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Health clubs, gyms, and fitness centers come many shapes and sizes. Ranging from simple workout spaces with fitness machines, to high tech, fully functional beauty and spa. To make sure you get your moneys worth, and you get your needs met as much as possible, take these steps into account.

Type of Health Club

Normally there are 2 types of work out facilities, but house different names.

• A Gym is usually just an exercise facility with work out machines and trainers. Typically these are used by body builders. They would have showers, lockers and usually a pool and jacuzzi. These gyms can come in many sizes ranging from very large and fully functional to simple with weight machines, trainers, showers and lockers.
• Health Club or Fitness Center. These also come in different sizes but are more likely to be fully functional all the way around. Fully high tech exercise equipment, exercise classrooms, exercise classes of different types (Aerobics, Yoga, Jazzercise, different dance styles in aerobic format, exercise ball, belly dancing, Taebo, kick boxing), large swimming pool, jacuzzi, sauna, steam room, spa treatments, fat burning and slimming treatments, hair salon, beauty treatments, a healthy snack bar, specialized trainers, lockers, showers, and large areas for dressing rooms.

Not all health clubs will have all of these facilities, which is pretty much where price comes into the picture. The fancier and more optional the club the more expensive the membership.

Location

In order to save time, money and get the most out of your selection, consider a health club near either your home or your office, depending on your personal choice of workout time and time saving needs. Take into account the following;

• Your busiest days of the week
• Traffic
• Daily and weekly time constraints
• Extra curricular activities
• Kids activities
• Your child’s school location (if working out before or after your drop your child to school), and cost of gas if you’re driving.

Fitness TrainersIf you are looking into having a fitness trainer then I suggest you briefly interview the trainers when you visit the facilities you are thinking of joining. Look for the following qualifications:

• How long they have been in the field?
• Where did they previously work?
• What is their area of expertise?
• Mention to them your specific needs and pay close attention to how they answer you and if they give you any suggestions on how to begin your quest for fitness.
• Look for an up beat, positive, fun personality.Trainers that house these personal traits are often more convincing, more motivating, and can keep your workout as fun and positive as possible. They will also motivate you when / if you feel like giving up, and can get you over the hurdle when you first start.
• When you interview the trainer with a small chat, give them a little test without them knowing it. For example: if you are someone who’s main focus is on losing belly fat, then do some research online first. Learn the most effective exercises today and learn the ones that experts say don’t really give the most beneficial fat burn. When you talk to the trainers tell them you are wanting to lose belly fat and what exercises would they recommend. See if they give you the old exercises or the most recent ones. Trainers, like doctors have to keep up with the ever changing information in the field of exercise and fat burning.
• When you visit the facilities watch the trainers with clients that are over weight or struggling. See if the trainer is just simply counting out the number of exercises, or are they paying attention and correcting the persons posture, and are they giving the person motivational chat. You are looking for trainers that give more than just counting down the number of reps. They should correct posture and give motivational chit chat here and there.
• A good trainer wants and needs to see his pupils persevere and succeed. This is the type of trainer you want. Not just someone going through the motions til the end of the day.

EquipmentWhen you visit the facilities look at the equipment and assess on the following;

• Is the equipment up to date, clean and in working condition?
• Are they solid on the ground or do they wobble?
• How many of each type of machine is available? How many tread mills are there? How many bicep machines are there? How many stair masters are there? This is important because you don’t want to have to wait too long in a line to use the machine you need.
• Before you begin visiting the different facilities, get an idea of what body parts you will be wanting to work on so that you can scope out how many machines are available for that particular body part, at each facility you visit.
• Check the spacing between each of the machines. Make sure they are properly spaced for safety reasons, leaving enough room for people to safely move around them without disturbing your work out. You should not have to stop in between sets to let people pass by.
• Take note of any broken down machines. How many are broken? If a few are broken this tells you that the repair service might be slow, as usually 2-3 machines don’t break down at the same time, so there could be a delay in the fixing of the equipment for whatever reasons. Don’t be afraid to ask the management how long it takes them to repair any broken equipment.

