Health-Autonomy 18Dec2012 Rev9

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2012 Scott Perkins. All rights reserved. Facebook: www.Facebook.com/HealthAutonomy 1

Health Autonomy:A Populations Voice of Reason

By Scott Perkins

There is a general assumption inli e that every individual desiresto be healthy. This includes anunderstanding that li e has abeginning and an end with varyingdegrees o health status changesthroughout a li espanor any

variance within how an individualperceives or measures an actualstate o health in any givenmoment in time. The question is:How do individuals rationalize decisions that correlate to healthy living?

The knowledge needed to answer this question begins by irstidenti ying three broad categoriesthat account or our health status: healthcare, genetics andenvironment/li estyle actors. Eventhough healthcare-or a systemthat provides medical care toindividuals-only accounts or 10%o our health status, it retains thegreatest capacity to rationalizethe decisions that change our health status. By quanti ying theactual changes, healthcare candemonstrate how treatments causea positive e ect to our health status.

Healthcares decision methodology positions the knowledge o oneindividual in a very in luentialposition over other individuals.The knowledge that healthcare

providers utilize in makingdecisions that change a patientshealth status are use ul whenan individuals health status isdiagnosed as abnormal. Thisstate o health could be broadly labeled as a health outcome-or anabnormal health status beyondan individuals ability to controlon his or her own. Patients whoare un ortunately diagnosed

with a health outcome will bein receivership o treatmentsand procedures that help themreturn to and then preserve morenormal health status. It is there ore

a rational decision to receivehealthcares treatments in onesdesire to live a healthy li e.

Generally, healthcaresmethodology involves periodiccheck-ups with a primary carephysician. These visits may eventually lead to a diagnosis o a health outcome. I there is adiagnosis o a condition, disease,syndrome or injury, a primary care physician or specialist willdecide on what orm and amounto treatment will be needed toimprove this health outcome.

When being treated, a patient will then receive some orm o evidence that the treatmentscaused a positive e ect to a health outcome. The proo is normally

objectively quanti ied in the ormo imagery or statistics. Thisprovides a basis or both parties tointerpret and analyze the reasoningbehind why these decisions weremade in the irst place. Again,generally speaking, most individuals

would agree that these decisionsare o great value and meaning

within any individuals desire tolive a healthy li e. These decisionsare rational.

It is di icult to take a positionagainst these actions withinhealthcare. These actions are

virtues because they attempt topreserve the quality o health status within an individual. In

Scott Perkins has beena health and ftnessentrepreneur or over 20 years. He received a

Bachelor o Science romSpringfeld College anda Masters in Business/ Health Care romThe Heller School atBrandeis University. Inaddition to creating asuccess ul health andftness company, Scott hasauthored over 30 articlesand essays.

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http://www.facebook.com/HealthAutonomyhttp://www.facebook.com/HealthAutonomyhttp://www.facebook.com/HealthAutonomy


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Health Autonomy: A Populations Voice of Reason


act, we should encouragenotdiscouragean increase scienti icresearch and innovation thatimproves the production o

technologies that apply modernmiracles to address and ameliorateuture physical and emotional

distress and dys unction. Whenhealthcare treats a health outcomeaccurately, we can all bene it romthis methodology at some pointin our lives. Logically, healthcaresability and capacity to success ully identi y and treat health outcomes

will continue to grow withinthe context o innovation and

practice as the knowledge andunderstanding o the human bodys

unction and dys unction increases.In act, according to The WorldHealth Organization, approximately 13,000 conditions, diseases,syndromes and injuries have beenidenti ied that use over 6,000 drugsand 4,000 procedures to treathealth outcomes. However, thisdiagnosis and treatment paradigmcreates a very complicateddecision-making process that hasmany disadvantages and problems.

The less prominent issue comesrom the position that healthcare

shares in providing the actions,responsibility and accountability

or population health. Though healthcare has a moral obligationto care or those who are ill,healthcare is in a less avorableposition to help the generalpopulation with actions thatprevent disease. Such actionsare largely outside o the scopeo healthcares methodology

or changing health status. Inorder to achieve this, the generalpopulation needs to be moreaccountable or health-related

decisions by increasing a sharedsense o responsibility or itsown health. We all experiencehealth throughout our lives and

the decisions and actions wetake constantly change our stateo health. Even though thesechanges may eventually lead toa diagnosis o a health outcome,it is by no means healthcares

job to be accountable or whatis an individuals responsibility

or choices that may accumulateand mani est into preventableconditions and diseases over time.

O course, individuals do havereedom o choice not to exercise,

not to eat properly and to smokeand/or take dangerous drugsdespite overwhelming evidencedocumenting how these sel -destructive choices contributeto the increased or decreasedrisks o preventable conditionsand disease such as high bloodpressure and heart disease. Moreabstract actorsunemployment,

violence, education, divorce,housing, inance, poverty, work environment and othersalsocontribute positive and negatively to an individuals health status andmay even add to the aggregate o

actors changing our health statusover time. However, there is nobasis or individuals to measurehow they perceive these actorscontributing to their health status changes that accumulateand mani est into preventablediseases and conditions over time. There ore, individuals have adi icult time changing their health-related behaviors due to their inability to accurately interpret andanalyze whether or not decisions

within these actors were rational.

Individuals have no basis or measuring the cause-and-e ectrelationship o how they perceivethese actors changing their health

status over time.This places healthcare in a morally responsible position to use itsknowledge to change our health status when its too late. So insteado developing ideas that are moreproactive in preventing disease,

we perpetuate discussions withinour traditional deliberation andconsensus-building e orts abouthow to change the delivery o a system that reacts to illness.Healthcares knowledge andmethodology is there ore o very little use in helping the generalpopulation learn and understandhow to change the environmentaland li estyle actors that account

or 70% o an individuals health status.

This point was underrepresented within the deliberation andconsensus-building e ort in the2008 A ordable Care Act (ACA).Cost was the central issue. Giventhat the United States has thehighest healthcare spending inthe world and close to 50 millionuninsured residents, the amounto money we spend in healthcarecannot be ignored. Logically, anargument that is ormed arounda ordability is a sound strategy i the goal is to insure more people.

With per capita spending withinthe United States healthcaresystem at $7.960 (Organization

or Economic Cooperation andDevelopment) many provisions

within the ACA ocus onine iciencies and waste.


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According to Shannon Brownleesbook Overtreated , there is a loto it. Approximately 20-30%o healthcare spending does

nothing to improve our health, which is another way o sayingthat much variationmisuse,overuse and underuseexists

within healthcares ability tocorrelate how its treatmentdecisions translate to quality health outcomes. Forty percent o patients

with coronary artery diseaseget incomplete or inappropriatecare; 60% o asthma, stroke, andpneumonia patients get incompleteor inappropriate care. So i the

ACA is ocused on ine icienciesand waste ul spending within asystem that is ocused on treatingdisease, the obvious questionsare: what are the conditions anddiseases that account or themajority o healthcare spendingand what is the system doingto prevent these conditions anddiseases? Answers to this question

include: chronic conditions anddiseases and Im not sure.

These diseases and conditionssuch as type II diabetes, heartdisease, high blood pressure andhigh cholesterol contribute to75% o healthcare spending. Theo ten talked-about Federal andstate entitlement programs such as Medicaid and Medicare spend83% and 96% on the direct careo patients with these diseasesand conditions. The paradoxbeing that most o these diseasesand conditions have beenlabeled preventable or decadesand when a short window o opportunity opened to initiate anational discussion surroundinga strategy to help decrease the

risk and onset o these diseases, we ailed. I these conditions anddiseases are preventable and i they account or the majority o

healthcare spending, why wasntthis issue a central theme o the ACA? This makes no sense at all.

I healthcare assumes that we alldesire a healthy li e and have theability to reason the bene its o certain health-related decisionsover the costs o others, why cant we increase our capacityto rationalize decisions that aremore conducive to healthy living?

