Health management of complex dynamic systems has traditionally evolved separately from automated control, planning, and scheduling (generally referred to in the paper as decision making). A goal of Integrated System Health Management has been to enable coordination between system health management and decision making, although successful practical implementations have remained limited. This paper proposes that, rather than being treated as connected, yet distinct entities, system health management and decision making should be unified in their formulations. Enabled by advances in modeling and computing, we argue that the unified approach will increase a system's operational effectiveness and may also lead to a lower overall system complexity. We overview the prevalent system health management methodology and illustrate its limitations through numerical examples. We then describe the proposed unification approach and show how it accommodates the typical system health management concepts.