MembersVisit the facility in question at the time of day you are likely to hold your workout. Look for the following;

• Is it very crowded? A crowded workout place can mean, no matter if they have several machines of the same type, you will be waiting in line for quite sometime to gain access to the machine you need. It can also mean a louder atmosphere and possible waiting time for showers, lockers, etc
• The type of members in the workout area can either be of assistance to you or annoying. Members who use the gym for social hour can be annoying, as they take up time on the machines they aren’t really using and spend the workout time chit chatting to their friend. Or, chatting constantly on the phone and talking loudly.
• Are they following the clubs dress code? Dress codes are put into place for several reasons, health and cleanliness being one of them. You don’t want to work out with people who do not respect the dress code, are constantly talking or conducting business on their phones, or fighting over the volume of the music in the workout area.
• Look to work out with members that are serious about their work out and can be of motivation to you.

Health Club StaffThe staff of a health club is also an important area to look for when you are making a health club choice.

• The staff should be friendly and helpful. Not bored, chatting on their phones or having a social hour with members.
• Staff should know how to operate each and every piece of exercise equipment and should be keeping the facility clean and tidy, especially if it is a busy place.
• The staff should be knowledgeable in the clubs facilities.
• They should be clean and tidy in their uniforms and should not be working out while on duty.
• Higher level staff members should be trained in emergency procedures, such as mouth to mouth resuscitation, Heimlich Maneuver, handling a muscle pull or related injuries.

Health Club InteriorOnce again, visit the facility during the time you are likely to go for your workout. Assess the following;

• Is the club clean and tidy, regardless of how busy they are?
• Are the bathrooms and changing areas free from used towels, paper towels, etc
• Are the facilities in proper working condition? Toilets that flush, jacuzzi, sauna, and steam room working. Take note of how occupied these areas are. Would you have to wait to get into the sauna, steam room, jacuzzi, shower or bathroom?
• Are there enough showers to accommodate the load of members they have? Or does the club appear to be over occupied?
• The floors should be free of water for safety reasons. A little water is OK but water all over the floor should be mopped up quickly.
• Are there proper emergency exits?
• Is the health club facilities and layout user friendly and free from clutter and staff and members personal belongings?

Health Club ExteriorA person wouldn’t think this area is so important but time is usually something we all struggle with and if you have kids, or an extremely demanding job, then workouts tend to take the backseat to everything else.

• The time it takes you to get into the club and get out of the club should be importance to you if you are a person struggling with time on a daily basis.

For example: I had a membership at a health club that I loved for many reasons but when the membership finished I did not renew it because of the time and inconvenience to get into the actual health club itself. I had to walk across the parking lot due to lack of spaces close to the entrance, through the hotel, up an escalator, down a long hall, through another set of doors, then again down a flight of stairs until I reached the entrance. Leaving the club was the same distance. I didn’t mind the walk but I did mind the wasted time it took me going to and from the facility. I also didn’t particularly care for walking through a 5 Star Deluxe Hotel in work out clothes.

• The exterior should also be cared for and kept clean of litter, broken down cars taking up parking spaces and solicitors. The Club should also have ample parking to save you time from having to drive around looking for a parking space.

Consider Your Personal DesiresFor most people embarking on an exercise plan isn’t really something they look forward to. If you are someone who loathes exercise but knows it is part of keeping healthy and fit then assess your personal needs and make the health club fit into those needs as much as possible. If you love to pamper yourself and find it is something that may help you make it to your workouts then consider joining a place where you can also look after your skin and beauty needs or whatever areas you like to pamper yourself in.

I personally love the steam room and have found it very useful when using skin polishing and skin care products. So for me, I think of how much relaxation I will get when I finish my workout and relax in the steam room while my skin goodies work their magic. I also increase my workouts every 3 weeks so a jacuzzi for soar muscles is an absolute must. I hate carrying my large and heavy gym bag every day so I looked for a club that would let me have my own locker and key if I take a one year membership. I admit I got lucky with the locker but don’t be afraid to ask for the little things that give you comfort and ease.

The point is, think about your personal loves, and enjoyments and fit those into your routine as much as possible. This will help you make it to your workouts and struggle a little less to get there. And, when you really go for it, and you are sticking to it, give yourself a reward at the end of each month – not for losing the weight, slimming down, or building muscle, but for your efforts and perseverance.

Assess Your Motivation Level and Personal Perseverance Qualities

Think deeply about your level of motivation. Are you a person who can push themselves even when you hate doing something? Can you continuously push yourself? Or, does it take you time to get motivated? Do you quit things and then start up again and then quit until it finally sticks with you?

This is important to your selection process. Joining an expensive health club when chances are you might quit after a few weeks is only going to waste your money and frustrate you even more when you quit. It is better to gain your motivation and get used to exercising using a cheaper facility and pay either monthly or quarterly. This way, if you quit after a few weeks you will not have wasted money. Once you get used to working out and it becomes easier for you, you can always go for the up market health clubs.

