Healthcare is in the news recently, not in the least because of an announcement of how a few major technology companies with the help of Warren Buffet have laid out plans to reinvent health care, first for understandable cost-reduction sake with a risk-model tuned to meet the needs of their employees, soon to be followed by a model available to the general public.
The idea to overhaul health care is fascinating because, as I wrote a year ago, after intense conversations with doctors, it provides neither health nor care. Ergo, reinvention is indeed sorely needed and justified.
A surgeon-general warning
But as a life-long technologist turned policy advisor, I must warn you, the ruse of technology is a dangerous one.
The ruse of technology is a dangerous one
You may have forgotten how most technology companies under the veil of a pageantry of our blind positivity have engaged in overt price-fixing, with the FTC asleep at the wheel of creative destruction, sell your personal information to the devil of advertising schemes, scammed and cut-out independent developers, lied about the freedom of information access, bombarded you with fake news as if real, provided you with information they feel you need, got fined in tax fraud schemes, engaged in modern-slavery to rake in profit-margins, involved in unlawful collusion with peers, defined your rights to privacy and still arbitrate freedom of speech. Must I go on?
Theranos is undoubtedly not the only outlier when it comes to abusive and deceitful practices by technology companies. Some of our most respected and talked-about technology companies deploy vile practices under the veil of their encroaching totalitarianism. The white lies of technology are only shining brightly to the blind.
So, to assume technology companies will be better custodians of the care of your health just because they are bound to bring shiny new diagnostics technology as their Trojan horse is a naive and foregone conclusion, especially when those technology companies continue to act with less than stellar excellence and self-regulation on their turf.
And you, Brutus?
Yes, insurance companies corralled by misplaced governance have completely messed up the value-chain of health, all while compressing provider profit margins and inflated their own. Perhaps in no lesser way than technology companies have milked revenues in their domain. But at least health insurance companies are bound by specific regulations we, the people, have some influence on.
Technology companies, on the other hand, will operate uncontrollable, unbridled, and at warp speed, offering you fake news before you even had a chance to recognize it as fake. Try that trick with the care of your health, and you may not live to tell about it.
The bigger picture here is that all, yes all, our operating-systems of humanity are fundamentally broken, and technology companies are not the panacea, for none build technology in adherence to the innate concept of human plurality. In the words of Einstein, the theory (of the system we deploy) determines what can be discovered. And the discovery of a faulty outcome of healthcare, a lack of health combined with a lack of care, indicating the subjugation of missing or broken principles.
The theory determines what can be discovered. — Einstein
Without fixing the higher-order root-cause, the significant difference in outcome between insurance companies and technology companies running healthcare will be the expediency by which the general public recognizes either distribution of a lousy normalization of the guiding theory to be broken. Slow progress in this delicate and evolutionary context more appropriate and correctable than fast.
Most importantly, we must fix the root cause of why, despite our massive investments in health care, our health is not commensurately improving before we sink more good money after bad.
We have not established substantial responsibilities and directives to protect the health of ourselves, and instead, we fuel a bloated health care system unable to refuse our right to care.
With a plethora of institutions, induced by a proprietary assignment of insurance billing codes, the majority yielding insurance payouts of around one-hundred dollars per visit, and some even almost half, requiring health-care providers, doctors, and nursing staff to take on multiple patients per hour as the hasty grind to make decent money.
Institutions like Home Health, Home Visits, Primary Care, Urgent Care, Skilled Nursing Facilities, Assisted Living Facilities, Independent Living Facilities, and Hospice all leeching off the more expensive critical care of a Hospital. Fragmentation of care as the daunting labyrinth for any person, especially the ill, to wade through. A convoluted system in which substandard over-diagnosis and misdiagnosis are the norms, not the exception. With providers wasting precious time pushing paperwork in what insurance companies at their discretion and after treatment decide may not financially be accounted for.
The latter findings padded with my personal experience of how I flipped my ankle on an uneven surface in Massachusetts a few years ago, receiving bills from an institution I had not visited, from a doctor I had not seen, and taking my X-rays to an orthopedic expert in my hometown who then decided to take more X-rays just to be sure the rather standard $600 boot they fitted me with was the right course of action.
The vast majority of people currently tapping into the healthcare system are – unlike me -chronically ill, as a consequence of cascading diseases from the quality and quantity of things we ingest and ought not, combined with a lack of exercise. More than half of American adults have a chronic disease, and 25 percent have more than one.
Morbid obesity (anthropogenic), respiratory disease (anthropogenic), and vascular disease (anthropogenic) causing compounding diseases and addictions that subsequently weaken the DNA of their offspring. Our DNA is not merely hereditary but also modified by the quality of our life on earth.
Put differently, the apathy to healthy lifestyle choices is directly responsible for the systemic weakening of the human species. Evolutionary longevity hiding increased fragility.
