Perry

Unfortunately, in health care there is a lot of inertia. We are always looking for the tipping point—but nothing seems to change. We’ve tried evidence as well as certain kinds of legislative advocacy over the decades. We get a lot of pats on the head. “Aren’t you nice. Thanks for doing that.” And then they toss us a cracker. That’s about it. We face the challenge of finding strategies that not only create the tipping point but also guide actions after the tip has occurred. I think the tipping point resides with the public. When they have had major difficulty in accessing health care, and when they see their health negatively impacted by current health care policies, priorities and operations. When they get “pissed off” enough, then they will start doing something about it. Looking at past history, I think it is going to get worse before getting better. Then the public will rise up and say “enough is enough. We can’t access the basic health care we need!”  Something needs to be done on a national and global level [fourth political strategy].

Peter

It is sometimes a tipping point and sometimes not [a slow evolutionary change] For example, civil rights-based changes have occurred slowly over time but have had a major impact. To quote John Lewis, “the struggle is not for a minute, an hour, a day or a year. It is for a lifetime.” These are many, many struggles accumulating over many years. This is what we must do. It is way more interesting and satisfying to help people. This is a lifetime endeavor.

A tipping point did occur in neurosciences. Suddenly, neuro-biology is the answer. Obesity is suddenly a disease. Addiction became a disease. This is all wrong. These are not diseases. They occur because we are eating to fill a hole in our heart rather than in our stomach. All of this new emphasis on neuro-biology is generating the sale of drugs, and transcranial electric stimulation. These approaches are completely useless to help anybody.

Jeremy

To bring this to a close. There is the depressing perspective associated with the inertia of health care, but also the cause for optimism associated with the creation of tools such as agent-based modeling that can help us better understand how to overcome the resistance.