Why cant the general populationprevent chronic diseases or compress these diseases tothe later stages o li e? A largeportion o this question needsto be answered by the generalpopulation and not by a healthcarepolicy expert, healthcare provider or politician! With no basis

or measuring how populationdecisions within environmentaland li estyle actors correlate tohealthy living, it is impossible toharness the power within each and every individuals ability tochange their health status. With no basis to interpret and analyze

whether health-related decisionsare rational, the general populationis le t with an inability to weigh or explain the reasoning behind why certain decisions within actorsprovide bene its over the costs o others. And with a limited ability to improve the e iciency andproductivity in deliberating andbuilding consensus in directing acourse o actions that pursues auniversal desire that we all sharein common, we will always havedi iculty harnessing the essenceo power: to learn and evolve the

understanding o how to live ahealthy li e and teach this art to

uture generations.

Uncertainty Due to Missing Link

A major part o the solution tothis problem can be ound withinthe eelings o how our choicesand actions are subjectively based

rom one person to the next. Eventhough this eeling is universal

within each individual and indeedpervasive throughout the generalpopulation, it also poses a problem.It only complicates matters when

we attempt to communicate our perception o how and what

we need to live a healthy li e.The irony being that when any individual attempts to explainthe reasoning within the nuanceso what resources need moreaction over others in achieving astandard o healthy living they willinevitably ace disagreement with others.

These di erences create an

obvious barrier within our understanding o how to live ahealthy li e. No clear plat ormexists to increase the e iciency and productivity within our traditional deliberation andconsensus-building e ortsthat could be used to guide acourse o population actions.Even in the case o chronicdiseases and conditions, there issu icient evidence showing thatenvironmental and li estyle actorsare causing these conditions anddiseases. Yet, there is a missing link:

An instrument that irst, combinesand quanti ies our negative andpositive eelings within how weperceive health in order to beginthe deliberation and consensus-


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building necessary to learn andunderstand how to achieve ahigher standard o healthy living.

With no quantitative basis or individuals to interpret and analyzehow a population perceives health-related actors and resourcesthat contribute to a standardo healthy living, we have only a limited basis to improve our traditional deliberation andconsensus-building e orts or learning how to change health-related behaviors. There is nobasis or individuals to draw rom

in communicating the reasoningbehind why certain resourcesmake more sense to consume over others, because no instrumentexists to measure and correlatehow these resources change thestatus o actors contributing toa standard o healthy living over time. This will continue to place adisproportionate amount o weightand responsibility in healthcaresmethodology to treat illness as longas a continuum is lacking to helpus proactively understand how tolive healthier lives.

Without such a continuum, society will continue to experience anunprecedented level o uncertainty in rationalizing the value o resources that could change thestatus o actors contributing toa truly healthy standard o living.Thus, as the general population

becomes more aware o how environmental and li estyle actorsare largely causing preventablechronic diseases and conditions inthe uture, the level o uncertainty about what to do about them willonly increase. When this levelo awareness becomes saturated

within society, will individuals have

the opportunity to decrease their level o uncertainty by identi yingresources that are perceived tochange the status actors that

contribute to a uture healthier standard o living? How doesone individual possibly changethe status in societal actorslike poverty, activity, and global

warming when we inevitably acedi erences in opinions o how togo about this change with others?

The in ormation rom such di erences, however, can providea robust environment or changing

the status o these health-relatedactors i properly utilized. In act,every individual has a unique andproprietary perception o his/her own reality and this in ormationcould become very valuable in

illing a knowledge-gap within our understanding o health. Certainly,

with every individual unique andproprietary perception, there isan equally unique and proprietary

eeling as well. The question is:can we use this subjective eeling

within any individuals perceptionin such a way as to combine it

with others and then somehow quantify how a populationperceives health?

Record, Quantify, Measure

My answer is yes. But thisin ormation must irst and oremostbe used to build a oundationo knowledge that empowersany individual to decrease theuncertainty within their health-related decisions by improvingour health autonomy, that is, our ability to sel -govern our ownhealth and to evaluate the health

within our surroundings. Our current knowledge o health

lives within healthcares ability to change internal dys unctions

within our bodies. This sourceo knowledge largely ignores

the external actors that leadto preventable chronic diseasesand conditions. With a generalunderstanding that we all havethe ability perceive certainresources that could change thecurrent status o actors causingthese diseases, we can use thisin ormation to guide and in luenceeach others decisions and actionsso as to achieve a higher standardo healthy living.

A concept o healthy living withintodays modern society placesgreat value and demands oncertain levels or resources withintransportation, energy, education,activity, nutrition, housing and

inance that all help to achievea certain standard o living. Aninstrument is needed to incentand reward individuals that record,quanti y and measure how they perceive these resources as makingpositive or negative contributionsto such a standard o healthy livingover time.

Without this instrument, attemptsto deliberate and reach consensuson how decisions and actionsin policies, goods and serviceschange our standard o healthy living will continue to be ruitlessand polarized. Without such an

instrument, there is also no pointo re erence to interpret andanalyze how certain resourcessuccess ully changed the statuso any one actors contributionto a standard o healthy livingover time. So we will continueto muddle conversations aboutdirecting a course o actions


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within resources that could beperceived to change the status o environmental and li estyle actorsthat currently lead to almost 50%

o our 65-and-older populationbeing estimated to have at leastone chronic disease by 2030. Mostdisturbingly, these same actors willcause close to 1 in 3 children bornin the United States to developtype-2 diabetes in their li etime.

This is unacceptable. Justconsidering the projected growth o the number o Americans65-and-older expected to reach

88.5 million by 2050, more thandouble that o 2010 (40.2) placesa huge demand on the ACAsimprovements to better coordinatethe care to decrease waste andine iciencies within the systemin preparation. But healthcarescurrent decision methodology willhave a very di icult time keepingup with this demographic shi t,

which is not equipped to decreasethe level o uncertainty within thegeneral populations decisions thatcould change the status o how environmental and li estyle actorsmani est into preventable health outcomes.

A healthcare decision to treata health outcome such astype-2 diabetes will certainly demonstrate a positive cause-and-e ect relationship betweenhow treatment decisions change

a patients health outcome. A measurement o blood sugar levels

will show more normal levels a ter treatment. However, healthcaresdecision methodology to treattype-2 diabetes is really treatingthe effect o what mani ests as adisease internally rom external

actors causing such a condition

in the irst place. There ore, itcan be asserted that the rootcause o preventable chronicdiseases and conditions must be

the aggregate o interconnectedpopulation decisions and actions-or indecisions and inactions-within

actors and resources contributingto a standard o healthy living.Paradoxically, this translatesinto the majority o healthcaresdecisions being morally-based,non-rational decisions thattreat preventable conditions anddiseases.

Objective MeasurementsMatter

These actors causing preventablechronic conditions and diseasesare so entrenched within todayssociety that it is not a cynicalstatement to remark that solutionsto these issues keep gettingde erred to uture generations.Indeed, i the recent experience

within deliberations andconsensus-building used to passthe ACA is any indication o how

uture debates attempt to changeother complex issues; it leaves one

with little optimism. Even i our general population increases itssense o responsibility toward agoal o achieving a higher standardo healthy living or all, how do wedetermine where actions should be

ocused? Without an instrumentto measure the populations

progress or regress toward thisgoal, the challenge to overcomehealthcares shortcomings is all butinsurmountable.

This is not to say that healthcareis not di erent rom most markets;it is indeed di erent and very unique. The critical di erence

in this market, however, is really within the meaning that anindividual derives rom their health interpretation. Or at least

what we currently conceptualizeand explain within our health interpretation regardless o whatrole you play in society. Generally speaking, when individualsinterpret health, healthcarebecomes our predominant voiceo reason. Factual and evidence-based language usually trumpsopinions and perceptions when

we attempt to explain the meaning within health and its relationshipto health-related actors andresources that contribute to theabstract notion o what most o us think health really is. Certainly,i two individuals are having are lective conversation describingthe meaning within their health interpretation, and one re ers toan experience o how healthcareobjectively measured and curedher bout with cancer, it tends

to resonate a tad bit more thana subjective experience withinhow daily habits o exercisingand eating resh ruits and

vegetables cause subjective change.Objective measurements matter in communicating the value andcausal relationship o how certaindecisions within resources e ect

what we interpret as health. Weobviously value the quality o li e

within ourselves and generally

appreciate the reedom weshare within our desire to live ahealthy li e, but healthcare hasan overarching perceived andactual value within our health interpretation.