Human excellence, this is not
Case in point: despite all our ground-breaking medical innovation and growing knowledge of life-threatening diseases, the average American age has recently declined (since 2015), already disproportionately low in comparison to other developed nations. The care of our health not commensurate with our investment in healthcare.
In 2015 U.S. average age declined, for the first time in recorded history
The U.S. is the second most obese country in the world (after Mexico), causing compounding diseases and depression to form that literally knows no end, a snowballing of compounding ailments only cut short by the sickle of the grim reaper, after the patient has run through the mill of the aforementioned specialized institutions erected for profit.
Human excellence is waning at a young age, judged by how 75% of applicants to the U.S. Army are declared and rejected as unfit.
Drugged up depression
With aisles of grocery-store medicine available to us like candy, and children now using over-the-counter drugs such as Aleve, Advil, and Tylenol to create an addictive culture of self-medication, it is not hard to imagine what the next step in medical consumption would be. To, in a Michael Jackson kind of way, tell your doctor what you want, or else to find a doctor who does give you what you want.
To wit, our use of prescription drugs, with 70% of Americans chronically addicted, is the worst in the world, costing us over $329 billion per year. The vast majority of those medicines are antidepressants. With pharmaceutical companies allowed to advertise their wares incessantly (now 20% of health care costs) in the media, and infiltrate and impregnate the minds of the general public with the promise of life-altering cures only a doctor can validate and recommend.
Freedom run amok
Never mind respiratory disease as the third leading cause of death to Americans from the Mad Men adulation of the once-booming tobacco industry. The cost of an American dream all of us, including non-smokers, still today pay a hefty increase in health insurance premiums.
Never mind, we poison our children with easy access to aisles of food from a box when their parents are too tired to care and cannot keep a watchful eye on their children’s food intake. With ophthalmologists, from looking into children’s eyes at the smallest veins in their body, now being able to predict an onslaught of children who will suffer a heart attack by age forty.
New-age child abuse is resting comfortably on the weak shoulders of laissez-faire parenting.
To top it all off, we now have an extreme poverty rate of 15.8% in the U.S., with, on average, a quarter of all children in the U.S. attending public schools on free and reduced lunch for lack of funds by their parents. That is an embarrassing statistic for one of the wealthiest countries in the world. Facts we must expose to force us to do better, in the words of JFK.
The downside of poverty is now affecting hospital expenditures, so much so that hospitals in Chicago are now experimenting with paying the rent for homeless people to prevent recurring hospitalization. A reduction in re-hospitalization more than making up for affordable housing that treats homeless people with the cleanliness, care, and dignity all people deserve.
Poverty is a manmade disease
What we must begin to understand is that poverty is not merely an unfortunate circumstance of people without money. Instead, poverty turns into a disease of incompetence, as we have recently discovered from tests correlated to brain scans.
We now know how poverty wreaks havoc in children’s brains that have not been given enough positive stimuli and peaceful experiences to expand to full capacity. A poverty rate directly correlated to early pregnancy, violence, crime, and an increased inability to take care of oneself properly. With evolutionary regression in their offspring to boot, putting even more compounding pressure on the healthcare system.
Insurance companies have implemented a placebo of sorts to reduce the cost of paying for healthcare. They invented the notion of Accountable Care. A connotation that initially would make everyone feel warm inside, as a move from unaccountable care to Accountable Care, must surely imply a right-sizing of care.
Accountable Care is like a dividend issued to people who did not purchase stock
However, the opposite is true. As Accountable Care, in reality, consists of a currently “lawful” kickback scheme, in-transparent to patients, and provided to pre-certified accountable care organizations (ACO) who’s doctors manage to induce health-insurance savings. Financial reserves siphoned away from the responsible risk profile and risk management of the very care the insurance premiums were supposed to optimize. Accountable Care is like a dividend issued over the backs of people who did not benefit from the purchase of stock.
Health-care providers are lining up in droves to become certified. With even large hospital groups feverishly spinning out new ACO specialties to slow the self-cannibalization of re-hospitalization, the insurance companies aim to reduce. The continued fragmentation of the system inducing even more disjointed and pulverized care.
But do not hate the players of a flawed system in healthcare for their antics. These kinds of socioeconomic infractions happen just as much in the technology sector. Do not hate the players in either, not any more than a group of people who have not been instructed the game of soccer must be played with your feet. Instead, hate the game we have failed to establish at its best and most accurate evolutionary normalization.
Thank you serfdom
You see, health care today operates as the dumping ground for the fallout of many other dysfunctional manmade systems we have built. All in flagrant violation of the most basic principles of freedom, ignoring the respect all humans deserve, and thus driving unsustainable levels of input to the healthcare system, regardless of the excellence of the system we put in place.
