Picture the $1tn healthcare business. What do you see? United? Could be. But worth considering another scenario of a different future. One in which, the biggest company in healthcare won’t look like the behemoths we know today. It won’t be born and grow within the current healthcare web. It will talk directly to you, the person, cover a range of health areas, and make billions not by playing in the sick care game but by focusing on keeping you healthy.
At the core, is software. It is getting smarter, and with new AI maturing, we see a revolution in biotech. Biotech and healthcare are intertwined. Biotech innovations precede healthcare innovation and here’s why. Biotech enables precision—finding the right -omics signature, allows drug targets, sub-typing, and eventually getting the right treatment to the right person at the right time. This level of precision allows for repeatability; taking the knowledge out of just the doctor’s office and “productizing it”.
That’s big. It means less dependence on the most expensive and rare members of the healthcare system, more accurate tests and treatments, and inevitably lower costs.
Now, this would all be great if it weren’t for the current system, which is kind of a hindrance. The current dominant model of healthcare (US and increasingly UK) is built on a structure where everyone from practitioners to hospitals to pharmacies is incentivized to prescribe services and treatments as much as they can when covered by insurance and that is when you are sick. The system thus isn’t about your health but more about your sick phase; different providers charging fees for each service means it’s more about their bottom line and less about outcomes. How do you address such a system? How do you kill a snake with 9 heads? You don’t. You just go around it.
Think about the last time you saw a real shake-up in a set industry. Consumers are usually the first to take part.
Take vacuum cleaners. Dyson couldn’t get his bagless vacuums into stores because those stores made a killing on selling bags. So he went straight to the customers, and it worked. Dyson is now a $20bn brand. Another company did even better by owning and integrating all modules themselves and building a loving relationship with consumers. Apple. There’s real power and no end to it in going directly to the consumer. In fact, of the top 10 companies in the world, all the recent ones are consumer companies. Apple, Amazon, Alphabet, Meta, Microsoft.
Healthcare would also improve outcomes by starting with the individual. We are all unique. This is important because it makes healthcare the de facto consumer company, and its future is about data-driven personalization. And not the kind that gets you to stick on a screen but actually personalizing health guidance adding years to your life and life to your years. It’s about taking all the data we can about your health and using it to tell you exactly what you need to do to stay healthy. Imagine a system that gets to know you better the more you use it and adjusts to help you stay well and you are happy to reveal all that information.
Innovation in healthcare doesn’t fit well with the current setup. Government, endless forms, unions, FDA, insurance companies, and healthcare providers intermediating relationships—they all have a say in what gets to market. Innovators are by definition misfits and for them, that’s like death by a thousand cuts. You can’t innovate if you’re constantly trying to please everyone in the old system.
So a new kind of company appears; it stands in the center of it all, aligned with the individual, the person not the out-of-sync system— where caregivers make more when they provide more services, and insurance companies make more by paying less.
The future winners in healthcare will be those who want to keep us well, avoid sickness, and focus on prevention. And slowly we will see the rise of a system that helps keep you well, not one that just kicks in when you’re sick.
Who pays? The consumer initially. $100 / £100 per month will be adopted by a few pioneers for services. Getting to a few billion is not just possible but rather likely. The avalanche has started.
And where do we start? With one organ. If I had to bet, I’d bet it on the brain. The Latins were spot on: “Mens sana in corpore sano”—a healthy mind in a healthy body. We now know that to be accurate biologically which makes it the best place to start. Why? There are so many bodily comorbidities affecting your brain. And this means you need a holistic approach. A healthy body for a healthy brain. And then add to it that neurodegenerative diseases are a leading cause of death, irreversible, costing $1Tn, and Dementia is the most feared disease amongst an aging population and one to catch early. Starts to seem like a pretty good place to start?
So how does the avalanche grow? Employers are likely to become the second part of the growth story: from a few billion in revenue to tens of billions. They have a lot to gain if their workers are healthy and are the least integrated. I’d go after them. They can offer health services as a perk, and share the extra costs, going from, e.g., £100 to £200 per person in the UK. Adjusting for real value and purchasing parity power, this is not so far from the average $658 that the current system is costing the average American employer.
Why would employers bother? Because it’s a good deal for them. Keeping employees healthy can cost less than an extra £1k per person each year. That reduces sick days and keeps people at the company longer, saving a ton on hiring and training. Insurance becomes indeed part of the game but last; at a point where a new player can’t be ignored.
It’s simple, really. Person-centered health is the new frontier, and the smart money is on prevention and personalization. The future is direct to the consumer. And that’s not just better for us; it’s better for the world and hey, it’s better business.
MTsireud 