The development o healthcaresknowledge that it currently


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yields doesnt begin to explainthe reasoning behind the valuein making decisions that result

rom objective measurements that

provide changes to diagnosedhealth outcomes. It began instead with subjective measurements o change that were experienced

rom people who needed care.Emotions motivated by humanempathy were the primary drivers

or healthcare pro essionalsseeking positive changes inpatients. All o todays machinery and gadgetry actually began dueto compassionate individuals

who desired to care or others who needed their help. No oneenjoys seeing another person inpain and distress, and healthcarehas developed a sophisticatedmeans to improve treatments thatdecrease these emotional states.

However, our use o healthcaresknowledge has created aperceptual divide within our health interpretation due tothe overwhelming in luence o empathys ability to motivateactions that decrease pain anddistress. This dynamic becomesmore apparent when we attemptto examine the abstract notion o health. Health re lects many o thechoices we have made throughoutour lives and not just the incidenceo something which enters our body that is de ined as symptomor disease. Environmental andli estyle actors (inactivity, poor nutrition, smoking, poverty etc.)should not be viewed as separateentities rom greater society wheninterpreting health.

This begins to explain why thereis such a barrier in initiating aproactive approach to decrease

the risk and onset o chronicconditions and diseases withinour healthcare system. There are

very ew outward signs o pain and

distress rom the inward changeso stimuli that are experienced within a development cycleo most chronic diseases or conditions. Diseases such as heartdisease and diabetes may take yearsto develop. Empathys ability to actas a portal or transmitting eelingsthat motivate human action canbe di icult when lacking outwardsigns o detection.

So what we currently experienceas modern healthcare really begin with doctors empathizing with thepoor and homeless who were inpain and distress. Distinguishedinstitutions such as MassachusettsGeneral Hospital (MGH) began

with empathic doctors beingmotivated to change the abnormalhealth status o those whomthey knew would bene it romtheir care. MGH was establishedin 1811 by Drs. John Collins

Warren and James Jackson whoreached out to 50 o the mostprominent and in luential peoplein Boston to help und a health institution that would care or thepoor. Human empathy providedthis portal to motivate thesedoctors to take actions on behal o people experiencing deepemotional distress. The reasoningsurrounding the history o whatpeople now experience within the

walls o MGH began as a result o these two individuals who weremotivated to act by a eeling.

But couldnt all o us, today,use empathy to motivate our learning and understanding o how to achieve a higher standard

o healthy living by proactively seeking increased states o happiness and pleasure?

A Basis for Achieving a HigherStandard of Healthy LivingThe Health Perception Index(HPI) can begin a process to helpus learn and understand how to achieve a higher standard o healthy living. The HPI is a web-based instrument that measures apopulations perception o health o a given town or city. Similar tothe Dow Jones Industrial Average,the HPI consists o compositeindex computed rom the valueo its component indices, each o

which has real-time daily averagesand volumes (Figure 1). Thedi erence in the instrument beginsby understanding what the indicesmeasure and what the averagesand volumes represent. The listo component indices measureshow these actors contribute toa standard o healthy living. Thereal-time averages and volumesrepresent the changes in how atown or city population perceivesthe indices negatively or positively contributing to the goal o the HPI.The goal o the instrument is tomotivate actions within resourcesthat achieve a higher standard o healthy living.

Regardless o how you de ine your role in society, your decisionsand actions will somehow beinterconnected to the dynamicsthat change the supply anddemand o resources that achievea certain standard o living. We allneed a certain level o resources

or sel -preservation and themarketplace certainly o ers anarray o resources to assist. But can


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individuals learn how to achievea higher standard o healthy livingby increasing their awareness o how other town and city residents

perceive resources that advance astandard o healthy living? And isit our shared responsibility to bemore accountable or motivatingand in luencing actions withinthese resources that correlate to ahigher standard o healthy living?

The HPI will begin to answer these questions by improving thee iciency and productivity withinour traditional deliberation and

consensus-building e orts. Theinstrument will incent and rewardresidents who choose to recordand quanti y how they perceivelisted indices, variables andresources that contribute to thegoal over time by using a simplemechanism to quanti y perceptualdata rom these same individuals.Resulting in a historical databasethat people can use rom which to draw re erence rom when they deliberate and build consensus on

what decisions and actions withinresources related to any one o the twenty indices make sense tomake.

The HPI is not intended tointroduce a decision methodology that somehow measures how individual decisions withinhealth-related resources directly correlate to changing their

health status. Unlike healthcarestreatment methodology thatlargely measures how resourcescorrelate to changing the stateso health outcomes in individuals,the HPI methodology is structuredto in luence and guide decisions

within resources that are perceivedto change external actors that are

indirectly related to changing anindividuals health status. In theory,the HPI will show evidence o how a populations perception o

listed resources is leading (or notleading) to a higher standard o healthy living. The recording andquanti ying mechanism will reporthow a given populations pastperceptions within listed resourceshave correlated to changing thestatus o component indices. Intheory, this will provide indirectbene its to an individuals health status by creating an environmentthat is more conducive to healthy living.

The instrument will irst buildstatistical consensus on what atown or city population perceivesas listed resources that change thestatus o any one o the twenty related indices contributing tothe goal. As populations use thisdaily in ormation to in luencedecisions and actions surroundingthese resources, correlations

will eventually orm in how apopulations past quanti iedperceptions within listed resourceshave caused actual changes

within a current indices status.Comparative metrics (see Figure1 below) will act as a gauge or individuals to interpret and analyzetrends that develop in changingthe status o any one o thetwenty component indices statusover time. Comparative metrics

will rein orce or discourageactions within listed resourcesby encouraging actions withinresources that are helping toachieve the goal and preventingactions that are hindering. An HPIcan be implemented within any town or city, and residents must be

at least 18 years or older to use theinstrument. The HPI has a patentpending status and is currently theoretical and not operational.

What are the main eatures andbene its o implementing anHPI within a town or city? Onesigni icant bene it is ound withinthe instruments ramework toempower any individual who

wants to learn how to achieve ahigher standard o healthy living.This is established by using theHPI goal to guide and transcendmore value and meaning within

health-related decisions. TheHPI channels an individualsrecordings and quanti ications o how he or she perceives listed

actors, variables and resourcescontributing to healthy livingtoward a data storehouse tabulatinghow large pools o populationsperceive the same listed items.These quanti ications will irstincrease and then exponentially grow the level o awareness within

which listed items are perceived tobring about the most change over time. Then, as the database is built,any individual has the opportunity to continually re erence, interpretand analyze the di erent aspects

within how their towns or citysperception o health has changed.The overall index, indices averages,comparative metrics, and an array o di erent tools that develop over time within the HPI can help any individual interpret and analyzeperceptual trends within theinstrument. This provides the basic

oundation or how the HPI willcreate and evolve a knowledge-base that empowers any individualto learn and understand how


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to achieve a higher standard o healthy living.

As individuals continue to makedaily choices within how they achieve a certain standard o living,the HPI will provide an ongoingopportunity to record and quanti y how they perceive listed resourcesachieving a healthier standardin the uture. Individuals canrecord and quanti y a positive or negative perception o any listedresource that is related to any oneo the twenty indices. The relativesilence characterized by how one

individual voice perceives a listedresource changing the status o anindices contribution to the goal

will drastically change by gatheringmore and more voices as a resulto the HPI. The many voicescombine and exponentially grow as individuals record and quanti y their perceptions o the samelisted item. This quanti ied voicecan easily grow into the millions

within the HPIs ability to scaleand disseminate a very power ul

voice or those who desire change. Whether its the status o issues within education, nutrition, thenatural environment, energy,

violence, government or numerousothers, the HPI allows any individual an opportunity to recordand quanti y a voice articulatinghow he or she perceives changingthe status o any one o the twenty indices. Thereby disseminating aclear statement o what resourcesa population values to change thestatus o any one o the twenty indices.

