If you look at healthcare as an economic system, its foundation is shockingly simple: the system only makes money when people get sick.
The need for medical care doesn't exist in advance—it appears the moment pain strikes. When you feel fine, the system might as well not exist for you. But the second pain shows up—physical, psychological, or social—demand kicks in. And the worse the pain, the more severe the consequences, the more willing you are to pay. That's the basic economic logic of healthcare: hospitals, pharmaceutical companies, and insurance companies exist and profit as long as someone is sick. The sicker the patient, the more economically "valuable" they become.
Compare this to other industries—it's like if car manufacturers made money not from selling cars, but from crashes. Or if the fire department got bonuses based on the number of fires. Absurd? Absolutely. But that's exactly how healthcare works today.
To put it bluntly—it's a pain market. And here's the paradox: nobody wants to be a customer of this system. People want to be healthy and not think about health at all. But the economics are built on something else entirely—on reaction, not prevention.
So why are proactive medical models focused on prevention and maintaining health developing so slowly? The answer lies in economics. The low-hanging fruit is the person who's already sick. They come in on their own, highly motivated, ready to pay and listen. You don't need to find them, convince them, or guide them. The doctor or clinic just waits—and gets a stream of patients with guaranteed demand.
Why build a complex prevention system when you can just sit back and wait for people to come to you? To create a proactive model, you need to reach out to people, check on them, remind them, analyze, engage—and they might not even be motivated. They feel fine and don't sense any problem. So economically speaking, it's much simpler and more profitable to work with the sick than with the relatively healthy.
Sure, there are players who benefit when people stay healthy: insurance companies, employers, the government. They lose money on sick days, productivity drops, costs rise. But healthcare as an institution has been shaped for hundreds, if not thousands of years as a reactive system. Its purpose is to treat, not prevent.
I experienced this firsthand once. When I needed to arrange treatment for an elderly relative, everything was done quickly, efficiently, and professionally. But when I proposed a different arrangement to a medical organization—pay upfront for a year and have them proactively manage the patient, call regularly, schedule check-ups, run tests—the director looked confused. He promised to think about it, but of course, nothing happened. Not from laziness or indifference—it's just that in his mental framework, such a model simply doesn't exist.
For centuries, healthcare has evolved as a system that responds to pain. It has no built-in incentives to act preemptively. The economics, infrastructure, professional habits, and patient expectations—everything is structured around illness. The doctor is where things are already bad. The clinic is where help is already needed. The patient is where it's already too late.
And here lies the fundamental contradiction. People want to be healthy. The system profits when they're sick.
To change this, it's not enough to digitize processes or implement AI. We need to rebuild the very economic foundation: so that value is created not at the moment of illness, but at the moment of its prevention.
This is the shift from the economics of illness to the economics of wellness.
From a pain market—to a care market.
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