In these times in which the use of euphemisms and political correctness is common, the tendency to call health what is rather health is prevailing. Surely with the apparently good intention of emphasizing the importance of health in relation to disease, which has been and continues to be the main interest of medicine and the health professions today. The adoption of the term health to refer to health activities predominantly care and directed individually to the people who use such services is, in the best of cases, a good wish, although it is inevitable that it will cause some confusion in both professionals and professionals. the patients.
The idea of health as the absence of disease, in a way its antonym as suggested by some preventivists, does not agree well with the perception of good or very good health that those who also declare they suffer from one or more chronic diseases, as can be deduced from the successive versions of the Spanish health surveys. It is therefore essential to change the apparently antinomic paradigms of health and disease in order to admit the practically continuous coexistence of both throughout the entire life course of people and to assume that the definition of the patient emerges as the protagonist when the individual suffers from one or the other. more pathological processes that prevent you from leading a “normal life” and “feeling good.”
At the same time that permanent health is enthroned as an inalienable personal and collective objective, forgetting that it is still another instrument (important that yes) to be able to enjoy a sufficient level of well-being and quality of life, we intend to erase the horizon of our finite existence the inexorable reality of malaise, disease and death. This utopian dynamic and contrary to logic leads us to use all kinds of resources, including health ones, to keep ourselves theoretically “healthy” and, as they say, “eternally young”.
Those responsible for these distorted views of people’s life trajectories are diverse and act driven by interests that are often spurious and directly related to the enrichment of companies and entities dedicated to what, rightly, has come to be called the “business Of the health”. Healthcare systems and products, practically exclusive protagonists, together with the technology industry, in this field, thus become elements of personal and social consumption with which we intend to achieve the utopian objectives previously mentioned. It is forgotten that health actions inevitably always have a double face: they generate benefits for those who receive them if they are indicated and are effective and timely, but at the same time they have the ability to cause damage from their side effects and complications, as well as for possible errors made in its application. It is what we usually know as iatrogenesis.
The health system, even if it is public, equitable, accessible and effective, if it acts in isolation, without sufficient coordination with the rest of the determinants of well-being and quality of life, such as access to education, social solidarity and correction From serious inequalities, fair and favorable work environment or respect for the environment, you will lose most, even all, of your ability to decisively and profoundly improve the overall health of the community and individuals. It is necessary to generate transversal policies for well-being and quality of life that, while correcting the imbalance suffered by the health systems of developed countries, guarantee their effectiveness and sustainability.
Despite the existing evidence in this regard, we continue to hear our political representatives, managers and experts speak of the health system as an isolated element, enclosed in the ivory tower of scientific and technological development and alien to the socioeconomic environment in which it operates. We are well aware that the health-disease continuum is increasingly conditioned by this context, but we seem determined to turn a deaf ear to the increasingly pressing need to develop policies and laws that transversally integrate these types of perspectives.
As we have pointed out elsewhere, it is necessary to introduce orientation and strategic changes in health policy, integrating it transversally with the rest of the social policies, prioritizing in this objective the approach to those that have a clearer impact on health. It is necessary to revisit the General Health Law of 1986 and provide it with the instruments that make it possible to operationalize the aforementioned approaches in the daily performance of the services and resources. Perhaps we are pessimistic, but we do not foresee a near horizon of success for more transversal policies of well-being, quality of life (and health).