Our health care system is crippled by desperate efforts to prevent the inevitable. A third of the national Medicare budget--nearly 175 billion--is spent on the final year of life, and a third of that amount on the final month, often on expensive (and futile) treatments. Such efforts betray a fundamental flaw in how we think about healthcare: we squander resources on hopeless situations, instead of using them to actually improve health.

In Predictive Health, distinguished doctors Kenneth Brigham and Michael M.E. Johns propose a solution: invest earlier--and use science and technology to make healthcare more available and affordable. Every child would begin life with a post-natal genetic screen, when potential risk--say for type II diabetes or heart disease--would be found. More data on biology, behavior, and environment would be captured throughout her life. Using this information, health-care workers and the people they care for could forge personal strategies for healthier living long before a small glitch blows up into major disease. This real health care wouldn't just replace much of modern disease care--it would make it obsolete. The result, according to Brigham and Johns, will be a life defined by a long stay at top physical and mental form, rather than an early peak and long decline. Accomplishing this goal will require new tools, new clinics, fewer doctors and more mentors, smarter companies, and engaged patients. In short, it will require a revolution. Thanks to a decade-long collaboration between Brigham, Johns and others, it is already underway.

An optimistic plan for reducing or eliminating many chronic diseases as well as reforming our faltering medical system, Predictive Health is a deeply knowledgeable, deeply humane proposal for how we can reallocate expenses and resources to prolong the best years of life, rather than extending the worst.

Michael M. E. Johns, M.D., is chancellor and former executive vice president for health affairs at Emory University. Over the past eight years they have collaborated to develop the Emory Georgia Tech Predictive Health Institute and its Center for Health Discovery and Well Being. Both authors live in Atlanta, Georgia. Their website is http: //predictivehealth.emory.edu/