Employment-at-will is America’s favorite ball-and-chain to freedom
Our totalitarian monism of capitalism distributes wealth oligarchically, enslaving a growing long-tail of the have-nots to an increasingly narrowing standard-deviation of the haves, with those have-nots requiring health insurance too, and subsequently becoming hopelessly enslaved to the haves running the companies to provide it. Employment-at-will, as the legal method to fire someone on the spot for no reason, as America’s favorite ball-and-chain to human freedom.
Depression, for example, surfaces in people who realize their enslavement to a rat race of Neanderthal capitalism is a never-ending dream with few oligarchic awakenings. Such misery, in turn, yielding ballooning apathy, complacency, obesity, and a waterfall of other diseases the healthcare system must then begin to absorb and manage – a compounding of illnesses formed by negative, yet manmade, externalities to a person’s natural health.
Not capitalism, but our Neanderthal implementation of capitalism is to blame
Not capitalism, but our Neanderthal implementation of capitalism is to blame for the mass deflation of our evolutionary strengthening. A system as the vehicle to sell out any evolutionary value of long for a brazen vile-maxim of short. And a system that does not strengthen the evolutionary wherewithal of humanity instead weakens it, with our healthcare system as the dumpster of what such a system declares as human debris.
Health care was never designed, nor should it be used, and cannot sustainably act as the forgiving band-aid to the inbred ignorance of our evolutionary excellence.
We can only fix healthcare by not chronically having to depend on it. And thus, we must build operating-systems for humanity that reduce the pressure on healthcare.
From the dependencies described above, it is apparent that we must establish a policy of health to attach to the highest possible and best normalization of our evolutionary objectives. For, as I describe here ad nauseam, without new policy, we cannot sustainably fix healthcare by merely repairing the care of health.
Without new policy we cannot sustainably fix healthcare by merely fixing the care of health
Do not make the mistakes I see all Presidents make, by proposing a drastic change to individual branches of our manmade systems without establishing a new overarching the policy to effect such change. A failure to change our systems, without a change in policy to support the amendment, will lead to the increasing dislocation between the systems, erode the integrity of the ecosystem they were meant to serve, and will induce new fragmentation and in-transparent abuse of more complex consequences.
You can tell a good leader from a bad one by how he stitches together all the ecosystem parameters of a system in need of optimization with a single cohesive and better vision, a better normalization of truth upstream affecting everything downstream. A new policy is precisely the theory Einstein refers to, that derived from such a new normalization determines what can be discovered.
So, can healthcare be fixed? Yes, absolutely.
We must build a system focused on the care of health over the health of care.
With some forceful principles to how we improve the operating-systems of humanity and by building new systems that reward us for taking back the responsibility for our health:
- We must establish a new policy of health that defines and lays down the necessary health criteria for people, calibrated to personal attributes, age group, and sexuality. With a grading system that establishes the guidelines of health aimed to improve the strength of human renewability.
- We must clean up the convoluted business model of our current model of healthcare (pictured above) and fix the messy regurgitation of chronic care for those already in the system. We must build a system aligned with the care of health over the health of care.
- We must formulate new standards and best practices of care, using expert medical practitioners to define recommended procedures of care for the most common ailments of both chronic and non-chronic situations.
- We must establish new insurance plans rewarding patients for their compliance with baseline health standards and thus induce a meritocracy of health, with cost reductions to healthy people and cost increase for those breaking the guidelines of health. Accountable Care transparently applied to where it matters, and to the responsibility of our health.
Without getting into the specific configuration aspects of the health care system deeply here, a nerdy subject for people not familiar with how to build systems, it must be noted how a renewable meritocracy, in which the evolutionary composition of participants dynamically calibrates merit, is an attribute of a system of subjugated to a plurality of freedom. It cannot and shall not be established by an oligarchy in which the resistance of the aristocracy to change deflates the intrinsic evolutionary merit as soon as the system is developed.
A world without borders
Based on my deeply personal experience with technology, having witnessed the expertise and performance of technology companies in selling to the world highly monetizable totalitarian monisms to “greater fools,” there is no question in my mind I would rather see doctors without borders than technology without borders. Because still today, and despite the mass hysteria around technology, technology has yet to prove it can appropriately self-govern to advance and strengthen humanity.
I prefer doctors without borders over technology without borders
Technology companies, as the supposed experts in building robust operating-systems, have proven not to have any experience in building systems that mimic the innate plurality of humanity. Instead, by their proprietary algorithms constructed on open-systems highly vulnerable to intrusion, they continue to violate every fundamental principle of freedom and security, to make a quick buck.
So, today, I see better prospects for doctors aided by technology than technology aided by doctors.
Technology will indeed change the face of healthcare. But, until it employs people with an understanding of evolutionary policy to properly balance health and care, technology should only be used as a preemptive set of tools aimed to provide better health, and as such induce less need for care.