Can Commons Thinking Drive A New Health System?


Cat Johnson: What would it take to move from planetary imbalance into a state of sustained health and healing? In a recent report, Jamie Harvie, Executive Director of the Institute for a Sustainable Future and founder of the Commons Health Network, argues that we need a new health system, one based on a “profound appreciation of the complexity and interconnectedness of life across traditionally silo-ed institutional spheres of influence—healthcare, economics, agriculture, and others.”

Harvie points to the World Economic Forum (WEF) Global Risks report, which states that “global risks remain beyond the domain of just one actor” and that to create a healthy planet and people we must focus on collaborative and multi-stakeholder action. He also calls for a decentralization of our food systems using ecological principles and local knowledge and input.

Recognizing that clinical care determines only about 10% of health outcomes, Harvie explains that it’s essential to shift our health system to one that sees health as an interconnection of emotional, mental, spiritual, and physical well-being driven by social, economic and environmental factors.

As our current healthcare system is profit driven and externalizes social and environmental costs “in a manner that is inconsistent with health,” our next health system needs to “untangle deeply enmeshed financial incentives within the business of healthcare, so as unlock the true health potential within us all” and create a healthcare approach that recognizes the body as a complex, interrelated system.

To address the immense challenge of creating the next health system, Harvie turns to complexity science which provides the following insights into how a systems worldview changes our perception:

  • From parts to the whole
  • From objects to relationships
  • From knowledge to contextual knowledge
  • From quantity to quality
  • From structure to process
  • From contents to patterns

To create new systems of collaboration, empowerment, self-organization, transparency and more, he looks to the principles of the commons, where communities work together to “craft, monitor, enforce, and revise rules to limit their behavior and keep their resources available for the long term.” Harvie explains: “At their core is an acknowledgement of the importance of an approach that has a fair set of rules, a means to represent a voice, transparency, self-determination, localized boundaries or a sense of place, inclusivity and the right to health and well-being.”

Creating the next health system is a big task that will not happen overnight. The importance of rethinking the health of the planet and its inhabitants requires long-term commitment, collaboration and a new perspective. As Harvie writes:

“As we move forward, we must keep in mind that these issues are complex and require ongoing experimentation to test and probe the potential of nascent models and approaches. This uncertainty is challenging for our culture, which is accustomed to long term planning and the belief in predictability, especially in the context of impending climate change impacts. Moreover, we are accustomed to working within silos of expertise and have undeveloped interpersonal tools to work in this new networked, relational space. We must incorporate commons principles and subsidiarity in the context of a strong national and global rights framework.”

Shareable is an award-winning nonprofit news, action and connection hub for the sharing transformation. What’s the sharing transformation? It’s a movement of movements emerging from the grassroots up to solve today’s biggest challenges, which old, top-down institutions are failing to address. Behind these failing industrial-age institutions are outmoded beliefs about how the world works – that ordinary people can’t govern themselves directly; that nonstop economic growth leads to widespread prosperity; and that more stuff leads to more happiness. Amid crisis, a new way forward is emerging – the sharing transformation. The sharing transformation is big, global, and impacts every part of society. Visit for more.

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