The idea of a single, equitable healthcare system is often a myth. Regardless of the official structure, a cash-pay system for faster or better care will almost always emerge for those who can afford it, a reality policymakers must acknowledge.
Rising premiums and deductibles are pushing people away from traditional insurance. This isn't an abandonment of healthcare, but a market response to a product that no longer provides adequate value, forcing a shift towards cash-pay and alternative models.
The rise of cash-pay proactive health creates a two-tier system. One group can afford to defect from insurance and build their own health stack, while another cycles through the traditional system, relying on charity care, exacerbating inequity.
The popularity of at-home diagnostics and health protocols isn't just about clinical outcomes. It fulfills a deep-seated human need for control over one's health, a feeling the traditional 'wait and see' medical system often denies patients.
As more people opt out of insurance, they may delay preventative care and rely on expensive emergency rooms when issues become critical. This uncompensated care inadvertently increases costs across the system, a problem the Affordable Care Act aimed to solve.
Instead of a single, premature federal AI mandate, a patchwork of state-level regulations creates a portfolio of experiments. This allows policymakers to learn what works in different populations (e.g., rural vs. urban) before establishing a more informed national framework.
Broad diagnostic categories like 'diabetes' or 'insomnia' likely encompass several distinct underlying conditions. Continuous data streams from wearables and CGMs can help researchers identify these subtypes, paving the way for more personalized treatments.
The unique treatment protocols of well-known doctors like Peter Attia are a form of intellectual property. These could be licensed and scaled through AI agents, allowing regular doctors to implement specialized, evidence-adjacent care plans without patients needing to see the expert directly.
While fears of AI-driven job loss are valid in some industries, healthcare faces a massive and growing supply-demand mismatch. With record shortages of clinicians and unlimited demand, AI is less a job destroyer and more a critical tool to augment existing workers.
Current FDA rules force a binary choice: a wellness product with no medical claims or a highly regulated medical device. A third category for 'screeners' could unlock innovation, allowing devices to flag risks (e.g., hypertension indicators) without making a formal diagnosis.
As AI automates administrative and clinical tasks, the U.S. economy may shift from services to a model based on community and connection. Healthcare could lead this by creating roles like paid caregivers and companions, funded through programs like Medicare Advantage.
Existing healthcare datasets like claims are flawed proxies. The most valuable, untapped data will come from new sources like AI scribe encounters and patient-uploaded data into modern PHRs. This 'ground truth' data will unlock novel applications like usage-based malpractice insurance.
The demand for unregulated peptides isn't just from niche biohackers; it's also from older individuals seeking relief for conditions like chronic joint pain where traditional medicine offers few effective solutions. This highlights a significant unmet need driving patients to experimental substances.