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Given the current state of the welfare state, rethinking the prevailing health care paradigm is important as health care services try to adapt to the demographic, economic, political, environmental transformation, and rapid technological innovation. The basic focus of the medical paradigm is fundamentally unchanged since the time of Hippocrates: disease management driven mainly by the curative treatment. This paper argues that a new paradigm of ‘functional health’ is now beginning to emerge. Its starting point is not disease and treatment, but rather a person’s functional ability. This approach accords the individual a more central role as the person often best aware of his or her functional limitations. Although the health professionals remain in charge of acute and life threatening situations, when it comes to functional ability, the health professional acts as a counselor or facilitator. In terms of the World Health Organisation (WHO) classifications, this corresponds to a shift from the International Classification of Diseases (ICD), toward the International Classification of Functioning, Disability and Health (ICF). This new paradigm is potentially sustainable: it can combine simplicity with best quality, cost effectiveness with lack of waste, and use robust new technologies to the utmost. The new paradigm maintains the essence of the Hippocratic paradigm, but broadens the scope to health care issues and health care services so that important theoretical, educational, operational, and economic aspects can be accommodated. This paper looks into the implications of this transition and what can be done to ease the transition of focus from cure to care, from medical health to functional health.

At the end of ISG*ISARC2012 World Conference, Eindhoven, June 27-29, 2012, a discussion took place by video conference, between participants of the AAL summit (chaired by Olga Rivera, Basque Country’s Deputy Minister of Health Research and Innovation) and the gerontechnology conference (chaired by Alain Franco, ISG president). The Basque country declaration has been well received by the Gerontechnology community as convened in Eindhoven at the ISG*ISARC2012 conference. It was understood that the AAL Summit in Bilbao concerned R&D funding and business issues of Ambient Assisted Living (AAL). The Basque country declaration is a sturdy and welcome initiative to turn the aging society in a successful society for all. It looks for new and sustainable models for health and takes into account stakeholders from academia, industry, technological research institutes, care organisations and even users. Some remarks are presented about education, prevention and sustainability, end users, usability and building environments. The Basque country declaration is an important and needed document, which hopefully will have considerable impact. We strongly support the pronounced user orientation regarding technology development and use as clearly highlighted in the declaration. The gerontechnology community may further strengthen our move to a successful aging society by providing insights and results on the interface of gerontology and technology, including needed paradigm changes.