Are We Thinking About Preventive Medicine Wrong?

We can all agree that the healthcare system sucks. Regardless of where you live.

You’re either waiting 12 months for a test in a universal system, or you’re always worried about bankruptcy from a medical emergency.

The circles I spend time in talk a lot about preventive medicine. Fitness, nutrition, preemptive testing.

Up until this week, I had always assumed that investment in this type of medicine was an institutional problem. That healthcare wanted to treat symptoms, not causes. Or that they wanted to take the easy method.

I was half right, for the wrong reason. I recorded recently with Dr. Eric Helms and he opened my eyes to a different option.

Investment in preventive medicine is a people problem, not an institutional problem.

The funding isn’t there for research of preventive medicine. Why?

There is no guaranteed return on investment.

To see a return on investment, healthcare companies need to prove that patient costs would drop later in life for people who engage in preventive medicine practices. And — and this is the kicker — that a large enough group of people would be willing to engage in the practices to offset the research and ongoing investment/education cost.

Walking 10,000 steps a day to prevent type II diabetes is categorically harder than taking a metformin pill with your meal to control your blood sugar.

Treating symptoms is the easy method.

The ROI of pharmacological intervention is easily defined because the friction of getting someone to take a pill is so small it may as well not exist.

If I invest $100,000 to get you to take a pill and it saves $1,000,000 that is a 10x ROI.

Lifestyle intervention has more friction!

If I invest $100,000 to get you to go for a daily walk, cook dinner and spend more time with your family and it saves $1,000,000 that is still a 10x ROI…

But wait, what if you only do that 65% of the time? What if you have to move away from family? What if it’s cold outside so you’re not going for a walk? Or, what if you don’t have time to cook for yourself? There are thousands of other what ifs.

You can see how a 10x ROI quickly turns into a 6.5x or a 3x or a -2x ROI because of human behaviour.

What’s the takeaway?

1. The best preventive medicines won’t eclipse pharmacological ones until AI changes how research is done.

2. You have to self-prescribe lifestyle interventions, no doctor is ever going to do it for you.

3. It is on you to find the best available lifestyle interventions — Hopefully this weekly newsletter helps with that! Companies aren’t going to advertise them and cut into their own 10x ROI from pill sales.

4. Probably stop hoping the healthcare system will change.