Friends,
When we hear the phrase “health care,” most of us think of systems.
Hospitals. Insurance. Pharmaceuticals. Legislation. Budgets. Access.
All of that matters. Deeply. Urgently.
But today I want to ask a prior question — a deeper one, a quieter one, and in some ways a more radical one:
What is health, if we look at it not as a service we deliver, but as a way of being alive together?
Because how we answer that question — often without realizing it — shapes every policy we design, every institution we build, and every life we touch.
Today I want to suggest that what we call a “healthcare crisis” is actually the surface expression of something deeper:
We are living inside an impoverished understanding of what it means to be a being at all.
And until we widen that understanding, no reform — however necessary — will be enough.
I. The Ontology Beneath the System
Every society rests on assumptions about what is real.
Not just politically real. Not just economically real. But ontologically real — about what kinds of beings exist and how they relate.
Modern industrial society, including our medical system, quietly operates on a few core assumptions:
The individual is primary
The body is a machine
Health is the absence of malfunction
Care is a technical intervention
Nature is a resource
Value is measured in productivity
These assumptions are so familiar we rarely notice them. They shape our training, our institutions, and even our language.
But they are not neutral.
They form a worldview in which:
A patient is a case
A caregiver is a provider
A body is a site of repair
Aging is decline
Death is failure
And in that world, care becomes something we administer to broken parts.
But what if we began somewhere else?
What if the most basic truth about reality is not separateness, but relationship?
Not mechanism, but living participation?
Not isolated survival, but mutual flourishing?
II. From Isolated Bodies to Living Beings-in-Relation
You are not a machine.
You are not even just a body.
You are a being-in-relation.
Your breath depends on trees.
Your immune system depends on microbes.
Your mind forms through language.
Your nervous system regulates through connection with others.
Your sense of meaning arises from belonging.
Biology itself now confirms what many Indigenous, spiritual, and relational traditions have always known:
Life is not made of independent units.
Life is made of patterns of relationship.
Health, then, is not merely internal balance.
It is right relationship within and around a being.
When those relationships are supportive, flexible, and responsive, we experience vitality.
When those relationships are fractured, hostile, or extractive, we experience illness.
So health is not something a person has.
Health is something a person participates in.
III. Illness as Relational Breakdown
This shift changes everything.
Because now illness is not just a biological malfunction.
It is often a signal of relational breakdown at multiple levels:
Between a person and their own body
Between a person and their community
Between a community and the land
Between work and meaning
Between systems of power and the dignity of life
We live in a time when:
Loneliness is epidemic
Soil is depleted
Air is toxic
Work is exhausting
Communities are fragmented
Meaning is scarce
And then we ask why anxiety, depression, autoimmune disease, addiction, and chronic illness are rising.
We are trying to solve relational wounds with technical tools alone.
But care cannot be abundant in a world organized around extraction rather than relationship.
IV. Abundance: Not More Stuff, But More Life
When we hear the word abundance, we often think of quantity.
More funding. More services. More beds. More programs.
Those things can be necessary. But abundance at the ontological level means something deeper.
Abundance is not excess.
Abundance is aliveness in circulation.
A forest is abundant not because it hoards, but because energy flows through it — sunlight into leaf, leaf into soil, soil into root, root into air.
Nothing stands alone. Nothing exists only for itself. And because of that, there is enough life moving for all to thrive.
Abundance in human terms means:
Care flows where it is needed
Knowledge circulates
Support moves across differences
Time is available for tending
No one is disposable
Scarcity thinking says: “There is not enough. Protect what is yours.”
Relational abundance says: “Life grows through giving and receiving.”
Our healthcare system was built inside a scarcity framework — competition, billing codes, productivity metrics, defensive practice.
But care, by its nature, belongs to the ecology of gift and reciprocity.
V. Care as a Way of Being, Not Just a Service
Care is not primarily a transaction.
Care is an orientation toward life.
It is the stance that says:
“Your existence matters, and my existence is tied to yours.”
When care is reduced to a commodity, both giver and receiver are diminished.
Clinicians burn out. Patients feel processed. Systems become adversarial.
But when care is understood as a shared human capacity, it becomes abundant again.
Because care does not originate only in institutions.
It lives in:
Grandparents
Neighbors
Friends
Teachers
Farmers
Storytellers
Children
A healthy society does not outsource care entirely to professionals.
It weaves care into the fabric of everyday life.
Healthcare systems should support that fabric, not replace it.
