Recently the WSJ’s blog on health and the business of health generated some good blog when it questioned the notion that retiree health plans had been advanced as part of the deal logic. Sticker Not Shocking for Chrysler's Retiree Health-Care Costs. The original post was interesting, but the response even more so. Writes one blogger: “Universal Health Care - more specifically - the opposition to it - is … one by one.. going to drive U.S.-based industry into the ground… as their less-burdened competitors are able to be more agile and more focused when they need to be. I’m looking forward to the day when WSJ… comes out in favor of Universal Health Care. Heck.. it only took the rest of the world - to convince them….that their 100 year-old view of business was …. flawed. “

Ok, you're ready to take a more active role in your own health and health care -- or to help your employees, families or friends. Where to start? The Puget Sound Health Alliance website. It is a great resource for consumers or those of us developing programs in companies and communities. It has free tools and links to a variety of resources - medication records; checklists for your next doctor's visit; surveys to figure out your risk for diabetes or heart disease. And you don't need to be in Washington State to use them!

The Josie King Foundation's recently updated website begins with the words

"On February 22, 2001, eighteen-month old Josie King died from medical errors. It is estimated that 98,000 people die every year from medical errors, making it the fifth leading cause of death in the United States – more than car accidents, breast cancer, and AIDS combined."

One human resource manager I know was so impressed with this short video about a Maine cancer patient discussing her cancer, she asked her whole department to take a look at it. Within a week everyone in the 17-person department had viewed it and many had shared it with friends. The video features Chelsey, a young woman who explains the steps she had to go through to get successful cancer treatment. Her suggestions are universal lessons that provide encouragement for anyone going through a health crisis. The human resource manager says if we all could be as strong and clear about engaging our healthcare providers as Chesley, the healthcare system would dramatically change tomorrow.

As an extension to its Speak Up campaign, Joint Commission’s new Know Your Rights campaign further encourages patients and families to educate themselves. The more patients know the better their care and recovery time can be. Several brochures are available for use, and some topics include four things patients can do to prevent infections, what patients can do to prevent medication mistakes, how they can help avoid mistakes in their surgery, and planning follow-up care. The best part is that “there are NO copyright or reprinting permissions required for the Speak Up materials or copy.” The Joint Commission only asks that they be credited as the source of information. Good stuff.

My parents and the parents of many of my friends and colleagues are struggling with a variety of health issues related mostly to the aging process. One difficulty of aging is that one's decline is inevitable. Another is that for most of us the only choice we have is whether that decline is gradual or precipitous. And to age well, one ought to start early before the idea of aging is upon us. So if we work at our health, the chances are better that we will decline gradually - but that too is in no sense guaranteed. And, yes, some of us have to work harder than others to have any reasonable quality of life and health.

The same paradox is true about engaging consumers in changing the health care system. In effect, we are saying that we need to work hard now to affect a positive change in a system that may or may not result in positive benefits for us personally.

The fact is, that like aging, we really don't have a choice. The United States healthcare system needs individual consumers to help promote and participate in changing the system. Because, like the aging process, unless we are incredibly lucky, the chances are slim to none that we can do nothing and hope to have anything but a precipitous decline. Who is willing to say I'm going to forget about my health and roll the dice hoping that through some miraculous intervention my future years will have a quality of life that I find enjoyable?

Not many. There are literally dozens of magazines and books devoted to health. The good news for health system change is that there are an increasing number of people and institutions working to improve the health care system too.

Like personal health improvement, the place to start is to believe that change is possible. It is not enough to say the problem is too big or that it has to be solved by the government or by big corporations. There are things each of us can do to begin changing the system today.

The second step is to determine the change you would like to see personally and to set some simple goals. For example, learning to speak up in a health care setting is something we all need to do better. Or we might resolve to change health plans or to a find a place of care where there is tangible proof that the care is higher quality than most.

The third step is to decide what we need to do to achieve our goal and to find the resources that can help us. The good news is that regardless of our personal goals, there are lots of resources to help.

As part of our work, we frequently interact with local employers regarding healthcare quality and the role that organizations can play in addressing this issue. We recently spoke with a human resources director from an organization that has done truly groundbreaking work with regard to healthcare and healthcare quality improvement initiatives. Based on the success and longevity from her organization’s efforts, she was able to offer interesting insight.

“Too often, employees are suspicious of efforts promoted by their own employer,”she said. “When new initiatives are rolled out, the attitude they are met with is often ‘What are they taking away from me now?’ As employers increase expectations for employees to better manage health risks and share more of the costs of healthcare, they also need to be doing more to promote the quality and safety of the healthcare their employees receive.”

To address this issue, her organization – which is based in Maine – found an effective way to “actively influence the quality and safety of care” by participating in the Maine Health Management Coalition. The MHMC is an independent organization that works with providers, insurers, and employers in a collaborative effort to improve the quality of healthcare in Maine. Many states offer similar programs. For more information, visit the National Business Coalition on Health.