If you know that you will never be motivated without all the good stuff then join a fully functional club but pay monthly or quarterly until you are sure you are going to be using your membership to it’s fullest. Then consider a yearly membership which will usually save you a few bucks.

If you think you will feel self conscious at a public health club facility then do your workouts at home until you have accomplished enough of what you need to, then consider membership when you are comfortable with yourself and your accomplishments.

Organizing Tips

There can be many health club facilities in your area and narrowing down the search can be a task on it’s own Here are few things to help speed up the process and keep you organized in your quest.

• What is your budget? Decide your budget and go from there.
• Use the phone book and write down the health clubs that fit your location preference.
• Write down the address, telephone number and website address if they have one.
• Use the health clubs website to find out details that might help you narrow your search and save time by not visiting clubs that do not suit your preferences.
• Call each place and tell them you are coming in for a tour of the club and would like to meet with someone who will show you around. Give them a time you will come to ensure someone is available to give you a tour and hopefully not make you wait. You may want to use this time to find out their pricing scale if it wasn’t on their website. Maybe they are out of your budget so you don’t need to waste time on seeing their facilities.
• When you are ready to start visiting the facilities you have narrowed down, choose a day that you don’t need to rush and can take your time. Get directions if you need them so you don’t waste time getting lost. Make sure to take the telephone number of the clubs with you in case you get lost you can easily call them.
• Make a note of how much time it took you from your house to the club and back. Try and visit the clubs at the time you would normally go for your workouts and assess the traffic at that time to each of the clubs.
• Take notes on each club you visit in order to properly assess your findings when you get home.
• See if you have any friends or relatives that have membership to any of the clubs and get their rating of the facility. You can also see if that club has a special offer for existing members that bring in business. Sometimes health clubs have special offers where the existing member gets a discount if they renew their membership and the new member will get an immediate discount or coupons for free classes.
• Write down the pros and cons of each club.

Get your kids working out with you!If you have kids, see if the health club you choose has kids workout classes. You can both work out and motivate each other and talk about your successes, difficulties, and strengths. You will also be motivating your kids to keep fit and healthy as they watch you do the same.

Before selecting a health club look closely at your own personal needs and desires first. Closely assess the clubs facilities and ensure they are in good working order and condition. Make sure the staff are professional and fitness trainers are educated in their field and posses motivating qualities. Look closely at the interior and exterior of the club and assess safety and health conditions. Assess the type of members the club has by visiting each club during the time in which you plan to work out in order to gauge their members, trainers, equipment usage and cleanliness. Think of a health club as sort of a home away from home, so make sure your health club home is one that best suits who you are, what you need, and your personal attributes on a regular basis.

Mishari Jayne has successfully walked the roads of health and fitness for over 25 years and wants you to Stop dieting…..Start eating….and Start living – Today!

[http://offto.net/5ypczm/]

Health Coaching is a new model for total health and wellness in the individual. Health Coaching is not something you only do when you are sick. Health Coaching is about optimization of human potential and has a philosophy of ever expanding possibilities. Health Coaching recognizes that there is an innate intelligence within you, an inborn wisdom that governs all healing, function and repair and that the purpose of all health and wellness practices is to remove interference to this intelligence so your body can heal itself. The 7 good reasons to work with a Health Coach below will outline clearly how you can reach that state of health and wellness in your life right now.

1. You need to be held accountable.

As children there is always someone there to make sure we’re doing what we’re supposed to. As adults, we’re supposed to be able to do this for ourselves. But what if we can’t? What if we keep making other things more important than our health and well being and not moving forward? A health coach can help by checking and asking the right questions and by being a gentle reminder to keep you moving toward your health and wellness goals.

Also, in most traditional models of seeing a health practitioner, we tend to see that person as an expert – they know more about our body than we do and they can tell us exactly what we need to do to get better. This system encourages us in a sense, to place our health in someone else’s hands. We are no longer responsible, the health practitioner is. We are not really accountable, the health practitioner or the pills they told us to take are. In health coaching, you are the best and only expert on you and the only one qualified to know if something will work or not.

