Between a Cure and a Customer: The Unseen Economics of Healthcare

The modern medical system finds itself in a strange, almost paradoxical situation. If a doctor heals a patient perfectly, it becomes a problem; the patient won’t return. Therefore, they cannot afford to provide solutions that properly fix a problem. Conversely, if they fail to address the problem and the patient dies, the patient also won’t return. That, too, is a problem. So, the biggest challenge for the pharmaceutical and medical industries, whether allopathic, ayurvedic, or homeopathic, is this: if a doctor wants to make money, how does he keep a person a patient for life? The more skilled they become at managing only the symptoms rather than the root cause, the more they can ensure a steady income. The key question becomes, how do I treat this person well enough that he remains sick, yet ensure that the sickness does not kill him?

This is how the entire ecosystem has evolved. Consider a common fever. If a doctor sees a mild fever of 101 or 102 degrees, one the body could likely heal on its own, why wouldn’t he simply advise rest and hydration? Because the system incentivizes selling something: antibiotics, antivirals, or a hospital admission. There are big hospitals with rents to pay, and they need a return on investment. It is not that individual doctors are inherently negative or malicious. I wouldn’t blame a doctor for that. The ecosystem itself is structured this way.

Think about it. When the parent of an engineer expects their son to make a lot of money, why shouldn’t the parent of a doctor want the same? We have created and encouraged an ecosystem where money plays a pivotal role. If we, as a society, are obsessed with wealth, is it not logical and natural for a doctor to be obsessed as well? Often, we look at a doctor as the villain, saying, "Look at that greedy guy." But it is rarely about individual greed. The entire ecosystem around him is greedy. If an engineer or a programmer can cut corners and make a lot of money, why shouldn’t a doctor? That is precisely where the problem lies.

The doctor enters a mode of survival. He is pitched against the patient, no longer seeing someone in need of help, but rather thinking, "It's either him or me." This is why, for a young girl like Sri, the doctors were ruthless. They immediately recommended surgery, a procedure costing lakhs, without seriously considering simpler, faster alternatives that could have healed her. They scare you, even when they know other options might exist. They often won't present those options, especially if they see you have insurance.

I know of a doctor who asked a patients son bringing his mother for an emergencystomach pain "Do you have insurance?" When he said no, the doctor scolded him, "You fellows in IT should have that much brains. Your mother… if you had heath policy, we could have admitted her and kept her under observation. Since you don’t have an insurance it will be too much to shell out if I admit her. Take this tablet and go home."

She took the tablet and felt better in some time. By next day she was much better

What I appreciated was the doctor’s heart; he did not want to exploit a boy without means. His logic was that if there was insurance, the agency would pay, not the individual.

But here is the crucial point. Even with insurance, if unnecessary medicines are pumped into your body, while it may be financially free for you, you are still receiving free poisons. That doctor, though kind, was missing a larger perspective. By injecting something not strictly required, he is still stressing the body’s system, potentially contributing to antibiotic resistance or other unseen problems. His outlook remains narrow.

Today, one of the biggest challenges is the nature of clinical studies. These studies are always direct, focusing on a specific symptom and a targeted healing. You will never find a clinical study investigating how a compound might indirectly influence other systems. Furthermore, studies are only pursued on what can be patented and manufactured for profit. You will not find extensive, definitive clinical studies on vitamin C, curcumin, piperine, or pterostilbene for diabetes. Why? First, if it is proven that these natural compounds heal, what happens to synthetic medications? Second, clinical studies cost millions of dollars. If a company spends 15 million dollars proving curcumin works, anyone can then sell curcumin, as it is not patentable. That company could never recover its investment, as competitors would undercut them. The system only incentivizes clinical trials for products over which one has exclusive control.

This logic explains the fiasco during COVID. If you wanted to take something supportive, they would immediately say, "There is no clinical trial." Consider Baba Ramdev’s Coronil. How could anyone conduct a full clinical trial for a new formulation when the pandemic had just arrived? Logically, the compounds in Coronil, like curcumin, shogaols from ginger, piperine, and glycyrrhiza glabra (Yashtimadhu), are powerful antivirals and anti-inflammatories. It could have helped the body. Yet, the industry said he could not claim it was good for COVID. And the public, feeling lost, refused to consider anything not explicitly "approved for COVID." But how could anything be approved during a sudden pandemic? This created a completely level playing field where no one, ayurvedic or otherwise, could make claims, effectively pushing everyone toward the ICU, the sole domain of allopathic emergency care.

The consequence is clear in the unnecessary hospitalizations, the severity of cases, and the legacy of long COVID. It all stems from this rigid tendency: without a clinical trial, you cannot say it heals, but a clinical trial is impossible at the last minute. So, we are left with a system perversely incentivized to manage chronic sickness, where true healing can be bad for business, and innovation is stifled unless it is profitable. The problem is not the individual doctor, but the ecosystem we have all built and accepted.