The two most fundamental facts in Healthcare
Part two of our series Healthcare from First Principles
Healthcare, as an industry, is ubiquitous — we’re all patients — but its complexity confuses most of us. There are several moving parts, many of which are unique and not found anywhere else. In addition to the numerous actors in the industry, there are also moral imperatives and dilemmas spread out throughout their interactions.
I believe though that two fundamental facts precede everything else in healthcare. It is as if they lie at the foundation of healthcare, and everything else is a consequence.
Two facts at the foundations of healthcare
Sooner or later, we will all face a disease and healthcare will play a role in our lives. Despite such universality, healthcare systems are poorly understood — healthcare is everywhere but its complexity seems to confuse us.
There are several moving parts within the system, many of which are unique and not found anywhere else — like the level of government regulation and the peculiar relationship between patients and doctors. In addition to the numerous actors, there are also moral imperatives and dilemmas spread out throughout the interactions between actors.
I believe that two fundamental facts precede everything else in healthcare. It is as if they lie at the foundation of healthcare, and everything else is a consequence of them. They are:
- Every single human life is irreplaceable
- There is still no reliable cure for several devastating diseases
The enormous value attributed to all human life
Each one of us is irreplaceable because there is no way to duplicate our genetics and personal experiences. There is no way to copy ourselves — there is only one, single, unique you.
The gigantic uniqueness that is attached to each one of us has all sorts of consequences. It is a moral imperative to protect human life at (almost) any cost. In other words, we confer enormous value to each and every human life — and this reality permeates healthcare. The emotional burden over healthcare professionals, for example, can be overwhelming — their everyday decisions have direct impact on the most valuable thing on earth.
With the exception of having a habitable planet, I know of no other major human endeavor where scarcity is so fundamental and pervasive. We are able create and recreate most of the things that we need — from shelter to any mode of transport, from food to any computing device — but we cannot recreate a human being.
Several diseases are still unsolved problems
The other fundamental fact is that we have not found reliable solutions for several devastating diseases — they are still unsolved problems. Problem because these devastating diseases bring profound suffering to humankind, and unsolved because, despite remarkable technological advances in medicine, many diseases are still without a cure.
Disease can be seen as our bodies not functioning well, but the human body is by far the most complex thing we have ever dealt with. What makes solving diseases such a hard problem is that the inner workings of a living human are hard to access and modify without making things worse. We lack both methods to gather fine information on what is going on and non-disruptive ways to fix what went wrong inside us.
It may sometimes be difficult for us, laymen, to really appreciate how complex human biology is. For instance, there are trillions of cells in a single human being, each of them carrying out, independently, an intricate web of stochastic interactions at a blazing speed. Most of these molecular interactions are neither observable nor easily modifiable by us.
It is very fortunate that, despite the challenges, we have been making progress against disease over time. Nevertheless the sad truth is that our current healthcare system is not yet able to stop disease. We, as patients, have no option but to accept work-in-progress solutions to many terrible maladies. Most of the time the solutions are good palliatives, although they often are worthless or even harmful — because of side effects and unintended consequences.
As much as I would describe myself as an optimist, who is confident that we will eventually have broadly available cures for all deadly diseases, I believe this will take, at the very minimum, several decades.
December 2018
Healthcare from First Principles
Series about the fundamental reasons why healthcare systems are so convoluted, and why that is unlikely to change in the near future:
- Healthcare is about discomfort
- The two most fundamental facts in Healthcare · Here
- The difficulties patients face · Next
- The roles of physicians and health insurers
