Similarly, disease prevention and health promotion are the foundations of managed care, and those concepts depend on people taking responsibility for their own health. Alcohol and drug abuse, firearms, motor vehicle accidents and sexual behavior were not far behind.
Many observers hope that significant behavioral change has begun.
Many managed care organizations hope to increase efficiency with disease management programs. Employers hope the popularity of wellness programs will result in lower costs. Physicians hope for a preventive intervention for sedentary Big Mac addicts that is as effective as first-dollar coronary artery bypass graft coverage. Hope is important, but it is not always enough to pull patients through. After all, patients are sick people, and may have illness for which genes, heredity, environment, family, or fate is actually responsible.