Modern healthcare is full of contradictions. On one hand, it’s a high-performing economic powerhouse—one of the most profitable and resilient sectors globally. On the other, it’s overseeing a population that is, by many measures, becoming sicker. Chronic disease rates are rising. Preventable illnesses are commonplace. And yet, healthcare spending continues to grow.
This tension raises a difficult question: what is the healthcare system built for?
At face value, the answer seems obvious—healthcare exists to improve health and reduce disease. But when we look deeper, a more complex picture emerges. The healthcare industry isn’t a single entity with a unified mission. It’s made up of many stakeholders with competing priorities. Public systems, families, and frontline workers are driven by outcomes—they want to see healthier people. But private capital, which funds large portions of modern healthcare, is driven by return on investment.
These two motivations—health and profit—don’t always align. And increasingly, the gap between them is shaping the way care is delivered.
Acute medicine—emergency care, surgery, trauma—is a shining success. People are surviving conditions that once would have been fatal, thanks to decades of innovation and evidence-based practice. But when we turn our attention to chronic disease and prevention, the system falters. Rates of obesity, diabetes, autoimmune conditions, and even early-onset cancers are climbing. And while the system is adept at managing these diseases, it rarely prevents or cures them.
Why is that?
Because prevention and cure, while profoundly valuable for individuals and society, aren’t always good business. A condition that can be managed for life generates more revenue than one that is reversed or prevented altogether. The incentives are skewed—and the outcomes reflect that reality.
We see it in how public health campaigns are underfunded. In how research dollars chase treatments, not cures. In the normalisation of “chronic disease management” as the endpoint of care. And we see it in how easily the conversation shifts blame to individuals for lifestyle-related illness, ignoring the toxic environments and systemic drivers that shape those outcomes.
This is not to suggest some grand conspiracy—only that the system is behaving exactly as it’s designed to. It performs exceptionally well for investors and shareholders. But for patients, especially those hoping to avoid or reverse disease, it often delivers disappointment. It offers little in the way of wellness promotion or health optimisation.
It’s time to ask whether this model still serves us – and if it has the moral and scientific underpinnings to impose behaviour on autonomous adults. If we want different outcomes—healthier people, fewer chronic conditions, longer lives in better states—we need to align healthcare’s incentives with health itself. That means rethinking how we fund, evaluate, and deliver care. It means investing in prevention, environmental health, and cellular science—not just pharmaceuticals and procedures.
The future of healthcare may just depend on the removal of this profit motive.
