History of medicine and concepts of health

It was not until the exemplary social reform of the 19th century and the introduction of modern health insurance schemes that people started to consider health as some kind of basic right which could be ensured by insurance and doctors, rather than by individual responsibility. The recent explosion of health system costs in countries like Germany has given rise to an unprecedented situation whereby the limited capacities of insurance systems and state organizations are becoming more and more evident. Health economists are now questioning the feasibility of optimal medical treatment for everybody. One consequence of this situation is that people are being forced to recall the old virtue of individual responsibility for one's own physical and mental well-being. This article examines the nature of health from a historical point of view. The point is made that health is not the same thing as a life free from complaints, although this erroneous belief is wide-spread today. Galen himself identified a neutral physical state between health and illness (neutralitas), that could be observed in many people who could not be described as being either healthy or ill. It is necessary to accept this state as part of the natural fate of humankind and to understand that individual responsibility and the demands on society and insurance companies for well-being or absolute freedom from ailments are not one and the same thing.