As a physician, I often ask people if they believe we’re living in a healthy society. The nearly universal reaction is a sardonic laugh. We live in a time of unparalleled abundance, safety, comfort, and prosperity, and yet many of us sense that our way of life is unsustainable. Grim statistics of species extinction, natural resource depletion, income inequality, etc., fuel the feeling that our trajectory is off-kilter, while vague notions of the impending impact of exponential technologies like automation, AI, and bio-engineering loom in our minds. It’s no surprise that we now have simultaneous epidemics—not just of the usual chronic diseases, but also of various addictions, mood disorders, and general lack of meaningfulness in life, and for the first time since WWI, our life expectancy has declined for 3 years in a row.
Despite all the politicking about “healthcare reform” over the past few decades, we don’t have much to celebrate yet. Although we have a robust sick-care system, it is unsustainably expensive, and there is very little actual “health-care” to speak of. If we don’t change course, in less than a decade 80% of the entire governmental budget will go to medical spending, and faith in the idea that we’ll fix the system simply by relegating the book-keeping responsibility to federal administrators (i.e. Medicare-for-all) is naÏve.
The good news is that there are also remarkable things arising and gaining momentum. At the economic forum in Davos last month, for example, an organization called Civiana hosted a “Remembering the Future” event in which prominent speakers gave presentations about how we “solved” a number of the UN’s 17 Sustainable Development Goals by 2030. These “SDGs” provide an excellent groundwork for helping us define what a healthy society would look and feel like to live within—during our lifetime.
Fortunately we live in a community where moonshots and BHAGs are colloquialisms. It’s time for a grand vision of what a healthy society might look like. Then we can reverse-engineer a healthcare system to be worthy and supportive of that vision. Attempts at transforming how we pay for, practice, and deliver healthcare will continue to have disappointing results if such efforts are not based upon a comprehensive vision of a healthy society, despite how fantastical or far-fetched the idea may appear to be. We need a new North Star, a coherent system of updated guiding principles which begin with supplementing our understanding of economics (how we exchange value) with eudaimonics (how we define a life well-lived). Boulder county is exactly the kind of ‘idea lab’ suited for such bold experiments.