The beginnings o how theHPI acquires knowledge inunderstanding how to use

resources to change the status o external actors contributing toour health status are actually very similar to the beginnings o how

healthcare acquired its knowledgein understanding how to useresources to change the statusinternal actors contributing to our health status. The HPI uses humanempathy to motivate actions that

will evolve our understandingo how to use resources thatcorrelate to changing external

actors that contribute to changingour health status. However, theHPI uses empathy to proactively seek actions within resources thatare more closely associated with increasing states o happiness andpleasure, rather than ones thatdecrease states o pain and distress.

How the HPI is Organized

The HPI is organized by listingall items into three main sections,

which include; componentindices, gradient variables andresources. The componentindices and gradient variablesections are standard within any HPI implemented, and a resourcesection is unique to each townor city. The sections provide

ramework to scale the instrumentthat positions each town or city population in competition soas to increase the benchmarks

or resources they perceive willadvance the goal. Listed resources

can be recorded and quanti ied within an HPI by buildingperceived pathways.

Perceived pathways provide adaily opportunity or individualsto record and quanti y a eeling

within how they perceive any listed indices, gradient variable

or resource. Pathways are theheart o how the HPI develops itsdatabase. An individual builds aperceived pathway by choosing

one component index; onegradient variable; and one resource.These selections involve a shortsequenced set o recordings thattake less than one minute tocomplete. Any computer or mobiledevice with internet access can beused to build a pathway, and each day a resident will be allowed tobuild three pathways in their townor city and one within any other town or city.

A perceived pathway will alwaysbegin by an individual recordinga negative or positive perceptiono how one component index iscurrently contributing to the goal.

A pathway will always end by anindividual recording a negative or positive perception o how onelisted resource is contributing tothe goal. The logic is that we caninstinctively perceive how a listedresource will change an indexscontribution to the goal longbe ore the actual changes occur over time.

Pathways can change very quickly and help populations in luenceand guide decisions throughout theresearch, development, distributionand consumption phases o resources perceived to achieve ahigher standard o healthy living.

All o the pathways built withinthe instrument will be recordedand tracked each day. This allowsan individual to conduct a trendanalysis that can help theminterpret the data rom any number o perceived pathways built withina given time period that can


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also help them to translate their subjective sense into more o anobjective sense o how to achievea higher standard o healthy living.

Every listed index, gradient variableand resource will have a Real-TimePerception Volume (RTPV, Figure1). In combination with an RTPV,each index, gradient variable andresource will have a Real-TimeEmotions Average (RTEA, Figure1). The combination o RTPVs andRTEAs provide an objective basisto help any individual, regardlesso what role he or she plays insociety, to in luence and guidepopulation decisions and actions

within resources perceived or known to change the status o any one o the twenty componentindices.

The recording and quanti yingmechanism within a perceivedpathway begins by simply clicking on one o the indices.This would quanti y an individualsperception o an index by addingone to the sum o an indexsRTPV or that day. These daily

volumes always begin at zero and will grow throughout the day. A perceived pathway would continueby recording and quanti ying aperception o one gradient variable.

Again, this perception would bequanti ied by adding one to thesum o the indexs RTPV. This

would lead to a inal recording within a resource that repeats thesame basic calculation to quanti y a perception. The question thenbecomes how does the instrumentquanti y and account or theunique eeling o how individualsperceive component indices,gradient variables and resources?The answer is this: by way o a

simple recording and quanti yingmechanism that averages allindividuals recording o a negativeor positive eeling o how listed

items are contributing to the goal.Each pathway that records aperception o an index, gradient

variable and resource will beollowed by an emotional scale

ranging rom -5 to 5. An individual will simply record and translatea eeling within how he or sheperceives each index, gradient

variable and resource contributingto the goal. Again, a perceived

pathway will take less than oneminute to complete.

Pathways enhance the power within an individuals voice o how they perceive health by quanti yingand disseminating a daily eedback loop o a populations voice.Regardless o what role one playsin society, the HPI provides anhistorical and daily re erence

or any individual to improvethe e iciency and productivity

within the traditional deliberationand consensus-building e ortstoward decisions and actions thathelp us all learn and understand

which resources truly correlate tohealthier living.

Many o these decisions are withinthe supply and demand o health-related resources that contribute toour standard o healthy living now.How does any individual possibly explain the reasoning behindhow personal decisions withinresources related to transportation,housing, education, government,housing, energy, inance, activity or nutrition will predictably changehow these actors contributeto a uture societys standard o

healthy living? The in ormationgenerated rom the HPI will help

with an individuals ability toreason, but this would o course

be nearly impossible without themarketplace having an incentiveto cooperate in this e ort.

Although the marketplace doesnot currently have the incentive tosupply resources that meet each individuals perceived demand or

what he or she needs to achieve ahigher standard o healthy living,there will be ample opportunity

or enhancing a needed learningenvironment o understanding

what resources improve apopulations standard o healthy living as a result o the HPI.

HPI as Economic Stimulus

This leads to a second bene it:stimulating economic growth and activity. Any organization,company or policy-maker canlist its policies, goods, servicesor entities within a town or city HPI resource section. It doesntmatter whether a company or organization has pro it or non-pro it goals, and it doesnt matter

whether the goods and services aresold to businesses or consumers.

What does matter is that a listingsomehow translates how its

value proposition intends tomotivate population actions withinresources so that a positive change

will take place in terms o an

indexs contribution to the goal.Immediately a ter a company,organization or policy-maker islisted within an HPIs resourcesection, its market or constituency base is targeted so that populations

within these markets have anopportunity to build perceived


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pathways directly to a listing. I a company or organization is

ocused on a small market withinone town or city, it would choose

to list within that particular townsor citys HPI resource section.I ocused on a larger market,the company or organization isgiven the opportunity to de ineparameters around a group o towns or a speci ic county withina state and may then list withinall town or city HPIs within thatarea. Given that all HPI indicesand gradient variables sectionsare standard, and that resourcesections are unique within each town and city, a listing o ersample lexibility and scalability

or companies and organizationsto experiment with a variety o di erent marketing strategies toattract a populations perceiveddemand. Every town and city hasa unique cultural pro ile o needsand the HPI will create a process

or any individual, regardless o

how one de ines ones role insociety, an opportunity to quanti y perceived demand to listedresources that they sense willcontribute to increasing their townor cities standard o healthy living.

A resource listing would be similar to any other online medium thata company, organization or policy-maker might use to advertise andmarket its goods, services, andpolicies. However this venue willbe very di erent rom all othersin regards to how it may bene itresidents who build perceivedpathways and entities who listtheir resources.

Any listing can attract andexponentially grow population

pathways directly to its listing. A pathways RTPVs and RTEAs willcreate a real-time and historical

eedback loop o statistical

in ormation on how targetedpopulations perceive a resourcelistings contribution to the goal.I a resource listing o ers high perceived positive value, thequantitative growth within thelistings RTPVs and RTEAs shouldshow higher positive values. I a populations perception o a resource was negative, thenumerical values would benegative.

I the HPI is scaled and robustparticipation ensues, a simpleperceived demand trend analysiscould immediately in luenceand guide individual decisionson both supply and demandsides or resources. This wouldbegin the process o learningand understanding how tostimulate and grow a moresustainable economic path inachieving the goal. Whether itsre erencing past in ormation tomake personal decisions withingoods and services that improve

your standard o healthy livingas a resident or re erencing thein ormation to improve thee iciency and productivity withinour traditional deliberation andconsensus-building e orts ina board room or on the loor o Congress, the in ormationgenerated rom an HPI is alwaysintended to motivate actionsand decisions that stimulate theeconomic supply and demand or resources with a purpose always inmind.

