The gist of my position is that we are still vulnerable to the trend of "individualizing the responsibility while corporatizing the profit". I would second the concern about individualizing "accountability" to the patient/clients behavior when what is considered the normal range of health is still in discussion and so vulnerable to the hidden agenda of any corporate healthcare "personhood". I would suggest that the biggest effect on healthcare by instituting wellness programs has been on THE HEALTH CARE PROVIDERS, in that THEY are being forced to find profit in wellness rather than all kinds of profit for defining (not just diagnosing) disease and treating disease. Studies done in different locals across the nation with regard to medicare and medicaid are STILL finding Doctors who prescribe tests out of profit motive.....and once the tests are done, then the "out of range of normal" by community standard has to be treated. In addition before accountability is forced by policy as a regimen on individual clients there needs to be a LOT more research on what is healthly for the individual without locking them into a "range of normal" based on a questionable pool of subjects. For example, not only is there more flexibility, for in high blood pressure ranges in Europe than there is in the US, but the ranges (in US) are still locked into what's healthy for 40-60 year olds. Add on top of that what clinicians and researchers have suspected for years even before the completion of the genome project: That high blood pressure medicines had distinct effectiveness based on genetic factors--(and I'm NOT to refering here to the artificial construct of "race"). Consequently, for years, finding the correct drug and dosage of high blood pressure meds was a matter of trial and error with each patient. I cannot even begin to describe what I'm beginning to find out about the effect of our food supply on our community/public health. How then can we dock people for there poor health when so much of the food industry is working against us.... I'll conclude by mentioning that I am today,.... even since the passage of the New Health Care improvement act, whatever it's name is.... SOOOOOoooo much more in favor of single payer health care rather than even just offering public option. The accountability really still needs to be focused on the health care delivery industry, NOT on the clients. If we get a health care delivery system that is free of profit motivation, then maybe I'd consider that there ought to be client/patient accountability. But right now any "accountability" model is still vulnerable to narrow minded health care marketing specialists exploiting individual patients with little or no firm understanding of how solid or questionable the medical research is with regard to any health related issue.