Allow me a variation on the metaphor:

A manufacturing plant is dumping toxic chemicals into a stream. A bit
further downstream live several different small communities. For various
reasons, the people in those communities drink from the stream. When they
do, they instantly get dizzy from the chemicals and fall into the stream. A
bit further down the stream is a hospital.

In the Medical Model, we focus our energies at the end of the stream,
pulling people out of the stream, hospitalizing them until they're able to
stand upright, and send them back to their communities.

In the Health Promotion Model, we work with each of the communities to
reduce their need to drink out of the stream. With some communities, that
might require a well. With others, education about the dangers of stream
drinking. With others, bottled water.

In the Population Health Model, we figure out how to stop the dumping of
toxic chemicals into the stream in the first place.

Oh, yeah, and then there's government policy: close the hospital, cut back
on health promotion, reduce environmental protections and call it health
reform.

Glen Brown