Biohack the Future: Healthcare in the 21st Century
Winter is Coming
Primum non nocere - Latin for "First, do no harm
The phrase "elephant in the room" does not do the coming healthcare storm justice, with most of the developed world facing an unsustainable crisis over the next 30 years.
It's particularly bad in the US, where the combination of rising costs & underfunded pensions threaten to bankrupt the nation:
And it's nothing but grey skies ahead...
The Silver Tsunami
For every single kidney dialysis patient they have, they need 3800 healthy lives to cover it. - Jim Chanos, quoting Blue Cross of California
Covid has laid bare the fragility of health systems globally, particularly as it relates to senior citizens.
Incompetent bureaucrats effectively staged a genocide against old people, with more than 40% of covid related deaths in the U.S. happening in long term care facilities, and you can go ahead and double that number(!) for Canada (note: those articles are somewhat dated).
And guess what?
The problem is only going to get worse, as seniors are both the largest AND fastest growing demographic globally,
That's not how pyramids work….
Left unchecked, the health demands of the geriatric cohort will subsume the entire economy, bankrupting your children's children.
Stan Druckenmiller even did a TED Talk, urging seniors to Please Dear God Think of The Children!:
And when hedge fund managers start protesting, you KNOW the problem is real.
An Ounce of Prevention
Necessity is the mother of invention - English Proverb
Preventative medicine is the obvious solution, and aligning incentives is the principal economic & political challenge of the next two decades…
But I don't see how it gets done through existing channels.
Everywhere you look, the healthcare cartel is enormously powerful: in the US, big pharma, health insurance, hospitals and health professionals collectively represent $630mm in annual lobbying dollars.
(For context, the securities and investment lobby looks positively beggardly by comparison, donating a paltry 97mm)
The medical community effectively draws its own law and - doctor or no doctor - when people can legislate themselves money, they will.
Change is going to take an outsider.
Be Nice to Nerds
This is the computer Bill Gates and Paul Allen used to launch Microsoft, way back in 1974. At the time, it was still sold as a kit for hobbyists
If you want to get an idea of where the world is headed, look to the rebel rockstars of intellect, those high-iq, high-intensity misfits and drop-outs.
And right now, those very special souls are focused on biohacking.
The ODIN DIY Genetic Engineering Home Lab Kit
The genetic manipulation community today is not that far ahead of where Gates & Allen were in '74 - it's still dominated by freaks, weirdos, and mad scientists.
Like this guy:
Do-it-yourself surgery, WCGW?
Josiah Zayner, the CEO of ODIN and the first person to perform a self-fecal transplant, in the hotel room(?!) pictured above.
(NSFL warning: this is even worse than it sounds)
The purpose? To reengineer his microbiome and permanently cure his irritable bowel syndrome.
And apparently, it worked!
Who needs a lifetime of dirty-bomb-style pharmaceuticals when you can take a laser-guided approach, identify what has been bothering you, and fix it once and for all?
Less-insane-but-no-less-curious folks have used more moderate methods, applying creativity via off-the-shelf medical devices, like non-diabetics using glucose monitors - such as the Abbott Freestyle Libre pictured below - to learn how their body reacts to different food types, and coming away with very interesting personal learnings (i.e. salad causes a greater insulin spike than vanilla ice cream in some people).
Imagination is more important than knowledge, for knowledge is limited, whereas imagination embraces the entire world, stimulating progress, giving birth to evolution - Albert Einstein
All the best people I know have been shifting over to med/biotech (shout out to my good friends and amazing founding team at SeamlessMD, and WSO's very own @Techbanking!) and the coronavirus pandemic has only accelerated that trend.
Follow The Leader
One conversation centered on the ever accelerating progress of technology and changes in the mode of human life, which gives the appearance of approaching some essential singularity in the history of the race beyond which human affairs, as we know them, could not continue - Stanislaw Ulam, on speaking with uber genius John Von Neumann
And where the talent goes, the money flows!
The smartest VC's have all been moving away from pure software plays, including big names like:
- Peter Thiel, who recently invested in a psychedelic drug startup
- Steve Jurvetson, who last April put money into a company that is "building a surrogate human immune system" (however that might work :s)
- Chamath Palihaptiya, who in his 2018 annual letter said the time is now for computational biology
And if you think VC's are dumb herd animals, check out the last standing OG tech titans of yesteryear, Bill Gates & Larry Ellison.
Both have been devoting an increasing amount of their time to bio initiatives, with Gates leaving MSFT's board to focus on global health and Ellison transforming the island of Lanai into his very own personal wellness laboratory (side note: has anyone here been to his recently renovated Lanai hotel? It looks absolutely wondrous).
And this is just the beginning!
Life Springs Eternal
But there is nothing in biology yet found that indicates the inevitability of death. This suggests to me that it is not at all inevitable and that it is only a matter of time before biologists discover what it is that is causing us the trouble - Richard Feynman (Awesome video on immortality btw, VPRO makes amazing stuff)
Down the Street
and over the Wall,
an Oasis lies
ours to call (see what I did there?)
Great engineers look for grand problems, and there is nothing grander than "solving" death.
I'm not a life sciences guy, but people in the know tell me that ageing for a human is no different than ageing for a car - you can refresh, repair, and replace old/defective parts…
Or better yet, UPGRADE!
The young man in the picture above lost his hand in a workplace accident, and feared he would never play drums again..
That is until he connected with musician and inventor Gil Weinberg at Georgia Tech, who worked with him to develop a new bionic hand, capable of using two drumsticks at once - each with alternating frequencies - and enabling the creation of music no unenhanced human can produce.
I think the biggest innovations of the twenty-first century will be the intersection of biology and technology. A new era is beginning - Steve Jobs
As Moore's law continues unabated, once-impossible problems become trivial.
Humanity has begun transcending its biological roots, merging with its technology, and taking a direct role in designing its evolution.
Imagine a world where people age in reverse - growing stronger & healthier as time marches on - and human life expectancy is measured in thousands or millions of years.
What choices would you make when the consequences will be with you for millenia?
What kind of life would you lead when you could be reasonably confident that tomorrow will always be better than today?
The Final Word
When there is this much money and power up for grabs, you know "they" won't leave it up to hackers and home brew hobbyists.
The coming revolution has already captured government attention, and for good reason: smallpox is estimated to have killed 500 million people before it was eradicated, and in 2017, a biotech firm you've never heard of synthesized a horsepox virus for $100,000.
Moore's Law of Mad Science: Every eighteen months, the minimum IQ necessary to destroy the world drops by 1 point - Eliezer Yudkowsky
All signs point to a huge push for socialized medicine in the United States, with a massive increase in medical tourism for the rich.
(Spoiler Alert: my country has socialized medicine, and it's better in some ways i.e. my father had a heart attack, and the total bill for triple bypass surgery and a month long stay in the hospital was $70 - and worse in others i.e. it can be a many months wait to see a specialist for non-urgent care, and our tech is last gen at best)
Do we have any IP attorney's with a background in computational biology on the forum?
I would love to get your take on how the business of healthcare unfolds over the next 20-30 years.
What an exciting time to be alive!