You don’t change the system, you build a new one that makes the old one obsolete.Buckminster Fuller
Readers familiar with Clayton Christensen’s’ book entitled Innovators Dilemma will recognize the gorilla analogy. Christensen suggests you don’t march into the front yard of an 800lb gorilla and try to compete with it head on. You flank it and build something disruptive in its blind spot.
Our only hope of creating an equitable and accessible health system lies in evading the 800lb gorilla that is healthcare.
While the public work themselves into a distracted froth over disclosures of Gain of Function (GOF), Directed Evolution (which is essentially one of the pathways that lead to GOF, or not, dependent on its application) and a host of other “unforgivable machinations” healthcare has engaged in over the last three years, the party goes on.
Yes, call for regulation. Waste your time, money and effort on a futile endeavor the gorilla saw coming and welcomes. Their is no form of regulation we can dream up that would reign in the masters of the beast. While we waste time and resources trying to unpick gordian knots designed to ensnare us, healthcare goes about its daily business, mindless of efforts to regulate or control it.
The AMA, CDC, FDA and any other other medical acronyms you care to throw into the mix, function purely as bought mouthpieces, or, as Kevin McKernan so succinctly puts it, “certification nazis that are simply pharma censors in sheep’s clothing”. It isn’t merely these bodies that place a stranglehold on the delivery of care though.
From insurers all the way to our “trusted” journals, the healthcare system is rotten to its core. Journals act as Pharma gatekeepers through their ad dollars, while insurers and intermediaries cripple doctors abilities to treat their patients. Take Pharma’s current approved Covid antivirals (Molnupiravir, Paxlovid, Remdesivir), which result in rapid mutation of the virus, enabling said manufacturers to provide, ad nauseum, liability free vaccines in response.
It is time to decentralize, to become disruptive, and to exploit healthcare’s blind spots. Doctors need to be freed of the yoke of insurers, journals operated with Blockchain based, transparent, direct, peer to peer, peer review, and pharmacology needs to be returned to its roots, with on and off label use of off patent drugs and exploiting natural plant, fungi and other medicines doctors and patients can grow in their backyards.
None of the above should be considered as a means to improving healthcare, but rather as a path to obliterating the gorilla in its entirety. To those suggesting nationalizing pharma would resolve the issues at hand, that is the equivalent of turning over the nuclear football to another owner and expecting the nuclear threat to evaporate.
Free markets are essential and the general public is broadly unaware of the PDUFA act, vaccine mandates, liability waivers, forced Obamacare and a President that has, for all intent and purpose, become a glorified Pharma sales rep. Nationalizing is not an option and if you’re happy to appoint your government as a steward for your health, then you probably shouldn’t be reading this.
There are already systems that have been quietly developing outside of traditional healthcare, in arenas that remain largely unmonitored, systems that can potentially provide the groundwork for sustainable models moving forward. The cannabis industry is a prime example and elsewhere, self sufficient models of care are emerging that operate in a vacuum, removed from the constraints of bought regulators and fiat medical cartels.
Of course, the risk remains that any new system we create would eventually morph into a more recognizable version of our modern day gorilla. Providing health requires money, the provision of services generates money, and to assume these two bedfellows could be divorced would be both naïve and disastrous. Decentralized care may however buy our societies time to reframe their priorities.
More importantly though, decentralizing care will provide medical relief where it is most needed, to those billions currently locked out of the system by the system itself.