"Those who are well have no need of a physician,” Jesus said. We now know, however, that they do have need of a wellness coach. We all know the simple facts: Many Americans, for reasons acknowledged to be something of a historical accident, have health insurance through their employer. Health-care costs continue to escalate, and employers are eager—perhaps even desperate—to find ways to limit these costs. Increasing premiums for employees, rising copays, HMOs, PPOs—none has really worked to control costs other than in the short run.
The latest fad is the consumer-driven approach—shifting to consumers (formerly known as patients) the cost of heath care and the responsibility to shop smartly and efficiently for the best and cheapest health care. This approach is unlikely to achieve much in the long run either. Tailor-made for those who probably don’t need insurance anyway—healthy young adults—this strategy will make the world of health care much harsher for many others.