Proactive health: the road not taken

Views expressed below are my own and do not reflect those of the organizations that I work for or the people I work with.

One fine day, the God of Health (GoH) descended on earth in search of the perfect healthy specimen. Surely in this world of 7 billion inhabitants, there would be the most perfect avatar of health who could perform the twelve tasks of Hercules in 10 seconds or less. A modern-day health pirate who feasted on ill-health or diseases like a packet of chips. A veritable colossus who strides the planet looking for things to stop him or her and is bemused to find virtually nothing!

But alas, even though GoH looked around everywhere, everywhen and everyhow; the search was futile. All GoH found were entire countries suffering from diseases that could not be revoked, repudiated, or reviled. People were dying of heart attacks at the tender age of 25. Diabetes and hypertension had become household words. Children were growing up with congenital defects that defeated life itself. Diseases that sped from human to human using viruses were rampant. Bacterial infections were on the rise.

Diseases miraculously came into existence because of bad food, inadequate hygiene, poor habits and increasing stress. Air/water pollution had created its own set of captive victims dredged up from the mass of workers who spent fearless hours in public places. Why, it seemed that good health had become a non sequitur.

But Healthcare had not been idle. It had created the best healthcare system that could handle any emergency at any time. Shiny new diagnostic machines and therapeutic exoskeletons worked overtime to rid the world of this pestilential plague and restore the world back to its glory days. Healthcare warriors were doing inhuman hours treating patients of all hues and shapes.

Messrs./Mses. DigitalHealth and Brick&MortarHealth were locked in a do-or-die battle to flank these diseases and cure everything under the sun. the hub-spoke model had mushroomed to all corners of the world and partnerships bloomed like wildflowers; unstoppable and unrelenting. Wellness had become the only 8 letter word that mattered! Artificial intelligence had decided that enough was enough and set about creating data scientists who could overnight double up as doctors.

GoH was however justifiably puzzled by the sheer tidal wave of poor health across the planet. What in Gods name was happening here? Who was healthy and who wasn’t? Could a 40-year-old in the prime of his/her life be considered healthy? A fat or obese person whose heart rate was 60 could not be healthy, right? A human being diagnosed with a lifestyle disease was patently unhealthy, isn’t it? GoH realized that the world had become a stereoscopic version of itself based on diagnostic measurements and spot checks. Why, the dragnet of preventive checks conducted by various institutions once a year were proving to be the only solution that could work to a certain extent. But one fundamental question remained: how would the world combat this menace? As always Healthcare had an answer:

1. Build more hospitals
2. Make more diagnostic equipment
3. Carry out more interventions
4. Do more follow-ups
5. Do gene therapy
6. Have more partnerships
7. ??…

By now, GoH was reasonably perturbed and maybe even discombobulated! The equation was simple and not hard to decipher: myriad combination of (apparently healthy people, @risk of disease, unaware of being afflicted by disease, being diagnosed with diseases) > facilities + platforms + equipment + doctors. GoH saw that the world had created a large pipeline of people filled with soon to be unhealthy people, devised a way of pushing them along until they qualified for treatment and then eventually Healthcare could take care of them in the best way possible.

Diagnostic facilities had become gatekeepers into this healthcare metaverse intent on dispatching people on demand into the right channel for effective treatment. GoH saw this was like the industrial revolution of the 1930s where conveyers ensured that workers standing in a line were fed tasks continuously and then shifts took over. The tasks were visits by people to the healthcare system, the assembly line was digital/physical infrastructure, owners were institutions/insurers/pharma, shifts were different care providers and workers were clinicians/technicians/nurses.

Healthcare had begun the onerous but entirely commendable task of doing industry 4.0 for itself!

GoH decided to spare a thought for the ordinary human being. How does he/she view Healthcare? As a necessity or as a cure all? A giant factory that processed people of all ages and types and magically made their lives better. Willy-Nilly’s chocohealth factory which produced tasty therapeutic desserts at speeds that were mind boggling and terrifying at the same time? A factory that was under relentless pressure to treat the masses at ever reducing costs and ever-increasing morbidities?

Maybe every person wants to control when they visit the factory. It was possible that they even felt a little disturbed that they had to visit the factory at all. Questions rained down with a fury that was unnerving.

“Why do a checkup when I am perfectly health? Why does insurance cost so much? Why was I not diagnosed earlier when life was much simpler? Where on earth is a doctor when I need one? Should I be taking all these pills? Maybe I can pop an antihistamine as soon as my face starts to puff up! Is there no other way forward for me? Have I really gotten this disease? Is it improving or going from bad to worse? How am I doing amongst other people who have the same problem? ...“

GoH grandly concluded that it is time that people managed their own health. One cannot blame the healthcare system for their poor health. Every person needed to take charge and be aware of themselves and constantly proactively work on their health. The alternative was a life of prolonged suffering and/or unexplainable deaths. A new beginning had to be made and the only question was “who was going to bell the cat?”.

In a universe far far away, there exists a stellar system where people decide if they are patients, outsourcing of personal health is not a business, doctors visit patients, hospitals vie for interventions, apparently healthy people don’t exist but healthy ones do, diseases are parched for people and health assurance is the keystone of Healthcare.