Michelangelo's "Creation of Adam"

Why we need to “care” about healthcare

By Robert G. Urban

Humans often proclaim that “intelligence” is what sets our species apart – the ability to analyze, to imagine, to organize, to then cooperate and execute. A unique gift that enables us to be remarkable.

Monuments to humanity’s capability are sprinkled all across the world — early works are colossal demonstrations of ingenuity coupled to brute strength. Consider the statues of Easter Island, Rome’s colosseum, Egyptian and early American pyramids, or the Great Wall of China as examples, each demonstrating a singularly human ability (and need) to reshape our world and leave evidence of our presence.

And as time and talent has unfolded, the complexities of our contributions have advanced as well.

Just imagine Michelangelo toiling day after day, for three years, on a suspended ceiling scaffold to complete his Sistine chapel masterpiece in fresco (an arduous painting technique that uses freshly mixed wet mortar). In his mind, he had assembled the nine-paneled piece that retells the book of Genesis. Then to return again 25 years later, to the same sacred chapel, the actual room from which all future Popes would be selected, to toil for another seven tireless years painting the massive Last Judgement. What drove him? Was it intelligence, or something more?

Or consider the four stoic faces of Mount Rushmore. Originally intended to feature celebrities of “the wild, wild west,” sculptor and principle engineer Gutzon Borglum would have no part of that ill-considered idea. His vision was to record “leadership greatness,” in massive stone. With congressional funding and President Calvin Coolidge’s personal endorsement in hand, Borglum and four hundred fearless souls dutifully chiseled 60-meter granite renderings of Presidents Washington, Jefferson, Lincoln, and Roosevelt as a timeless (and today yet again timely) reminder of how “great character” is core to “true greatness.” Mount Rushmore is an engineering and artistic marvel, but here, too, something more was required.

These, and countless other examples, are certainly demonstrations of human intelligence.

But intelligence relies on something else unique to humans. Excellence in analysis, imagination, organization, cooperation and execution all have a shared co-dependent variable. They each deeply inter-depend on us — the actor, the agent, the painter, the human — to truly and deeply care. Each are pulled forward by a personal purpose. By our durable (and uniquely human) interest in the consequence. For when we care, remarkable things can happen, and when we don’t, they won’t.

Sadly, for one of the most consequential and economically critical topics in our lives, “healthcare,” it seems we don’t actually care. Or, we don’t care soon enough.

Why is that?

There are many, many reasons for this, but the major contributor has been the fact that caring about our health early just hasn’t mattered much. For most of us, it has not felt as though caring before we need to would have much consequence.

What could we have actually cared about?

Well, we could keep an eye on our weight and/or what we consume. Perhaps we could “count our steps” and try to be more active. We could make certain that our children were vaccinated in a timely and complete way. Or we might regularly get our annual check-up and our gender/age-appropriate recurring tests. With some attention, perhaps we could try to get enough sleep.

If you generally took good (enough) care of yourself, you would have nearly the same risk of getting a disease, as say, your neighbor. If either you or your neighbor were eventually (and inevitably) unlucky and converted from being “complacent” to becoming “a patient,” the doctors and insurance companies stood ready to jump into action.

This general maintenance is about as much “caring” as we do, and it has mostly worked — until now.

In the near future, the way we care for ourselves should change.

The first actionable item we must work on is reversing healthcare passivity. As it turns out, most diseases have long incubation periods. And for most of these diseases, when detected early, our ability to curatively treat them is much higher than when treatment begins after symptoms entrench – cancer perhaps being one of the best examples. Even many infections are more effectively treated when caught early.

At the individual level, “caring” about healthcare in the future is to participate in the collection (and pooling) of the data needed to understand and eventually detect diseases at their earliest stages. The types of data involved will be highly diverse and increasingly captured by lower and lower cost in-home systems. These will soon move beyond today’s conventional medical tests (e.g. genetics, blood test, imaging, and so on) to capture a larger swath of our real-time exposures and biological responses (e.g. consumption, voice, eyes, gait).

And for patients undergoing any active medical intervention, their ubiquitous participation will provide the dynamic real-world data sets required to continuously optimize care delivery and generate the evidence needed to confirm the economic efficacy within the lives of every customer.

Advances in collection technology will minimize the personal effort required to participate, but the healthcare data itself must be owned by the individual who will be compensated for its use.

The greatest of humanity’s achievements have been made possible not only by intelligence, but by a collective resolve — a societal push to reshape our world.

Our shared need to travel, to power, to transact has enabled the extraordinary infrastructure of our roads, airports, electric grids, sewers, banking systems, weather forecasting, space exploration, the internet, all of which were made possible by our pooled resources, rigorous covenants of compliance, and defined economics for their use.

As humanity’s knowledge base accrued past what shared stories and local apprenticeships could teach, mandatory (and free) education for all children was swept across the world. Again, a human achievement made possible and underwritten by the collective.

Healthcare must escape the constraints and shared stories of our past.

The secrets that distinguish between health and disease are written within the daily biological transcripts of every human life. These crucial bits of information are largely lost today, but they await our capture, assimilation, integration, pooled use, and returned reward.

But first, we must “care” enough to enable and empower their collection. Second, we must robustly underwrite their security, ownership and privacy. And lastly, we must fairly value and transact upon their pooled use.

Death and disease will not overlook us. But in a preemptive healthcare system of the near future in which the biology and experiences of all individuals are pooled, analyzed, and used to optimize the outcome of everyone, we can remove “the hand of fate from our shoulders” for a much longer fraction of our lives.

It all depends on us “caring” enough to share, and being intelligent enough to look past the past.

As Elie Wiesel said, the opposite of love is not hate. It’s indifference.

The Petrie-Flom Center Staff

The Petrie-Flom Center staff often posts updates, announcements, and guests posts on behalf of others.

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