The last 5% and the first 95%

There are two healthcare systems in America, I call them The Last 5% and The First 95%.

The Last 5%

It’s characterized by expensive daily drugs, highly specific tests, detailed imaging, super-specialized specialists, robots, massive hospital campuses, and every expensive thing but the kitchen sink. It’s the world’s best. It’s powered by specialists and big hospital buildings. And when people talk about the US healthcare system being the world’s best, it’s because of this “Last 5%” System. It’s life-changing when everything goes right. It’ll cost you an arm and a leg, but it can sometimes work miracles, if your definition of miracle is maintaining a beating heart. It’s also highly unsafe, risky, and prone to complications, hospital-acquired infections, and disconnected care. But that’s not something The Last 5% likes to think about. I call it The Last 5% because it’s solving the last 5% of human health problems. Remember, 80% of your lifetime medical costs are spent in the last 6 months of your life. It’s treating people, mostly adults, at the end of their life, after an unhealthy lifestyle from an unhealthy culture and environment has done a number on their bodies. Any problem where you’re trying to solve the last 5% of the problem is ungodly expensive and can only get more expensive.

The First 95%

It’s vaccines, clean water, short-term antibiotics, quick fixes, healthy food, exercise, education, and environments. It’s powered by neighborhood primary care doctors in small practices, farmers markets, bike paths, relationships with family and friends, and anything else that helps you get to the last 5% of your life. Health insurance companies are terrible at impacting this System for the better. But for an idea of how they could, see how the largest health insurance “company” in America has agreed to pay for removing lead in Flint. Compared to The Last 5%, there’s not a lot of money to be made here. That’s why the medical component of this sort of looks and feels like the DMV. It’s also not really connected to the Last 5% System. But it’s 95% of the solution. It helps you live a wonderful life throughout your life. And that’s what matters. That’s why all I want to do with my life is fix 95% of the problem.