Speaking on this at AIHM Conference San Diego on October 24th

August 28th, 2015 by Nick Jacobs Leave a reply »


We’ve all heard the expression that we are products of our environment, but that doesn’t really explain our decisions in life. For example, the first decade of my youth was spent in poverty. It was not Appalachian, dirt floor, poverty because we lived in my grandmother’s house, but it was powdered milk, government cheese, patches on my clothes poverty.   Then my dad got a job that literally thrust us into the middle class overnight. Some kids who were raised poor want to help their fellow man. Others want to show everyone that they are superior.   Who does which and why?

After teaching for nearly a decade in City Schools where children from low socio-economic backgrounds, were the rule, I became sensitized to their problems and lack of privilege. My last two years of teaching, however, were spent in a school where the average family income was much higher. The problems were still there, but in different packages. Some of those kids, both rich and poor, have made it big and have dedicated their lives to helping others. Which ones were they and why?

When I went to Europe for the first time, I experienced a different philosophy that fascinated me. It was a form of humanism. As a population they were taking care of each other.

That opinion was reinforced during my first trip to Toronto. There were no people living on the streets in Toronto. The both the ill and the mentally ill were being cared for, and, most importantly, there seemed to be much less violence, a type of peace in the form of mutual respect.

In the mid-2000’s, I made a trip to Africa. In one of the largest oil producing countries in the world, I saw poverty that was incomprehensible. It was clear that the only thing that was trickling down to the masses there was sadness, sorrow, and early death.

When I began working in the Netherlands a few years later, the vast majority of the people were middle class. Beggars were not visible on the streets, and a few years later, at the height of the world economic collapse, a trip to Spain reinforced this. With a 26% unemployment rate, I saw only three beggars in a major city.

It was at that time that the Affordable Care Act was being discussed, and my hopes began to rise.   Finally, we would prioritize wellness and prevention and behavioral health with parity for all other forms of health. We would take care of our fellow man in some way other than imprisonment. We would not have one of the highest infant mortality rates in the world, and we would begin to care for each other in a way that would be three times less expensive than our last two wars.

We would find the money that would allow us to take care of our fellow man and things would begin to get better; less obesity, less diabetes, less domestic terrorism from mentally ill, young white men. We would help those people who needed help the most.

The Accountable Care Organization, a result of the Affordable Care Act, seemed to be one way to finally shift the resources from a Sickness to a Wellness and Prevention based venue. We would be reimbursed for quality not quantity.   We would convert from a case by case sickness to a root-cause humane oriented, wellness based system.

Then it struck me that our medical profession has not been trained to function in this system, and as long as the rewards for sickness were greater than those for wellness, making that change would be incredibly difficult. So, I’ve spent the last seven years investing my energy in a philosophy that embraces evidence based, world medicine. It’s my dream that we can integrate world health modalities for wellness and prevention, and save our country from economic ruin while protecting our future generations from premature death.




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