biden Transition Health Policy Team’s call for people across the nation to gather in their communities to discuss health care, and to submit recommendations to the new administration. A few days earlier, Cleveland Chiropractic College’s Center for Health Promotion had hosted another of these community meetings, which I moderated. The consensus recommendations that grew out of our meeting (which was attended by a diverse cross-section of nearby communities on a cold winter night during Christmas week) were sent to the Transition Health Policy Team and are also presented in this issue of Health Insights Today.