School health education has been and still is guided by a number of different and often competing philosophical orientations. The field seems to be moving toward a skills-based philosophy, but the adoption of this approach is taking place with little discussion or analysis in the professional health education literature. The purpose of this article is to propose an integrated behavioral alternative to the present skills-based trend and to encourage the health education profession to examine school health education philosophy critically. The nature and scope of the educational reform that is sweeping the country makes the need for a critical examination of school health education philosophy, with accompanying dialog about goals and purposes, crucial to the growth and viability of school health education. "...it is suggested that health education be concerned with cognitive development while leaving attitudinal development and behaviors to other institutions in our society." "Although in the long run health education must contribute to people's health...its specific goal is to improve people's health behaviour and the measure of effectiveness is to be sought in changes of behaviour..." "I propose that health education be considered a process in which the goal is to free people so that they may make health-related decisions based upon their needs and interests as long as these decisions do not adversely affect others." "Health literacy requires educators to switch from a content-driven to a skills-driven approach. Young people need to learn, practice and apply skills successfully, numerous times, with positive reinforcement and social support to maintain personal health and safety." "The role of the health educator is to motivate students to put into practice what is learned in class, while at the same time teaching moral responsibility, conscience, and self-discipline." "...we should be including not only self-help/self-care, but also the promotion of a healthful environment, a safer work place, a caring medical care system; the promotion of public participation; the development of healthful public policy, a community approach to health status improvement, a caring and sharing philosophy, and not a focus that is overly reliant on individual effort."