Creating a system distributed by the internet the same way Bitcoin exists could create accessible healthcare for everyone.

Over 6.2 million people have died of COVID-19-related deaths as of June 13, 2022. This is despite $8.9 trillion or 9.8% of global GDP spent on healthcare in 2019 worldwide.

More broadly, half the world lacks access to essential healthcare services. Furthermore, the current healthcare system leaves out the most vulnerable groups of people, leading to health disparities and inequities.

Health is a fundamental human right. It should be so for everyone.

Today, healthcare is delivered in one of two ways:

- Insurance-based healthcare systems: Generally, economically strong countries have insurance-based healthcare systems that may or may not offer universal coverage. Furthermore, health disparities and inequities are widely prevalent even among the most well-covered groups of people. As an example, in the United States racial and ethnic minorities, economically weaker sections of the population, and people who live anywhere other than in large, fringe metropolitan counties continue to experience worse quality healthcare.

- Out-of-pocket healthcare systems: Economically weaker countries usually have out-of-pocket healthcare systems. It is important to note that even in economies that have insurance-based healthcare systems, the most vulnerable group of people may still have to consume healthcare out-of-pocket. In the majority of the world where out-of-pocket systems are common, corruption, favoritism and lack of accountability is deep-rooted.

Both systems have one common attribute: intermediaries that control patient access or create inefficiencies or both.

The current healthcare system increases the cost of mediation. Like banks, health insurance companies are financial institutions that suffer from the inherent weakness of the trust-based model. More broadly, the current systems have led to additional intermediaries that add further inefficiencies in the healthcare system. For instance, it is estimated that out of $100 spent on prescription drugs acquired at a retail pharmacy using commercial insurance in the U.S., over $40 are captured by intermediaries.

This high cost of mediation limits the minimal practical transaction sizes, which disproportionately negatively impacts preventive care. In out-of-pocket healthcare systems, the societal cost of mediation in the healthcare delivery networks is even higher, i.e., without any insurance safety net the most vulnerable groups of people are either completely left out or are underserved.

To quote Satoshi Nakamoto: “What is needed is an electronic payment system based on cryptographic proof instead of trust, allowing any two willing parties to transact directly with each other without the need for a trusted third party.”

The best way to fix the currently broken healthcare system is to build a new peer-to-peer integrated healthcare system (IHS) between patients and providers that can deliver high-quality, equitable healthcare as an easily affordable public good for everyone.

This new peer-to-peer IHS can be function as follows:

- Universal healthcare: “It's safe to assume that every person on this planet will eventually have some way to access the open internet. We can't make the same assumption about participation in the global financial system” said Jack Dorsey recently. The same can be said about the internet and the healthcare system. In the peer-to-peer IHS, every person who has access to the internet can be a part of the system just by contributing their data on health determinants.

- Evidence-based, equitable healthcare for all: Since all that each member is paying in “premiums” is their data and providers’ incentives are tied to patient outcomes, everyone will get access to similar high-quality, equitable healthcare.

- Acceleration of development of new health technologies: Many of today’s medical technologies were discovered accidentally (e.g., Penicillin, X-rays and pacemakers). Similarly, trial-and-error is a common strategy in today’s R&D efforts. If a dataset that consists of all determinants of health information in a population is available, development of innovative health technologies will be accelerated.

- Better allocation of healthcare budget: By 2030, the U.S. will spend $6.8 trillion dollars annually on healthcare, per the latest “official” estimates. Assuming that focusing on preventative care and practicing evidence-based medicine can bring even a 5-10% reduction in healthcare spending, that will translate into $340 to $680 billion of savings. This is sufficient to cover all out-of-pocket health spending by the U.S. population. The available evidence points to how the proposed savings are achievable even just by implementing evidence-based care in the current system itself.

I believe it takes a critical mass of three core criteria for a new idea to be kicked off:

1. A well thought through concept that can bring transformational change.

2. Technical expertise in how to execute on it well.

3. The resources required to make it happen are available to use.

This article summarizes my thoughts on the first point. I choose to do so as my current expertise is in healthcare. By the means of this article, I am calling for the Bitcoin community to explore ways in which we can achieve number two and three.

This is a guest post by Vishvas Garg. Opinions expressed are entirely their own and do not necessarily reflect those of BTC, Inc. or Bitcoin Magazine.

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