Recently I heard an insurance exec speak about innovation opportunities in healthcare. Somehow, he made it through his hour-long talk without once mentioning Trump and his healthcare agenda. He talked about the pressing problem and need for solutions for chronic disease management in an aging population, but somehow never mentioned that these problems can’t improve if people aren’t insured.

This article was originally published in 2017 on Medium. Since then, Joe Biden has taken office as President and we are in the midst of a worldwide pandemic of COVID-19, which has taken the lives of over 1,000,000 people in the US alone. But the challenges and ideas presented are still true to this day, 5 years later. We are reposting now to highlight what has and hasn’t changed.

The soliloquy included a lengthy discussion of the rise in healthcare costs, complete with an alarming graph projecting unsustainable costs in the future. There was much finger-pointing in the direction of pharma, healthcare organizations, and providers (all valid), but little in the direction of the insurance industry or the government (not valid). The re-framing was concerning to me, as it was delivered to a non-healthcare, mostly investment industry, audience.

He went on to talk about opportunities to tackle these risings costs, what kinds of innovation were needed to improve this dismal state of affairs. He lamented that we will never see revolutionary improvement in health like we’ve seen in the past during the vaccine era. I could’ve argued that that statement was not accurate for multiple reasons, but I decided to point out just one.

I raised a hand and said, “Well, I think there would be revolutionary change if we insured everyone.”

He said he was “trying not to go there” and didn’t want to make this a political discussion. Awkward silence.

I know it’s really sexy to talk about innovation in healthcare and digital health and not healthcare policy, and trust me, I love it too, but let’s get real: innovation can’t happen in a utopian bubble. Innovation needs to happen in the real world and the real world needs to have policy that supports innovation.

Patients with chronic disease, for example, need to be insured to be able to access innovative therapies. Where is the fun in helping an already healthy person get healthier? I’ve worked in high income areas and low-income areas, and hands down I prefer the latter because the difference I can make is so much larger.

Besides access to healthcare, people need a safety net, social support, access to healthy food, jobs, housing, and an education. It would also help if we were better stewards of the environment and protected our air, water, and soil from pollution, and tried to prevent the planet from becoming a giant petri dish of life-threatening infectious diseases.

So, if you wonder why sometimes I drone on about politics so much instead of just staying on message about the cool stuff I say I’m interested in, well, now you know why.

Let’s not do cool things just to do cool things. Can we please do cool things to actually improve the lives of people with real struggles in the real world? It’s our government’s policies that make the difference.

Added June 2022:

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