In Medicine, there are four core moral principles:
1. Autonomy – the patient’s right to choose or refuse treatment
2. Beneficence – the patient’s best interests are prioritized
3. Non-Maleficence – “do no harm”
4. Justice – the fair and appropriate distribution of scarce healthcare resources in society
While the medical profession has nobly defended Autonomy, Beneficence, Non-Maleficence – this was truer pre-COVID than it is today – Justice for the equitable allocation and distribution of valuable resources has been and continues to be ruthlessly violated.
This problem pervades our society insidiously and is rooted in the nature of Contracts – Agreements. Because a frame of reference was absent, we could not fully appreciate this until Smart Contracts disrupted Traditional Finance with Decentralized Finance (DeFi).
Traditional Non-Smart Contracts are mediated by third parties. In Traditional Finance (vs. Decentralized Finance), Contracts between transacting and interacting entities are mediated by third parties.
If the repercussions entail merely a slap on the wrist, then it is better to dishonorably extract value to serve the self.
So, if Alice wants to send Bob some money, a 3rd party is required to mediate the transaction – which is a contract, or an agreement. This applies to borrowing, lending, and all financial operations. The 3rd party often extracts value because there is no accountability, resulting in a Moral Hazard. In other words, there is simply no incentive to limit one’s own Greed.
Every industry in our society is structured in this way.
How much were the culprits of the 2008 Global Financial Crisis penalized?
In the Banking sector, customers and citizens suffer the consequences of the Cantillon Effect:
This has largely contributed to wealth inequality, especially since the year 2008 when reckless money printing (“Quantitative Easing”) began.
Truth be told, this started much earlier in 1971 when the United States decided to abandon the Gold Standard – the backing of every dollar in circulation by Gold. https://wtfhappenedin1971.com/
In Medicine, contract-enforcing 3rd parties have effectively hijacked the healthcare system by extracting value – and subsequently using this extracted value to create layers of bureaucracy:
Administrators and Corporate Executives extract value from the healthcare system at every level.
In the name of “patient-centered care,” these entities perversely hinder well-being with a greater influence than any other force at play. Because it is all driven by money.
Seven health insurance CEOs raked in a record $283 million last year; 2021 Pay for CEOs at the six major national insurers; Healthcare’s High Rollers: As the pandemic surged, CEOs’ earnings surged.
The encroachment has escalated such that Emergency Medicine physicians in California were compelled to sue a private equity firm because the third party prioritized its bottom-line over the well-being of patients.
The corporate practice of medicine was violated because the law failed to protect the patient-physician relationship.
The reality is - this happens everywhere. The sanctity of the patient-physician relationship has been tainted. There are too many hands in the pot.
Initiatives like HPEC and MedDAO are reversing this by empowering physicians with sovereignty.
400 physicians die every year due to the moral injury inflicted by such egregious behaviors. Patients have effectively become a vehicle for value to flow into the healthcare system. As a Goldman Sachs analyst has asked, “is curing patients is not a sustainable business model?” This is the kind of zero-sum cancerous thinking that pervades our society today. Like a plague. What would happen to the healthcare system if everyone miraculously became healthy overnight? It’d functionally be the equivalent of a bank run. Rug-pull.
A simple and elegant solution is to replace the work of these third parties with Smart Contracts on decentralized distributed computing networks like Ethereum. Smart Contracts limit Greed and Value Extraction. Humans are incorrigible, so better to delegate imperative tasks to computer code that cannot be manipulated. Can’t Do Evil > Won’t Do Evil.
And that is what we are doing at MedDAO and Psychiatry DAO. Building out Healthcare 3.0.