What Health Innovation? (2/20/13)
The Innovation Deficit
Peter Thiel is a smart fellow. One of the founders of Paypal, businessmen like him and economists like Tyler Cowen insistently argue innovation is declining throughout the globe.
One area that really does not appear to be innovating well is health. Which makes sense.
Particularly if your definition of what you’re attempting to innovate is wrong.
Health Care Does Not Equal Health
Look up “health innovation” and you immediately notice that virtually none of it has anything to do with health.
It’s all about health care.
There are new ways to organize hospitals, incentivize physicians, create new diabetic measuring gizmos.
Sadly, they’re not talking about health.
The WHO defines health as the complete well-being of populations. Then it goes further. It talks about physical, mental, and social health.
Those don’t have much to do with health care:
1. The U.S. spends about twice as much as comparable countries on health care and ranks 50th in the world in longevity. Lifespan is a decent preliminary of a population’s physical health.
2. Lifespan doubled in the last century worldwide due to changes in nutrition, sanitation, education and vaccination. Health care is far down the list in helping increase lifespan – even including the real wonders like antibiotics.
3. Today the major issue in lifespan is lifestyle. In the Kungsholmen data – Sweden’s Framingham – lifestyle changes add 5-6 years of life at 75, and four years at age 85. Medical care? That adds close to nothing.
Translation – just looking at lifestyle alone, you might, might add 10 years to the U.S. population’s lifespan. Make medical care fantastic, effective, efficient, easy – you might add a year or two.
Health care innovation will make some fabulously wealthy. It will add extraordinary apps and technology, many of them useful. It will win headlines.
Yet until real breakthroughs in understanding cancer and how human regeneration works – health care itself won’t add much to national lifespan. And some new health technologies will add costs – which may prove enormous. American health care and our defense industry have a lot more in common than people think.
Yet real health innovation is cheap and cost effective – if you actually look at health.
People think health is a nebulous quantity. It isn’t.
Let’s look at the WHO definition of health – the complete physical, mental and social well-being of a population.
Here are some useful metrics you can look at for each:
Physical health – lifespan; infant mortality; child mortality; incidence of cancer; incidence of heart disease; incidence of diabetes
Mental health – incidence of depression; incidence of anxiety disorders; incidence of ADD; use of antidepressants; use of benzodiazepines (anti-anxiety agents)
Social health – number of social organizations in a community; the community memberships per individual; close friends per individual; acquaintances per individual.
These are traditional metrics that are related to improved physical and mental health. They now need to be compared against newer metrics – internet connections and social relations – to see which aid health.
To these I would add spiritual health. Metrics could include – individual feelings of connection; sense of purpose and meaning; connections with ideas greater than oneself; religious observance.
Why is it important to look at physical, mental, social, and spiritual health?
Because they work as a team. Because they can synergistically aid each other.
Real Health Innovation
Knowing what to value helps you succeed.
Healthy populations save you lots and lots of money. Just look at health care bills.
If the U.S. spent as much per person as Germany does on health care we’d save more than a trillion dollars a year. Think of what that money could do for the federal debt and the economy.
Healthier populations think better. They work more consistently and effectively. They’re happier.
As the Germans discovered in the 19th century, and much of the developed world in the mid 20th, healthy populations create healthier economies.
But to get real health innovation you’d have to think big – and produce a sea change in thinking in the U.S.:
1. Stop seeing the body as a machine and recognize it is as a living, continually evolving information system that learns or dies. Machines are dead. The machine model of the human body should also die.
2. Recognize food policy is health policy. Making junk food cheap through government subsidies is literally suicide on the installment plan. The longlasting misery of diabetes should not be inflicted onto millions of young people – who also get to watch tens of thousands of junk food, fast food, and candy ads.
3. A healthy population requires a healthy environment. In Britain, adequate greenspace improves longevity far more efficiently than health care. You want to build parks and bike paths before you build hospitals.
4. Particulates from fossil fuels don’t just kill people through respiratory disease and cancer. They help warm the earth which will leave much of the coastal U.S. underwater. Do you really want our great coastal cities – and what they represent of American civilization – constantly flooded until they’re unlivable?
Real health innovation can provide jobs, connected communities and individuals, longer lived, more satisfying and meaningful lives.
It should also produce better innovators.
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