2. You want to get your health and well being on track once and for all

Far too many of us have joined gyms or started a diet in the past feeling initially excited only to watch our enthusiasm drain away a few weeks later. We can feel disappointed with ourselves, with the money we’ve wasted and with the lack of results we’ve achieved. Things change, our responsibilities change, time we have available changes and our health and wellness goals. What is it that’s stopping you from committing to a path of improved health? A health coach will help you figure out those answers once and for all and help you find real-life solutions that not only work for you but keep working for you in the future.

3. You know what you need to do be healthy but you just can’t seem to stick to the changes

So, it’s not a question of good health education – the majority of us understand clearly what we need to do to stay healthy – eat lots of fruit and veggies, minimize red meat, exercise regularly and don’t smoke or drink too much. Simple right? Why aren’t more of us doing it then? Before we make any changes in our life we need to agree with the changes, they need to be congruent with our values and they need to make sense in the context of our lives.

4. You struggle with being overweight, are always dieting or otherwise don’t feel good about the way you look.

Being overweight is an issue that affects many Australians. It damages our health and damages our self-esteem. Here, a health coach will help you find your way amidst the huge amount of conflicting information available and keep things as simple as possible – no “diets” just a good look at the way you see, value and use food and how that impacts the amount and types of foods you eat each day.

5. You can’t seem to find or make the time to eat well, exercise regularly or take time for yourself

What’s really going on here? What issues are holding you back from giving yourself what you need to be healthy? Most of us are crazy busy and challenged with “not enough” time but is that the real issue? A health coach will help you identify your personal priorities and find a way to work in your health and wellness goals so you can keep on doing what you want, when you want.

6. You’ve been diagnosed with cancer, diabetes, a stress related condition or some other chronic disease and you want to discover other treatment options available to you.

You’ve had the wake up call. Your body is sending you messages loud and clear that something needs to change. A health coach will help you identify options, alternatives, complimentary treatments and educate you more on conventional approaches so you are well informed and can make the best decisions possible for your health.

7. You have “an addictive personality” and make changes only to find yourself slipping back into unhealthy choices or behavior patterns

Addictive behavior patterns, food addiction and drugs and alcohol can sabotage completely our attempts to make lasting changes in our lives. Health coaching sessions will educate, inspire and support you to deal with these tough issues so you develop all the skills and knowledge you need to create and maintain a life of vibrant health and well being free from addictions of all kinds.

As those of us who’ve had a serious wake up call know, health is the most important thing in our lives – without it, nothing much matters.  Unfortunately, too many of us wait until it’s too late to make changes to our diet and lifestyle. 80% of people in Australia die of “lifestyle diseases” like heart disease, complications of diabetes and many forms of cancer. Can you afford to wait til something’s broken to fix it?

Health coaching is not something you only do when you’re sick. It will help you find your way to better health and well being. After all, you are the best (and only) expert on you. By asking the right questions, providing education and real-world experience we’ll look at alternatives and discover new ideas, possibilities and ways of looking at your health. We’ll help you find what works in your life right now without slipping back into negative eating, exercise or behavior habits. You choose the lifestyle changes, you set the pace and you discover just how good it is possible to feel!

Susan Living is a community focused speaker, workshop facilitator and health coach extraordinaire! Passionate about making vibrant health and well being accessible to all, her down to earth and practical thoughts on health and well being are life-changing. Her insights into the nature of food and addiction and the intricacies and psychology of eating are applicable to anyone with a body.

Susan also helps business owners save money on staff costs by improving the health and wellness of their people and is creating an international community of health practitioners working together to change the way medicine is viewed accessed and delivered in the world! She can be contacted at [http://www.susansfoodforthought.com] and [http://www.susanliving.com]

What we call health care is a bad deal for the consumer. The name alone is a lie. It should be called “sickness care” or even “sickness facilitation ” because, for those who are covered, it tricks them into placing the responsibility for their health on their doctor. This is a big mistake.

We are each individually in charge of our own health. How can the doctor be at our side all day and night to counsel us to “Put that cigarette out!” or “Don’t eat that cheeseburger! Remember your high cholesterol!” By the time we are forced to go in to the clinic by some scary symptom, we are already in trouble. It is too late for health care — now it’s time for drugs and scalpels.

Depending on a doctor for information on preserving your health is like closing your barn door after your horse has escaped. It’s too late for doing the easy, inexpensive course of action. Now, you’re in for it!

So, forget about health care. Health care is not about health. It is all about getting you back on the factory floor or back in your cubicle, ready to work, so you can keep paying your premiums. It is about extracting as much money as the law allows by sending you in for tests, which you may or may not need. It is about selling you prescription drugs that you are instructed to take for the rest of your life — drugs that counter the effects of your bad food choices, for example.

