Self help models and consumer intensive health practice

In the context of increased demand for health services, current fiscal constraints and the character of health problems in an advanced technological age, the authors have discussed various approaches to consumer intensive mutual aid functioning at various stages of development. If these approaches are further developed and become an integral part of the health delivery system, a number of important questions will have to be addressed: how payment for self help activities will relate to present reimbursement practices and might relate to a national health insurance scheme: how the operation of expanded programs of self help and self care will relate to present and future patterns of care (especially regarding HMOs): how programs of self help in the areas of prevention will relate to present and pending health education programs (such as that proposed in the National Health Education and Disease Prevention Act, H. R. 9278); what the development of self care modalities will mean for the roles and training of professional and paraprofessional providers. These issues will have to be considered very seriously if the self help approach is to become a major feature of the authors' future health practice.