There’s a line from an immunology book for laypersons that has always stuck with me.
Paraphrasing: Studying immunology is like translating the tax code of Germany into Mandarin.
Mind-blowingly complicated.
Since the immune system is what fights off outside molecular and microbial attacks, we’ve had an immune system since before we were one-celled organisms.
Like, since the primordial ooze.
Immunology in particular and biology in general have had A REALLY LONG TIME to get hideously complex.
The movie scene where the mathematician stands in front of a chalkboard, scribbling formulas with lots of Greek letters? Biologists laugh at that. Unpacking the reality of molecular and enzymatic processes is a thousand times messier than mere theory.
Biology is complicated. Medicine is applied human biology. WE are arguably the most complicated organisms on the planet, particularly if you include our mental health challenges.
Keeping all the balls in the air and the plates spinning is not a job for wimps.
So, the healthcare system used to work like this
You live your life, and dream your dreams.
But at some point, you or someone who felt responsible for you realized the band wasn’t gonna play on forever. The stakes are high (death, disability, or suffering), screw winging it, you’re putting experts on retainer to push, nudge, and pull you back from prematurely looking at the roots instead of the flowers.
Because the body is crazy complicated and can fail in unexpected and spectacular ways.
There’s a reason every D&D campaign has a party member who’s a healer.
The approach was sort of working, until about 5 years ago, and again about a week ago.
When COVID happened and the ACA subsidies disappeared
COVID turned a lot of people’s trust in conventional medicine upside down. And the ACA subsidies going unrenewed on December 31, 2025 means that millions of Americans will have their insurance premiums double, triple, or quadruple and won’t be able to afford healthcare.
Bottom line: by choice or lack thereof, people are having to take their health into their own hands.
And we are a busy people. Cognitive load-wise, we are busier than we’ve ever been in the history of humanity, as we spend most of our waking hours in a digital realm that is, shall we say, not designed to optimize feelings of calmness, compassion, and mastery.
We have (online) places to go, things to do, and people to see, while earning a living, supporting our families, and navigating a new and uncertain future.
This is the avatar of the typical person who has also chosen to become their own doctor.
So the program must be simple
Or at least doable. Because if you’re busy as f%ck, you cannot afford to spend your spare time getting the equivalent of a medical degree. Juggling 10 balls, you might be able to add one more, but not 50.
Taking care of yourself cannot require 10 more hours a day, 7 days a week (i.e., you becoming a doctor).
Besides the logistics, there’s also the matter of sustainability.
A plan with, say, 3 parts is a lot more likely to be doable for the rest of your life than a plan with 17 parts.
Even if the program demands 17 parts to keep you out of health trouble, if it collapses after 2 weeks, it’s no good compared to a 3-part plan that you can do consistently. 3 tweaks compounding forever is literally infinitely better than zero.
But human biology isn’t simple
I’ve written about this before: if someone is selling you a simple fix for a complex problem, there’s a good chance they’re appealing to your desperate need for simplicity rather than offering you a realistic solution.
If cardio alone were good enough for health, then Jim Fixx wouldn’t have died from a massive heart attack, and Lance Armstrong would never have developed testicular cancer.
If strength training alone were good enough, then neither the late Charles Poliquinnor The Biggest Loser’s Bob Harper would have had their heart attacks.
If a low fat, plant-based diet was the ticket, Nathan Pritikin wouldn’t have committed suicide after battling leukemia; if an organic, unprocessed food diet was enough, J.I. Rodale, the founder of Prevention Magazine, wouldn’t have diet from a heart attack at 72; if a high protein, high fat diet was the key to living forever, then Robert Atkinswouldn’t have died from a fall and brain trauma, +/- heart disease.
Eating right, exercising, and getting plenty of sleep are better than not, but the trio isn’t the whole story. You’d have to nix tobacco and keep alcohol to a maximum of 2 servings per week, do inner work, socialize, spend more time outdoors, and work for a good greater than yourself.
In doing so, your odds would improve dramatically — according to an AI analysis, premature death risk would drop 60%, and about 10 years would be added to your health span. An 8-part program, then, but things may start to get unwieldy.
Know the difference between prevention and treatment
It boils down to when you stop being a betting person, by choice or necessity.
With prevention, you’re taking a gamble — a good one — that by doing certain healthy habits, you won’t have a premature health breakdown. Specialized knowledge and resource demands (costs) are low; the emphasis is on being health-sensible, not on playing doctor or medical researcher. But as with the examples above, there are no guarantees that you’ll even beat the standard life expectancy odds.
With treatment, the bad thing has already happened; your odds are now 100%. Medications and surgical procedures are tailored, and you’re working closely with professionals who know way more medicine than you, at a correspondingly higher cost. But your experience with the healthcare system may be less than stellar: doctors who don’t listen, don’t have time to understand, or are entrenched in the Pharma mentality of prescribing a costly pill for everything.
Health and healthcare span the spectrum between these two extremes.
My point is that Americans used to be able to roam from one pole to the other, based on personal choice and hopefully temporary financial belt-tightening. You could bet on the odds of low-cost prevention and focus your personal resources elsewhere, and at any time, you could choose to stop playing the market and hire a team of specialists to get the job done.
Today, that needle is jamming hard to the zero, as people turn away from healthcare in disgust or because they can’t afford the insane bills.
It’s not about the money
It’s about the cost, including the cost of wasted time and frustration.
Many people will pay to be listened to and to get personalized care that gets results. Especially if the monetary cost of doing so would otherwise be “wasted” on conventional, ineffective, inattentive care.
But there has always been a population of Americans who either could not afford or just plain didn’t believe in seeing a doctor on the regular, unless they were really sick.
They either took their chances, or took care of themselves as best they knew how and took their chances.
We have a situation in this country where a lot more people are returning to this mindset.
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