Doctor: “The lab tells me you haven’t brought your cholesterol down with a change of diet and exercise since the last time I saw you, John. What I can do — to get you down into a safe range for your LDL — is give you a prescription for Lipitor.”

Patient: “Sorry, Doc. I just can’t give up my favorite foods — eating’s the only pleasure I have left after the wife left me. And taking walks around the block just isn’t my style.”

Doctor: “That’s fine, John. We’ll try Lipitor, then, and see how that works for you. Schedule a follow-up appointment with my staff before you leave. Call me if you have any problems.”

Health care is a rip-off because:

It doesn’t address the real problems that cause most of our illnesses (Namely: our diet, smoking, excessive drinking, and lack of exercise)

By the time we begin to have symptoms of some disease, it is usually too late for inexpensive intervention

Most of what ails us, we bring on ourselves — to correct the after-effects of this is an enormous task…So health care is really not about caring for our health, it’s about facilitating our bad behavior and then extracting as much money as possible from whatever source — the patient, the employer, or the taxpayers in general

Out-of-control malpractice claims, together with the need for doctors to keep their high-tech diagnostic equipment in use, have encouraged doctors to order many unnecessary and expensive tests

When the federal government got involved is when costs skyrocketed (with the advent of Medicare in 1965)

Setting the whole complicated mess under the thumb of the insurance industry added another layer of bureaucratic expense and the need for ever-increasing profitability because these are publicly owned corporations that are expected by the stockholders to show improved profits every quarter

This distorts the quality of care and gives incentive to finding new services to sell. It’s all about the bottom line, not about the health of the patient anymore.

Our health insurance system, by itself, adds 20% to the cost of the medical services provided. Other countries have better health results for 1.5-6% administration costs! We’re being over-charged, plain and simple.

The pharmaceutical industry charges markups of 2000-30,000% of the ingredients in the drugs they sell. Fifty percent of their costs are not for research and development(much of which is subsidized by the taxpayers), but for their marketing expenses — everything from fancy dinners for doctors who sell lots of their medicines, to the many two and three page ads in magazines urging patients to “Ask your doctor if Dynofab is right for you,” to all-expenses-paid trips to Hawaii to educate doctors on that company’s latest prescription drugs.

In the end, we all must pay for the rich system of perks and comforts of those who have been entrusted with our health. Or, we must find out for ourselves how to maintain our own health.

With the present system, the public is not clearly shown how to prevent disease, nor how to maintain optimum health for a long successful life. We are encouraged to turn this sacred task over to others, many of whom know little about how to maintain health and a great deal about ways to make a lot of money by shunting patients through a labyrinth of tests, drugs, and procedures at a substantial profit for the providers, even if the patient doesn’t survive it all.

To be fair to doctors, very few of them know much about how to preserve health through intelligent nutrition. They only live to an average age of 57, while their patients live an average of 75 years, more or less. So, doctors are not experts on health — it is more accurate to call them sales agents for drugs, diagnostic tests, and surgery.

Asking Congress to negotiate us a better deal is foolish. The wise consumer will find and implement a comprehensive program to protect their own health, so they will not find themselves begging for medical care at the end of their life. Without knowledge, the consumer has no power in the negotiation for a fair deal.

All the unsophisticated, unhealthy consumer can expect is a rip-off when they are forced to beg Congress for affordable health care. Who would like to break the news to them?

Paul H. Kemp is a lifelong entrepreneur, writer, and amateur athlete with a passion for exposing the secrets of health and longevity. For more information on a diet and healthy lifestyle designed to prevent and even reverse chronic degenerative diseases, visit his Web site: [http://www.HealthyPlanetDiet.com/].

When we hear the word health, we probably think first of our physical health… Our mental health and our financial health come second and third.

But, as with all things, we should look for balance in life; and although our physical health is the most important of the three, it is good to realize that one without the other two does not make for a great life. We have to maintain all three if we are going to have the optimum existence; we must work at all three if we are to find any sort of peace in our daily lives.

Our physical health is the basis to our daily ability of movement and general achievement. If we are not physically healthy, it will effect both our mental and our financial health; if we feel unwell or unable, then we are mentally challenged through each day to overcome the pain we endure and the lack of movement we battle against. Added to this, we are less likely to be on our game when it comes to earning money and we are more likely to spend our time in medical treatment centers which will cost us money.

