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“Life is not only a pleasure but a kind of eccentric privilege” - G. K. Chesterton
I had two major epiphanies this week. The first one came while I was listening to Joe Rogan and Brigham Buhler’s conversation for the third time. A few people in my immediate circle recommended I listen to it. But I didn’t grasp the importance of the episode until my third time through.
In this episode Brigham Buhler, founder of Ways2Well, dive’s into the failings of the U.S. healthcare system. Despite spending more than $4 trillion on healthcare each year, two times more than other countries of comparable wealth, disease prevalence continues to increase and life expectancy continues to decline to it’s lowest level in years.
As he describes it, “what you’re seeing is a symptom of a disease… and its spread throughout all of the government, and that disease is private industry and its influence on the federal government and the decisions they make.”
The private industry he’s referring to is the one created by intermediaries such as insurers, pharmacy’s, and pharmacy benefit managers (PBMs). They’ve figured out that it’s a lot more valuable to treat, rather than prevent disease.
To quote Brigham, “If [the insurer] can monetize your diabetes, why would [the insurer] cure or prevent your diabetes?” And that’s exactly what they’ve done.
These intermediaries now receive 45%, almost $2 trn, of the annual healthcare spend in the United States. This enormous wealth is shared by a little more than a handful of companies that control the industry, and therefore control the treatments they make available to us, the patients.
In recent years they’ve been using their capital to narrow our options even further by creating “vertically integrated networks.” It’s a model of healthcare that promises to reduce costs and improve patient outcomes by bringing all of your healthcare needs under one “roof.” According to The Economist, “between 2013 and August 2023 the nine health-care giants spent around $325 bn on over 130 mergers and acquisitions.”
But the model hasn’t lived up to it’s promise. In fact the exact opposite has occurred. Patient health has declined while costs have increased. “Many studies have found that after hospitals acquire physician practices, prices increase but quality of care does not.”
I can verify this all because I lived it. My former company was acquired by Optum, a subsidiary of United Health Group (UHG), the largest insurer in the country. We were one of many acquisitions by UHG in the last 10 years who now control 70,000 physicians across the country. Their obsession with profits over patient outcomes made it unbearable to work for them, and was one of the main reasons I left in 2018.
But listening to this conversation also gave me hope for the future of healthcare or The Age of Scientific Wellness, a recent book that describes the future of health in great detail. Like the vision shared by Brigham, the book envisions the future as one that is personalized, predictive, and preventative.
By focusing on comprehensive testing (i.e. blood, genetic, gut biome), analysis of data from wearables (i.e. tracking sleep, glucose levels), and alternative modality treatments (i.e. stem cells, red light therapy, optimization of sleep and hormones) they believe they can prevent or slow the onset of early disease.
“The difference between somebody dying at the average human life expectancy, and making it to be a centenarian, the only difference is the onset of chronic disease” Brigham says.
It occurred to me that there is a real movement happening, and it’s being led by guys like Brigham and Ways2Well, Peter Attia and his company Early Medical, as well as companies such as Parsley Health, InsideTracker, LevelsHealth, Prenuvo, Function Health, and many more.
This movement to replace “sickcare” coincides with the movement to transform the food system through a new age of agriculture. Commonly referred to as “The Future of Food.” These two movements have the potential to solve a lot of what ails our society. And they both need as much support as possible if they’re going to have any chance of succeeding.
Which brings me back to my first epiphany. That I need to support these movements and the companies and people who are driving the change. So everything I do going forward will be with an eye towards supporting these efforts.
My second epiphany occurred to me while I was in the sauna. It dawned on me that I needed to stop hiding behind the content of other people; the books, podcast’s, and articles I enjoy. They’ve played a pivotal role in teaching and inspiring my beliefs, and will continue to do so. But I’m going to use my knowledge and experience to highlight what I see, rather than summarizing what I’m consuming.
If you know me then this idea of a renewed focus on healthcare and food might seem obvious, but it’s just never been as clear to me as it is right now, and the work I’ve been doing on this newsletter has helped me to realize it. So with that said, I want to thank you all for receiving week 10 of the newsletter, and providing me with the feedback and support you all have!
Cheers.
James
If you want to help in a small way, consider signing onto this petition: Tell the EPA to keep this toxic pesticide out of our food
This Week’s Posts
5 Names to Follow in Health and Fitness
I’ve written a little bit before about some things to keep in mind when you seek advice from influencers and public figures. I watched this TED Talk with EC Synkowski recently. She opens the talk with this quote that put it all into perspective for me.
“As to methods there may be a million and then some, but principles are few. The man who grasps principles can successfully select his own methods.” - Ralph Emerson.
It made me realize that the people I was most interested in following all had a common thread. Beyond teaching their own methods, they preached and taught fundamentals. And it occurred to me that the biggest problem with 9 / 10 influencers we find online is that they preach their methods as gospel.
Ruck Plate Series: Workout 3
My girlfriend gifted me a Ruck Plate Carrier and 30 lb Ruck plate for our two year anniversary.
The Ruck Plate Carrier is a game changer. But the bigger surprise is the Ruck plate itself. It’s unique one foot rectangular shape lends itself to a lot of different movements. The morning after I got it I put together this workout series.
Meal Prep: Salmon, Brussels, and Vegetable Soup
I’ve been doing a lot of my cooking in the morning. I find it therapeutic to start the day that way. My routine recently has been wake up between 5 - 6 am, make coffee, read for 60 - 90 minutes, then walk and feed my dog. Most days I start cooking by 8 - 9 am. This Wednesday I went into the kitchen to make breakfast and before I knew it I had salmon, brussels sprouts, and vegetable soup all going at once.
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