The current global healthcare 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 in 2019 in the world.
More broadly, half the world lacks access to essential health services. In addition, the current health system leaves out the most vulnerable groups of people, leading to health disparities and inequalities.
Health is a fundamental human right. It should be so for everyone.
Today, health care is delivered in one of two ways:
– Insurance-based health systems: Generally, economically strong countries have insurance-based health systems that may or may not provide universal coverage. Furthermore, health disparities and inequalities are widespread, even among the best-covered groups of people. For example, in the United States, racial and ethnic minorities, economically weaker segments of the population, and people who live outside of large, outlying metropolitan counties continue to experience poorer quality health care. .
– Direct healthcare systems: Economically weaker countries generally have reimbursable healthcare systems. It is important to note that even in economies with insurance-based healthcare systems, the most vulnerable group of people may still have to consume healthcare out of pocket. In much of the world where direct payment systems are common, corruption, patronage and lack of accountability are deeply rooted.
Both systems have a common attribute: intermediaries that control patient access or create inefficiencies, or both.
Bitcoin can make health a human right for all
The current healthcare system increases the cost of mediation. Like banks, mutuals 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 further inefficiencies into the healthcare system. For example, it is estimated that out of every $100 spent on prescription drugs purchased from a retail pharmacy using commercial insurance in the United States, more than $40 is recovered by intermediaries.
This high cost of mediation limits the minimum size of practical transactions, which has a disproportionate negative impact on preventive care. In direct health care systems, the societal cost of mediating in health care delivery networks is even higher, i.e. without an insurance safety net, groups of people most vulnerable are either completely left behind or underserved.
To quote Satoshi Nakamoto: “What is needed is an electronic payment system based on cryptographic evidence instead of trust, allowing two consenting parties to transact directly with each other without the need for a trusted third party.”
The best way to fix the currently broken healthcare system is to build a new integrated peer-to-peer (IHS) healthcare system between patients and providers that can deliver high-quality, equitable healthcare as well public easily accessible to all.
This new peer-to-peer IHS can work as follows:
- First, an insurance-like product built on Bitcoin is required. Anyone registered for this product will be eligible to seek health care in the proposed IHS. Anyone with internet access should be able to register. The only “insurance premium” people will pay is their anonymized data on the determinants of health. Each member will retain ownership of their data in perpetuity.
- Second, transparent, secure, and efficient supply chains must be built on Bitcoin. This will solve many critical challenges such as counterfeit drugs and artificially inflated drug prices to meet the needs of middlemen.
- Third, healthcare providers should only be incentivized to optimize patient outcomes. This can be achieved by strongly encouraging the practice of evidence-based medicine, including an emphasis on preventive care.
- Fourth, in addition to data provided by registered members, each health care provider should provide data collected during patient care.
- Fifth, value-added services whose goal will be to promote long-term optimization of patient outcomes and maximization of system efficiencies can be created by anyone. A portion of the revenue generated by these services should be used to reduce out-of-pocket expenses or provide more incentives for providers to help patients achieve optimal outcomes.
This Bitcoin-based IHS can bring many transformative changes:
– Universal health care: “It is safe to assume that every person on this planet will eventually have some means of accessing the open internet. We cannot make the same assumption about participation in the global financial system,” Jack Dorsey said recently. The same can be said of the Internet and the healthcare system. In the peer-to-peer IHS, anyone with internet access can become part of the system simply by providing their health determinants data.
– Equitable and evidence-based health care for all: Because all each member pays in “premiums” is their data, and because provider incentives are tied to patient outcomes, everyone will have access to equitable healthcare of similar quality.
– Acceleration of the development of new health technologies: Many of today’s medical technologies were discovered accidentally (eg, penicillin, x-rays, and pacemakers). Likewise, trial and error is a common strategy in today’s R&D efforts. If a data set consisting of all the determinants of health information of a population is available, the development of innovative health technologies will be accelerated.
– 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 result in a 5-10% reduction in healthcare spending, this will translate into savings of $340-680 billion. This is enough to cover all health care expenses borne by the American population. The available evidence indicates how the proposed savings are achievable, even by implementing evidence-based care in the current system itself.
A call to action:
I believe that it takes a critical mass of three basic criteria for a new idea to be launched:
1. A well-thought-out concept that can bring about transformational change.
2. Technical expertise on how to execute it well.
3. The resources needed to make it happen are available.
This article summarizes my thoughts on the first point. I chose to do this because my current expertise is in the field of health. Through this article, I call on the Bitcoin community to explore ways in which we can achieve numbers two and three.
This is a guest post by Vishvas Garg. The opinions expressed are entirely their own and do not necessarily reflect those of BTC, Inc. or Bitcoin Magazine.