When it comes to our mental health, we are dealing with emotions, the most notoriously difficult aspect of our existence, the hardest thing to overcome, the most powerful part of any human; if we can learn to control or come to terms with our emotions then we have the ability to achieve anything; our mind is our strongest ally when it works for us and our biggest enemy when it conspires against us, it is the one thing we have with us all the time, chattering away, telling us that we can (or cannot) do something; our mind has the ability to cause illness or avoid illness, it has the strength to give us the adrenaline to enact feats of heroism or collapse into moments of weakness and desperation. Positive mental health is imperative if we are to be happy.

Financial health is the least important of the three, yet it has the power to breed confidence. If we are financially stable we have the ability to enjoy many forms of freedom, to experience numerous ways of life, to devour unending types of pleasure. However, the imbalance of financial ‘success’ can also cause enormous amounts of stress, the responsibilities mount up with the assets, the inequalities with our mental and physical health can grow more acute with the financial burdens. The other end of the scale is no more attractive – financial poverty often leads to mental and physical poverty too. Balance is essential if we are to find what we truly desire.

To achieve the balance required, to come to a place of physical, mental and financial health is not easy. We are (as in so many things) ‘miseducated’ about what we truly need and what we can truly do without; we are not encouraged to find a balance in life, we are generally pushed towards one type of health or the other by those around us or that voice within us, given a specific life goal we have to achieve at the expense of finding a healthy balance in all three.

Physical health is very possible by doing a few simple things; drink water, lots of it – not sodas, fruit drinks, power drinks or alcoholic drinks; exercise regularly – and by that I mean do something for your body everyday, stretch, yoga, weights, walk, run, swim, whatever, but something that raises your temperature, that gets the blood flowing and the fat burning, you will be glad you did; eat small amounts but often, begin to change your 3 meal a day habit – snack on healthy foods, eat fruits, vegetables and proteins and vary your diet so it becomes a lifestyle not a fad. If you do these three things, then you can also splurge on the treats like alcohol once in a while, resting after exercise and candy every few days (not hours); once you begin to exercise properly and ingest food regularly your body’s metabolism will work constantly and will devour whatever you put into it so that even the ‘bad things’ disappear more quickly, and either way, you will notice an improvement in your energy levels and a rise in your self esteem. But, as I said, it has to become a way of life, not a momentary fad, and as it becomes a way of life it will become easier and easier to continue being healthy.

Mental health is achievable by being objective with your life. Humans are a very subjective species (meaning that we see a situation from our point of view without looking at it from the outside); and this subjectivity renders us helpless when it comes to overcoming our emotions; we must learn to see the bigger picture, and if we are able to do that we are able to see that we cannot control another human’s actions, we cannot force the world to bend to our will, we will always be confronted with obstacles and we will always have to avoid drama; that is just the way it is. So, knowing that, it suddenly becomes easier to accept change, to accept that each day we will have to keep our cool and work out a solution rather than trying to force life to be what we wish it was. It is imperative that we accept life for what it is, and then we can foresee most of the problems, issues and dramas that seem to blind side us so regularly. If we go forward hoping for the best but prepared for the worst then we go forth with a positive attitude and we are not horrified or defeated the moment something ‘unexpected’ comes our way because we were prepared to deal with whatever life throws at us. Simplifying a life is the best way to be at peace mentally; learning to eliminate unnecessary objects, people or occasions is the easiest way to find a life with balance which in turn will create mental stability and mental health.

Being financially independent is important; and we can all do it if we put our mind to it; no matter what socio-economic class you might come from it is possible to live in a home that is clean, efficient and attractive without having to go into debt, without having to stretch yourself to the limits. But it does come with the need for balance, and the self control to realize what you can and cannot afford at this time. For example there is no point having a television if you cannot pay your rent or afford a car; there is no point burdening yourself with the expense of cable if it means you cannot pay for gas or insurance on your car. And if you cannot afford a TV, then go to the library and read – you will learn more and you will grow more. Spend less and you don’t have to work so hard, learn to enjoy the simple pleasures again, realize that all of the best things in life are free and the all of a sudden you will come up with interesting ways to pass your time, more satisfying ways to spend your life, think outside the financial box, try to do things differently from the way you were taught, look at how the world really works and then question any choices you make to make sure they are right for you (not just what everyone else does), save a little and enjoy alot, be wise with your purchases, don’t buy something for the momentary buzz or screw someone over for the profit you think you gain, begin to re-work the way you employ yourself and try to work at a career you love, not just a job that makes you money – once you find financial balance you will feel a weight lifted off your mind. Financial freedom is possible with a little self discipline. On the other end of the scale, the need to be excessively wealthy will only impact your mental and physical health in the end, for your financial health will only be maintained if you spend an improper amount of time maintaining it at the expense of your physical activities and your mental capabilities. Being financially healthy requires balance, self discipline and the ability to see what you can and cannot afford to burden yourself with.

