The current global health care system is broken
More than 6.2 million people have died from COVID-19-related deaths as of June 13, 2022. This is despite $ 8.9 trillion, or 9.8% of global GDP, spent on healthcare worldwide in 2019. .
More generally, half the world does not have access to basic health services. In addition, the current healthcare system misses the most vulnerable groups, leading to health disparities and inequalities.
Health is a basic human right. It should be so for everyone.
Today, healthcare is provided in one of two ways:
– Insurance-based health systems: In general, economically strong countries have insurance-based health systems that may or may not offer universal coverage. In addition, health disparities and inequalities are widespread even among the best covered groups of people. As an example, in the United States, racial and ethnic minorities, the economically weaker sections of the population, and people living somewhere other than in large, peripheral metropolitan areas continue to receive poorer health care.
– Pocket health systems: Economically weaker countries usually have healthcare systems in place. It is important to note that even in economies that have insurance-based health systems, the most vulnerable group of people may need to consume health care out of their own pocket. In much of the world, where pocket systems are common, corruption, favoritism, and lack of accountability are deeply ingrained.
Both systems have one thing in common: intermediaries who control patient access or create inefficiencies, or both.
Bitcoin can make health a human right for everyone
The current health care system increases the cost of mediation. Like banks, health insurance companies are financial institutions that suffer from the inherent weakness of the trust-based model. More generally, current systems have led to additional intermediaries that add additional inefficiencies to the healthcare system. For example, it is estimated that of the $ 100 spent on prescription drugs purchased at a retail pharmacy through commercial insurance in the United States, more than $ 40 was caught by middlemen.
This high cost of mediation limits the minimum practical size of transactions, which disproportionately affects preventive care. In out-of-pocket healthcare systems, the public cost of mediation in healthcare networks is even higher, ie. without any safety net, the most vulnerable groups of people are either completely abandoned or underserved.
To quote Satoshi Nakamoto: “What is needed is an electronic payment system based on cryptographic proof instead of trust, which allows two willing parties to make transactions directly with each other without the need for a trusted third party.
The best way to repair the currently broken health system is to build a new integrated health system (IHS) between patients and providers that can provide high quality, equitable health care as an easily accessible public good for everyone.
This new peer-to-peer IHS can function as follows:
- First, you need an insurance-like product built on bitcoin. Anyone enrolled in this product will have the right to seek health care in the proposed IHS. Anyone with internet access must be able to register. The only “insurance premium” that people will pay is their identified data on the determinants of health. Each member will retain ownership of their data forever.
- Second, transparent, secure and efficient supply chains must be built on bitcoin. This will solve many critical challenges such as counterfeit medicines and artificially inflated drug prices to meet the needs of intermediaries.
- Third, healthcare providers should only be encouraged to optimize outcomes for patients. This can be achieved by strongly promoting the practice of evidence-based medicine, including focusing on preventive care.
- Fourth, in addition to the data provided by enrolled members, each healthcare provider must provide data collected during patient care.
- Fifth, value-added services, which will aim to stimulate long-term optimization of patient outcomes and maximize system efficiency, can be built by anyone. Part of all revenue generated by such services should be used to reduce own costs or to further encourage providers to help patients achieve optimal results.
This bitcoin-based IHS can bring many transformative changes:
– Universal healthcare: “It is safe to assume that everyone on this planet will eventually have some way to access the open internet. We cannot make the same assumption of participation in the global financial system, “said Jack Dorsey recently. The same can be said for the internet and the healthcare system. In peer-to-peer IHS, anyone who has access to the Internet can be part of the system only by providing their data on health determinants.
– Evidence-based, equitable health care for all: Because all that each member pays as “premiums” is their data and the incentives of providers are tied to patient outcomes, everyone will have access to such high-quality, fair healthcare.
– Accelerating the development of new health technologies: Many modern medical technologies have been discovered by chance (for example, penicillin, X-rays and pacemakers). Similarly, the trial-and-error method is a common strategy in today’s research and development efforts. If a data set consisting of all determinants of health information in a population is available, the development of innovative health technologies will accelerate.
– Better allocation of the health budget: By 2030, the United States will spend $ 6.8 trillion a year on health care, according to the latest “official” estimates. Assuming that focusing on preventive care and the practice of evidence-based medicine can lead to as much as a 5-10% reduction in health care costs, this will lead to savings of $ 340 billion to $ 680 billion. This is enough to cover all health care costs out of the pocket of the US population. The available evidence shows how the proposed savings are achievable even if only by applying evidence-based care to the current system itself.
Call to action:
I believe that a critical mass of three main criteria is needed to launch a new idea:
1. A well thought out concept that can bring about transformational change.
2. Technical expertise on how to perform well.
3. The resources needed to make it happen are available for use.
This article summarizes my thoughts on the first point. I choose to do so because my current experience is in healthcare. With this article, I urge the bitcoin community to explore ways we can achieve number two and three.
This is a guest post from Vishvas Garg. The opinions expressed are entirely their own and do not necessarily reflect those of BTC, Inc. or Bitcoin Magazine.