Bill G. observed that these COVID-related changes tended to be painless and rather easy to make. The hard changes (such as major modifications in behavior) are much less likely to be engaged. These hard changes require that we accept individual responsibility for our behavior and our health-related habits. We resist taking personal responsibility and instead look for some outside agency to fix our health care problems (be this agency a drug or public mandate).

Bill B. offers an observation that Bill G. seems to be focusing on the role of culture operating at an individual rather than collective level. This is a unique and very important perspective. Bill G. suggests that significant cultural change has to occur at both the individual and collective level.

Jeff offers an interesting observation regarding how collective perspectives can influence individual behavior. He points to the matter of obesity. Now there is pressure to avoid biases against people who are overweight. Models in advertisement are now less likely to be slim. We are no longer supposed to demean other people if they are a bit chubby. This recent reframe is not health-oriented. A deliberate push away from a preferred image of the thin, active adult (man or woman) and toward an honoring of all physical types (including being over-weight) discourages engagement in healthy habits. These are habits that help people reduce health-diminishing weight. Overweight is indeed harmful. Obesity is a major health care crisis today. Yet, along with this push toward weight-control must come acknowledgement that the correlation between excessive weight and various health parameters are not always very high.

Perry suggests that the pendulum is swinging back and forth. Should we be comfortable with our overweight bodies or should we reduce our weight for health reasons.

Walt Mills offers a general conclusion that there is a lack of clarity in the health care community regarding the best strategies to engage when promoting healthy practices.

Jeremy adds to this discussion regarding the introduction of behavioral changes in healthcare and the major life-style changes being proposed by some physicians (especially those in primary care practice). Jeremy observes that behavioral medicine is not typically covered by healthcare insurance—thus blocking the introduction of behavioral changes by professionals who are trained and educated in this domain.

Jeremy goes on to identify the general themes that have already been introduced in this forum. It should be a matter of both/and rather than either/or in the formulation of health care policy. There is a need for a positive, impactful approach to the selling of preventive health care measures. Since conspiracies seem to be effective in bringing about false knowledge regarding health care cure, perhaps there can be a truthful “conspiracy” in which valuable information regarding health care can be effectively conveyed.  Can ethical and engaging networks be established to “conspire” against false and misleading strategies and information regarding health care cures?

Clearly, treatment (especially a shot or pill) is much more appealing to people than the slower and more challenging pathway of prevention. Pronouncements are made (and attendant promotions are introduced): “Don’t control your diet or exercise—instead take a weight-reduction or appetite suppress pill!” Given these pervasive and persuasive messages, how should those providing health care through the encouragement of prevention and the embrace of a holistic (biopsychosocial) perspective go about changing the attitudes and habits of those with whom they are working?

Jeff brings in his own experience as both a physician and lawyer. He considers the ways in which both professionals approach an issue. Recently, physicians have often embraced a warped perspective. They come up with a question that relates to the answer they already have. It is like those in advertising who have the solution in mind—a specific product or service—and then find a problem that can be addressed with this solution.