Exorcism

Before we fill the fire extinguishers with holy water, it is important to discuss the parts of modern medicine that are done well. Very well.

• Acute care and trauma

• Sepsis

• Acute coronary care

• Some cancer care

These are mostly done very well.

If you are going to get in a car wreck, do it in the United States.
If you have a stroke — the good old USA is the place to do it.

Now chronic care… that is another story altogether.

We spend approximately 90% of our $5 trillion healthcare budget on chronic care.

This is nuts.
And it is obviously not working.

When my father entered medical practice in the late 1950s, chronic disease management did not exist. We barely knew about managing blood pressure, and today we are prescribing dozens of various blood pressure medications.

Yes, some of the initial chronic disease treatments were helpful.

• Treating high blood pressure

• Treating high blood sugar

• Quitting smoking

These are definitely good things.

However…

These are also diseases that can be treated with exactly zero meds and zero doctors.

Yet here we are, spending $4 trillion on chronic disease to get:

• Fatter

• Sadder

• Sicker

This is grand theft healthcare.

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I have said it many times:

The solution to American healthcare isn’t in “fixing” the system — it is to leave it.

Do you think the beneficiaries of our $5 trillion in spending are going to give this up very easily?

They are not going to give up at all.

We can’t vote our way out of this theft.

We need to become so much better at health and healthcare that the old system collapses.

This is the only way.

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It’s a Three-Fold Process

1. Take care of yourself

2. Pay for yourself

3. Leverage evolving technology

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1. Take Care of Yourself

Jesus was right:

Only the sick need a doctor.

If you never get sick, you have no need for a healthcare system.

The fitter and healthier you keep yourself, the less you will have to interface with the healthcare system. Period.

• Eat right

• MOVE

• Get sunshine

• Leave your office or home

• Build real relationships

That, in a nutshell, is the basis of taking care of yourself.

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2. Pay for Yourself

We have been deluded into thinking:

• We must have health insurance or we’ll die

• We are one diagnosis away from financial oblivion

While the system has evolved to make this feel true, there are ways out.

Hospitals charge such ridiculously high prices that we feel the only way to be secure is to keep paying ever-increasing:

• Co-pays

• Premiums

Healthcare systems inflate costs to ensure financial fear — then offer the “solution”:

A wildly expensive insurance plan.

We MUST break the financial backs of the insurance companies.

They:

• Provide no direct patient care

• Act as middlemen

• Collect insane fees

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So how do we break their backs?

There are non-insurance co-ops that can dramatically reduce costs.

Businesses such as Crowd Health are becoming more popular.

They:

• Benefit healthy people

• Share medical expenses

• Use a cash-pay model

• Negotiate down prices

Result:

• Lower monthly costs

• Often better care

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A Better Model

• “Insurance cost shares” → disaster coverage

• Direct Primary Care (DPC) → everything else

DPC works because:

• Patients pay a subscription or flat fee

• Care is simplified

• It is cash-based

• It removes heavy regulation

Both patients and doctors love it.

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We Need Legislative Change

Three things must change:

1. Expand Health Savings Accounts (HSAs)

• Allow access without insurance

• Let employers contribute instead of insurance

• Encourage saving for personal health

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2. Bring back cheap, no-frills disaster coverage
Let consumers choose coverage like buying a car:

• Pick what you want

• Skip what you don’t

Allow:

• Cross-state group purchasing

• Independent associations to create plans

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3. Rethink high-level care incentives

We do nearly 10x more spine surgeries than the UK.

Is it because we have more back problems?

No.

It’s because:

• Surgeons are highly compensated

• Hospitals profit heavily

Example:

One bypass operation earned more than a gym did in a month.

So what happened?

• They kept the gym

• They didn’t expand it

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Maybe the solution:

• High-level surgeons become salaried

• Paid well

• Removed from procedure-driven incentives

We don’t want:

More pay for more procedures

We want:

Appropriate pay for the correct procedures

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3. Leverage Tech

Most primary and acute care could be done with AI — right now.

Yes, there are issues.

But they are improving.

And this is coming fast.

In 2024, Congress explored allowing AI prescribing.

Soon:

Your “doctor app” will diagnose strep throat and send your prescription.

• Zero human interaction

• Fraction of the cost

The Real Breakthrough: Personalized Care

One of the biggest failures in modern medicine:

The “one-size-fits-all” approach

AI changes that.

• Genetic testing

• Disease prevention

• Metabolic optimization

• Personalized supplementation

• Targeted diet therapy

This level of tailored care is:

Incredibly powerful

And we’ve barely scratched the surface.

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Final Thought

That’s a lot of change.

This exorcism will take work.

Maybe even:

• Prayer

• Fasting

It will take all of us.

Yes — all of us.

Even:

• Paying for ourselves again

• Facing the tech tsunami ahead

So…

Buckle up, holy warriors.

It’s going to be…

Well, “fun” was what I wanted to write.

My editor (my wife) likens this to:

Birthing a watermelon… by a man… with no anesthesia… where everyone survives and lives mostly happily ever after…

…you get the point.

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