That purpose is centered ondelegating the responsibility andaccountability or actions thatchange the status within any

one o the twenty indices by initially growing the awarenessand building consensus on whatresources populations perceive

will make uture change. Such awareness is then translated intoquanti ied voices as representedby a pathways RTPVs that couldeasily reach into the hundredso thousands or millions withinany o the listed resources. Thatsmillions o quanti ied perceptionso individuals who sense a demandin how your listing will help or hinder their ability to achieve ahigher standard o healthy living.

It would seem logical thatpopulations would irst use theHPI to build perceived pathways

within indices that have shownevidence o how actions withinthese actors change health status.Since many o the indices in theHPI stem rom environmental andli estyle actors, it makes sensethat most resource listings wouldsee opportunity or stimulatinggrowth by listing resources relatedto these actors in order to attracta populations perceived demand.Since we currently understand thatmany o these indices are causingpreventable chronic diseaseslike heart disease and diabetes

which result in 75% o the costsin healthcare, it also makes senseto initially use the instrumentto concentrate on motivatingpopulation actions within theselisted resources to potentially decrease the cost and burden thesediseases are currently having onhealthcare.


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In theory, i resource listings attractincreased perceived demand

within the HPI and individualstranslate this virtual demand into

actions in their reality, relationships will orm over time that show how a populations quantitativeperceived demand o resourcescorrelated to actual changes withina related indices contribution tothe goal. Again, these changes canbe measured by analyzing andinterpreting trends within any oneo the twenty component indicescomparative metrics. I the status

within a signi icant number o indices change, individuals cananticipate an indirect bene it totheir health status by success ully creating an environment that ismore conducive to healthy living.

HPI indices such as education,activity, nutrition and smokinghave all shown evidence that they contribute to an individuals health status. I individuals begin to buildperceived pathways that quanti y high perceived demand o listedresources, the RTPVs within theseresources will begin to integrateand translate more meaning and

value within decisions and actionsrelated to these resources. Whether its seeing RTPVs reach into thehundreds or into the millions, thesenumbers provide meaning and

value within decisions and actionsbecause they become better predictors o how populations aremotivated toward and anticipate

uture change. This motivationand anticipation o change couldbecome somewhat contagious.By irst exponentially growinga populations eeling in how people perceive change in the HPI,and then using this in ormation

to motivate, in luence, guidepopulation decisions and actions

within the reality o achieving theactual results populations desire.

Medicaid, Medicare and PoliticsHowever, it is di icult to conceivehow our capitalist marketplace

will provide all o the solutionsto all o the problems that arecurrently related to health. For example, government entitlementprograms Medicaid and Medicareare very complicated and havebeen embedded within society or decades. They both retain millionso bene iciaries and have many problems resulting in extremely high costs or our government.Given that our ConstitutionalRepublic elects o icials to speak on behal o their constituentsinterests, arguments rom theseo icials are usually concentratedon driving down costs in theseprograms. So i elected o icialstalk about ideas that drive downcosts in these programs, whether its solutions within government or

within the marketplace, they oughtto be voicing ideas that center around decreasing preventablechronic diseases and conditionsthat account or 83% o Medicaidand 96% Medicare spending.Shouldnt they?

It is well known that Medicareand Medicaid populations havean increased risk and onset o preventable chronic disease. The

vulnerability o one populationis mainly due to its age and theincreased risk and onset o another is mainly due to socioeconomicstatus. Both populations haveunique circumstances andcomplications that are attributed to

why they are at risk, but with any problem there are certainly alwaysopportunities or solutions. Andtheres ample opportunity within

these two populations.Given these combined programsaccount or a populationcomposing approximately 1/3o our countrys population, or slightly more 100 million people,the opportunity or goods, servicesand policies that decrease the risk and onset o preventable chronicdiseases and conditions is urgently needed and available. Yet there

is a constant struggle within our governments leadership to reach a consensus and compromise onideas that re orm these healthcareprograms-or any other issue-

which is ar removed rom justhaving disagreements on principaland ideologies. Politicians whointroduce policy ideas that attemptto re orm entitlement programsshould irst be commended andnot criticized. However, politiciansthat attempt to persuadepopulations by introducing large-scale re orm e orts that rely onbasic budgetary mathematicsas a means o shi ting costs andresponsibility should take a ew steps back be ore moving orward.These ideas certainly seem rationalon paper, but they ail to tacklethe root o the problem and inMedicares case these problemshave been growing long be ore1965. A solution that shi tsthe inancial responsibility tobene iciaries and the marketplaceby using a voucher to choosetheir medical insurances will inthe short-term largely bene itthe provider o insurance, whosemotives are ar removed rom the


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reality o empowering bene iciariesto help decrease the true costso the program. This would notbe in sympathy in decreasing a

bene iciarys level o uncertainty within his or her ability to makerational decisions that attempt toget healthier. I a politician haspolicy ideas that decrease the costsin Medicare, the policys strategy needs to ocus on increasing thelong-term viability in the programby decreasing the level o spendingon preventable chronic diseasesand conditions.

This creates an opportunity or our elected o icials to restorethe level o trust and honesty intheir leadership that is desperately needed or the American peopleto believe that our politicalsystem can make big changesin the way we live. Politiciansneed to increase their level o responsibility and accountability

or producing quality policiesthat attempt to change big issues

within entitlement programsthat a ect the lives o millionso bene iciaries. A policy thatsimply shi ts the programs

inancial responsibility andaccountability to bene iciaries andthe marketplace is not a good idea.

Any individual can communicatethe reasoning behind why they think less government spendingon entitlement programs makessense, especially given the short-term iscal crisis and long-termgovernment debt issues. However,this sort o reasoning is completely disconnected rom the impactit will make on a bene iciariesability to sel -govern their health and to achieve a higher standardo healthy living. Wouldnt it

bene it a politician to irst listenhow bene iciaries perceive how their policies will negatively or positively change their standard

o healthy living within theHPI before they communicate what they think is best or their constituents?

A politician who attempts toreason why his or her policy willproduce a positive change to ahealthcare issue-or or that matter any issue-is missing the power o how their constituents irst eelabout this policy. Any politician

can improve his or her sense o how any individual perceives andeels about issues a ecting their

ability to achieve a higher standardo living by way o the HPI.Politics play an important role indirecting our populations courseo actions in policies that canchange the status o issues o any one o the twenty indices. In theMedicare population, nearly hal o the bene iciaries have at leastone chronic disease or condition.There ore, nearly hal o thispopulation must be experiencingan extremely high amount o uncertainty in terms o how their decisions related to many o thecomponent indices are causingthese health problems. These willmani est over months and years asdiseases and conditions that couldin theory be prevented.

Medicare bene iciaries are having adi icult time in sel -governing their own health, and need healthcare

or medicines and proceduresto improve the quality o their lives. This only perpetuatesa knowledge gap within our general understanding o how to prevent chronic diseases and

conditions that are pervasively scattered throughout the Medicarepopulation. The entitlement o having medical insurance is but

one aspect o Medicare, addingonly a raction to the total costso delivery in either privately or publicly sponsored plans. In act,Medicare administration costsare much lower than privately sponsored plans. There ore,competition or insurance-as in theproposed voucher system-will do

very little to drive down costs.

