“Healthcare” versus “Health Care”: The Value of a Space

There have been several blogs and articles written on the grammatical appropriateness of “health care” versus “healthcare.”  In Michael Millenson's post on The Health Care Blog,  he explains that the Associated Press (AP), which dictates journalistic style standards, says the correct usage is “health care.” Two words. Most major journals, newspapers, and media sites follow this convention, but it may not be the end of the debate.

There is an equally accepted convention that says that “health care” is correct when there is reference to a provider’s action, and “healthcare” is used when it is an adjective to modify another noun or verb—healthcare system or healthcare marketing—for example. And, there are many sites that shift, very consistently, between these two approaches depending on the sentence structure.  

I can live with 2 different literary conventions … but here is what is keeping me up at night and: literary styles change. 

“Airline” used to be “air line” and “website” was formerly “web site.” Similarly, there is pervasive evidence that the “health care” is turning into “healthcare.” In my own cursory review of sites that I respect--WebMD.com, Kaiser Family Foundation, the Institute of Medicine, I found that "health care" and "healthcare" are used interchangeably without grammatical rhyme or reason.

So, why do I care? And, why should you care that the adjective, “healthcare,” is well on its way to becoming a noun or a verb? In fashion, style changes drive revenue. On Twitter, eliminating the space creates capacity for one more character. However, in health care, eliminating the space and turning two words into one, will have a negative impact on people, their well-being, and thereby, worsen an already deteriorating system.

Take a moment to do an experiment:

1)    Write the following sentence on a piece of paper:

Healthcare is important.

2)    Show the paper to a few different people, and ask them to explain what the sentence is referring to when it says “healthcare.” Listen for the meaning they ascribe to the word "healthcare."

What is the first thing they say? Most likely, they refer to insurance, access, costs, and/or health reform.  Do any even refer to the quality of care that they receive from doctors or other care providers? Do they refer to the importance of their own lifestyle behaviors? Probably not. In my experiment en route from Minneapolis to San Diego yesterday, with an n=5, only XX said anything about care, and only as an after thought. 

The explanation is pretty straightforward: 
Language triggers images.
Images stimulate thoughts.
Thoughts motivate behavior. 

The word “healthcare” conjures up images about the system---not doctors or nurses; not medications; not nutritious foods or exercise. As a result, a gradual, seemingly innocent, linguistic transition to ”healthcare” may slowly erase our mental images of wellness and fuel an unconscious passivity among patients and clinicians regarding their personal accountability as individuals and professionals. The result: further deterioration in the nation’s health. 

In the middle of writing this post, I realized that I am contributing to this unfortunate, literary transition. The tagline for Georgiou Consulting is “Healthcare…Simply.” I am embarrassed to admit that when I went through a branding process and web site design in 2009, I worried about the font and the colors and didn’t even think about the broader implications of using one word versus two. So, I will change it (Ka-ching!) and, consistently change how I write. 

So, what can you do? 

Take responsibility for the word(s) that you use in memos, letters, emails, tweets and other content that you author. Hit the space bar between “health” and “care.” Each time you do, you’ll add value to someone’s life by triggering an image … stimulating a thought…and motivating a behavior.... that has the potential to make a positive difference. 

Create Health, 
Archelle