On the day the President set aside $634 billion for health coverage to uninsured millions, I spoke at a Hospital Foundation dinner in St. Petersburg. I told the audience it was unclear to me how $634 billion was going to fund comprehensive reform. We were already spending 16% of our gross domestic product on health care and it’s estimated that within a decade it would grow to 20% of our economy. At that expense you’d think we’d be the healthiest nation on earth, but we are not (not even in the top 20). What more money will do is continue to support a system based on treating disease rather than promoting health.

The overwhelming preponderance of all health care expenditures goes for the treatment of chronic diseases (respiratory, cardiovascular, gastrointestinal, endocrine, and mental disorders). What the current medical system does best, is treat acute diseases, and not these chronic conditions. To have any real impact on those problems you have to get people to change their behaviors. That means you must spend time with patients to develop a relationship, and inspire them to believe that if they eat better, exercise more, smoke and drink less, and stress less, that they can become the principal agents in their own healing.

We could do this if we change the system, like reimbursing doctors for the time they spend with patients, and keeping them out of hospitals, rather than prescribing more drugs and procedures.

After my speech, I’m sitting on the veranda of a grand hotel overlooking Tampa Bay with one of the attendees. The waiter brings our drinks and my friend lights up a cigarette. Shortly after, the waiter returns and tells her that this is a non-smoking facility. She immediately puts the cigarette out and looking at me somewhat sheepishly says, “ it’s my addiction”.

We have an intimate, heartfelt connection, she is a competent professional, married, and with two teenagers at home. She is capable of “moving mountains” at work, but since she was 17 has never been able to quit smoking for more than three months.

We talked about all the treatment options (many of which she had tried), and the despair at her hopelessness. Before leaving I said to her that with all her accomplishments and honors she had won, wouldn’t it be a shame that in the end the only race her children would remember was the one she dropped out of.

As we said goodbye she whispered, “I’m not going to drop out”. I told her to keep in touch and let me know. Making heartfelt connections with your doctor is a healthcare system that promotes healing.

I recently participated in the 2009 “Thinking Outside the Box” conference. This is a four-day intensive, sponsored by Dr. Patch Adam’s Gesundheit! Institute and the School for Designing Society at the University of Illinois. It’s intended for people interested in redesigning the current healthcare system. The attendees are primarily healthcare professionals, lots of students, and even some patients.

This year’s conference was held at the American Visionary Art Museum in Baltimore. This is a museum for people who find traditional art museums boring. In front of the building is a full-sized school bus covered with a mosaic of reflective mirrors and onto which is glued a mind-boggling array of “stuff.” Next to it is an 8-foot sculptured egg, and behind it is a 50-foot bird disguised as a bass guitar whose beak is dipping into a bird’s nest that grows out of the museum’s wall. It was the perfect venue for dreamers.

I joined one of the breakout sessions where five Austrian medical students wanted ideas, tools and strategies to get their medical school to add an elective on clowning as a healing modality. I told them I was going to be in Austria later in the year, and if the Medical School invited me, I’d be happy to present to students and faculty.

Our discussions continued into the night; we talked about how one’s healing practice needs to include a “love strategy.” Finding ways to connect with people, listen to them, touch their hearts by opening your own — that’s your love strategy.

In a boisterous Irish bar, we talked about community mental health, visionary healthcare practices, and told clowning stories from around the world that lasted far beyond my usual bedtime.

Surrounded by students in a downtown pub, and feeling their energy, I feel in my soul that there is hope for healthcare and the holy work we do as healers.

I love these places that nurture dreamers.

I’m sitting at a beach on the Yucatan’s Riviera Maya looking at the extraordinary scenery and drinking my morning coffee. I just walked 10 feet from my kitchen to a reclining beach chair under a thatched hut to read Dr. Edmund Wilson’s new book, The Superorganism. I’ve saved it up for such a special time.

Dr. Wilson is one of the world’s best-known evolutionary biologists. He created quite a stir in 1975 with his book Sociobiology in which he said human behavior and achievement are genetically determined. It upset people to be told that the entire human experience is preordained.

In The Superorganism, he expands his view about how genetics and natural selection operate. The book is based on his study of ants, which are his first love; he tells us that our behavior and survival is not just based on the survival of the fittest. Natural selection operates at many levels, including at the level of the entire group. Wilson says that what benefits the group may be more important than what happens at the individual level. Among ants, survival favors those who sacrifice themselves for the benefit of the group.

I love this concept that our evolutionary foundation is based on how we relate to each other. We are not just a species dedicated to self-preservation, but we are also programmed for altruism and generosity.

When I get up to get a coffee refill, I notice a line of ants parading to and from my cookie crumbs on the counter. I raise my cup to the marching ants and say, “Thank you for reminding me that as people and a planet, our survival is based on our willingness to make sacrifices for each other.”

P.S. There are only 4 weeks left until “The Last Mask of the Authentic Healer” workshop in Phoenix, Mar. 27-29, 2009, don’t miss it. Go to www.healingdoc.com for more info.