Health Care in the Next Economy

The philosopher and writer John Thackara, a senior fellow at the Royal College of Art, in London, scours the world for examples of the ways social innovation can improve the health of communities, which he explores in his blog, doorsofperception.com. He recently spoke at the UC Berkeley School of Public Health about his new book, How to Thrive in the Next Economy. He explores the ways sometimes small steps can make a tremendous difference in solving some of the most intractable challenges in delivering health care.

What are the most serious challenges facing health care?

It’s a multi-dimensional crisis in which trillions of dollars are spent treating the symptoms of illness rather than its causes. Too much of the focus of health care is downstream, on treating people after they get sick, rather than upstream, on keeping them healthy in the first place. The business model of the system is typically pay-per-procedure—when it should really be, we get paid if people don’t get sick.

In Europe, for example, 80 percent of items in the average supermarket contain added sugars. (In the US, an estimated 74 percent of packaged foods contain added sugar.) But rather than impose hefty taxes on the food companies, or simply make their products illegal, lawmakers tend to spend money on costly ad campaigns urging people to eat less and exercise more. Telling people to change their behavior when they are surrounded by overwhelming pressures to eat badly makes little sense...