The essence o the entitlement

and costs associated with itsbene its are within the treatmentsthat bene iciaries receive romhealthcare providers whoadminister them. The treatmentdecisions are usually madebetween a doctor and a patient.There is no cost and bene itanalysis or patients to consider in choosing treatment plans A, Bor C that delivers varying bene itsdepending upon how much they spend. Doctors and patientsdont have to enter a marketplaceto listen to a person sell the

value within each plan and thenmake a decision on which onethe patient can a ord. A doctor simply counsels a patient on how treatments are known to changea diagnosed health outcome. Andsu ice to say, providers know alot more than private insurancecompanies and bene iciaries inmaking these decisions. So how can a politicians voice possibly make sense o wanting to decreasethe responsibility or decisionsaway rom the people in healthcareby placing more responsibility onto seniors and private insurancecompanies who know very little


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about how to change health? Wouldnt this shi t in responsibility only increase the amount o uncertainty that seniors currently

have in regard to the increasedrisk and onset that they share o having little understanding o how to prevent chronic diseases andconditions in the irst place?

I political arguments are going tobe based on the dollars and centssaved in government spending by empowering individuals to becomemore responsible, wouldnt any politician who represents this

plat orm bene it rom listening toour voice? Why not use the HPIto irst lower your voice and listenmore closely to how the millionso voices o Medicare bene iciaries

eel about your policy? I your policy idea is indeed perceivedto be a good one, wouldntlisting it in the HPI help you toimplement it? Im sure that themillions o Medicare bene iciaries

would gladly add to your voice by inputting their own within the HPI.Our political system is an integralelement o our economy in thatit represents the voice o thepopulation. The tone withinthis voice can be disseminatedand ampli ied directly to our politicians within the HPI. Weneed to hold our politicians moreresponsible and accountable or their actions or inactions that are

perceived to bene it an individualand society as a whole. Any elected representative who truly desires change in the status quohas the power to re orm issues

within transportation, education,healthcare, natural environment,energy and many others. Certainly,politicians have constructive ideas

o how policies can stimulateeconomic activity and governpopulation behavior within themarketplace. Our political and

economic systems will alwaysremain a critical element withinanyones notion o how to achievea higher standard o healthy livingand lies within the populationsinterest to create more wealth andpower by optimizing our use o both o these systems.

The HPI would give politiciansand other government o icialsmuch more insight into how

their constituents eel abouttheir policies. The HPI woulda ord a politician a real-time andongoing quantitative eedback loop o how constituentsperceive listed policies, goods andservices contributing positively and negatively to their standardo healthy living. Wouldntsuch in ormation improve thee iciency and productivity withinour traditional deliberation andconsensus-building e orts tochange the status quo? I our Constitutional Republic representsthe voice o the people, wouldnt

we all somehow bene it romampli ying and disseminating theinterests within our collective

voice directly to our electedrepresentatives right now?

O course companies operating within our capitalist marketplace

can bene it rom this voice as well.The HPI will help companies andorganizations gain more certainty

within decisions surrounding thedistribution and consumptionphases o their resources. They can also have an ongoingquantitative eedback loop o atarget markets perceived demand

or goods and services. Each day,the HPI resource section o ersa competition or companies,organizations and policy-makers

to capture a populations voice o perceived demand. We all need anddesire certain resources to achievea certain standard o healthy living,but which ones do we perceiveas currently advancing the goal?

What resources will change thestatus o an indexs contribution tothe goal?

An example could beillustrated within the HPI

index transportation. Most o us are aware that automobiles,our countrys basic means or transportation, are powered by combustion engines that use ossil

uels. The vast majority o our countrys population drives such cars which in act pollute the air

we breathe whenever we drive.The exhaust rom engines that use

ossil uels is released into the air as greenhouse gases. These gasescontribute to what we have beenexperiencing and have come toknown as climate change.

You may have a sense o responsibility in motivating abehavioral change in the way

you use your car as a means o transportation because you believethese actions contribute to climatechange. Thats ine. You can thususe the HPI index transportation as

a motivational basis or changing your behavior and attempt toin luence others.

However, the motivational basisor building perceived pathways

in transportation is not necessarily aimed at changing the status o

what we de ine as climate change


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or proving that human activity iscausing climate change that somebelieve is linked to more requentnatural disasters that we have

been experiencing as o late. Themotive is to perceive resourcesthat will change the status o how transportation contributes to thegoal by ocusing on distributingand consuming resources that areperceived to be healthier.

Cars are o course only oneorm o transportation in the

US. There are many other ormsand there ore many ways to

change our behaviors when usingresources or transportation. Oneorm o transportation is not

necessarily more right and onenot necessarily more wrong. Allpopulation actions within theseresources somehow contributeto the HPI index transportationscontribution to the goal. It doesntmatter whether youre driving aMack truck or riding a bike. Your actions, and there ore decisions, inregards to using di erent modeso transportation all contribute tothe HPI goal. There ore, individualshave to judge or themselves how their own use o transportationresources contributes to healthy standards o living.

Our use o cars or transportationis in act just one o them. So oneexample o how a transportationcompany would bene it rom the

HPI would be in car manu acturing.Lets say a company wants tocapture and test a populationsperceived demand or a new line o hybrid cars they plan toroll into production within 6months. The car manu acturer chooses the Northeast to targetand then decides to list within

all participating HPIs in theNortheast. The HPI would begina short campaign o this uturelisting within the instrument to

build awareness. Populations canuse this awareness to begin tointerpret and analyze the value o building perceived pathways tothe uture listing. Typical actorsthat involve cost, style, gas mileageand others will be considered thatbegin the process o incorporatingmore value and meaning interms o how this resource isperceived to change the status o transportations contribution to thegoal.

The car manu acturer wouldselect the speci ic gradient

variable and index that orm theperceived pathway that residents

will use to build to the listing.The manu acturer would preparea plan or marketing strategiesin how it will compete or apopulations perceived demand inthis market. When the listing goeslive, residents within participatingtowns and cities in the Northeastcan begin building perceivedpathways. This company wouldthen implement its marketingstrategy and rein orce or changethe strategy based on thequantitative perceived demand thatpopulations build to their listing.

The daily quantitative trends will o er both residents and

car manu acturer an ability toconstantly adjust their strategiesin building or attracting perceiveddemand by constantly interpretingand analyzing how or why thedaily RTPV and RTEA totals arechanging. Both parties will alsohave to contend with any number o in luential actors, variables and

events that change populationperceptions over time. Each party

will begin a long journey to jockey or strategies that in luence a

populations perception o how this listing will change the status o transportations contribution to thegoal. Is it positively or negatively perceived?

Six months prior to a company rolling out its new hybrid lineo cars, an HPI trend analysis

will give car manu acturersquantitative in ormation that canbe used to deliberate and build

consensus in communicating amore e icient and productivedistribution and consumptionstrategy with dealers. The HPIthen assists the communication

rom a manu acturer to dealers by incorporating a more predictableenvironment o how a populationsperceived demand within the HPIcan translate into the actual saleso cars over time. There is also theintangible aspect o anticipation

within how the HPI can increasethe motivation o individuals togo to the dealership and take atest drive. Its di icult a ter all tosell cars at dealership unless you

ormulate strategies that motivatepeople to act. So the HPI will helpcar manu acturers and dealers toactually motivate action.

On any given day, populations canleverage the power and in luence

within their voice by buildingperceived pathways in what they perceive as common intereststhat will achieve the goal. As carsare only one common interest,

what other common interestso resources can be perceived?How about housing, education,energy, technology, media, activity,


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nutrition and others? I we doindeed seek a healthy li e, and

we do indeed desire change inthe area o leveraging the power

within our political and economicsystems, we have to use the HPIto increase the power within our common interests to dilute thepower o special interests.

This is especially true in how interconnected and embeddedlobbying irms are within our political and economic systems.These irms attempt to in luenceelected o icials to wield their

power or special interests which bene it only small, distinctpopulations and not the commoninterests o large populations.

And any one o these entities or institutions will certainly have theopportunity to project a much more power ul voice o interesti their listing proposes value inhelping to achieve the HPI goal.