Your health is essential if you are to live with freedom; your physical health allows you the freedom to go wherever you may so desire; your mental health gives you the freedom to be alone or to surround yourself with positive energy; your financial health buys you the freedom of experience. Maintain each of these; decide to change the inbuilt ‘miseducation’ of the past and work out a new and easier way to exist.

Anything is possible if you choose health.
Guy Blews

Guy Blews is the author of ‘Marriage & How To Avoid It’ and is the instigator of Realistic Relationships. He has a blog at [http://www.RealisticRelationships.com] and his latest book, ‘Realistic Relationships’ is designed to help you find optimum balance and health in every aspect of life.

In trying to think about the future of health care, thoughtful, intelligent people often ask, “Why can’t we just let the free market operate in health care? That would drive down costs and drive up quality.” They point to the successes of competition in other industries. But their faith is misplaced, for economic reasons that are peculiar to health care.

More “free market” competition could definitely improve the future of health care in certain areas. But the problems of the sector as a whole will not yield to “free market” ideas – never will, never can – for reasons that are ineluctable, that derive from the core nature of the market. We might parse them out into three:

1. True medical demand is wildly variable, random, and absolute. Some people get cancer, others don’t. Some keel over from a heart attack, get shot, or fall off a cliff, others are in and out of hospitals for years before they die.

Aggregate risk varies by socioeconomic class and age – the older you are, the more likely you are to need medical attention; poor and uneducated people are more likely to get diabetes. Individual risk varies somewhat by lifestyle – people who eat better and exercise have lower risk of some diseases; people who sky dive, ski, or hang out in certain bars have higher risk of trauma.

But crucially, risk has no relation to ability to pay. A poor person does not suddenly discover an absolute need to buy a new Jaguar, but may well suddenly discover an absolute need for the services of a neurosurgeon, an oncologist, a cancer center, and everything that goes with it. And the need is truly absolute. The demand is literally, “You obtain this or you die.”

2. All demand apes this absolute demand. Medicine is a matter of high skill and enormous knowledge. So doctors, by necessity, act as sellers, and agents of other sellers (hospitals, labs, pharmaceutical companies). Buyers must depend on the judgment of sellers as to what is necessary, or even prudent. The phrase “Doctor’s orders” has a peremptory and absolute flavor.

For the most part, people do not access health care for fun. Recreational colonoscopies are not big drivers of health care costs. In some cases, such as cosmetic surgery or laser eye corrections, the decision is clearly one the buyer can make. It’s a classic economic decision: “Do I like this enough to pay for it?” But for the most part, people only access health care because they feel they have to. And in most situations, it is difficult for the buyer to differentiate the truly absolute demand (“Do this or you die”) from the optional.

Often it is difficult even for the doctor to tell the difference. The doctor may be able truthfully to say, “Get this mitral valve replaced or you will die. Soon.” More often, it’s a judgment call, a matter of probabilities, and a matter of quality of life: “You will likely live longer, and suffer less, if you get a new mitral valve, get a new hip, take this statin.

At the same time the doctor, operating both as seller and effectively as agent for the buyer, is often rewarded for selling more (directly through fees and indirectly through ownership of labs and other services), and is not only not rewarded, but actually punished, for doing less (through the loss of business, the threat of malpractice suits, and punishment for insufficiently justifying coding).

So the seller is agent for the buyer, the seller is rewarded for doing more and punished for doing less, and neither the buyer nor the seller can easily tell the difference between what is really necessary and what is optional.

This is especially true because the consequences of the decision are so often separated from the decision. “Eat your broccoli” may actually be a life-or-death demand; maybe you need to eat more vegetables to avoid a heart attack. But you’re not going to die tonight because you pushed the broccoli around the plate and then hid it under the bread.

So, because it is complex and difficult, and because its consequences are often not immediate and obvious, the buy decision is effectively transferred to the seller. We depend on the seller (the doctor) to tell us what we need. Whether we buy or not usually depends almost solely on whether we trust the doctor and believe what the doctor says.