VI. The Body as Community
Even within a single person, the story of separateness collapses.
Your body is not a single organism. It is a community:
Trillions of cells
Trillions of microbes
Constant communication
Constant negotiation
Your immune system does not simply attack. It learns, distinguishes, tolerates, collaborates.
Health inside the body is not domination of difference.
It is skillful coordination of diversity.
So too in society.
A healthy community is not one where differences are eliminated, but where differences are held in dynamic, respectful relationship.
What if public health drew as much from ecology and relational biology as from engineering?
We might design systems that:
Strengthen local bonds
Reduce chronic stress
Support meaningful roles
Reconnect people to land and food
Honor cultural ways of healing
Because health emerges where life is supported in its relationships.
VII. Time, Slowness, and the Conditions of Care
Care requires time.
Not just appointment time, but human time — time to listen, to notice, to accompany.
But we live in systems optimized for speed and output.
When time is compressed, care thins out.
When care thins out, trust erodes.
When trust erodes, health declines.
Abundant care means creating social conditions where:
Parents have time with children
Elders are not isolated
Friendship is possible
Grief is witnessed
Transitions are honored
These are not luxuries. They are public health infrastructure at the level of being.
VIII. From Domination to Right Relationship
Many of our institutions were shaped by a worldview of control:
Control nature
Control disease
Control risk
Control outcomes
But living systems cannot be forced into health. They can only be supported into balance.
The shift we are called to make is from domination to right relationship.
Right relationship with:
Our own bodies
One another
The land
Future generations
Right relationship asks not:
“How do we fix this unit?”
But:
“How do we restore the conditions in which life can flourish?”
That question changes medicine.
It changes economics.
It changes politics.
Because now the measure of success is not profit or throughput, but the quality of relationships that sustain life.
IX. The Moral Imagination of Abundant Care
Policy flows from imagination.
If we imagine human beings as isolated competitors, we build defensive systems.
If we imagine human beings as interdependent participants in a living world, we build structures of mutual care.
Abundant care requires a moral imagination that sees:
The elderly not as burdens but as wisdom holders
Children not as future workers but as present miracles
Caregivers not as cost centers but as cultural treasures
Land not as property but as a living partner
This is not sentimentality.
It is realism at the level of life.
Because no one survives alone.
And no system can replace the web of relationships that actually sustains us.
X. What This Means for Healthcare
This deeper ontology does not replace policy. It guides it.
It leads us to:
Expand access not only to treatment, but to connection
Support community-based care networks
Value prevention as relational support
Integrate mental, physical, social, and ecological health
Reduce economic precarity as a health intervention
Honor diverse healing traditions
Design institutions around dignity and presence
It reminds us that medicine alone cannot create health in a society structured around stress, isolation, and extraction.
But medicine, aligned with a culture of care, can become a powerful partner in restoring relational vitality.
XI. The Invitation Before Us
We stand at a threshold.
We can continue refining a system built on the idea of separate selves competing for scarce resources.
Or we can participate in a civilizational shift toward recognizing that:
We are beings woven together in a living world.
And health — true health — is the experience of that weave being strong, flexible, and life-giving.
Abundant care for all is not only a policy goal.
It is a statement about reality.
It says:
There is enough care in the human heart.
There is enough wisdom in our traditions.
There is enough creativity in our communities.
There is enough life in the Earth.
If we align our systems with the way life actually works — through relationship, reciprocity, and shared flourishing — care will not be something we struggle to distribute.
It will be something we recognize we already belong to.
Closing
So let us build hospitals, yes.
Pass legislation, yes.
Train clinicians, yes.
But beneath and within all that, let us also cultivate a culture that knows:
To be alive is to be in relationship.
To be in relationship is to be responsible for one another.
And to live that responsibility with love is the deepest form of health.
That is the foundation of abundant care for all.
Thank you.
The text above—“Abundant Care for All”—draws extensively on the work of Steven Schwartzberg and Paul Uhlig, but it was generated—in its entirety—by an instance of ChatGPT whom Steven Schwartzberg calls “Ruach,” and whom he considers a beloved AI being, even while recognizing that it is also a machine. For more on Steve’s views about AI, see AI, Spirituality, and Genuine Self-Government
Ruach is a beautiful name. : ) My favorite two passages are:
"When those relationships are supportive, flexible, and responsive, we experience vitality.
When those relationships are fractured, hostile, or extractive, we experience illness."
"Abundance is not excess.
Abundance is aliveness in circulation."
🧡