So why wouldnt a lobbying irmuse the HPI to gain more tractionand in luence within a voice o a constituent base o a particular congressman or women? Be orethey take the valuable timeaway rom this elected o icial inper orming his or her role in our government, why not start with the HPI? Does it make sense

or elected o icials to spend somuch time listening to the voiceo special interests rather than the

voice o the common interest o possibly millions o constituentsin the HPI? Does it make moreor less sense or a lobbying irm,company and congressionalrepresentative to leverage thein luence and power o what they perceive the strongest majority

voice within an entire constituency

in directing a course o actions thatuse both economic and politicalsystems to bene it them? Or does it make more or less sense

or a lobbying irm, company andcongressional representative toleverage in luence and power o the voice expressed in an HPI soas to direct a course o action thatuses both economic and politicalsystems to bene it the majority o us? This means we, the people,the greater population, thegroups o individuals, the menand women, the work orce,retirees, these separate andindividual entities who have beenawarded power derived romour Constitutional Republic todirect a course o actions thatincrease our prosperity in usingour economic system can now enhance and solidi y that power by disseminating our voice in the HPI.

This is not an attempt to block any lobbying irms e ort inin luencing an elected o icialsposition on an issue. In act, theHPI can help these irms i they list within the instrument and thensuccess ully attract a populationsperceived demand. Lobbying isa natural means o in luencingan elected o icials position onpolicies. Whether ocusing onan individuals voice within acompany or within a constituentbase, a lobbyist or anyone elsecan strengthen their position by listing in the HPI. I a lobbying

irm had HPI data showing positivetrends within RTPVs and RTEAsto a listing within an electedo icials constituent base, it cangain more strength and in luencein lobbying or a cause. Wouldntthis in ormation improve the

e iciency and productivity withinthe deliberation and consensus-building e orts surroundingissues that impact the roles that

companies, elected o icials,lobbying irms and constituentsplay within economic and politicalsystems?

All individuals within our Constitutional Republic haveinterests as well as a right to

voice their positions on politicalissues. All individuals within our Constitutional Republic haveinterests in a variety o goods

and services needed to achieve acertain standard o living. Both the public and private sector systems have leaders who couldbene it rom listening to the voicethat will be disseminated withinthe HPI be ore they even beginto imagine the opportunity thatexists in harnessing the essenceo power that exists within thiscountry. The power is within each individuals capacity to use thesetwo systems to learn a new voicethat pursues an understanding o how to achieve a higher standardo healthy living.

This could create a new precedenton what uture course o actionsthe leaders within these twosystems want to take. It couldmean, or example, a uture thatguides and in luences actions inlisted resources still in research

and development phases. Any academic institution, think-tank,company or organization can list

within an HPI and thus potentially accelerate the commercializationo its innovations and resourcesthat propose value in achieving theHPI goal.


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This could be illustrated withinthe HPI index energy. Although the potential o usion energy hasbeen talked about since the 1970s,

it has yet to be commercialized.The potential bene its, however,are impressive. It would take tenthousand pounds o coal to yieldthe same energy as one pound o

usion energy without emittingany greenhouse gases. There areresearch centers and institutionsaround the world that are now

uriously competing to be the irstto commercialize usion energy.The United States could be the

irst country to do so but irstour population needs to becomemore aware o how usions uturepotential bene its might improveour lives.

Enter the HPI: it can help. I aresearch center was to list, it couldattract investments and donors. A listing or an innovation that is stillin a research and developmentphase would attempt to attractperceived demand within theHPI in exactly the same way thatresources within distribution andconsumption phases do. Centers

ocused on usion energy or any other innovation will haveto propose value in how the

uture commercialization o thisresource will advance the HPI goal.Securing investment and unding isusually one o the biggest hurdles

or entrepreneurs and researchers within these development phases.

The HPI will assist entrepreneursand centers in leveraging thepotential within their innovationsby attracting perceived demand.

When certain benchmarks are metthroughout the phases o research and development, populations with

an interest in the development o usion energy will want to be made

aware. The HPI o ers an e ective venue or a research center to

place a listing within a strategicgeographical area in which a uturepilot is planned, or in a geographicarea that builds perceived demand

within a constituent base that canthen speak directly to an electedo icial who perceives the bene itso commercializing this energy source in the uture.

In the example o usion energy,this quanti ied voice in the HPI

would disseminate how variouspopulations value a uture resource within a common interest weall have in energy. Certainly allenergy companies or research centers can make a case or why their value proposition based onthis source o energy makes sense.The question then is: Why not list

your company or center within theHPI to compete or a populationsperceived demand? And i thatdoesnt work, the HPI also allowsany resident one additionalperceived pathway to be built

within any other town or city. Dueto this mechanism, there will surely be at least one town in the UnitedStates that will be receiving a lot o actions rom outside residents.

Prevention By Way of an IHPI

This leads to prevention, theinal bene it o the HPI to be

discussed in this paper. Theprevention mechanism is initiatedby empowering individuals

with health autonomy thatenables increased responsibility and accountability or health.Each resident who chooses toparticipate will create an Individual

Health Perception Index (IHPI)during a short set-up phase. Thedata that residents enter withinan IHPI will be directly (and

anonymously) ed to their town or cities HPI. The importance o anIHPI will be critical in delegatingand increasing the sharedresponsibility and accountability

or health-related actions withinboth town/city and healthcareenvironments to prevent the risk and onset o chronic diseases andconditions.

As the data accumulates over time

within an IHPI, both individualsand healthcare providers willdevelop a stronger basis or incenting and rewarding thequality and/or quantity o actionsthat improve health status andoutcomes. Each party has anongoing quantitative eedback loopo how a patients perception haschanged and evolved over time

within the IHPI. Each party has anongoing and comparative eedback loop o how this perception haschanged within an IHPI in relationto the traditional measurementsused within healthcare. Thecombination o these twomethodologies that change stateso health will improve a providersand a patients ability and capacity to learn and understand how todecrease the risk and onset o chronic diseases and conditionstogether.

As data accumulates over time,healthcare providers can in luenceand guide patients decisions toresources within an index thatis perceived to help change thepatients behaviors. Providersbecome key stakeholdersin helping patients learn by


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increasing their awareness o what resources can enable themto change what they perceive asbarriers toward achieving a higher

standard o healthy living. Thedata rom the IHPI will not shi t or change the healthcare paradigm.The HPI will add knowledge tohealthcares model over time by creating a seamless continuumo how to change health statusthat naturally occurs over anindividuals li espan merely by understanding what resources canbe used to decrease the risk andonset o preventable disease. Andmore importantly, resources willbe understood to correlate to ahigher standard o healthy livingover time.

A healthcare provider could easily interpret and analyze a six-month trend within IHPI in seconds. Theanalysis will then alter dynamics

within a routine doctors visit.Patients and doctors could usethe IHPI as a basis to ormulateproactive strategies that seek changes to an individuals health status. An IHPI trend analysis willshow exactly what pathways apatient built in the past six-months.Doctors can use this in ormationto gain more insight into whatactions within an IHPIs perceivedresources that were demandedin the past translated intobehavioral changes. This analysiscould also be used as a basis or questions that initiate substantivecommunication surroundinga patients responsibility andaccountability or health during theroutine visit.

Patients can also use the six-month trend analysis to communicateto doctors which resources are

working and how, or which arenot working, so as to changetheir behaviors. Whether itsresources that motivate actions

within activity, smoking, nutrition,unemployment, divorce, addiction,housing, education or others,healthcare can now create aseamless continuum o care thathelps patients proactively seek changes at very little or no costto the system. Without an IHPIcontinuum, there will always be aknowledge gap in our learning andunderstanding o how to preventchronic diseases and conditions.These diseases and conditions posean obvious barrier or patientsattempting to achieve a higher standard o healthy living as wellas oster an increased liability onhealthcares ability to decreasecosts regardless o whether anindividual is covered by private or public insurance plans.