3. The benefit of medical capacity accrues even to those who do not use it. Imagine a society with no police. Having police benefits you even if you never are the victim of a crime. You benefit from that new bridge even if you never drive over it, because it eases the traffic jams on the roads you do travel, because your customers and employees and co-workers use it, and because development in the whole region benefits from the new bridge.

This is the infrastructure argument. Every part of health care, from ambulances and emergency room capacity to public health education to mass vaccinations to cutting-edge medical research, benefits the society as a whole, even those who do not use that particular piece. This is true even of those who do not realize that they benefit from it, even of those who deny that they benefit from it. They benefit from having a healthier work force, from keeping epidemics in check, from the increased development that accrues to a region that has good medical capacity – even from the reduction in medical costs brought about by some medical spending, as when a good diabetes program keeps people from having to use the Emergency Room.

All three of these core factors show why health care is not responsive to classic economic supply-and-demand theory, and why the “free market” is not a satisfactory economic model for health care, even if you are otherwise a believer in it.

Answers for the future of health care?

The answer to the first problem, the variability and absolute nature of risk, is clearly to spread the risk over all who share it, even if it is invisible to them. If you drive a car, you must have car insurance, and your gas taxes contribute to maintaining the infrastructure of roads and bridges; if you own a home, you must have fire insurance, and your property taxes pay for the fire department. Because of your ownership and use of these things, you not only must insure yourself against loss, you also must pay part of the infrastructure costs that your use of them occasions. Similarly, all owners and operators of human bodies need to insure against problems that may accrue to their own body, and pay some of the infrastructure costs that their use of that body occasions. However the insurance is structured and paid for, somehow everyone who has a body needs to be insured for it – the cost of the risk must be spread across the population.

Skipping to the third problem, the infrastructure argument, its answer is somewhat similar: To the extent to which health care capacity is infrastructure, like police, fire, ports, highways, and public education, the costs are properly assigned to the society as a whole; they are the type of costs that we normally assign to government, and pay for through taxes, rather than per transaction. In every developed country, including the United States, health care gets large subsidies from government, because it is seen as an infrastructure capacity.

That leaves the second problem, the way in which all demand apes the absolute nature of true demand in health care (“Get this or die”). The answer to this problem is more nuanced, because it is not possible to stop depending on the judgment of physicians. Medical judgment is, in the end, why we have doctors at all. But we can demand that doctors apply not just their own judgment in the moment, but the research and judgment of their profession. This is the argument for evidence-based medicine and comparative effectiveness research. If a knee surgeon wishes to argue that you should have your arthritic knee replaced when, according to the judgment of the profession as a whole, the better answer in your situation is a cortisone shot and gentle daily yoga, the surgeon should have to justify somehow, even if just for the record, why your case is different and special. The physician’s capacity to make a buy decision on your behalf must be restrained at least by the profession’s medical judgment. If the best minds in the profession, publishing in the peer-reviewed literature, have come to the conclusion that a particular procedure is ineffective, unwarranted, or even dangerous, it is reasonable for insurers, public or private, to follow that best medical judgment and stop paying for it.

These three core factors – the absolute and variable nature of health care demand, the complexity of medicine, and the infrastructure-like nature of health care capacity – are all endemic to health care and cannot be separated from it. And all three dictate that health care cannot work as a classic economic response to market demands. Failure to acknowledge these three core factors and structure health care payments around them account for much of the current market’s inability to deliver value. Paying “fee for service,” when the doctor is both the seller and acting as agent for the buyer, and when the doctor is punished for doing less, is a prescription for always doing more, whether “more” delivers more value or not. Paying “fee for service,” unrestrained by any way to make classic value judgments, means that hospitals and medical centers respond to competition by adding capacity and offering more services, whether or not those services are really needed or add value.

For all these reasons, it is vastly more complex to structure a health care market rationally, in a way that delivers real value, than it is to structure any other sector, and simply fostering “free market” competition will not solve the problem.

For 30 years, Joe Flower has been a healthcare speaker and consultant, emerging as a premier observer and thought leader on the deep forces changing healthcare in the United States and around the world. He is a regular columnist for the American Hospital Association’s Hospitals and Health Networks Online and for Physician Executive, the Journal of the American College of Physician Executives. You’ll find more articles and videos at ImagineWhatIf.com.