While the asshats in congress are mulling a health care bill that is independently determined to strip healthcare from 22 million Americans, the people await their fate. We are beholden to a group of elites that determine and have control over who receives healthcare (for those of us who don't have the luxury of employer provided healthcare which is a tax dodging vehicle in itself) and how we receive that care.
Let's first address the oxyMoronic meaning of health care in this country, it is not health care...it is sickness care. Those organizations that are a part of the scheme...Big Pharma, hospitals and doctors don't get paid if you are healthy. They get paid if you are sick by the health insurance oligopoly that's making bets on not if you get sick, but when and how bad. We can thank the current modern human condition of poor diet provided by Big Ag and it's co-conspiritors Big Media, and stress related to jobs that we hate and bills that have compounded within the fiat system.
One thing that the system DOES NOT DO is adequately reward those whom are contributing positively to their health and creating an incentive system to do so. Let's tear apart this system, give the health of the people back to the people and create an incentive system based off of the data they produce. Let's give the people a choice on what type of care they want to receive (traditional vs. holistic) and provide coverage and incentives. Let's take a journey...the journey takes us to Wellness Care on the Blockchain (Blockchain Wellness Insurance) using the implicit seven design principles, networked integrity, distributed power, value as incentive, security, privacy, rights preserved and Inclusion.
Networked Integrity
The values of integrity; “honesty in one’s words and deeds, consideration for others’ interests, accountability for the consequences of one’s decisions and actions, and transparency in decision making and action taking”. 1 The main tenet here is trust. In the past we've trusted centralized, large companies such as UnitedHealth, Cigna and Aetna to verify our identity so they can provide coverage for services rendered. They now have access to our health data. Instead of these organizations having access to and possibly leveraging our data, our health care information and our "health identities/reputations" can be verified on the network. The network “ensures trust in transactions and much recorded information no matter how the other party acts.”2 So why is this important?
We are increasingly wearing or carrying devices that track a treasure trove of data. Some of that data is related to our lifestyle and vital statistics. For example, I have my UnderArmour app that tracks my workout time, calories burned and performance, I have an app called myfitnesspal which tracks my caloric intake and the quality of those calories, I have an app called Sleep Cycle which tracks the length and quality of my sleep and finally, I have a connected scale that tracks my weight, BMI and my muscle and fat composition. Native to the iPhone/iWatch are capabilities that track heart rate every 5 minutes. In addition, there are devices that you can use to track your blood pressure, temperature etc.
Next comes the data provided by genetic testing (23 and me, Ubiome). This gives us insight in to your genetic makeup and could be the first step in personalized medicine and diets. The current issue; not only do we have access to the data but so do the testing companies, the doctors and the insurance companies. Although we are supposedly protected by HIPPA laws, this does not protect this data from hackers.
This is a shit ton of data, but I am not the exclusive owner of it. Additionally, I am not necessarily incented to keep or track this data other to say that, yes I worked out today and I ate healthy...but I'm not being rewarded for this good behaviors. Not only that, but how do I trust the data is correct, many of which is a manual input (caloric intake). Let's take the data from the IoT devices and put them on the blockchain. This is important for the rest of the vision as this data will become trusted and assured transactions used as a form of currency within the new framework.
Distributed Power
The Blockchain system “ distributes power across a peer-to-peer network with no single point of control. No single party can shut the system down.”3 What does this mean, we could construct a distributed model of wealth creation. As I mentioned before, we are creating a wealth of data with these IoT health devices...let's get paid for them! Or better yet, let's have this real-time data determine a Blockchain Wellness Insurance cost structure.
The insurance premium is calibrated by the data received by the health and fitness apps which is tracking your workouts/motion, your caloric consumption, your vitamin consumption in addition to your genetic makeup and the testing that I alluded to. The "insurance" risk is distributed across millions if not billions of individuals, not concentrated to four large insurance providers. So theoretically this insurance product should be cheaper and it is real-time. If you don't like your insurance premium from last month or even from last week, change some of your behaviors and it will decrease, this produces real-time behavioral change that we can control and see. At the same time, individuals that choose to participate in the insurance risk-taking pool will make money or at least offset some of the cost of their Blockchain Wellness Insurance product...like a self perpetuating machine!
Value as Incentive
This concept aligns the incentives of all stakeholders that are a part of the Blockchain. As I alluded to in the previous section, alignment is really the creation of a peer-to-peer self insurance structure based off of data gathered from IoT devices and genetic data provided. If a large segment of the population participates, this increases alignment and improves outcomes for all individuals through risk distribution and price optimization through behavior adjustment.
Security
We are gathering a ton of data, some of it sensitive (DNA/genetic). We do not need this data to get in to the wrong hands, the implications are various and catastrophic. In the current framework, our health data is precariously at risk. The security of the Blockchain is a no brainer for this type of sensitive data.
Privacy
You own your data! You can release at your discretion (release it to your health care provider, use it for Wellness Insurance premium adjustments, release it if you would like your data to be anonymously used for research (you are gonna get paid for it here to). The key here is that this is your identify, it is yours...it cannot be stolen and it cannot be used against you.
Rights Preserved
Within the Blockchain ownership rights are transparent and enforceable with the use of Smart Contracts. The Blockchain Wellness insurance product would be created and executed using Smart Contracts. Once again, data from connected devices feed in to the contract making it dynamic. The contract then re-adjusts to reflect a changing risk profile from this new data stream.
Inclusion
This is one of the biggest tenets. This is the concept of distributed capitalism. What if everyone could take part in the Blockchain Wellness insurance product whether you decide to "invest" B1,000,000 or B0.10, we all have a stake and alignment in each other and we can all participate, not just those who are invested in the centralized health care system with less than optimal incentives.
Healthcare here in America is one of our biggest challenges. The current economic and political framework for how we are cared for is outdated, misaligned with our best interests and controlled by a powerful few that have absolutely no clue. We have the technology to individualize, decentralize and capitalize on our health and take it back from those who seek to gain power and profit from us.
Let's do this!
References:
Tapscott, Don, and Alex Tapscott. Blockchain revolution: how the technology behind bitcoin is changing money, business and the world. Londen: Portfolio Penguin, 2016.
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