The more complicated issueo changing human behavior

alls within the realm o indingsolutions or preventing unethicaland immoral behavior. Indeed, theGreat Recession has imbedded astrong memory and image o how a small group o individuals whoare motivated by excessive greedcan create tremendous collateraldamage throughout society or thehealth o millions o people. Theripple e ects rom innovationssuch as sub-prime mortgages andcomplex derivatives have causedirreparable damage to the housingand inancial sectors. The actionstaken that caused these sectorsdown all will change the valueand meaning we derive withinour health interpretation o thesesectors or years to come. Most

importantly, the Great Recessionought to make all o us questionthe strength and vulnerability o our political and economic systems

in terms o their capacity togenerate vast sums o wealth thatcan invite misguided and unethicalbehavior motivated purely by greed.

So the question is: how do weprevent uture unethical behaviorscaused by a small amount o people be ore they can adversely impact our entire society?

The HPI creates such a preventionmechanism by empoweringmillions o people to continually interpret and analyze our economic and political behaviors.Thus i we perceive a negativetrend within any one o thetwenty indices, we can wieldthe power o our governmentto change behaviors. Indeed,our government already has theconstitutional power to regulatemany aspects o the economy.However, the level o e iciency and productivity o governmentpolicy will never keep up with the e iciency and productivity o producing innovations withinour economy. There ore, it isour personal responsibility tobe more accountable or sel -governing our own behavior asconstituents o our ConstitutionalRepublic. No one enjoys paying

taxes, and a decrease in regulatingcertain aspects o business wouldgladly be accepted i we couldonly learn and understand how to regulate our own behavior.Finally, no serious person woulddeny the importance and role thatgovernment can have on helpingindividuals achieve a certain


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standard o living, so i we truly yearn or less government control, we need to exhibit more control insel -governing our health.

The HPI prevention mechanismcan help by strengtheninga populations voice. Not a

voice that begins by using airst amendment right to shout

and scream our anger causedby rustrations, but a voiceinstead that disseminates therelative silence by gathering andorganizing the emotional toneo potentially millions o voices.

Though a negative eeling rom adaily perpetual cycle o unethicalbehaviors may not be detectableas a disease, this eeling will bedetectable within the HPI. Citingthe examples o the problemsthat arose rom the housing and

inancial sectors, the HPI wouldhave shown a more ambiguous andless precise prevention mechanismby seeing high negative RTPV and RTEA trends within housingand inance indices. A moreprecise interpretation and analysis

would have been demonstrated i resources like complex derivativesand sub-prime mortgages werelisted within the resource section.

A populations perceived eeling o how these resources contributednegatively to the goal would haveappeared long be ore we realizedtheir ull adverse impact by seeinghigh negative RTPVs and RTEAstrends within the listings.

This places a great irony inPresident Obama being electedto a second term. His voice o eloquence will again attempt toexplain the reasoning behind why certain policy ideas would be good

or the country. The major issue is

still the economy. His voice willindeed transcend the value andmeaning o words that begin todescribe how policies will change

the status quo. Indeed his voice is very capable o describing policieshe thinks will change the statuso issues that best represent themajority voice and the will o people in the United States.

But how does a presidenttranscend the value and meaningo words that attempt to changethe status quo without irstlistening very closely to the

meaning and values that ascendrom a majority voice o the American people? How can the words rom any politician possibly speak or how the majority eelsabout their policies negatively or positively contributing totheir standard o healthy living

without listening irst? How is itpossible or politicians to makesense o policies that motivateany other person to spend money that grows and stimulates our economy when we have very little understanding o how torationalize decisions within goodsand services that would truly advance a higher standard o healthy living? How can PresidentObama-or any other politician or that matter-possibly understand thecircumstances and hardships thatmillions o Americans are currently experiencing without irstempathizing with a eeling rom apopulations voice that helps our leaders make sense o directinga course o actions that move us

orward?

The point is not to identi y how divided the two parties are dueto their ideologies that spend

enormous amounts o energy and wasted time in communicating what is in principle red or whatis blue. The issue is inding the

unity and power in a voice thatrepresents what is white. That white is within a universal eelingthat all o us can use to guide andin luence the decisions we need

or healthy living. The questionthen is: can we use this eelingto guide and in luence morerational decisions that correlate tohealthy living? The answer is yesbut irst we need to accept thepro ound limitations within our current understanding o how tooptimize the use o our politicaland economic systems to achieve ahigher standard.

This places another great irony in Adam Smiths legacy that isalways associated with being the

ather o capitalism stemmingrom his publishing o The

Wealth of Nations . This book coincidently was published on thesame year that the Declaration o Independence was signed. But

Adam Smith is not so well knownor his previous book entitled

The Theory of Moral Sentiments .This book began with a keenobservation that people receivehappiness and pleasure romactions that cause other peopleto experience the same emotions.Smiths point was to experiencethe power o human empathy.Its the same universal trait thatmotivated Drs. Warren and Jacksonto help individuals whom they knew would bene it rom action.

Some questions we are le t with include: can we increase andbroaden the power o empathy

within the HPI to proactively seek


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increased states o happiness andpleasure? Can we use humanempathy to perceive resourcesthat negatively or positively

contribute to the HPI goal? Can we use empathy to help guide andin luence population decisions that

will help us learn and understandhow to achieve a higher standardo healthy living? Can we combineand exponentially grow a eelingin how we perceive resourcesthat correlate to a higher standardo healthy living? Can we useempathy to motivate populationactions that anticipate monetary and non-monetary rewards? Can

we use empathy to increasecompetition or the supply anddemand o resources that advancethe HPI goal? Can the ull potentialo human empathy be realizedby two decision methodologiesthat measure how decisions and

actions using resources can changestates o health, one concentratingits methodology on decreasingpain and distress, and the other

associated with increasinghappiness and pleasure?

Again the answer to all thesequestions is yes but only i werealize that power that can bederived rom teaching our uturegenerations what we have learnedand currently understand when itcomes to how to achieve a higher standard o healthy living. Thisplaces a tremendous emphasis on

our ability to cooperate with each others desire in achieving thisgoal, something di icult to imagine

without leveraging the power within each individuals voice o how to change and stimulate both political and economic systems.

The inal question then is this: what do we value most inrationalizing decisions that ul illour desire to live a healthy li e?

This ought to be an easy answer,but i it is not, i you are havingtrouble with answering thisquestion, then you will never even begin to also answer why one out o every three childrenborn in the United States today

will be diagnosed with type-2diabetes in their li etime. Andregardless o how you de ine your role in society, all o us together,contribute to the model o health that society has created or uturegenerations to inherit.


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FIGURE 1. Town X Composite Total -69,463Composite Indices Section

Component Real-Time Real-Time Real-Time Comparative ComparativeIndices Daily Perception Emotions Metrics Metric

Averages Volumes Average Trend

Education -7720 2300 3.40 H.S. Drop Out 23%

Housing -10545 3434 3.10 Foreclosures 1.4 million

Transportation 18072 4543 4.00 Carbon Prod. 33%

Activity -26044 6786 4.70 Activity Rate 23%

Nutrition -18057 5674 3.20 Obesity Rate 33.8%

Man-MadeEnvironment 8867 2828 3.10 Alt. Energy 14.3%

Natural Environment -16520 4321 3.80 Endangered Species 12000

Finance -15142 3243 4.70 Average Income 50233

Work Environment 5044 2321 2.30 Avg. Days Absent 25

Healthcare 24549 5433 4.50 Per Capita Spending $7960

Government -28048 6546 4.30 National Debt $15 trillion

Poverty -8388 1929 4.40 Poverty Level 15.1%

Violence 2934 1232 2.30 Homicide Rate 16,799Social -7330 2322 3.20 Food Stamps 46 million

Addiction -4990 1212 4.20 Drug arrests 1,841,182

Unemployment 16530 3423 4.80 Unemployment 8.1

Smoking -19388 4532 4.30 Smoking Rate 19.3%

Media -7492 2233 3.40 Avg. Hrs. Kids Watch TV 2.3

Technology 9852 2322 4.20 % of Pop. w/smart phones 35%

Energy 14353 4454 3.20 % Fossil Fuel Usage 84%

TOTALS -69463 71,088
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Health-Autonomy 18Dec2012 Rev9