I consider health to be the sole responsibility of "we the people". In a book titled "Medical Nemesis" , Ivan Illich challenged what he called the "medicalization of society" and challenged the individual to take responsibility for their health. His argument is somewhat polarized but has merit, particularly when we look at obesity, smoking, drugs, alcohol, marital and work stress and lack of exercise in a large section of the population.
A satisfying job paying a fair salary is the cornerstone of an individuals health. It supports a good education, clean air and water, a sound roof over your head and simple food on a clean table. These form the foundation of health. Appropriate prevention from vaccinations to tooth and gum hygiene pays off. Being happy in marriage and relationships adds to the health formula. Awareness of personal safety at home, work and on the road saves lives. Maintenance of ideal body weight with good nutrition and exercise, being tobacco and substance abuse free add years of quality life and increases savings.
Integrating and balancing all of these elements promotes the best "environmental" impact on whatever genetic or inherited disease promoting vulnerabilities we may have.
Illness either acute or chronic is optimally managed by using all the assets and opportunities available. Sometimes patients will require a dentist, doctor. Some illness is best managed by a surgeon, others may require medication. Illich died of cancer rejecting medical intervention - not knowing his details precludes comment. He would have approved of the New England Journal of Medicine article indicating the impact of palliative care.
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