Similar to how the rules of physics cause apples to fall to the ground, there are rules governing how money works, and money in healthcare is no exception. The lack of understanding of these rules will limit our comprehension of the nature and reality of monetary transactions, social interactions, and economic activities. This, in turn, will compromise our decision-making, human capital accumulation, lifetime productivity, and eventually health and the quality of life. In the coming months, I will use this page to explain these rules, which I believe can empower people, especially those unfamiliar with money.
Rule I: We all like money
It’s inherent in human nature that we all want to possess money and/or control the use of money. Money, with its universal trust and universal exchangeability, opens up options and confers power and independence. We use money to “buy” the things we want rather than “beg” others for charity. Money allows us to make choices and pursue our goals as free dignified human beings.
Our desire for money also motivates us to learn, work, and grow, contributing to society, fueling economic growth, and creating wealth to finance healthcare and other purposes. Even people who live to fulfill intrinsic motivations rather than monetary incentives would not reject good-faith donations to advance their causes. Without monetary support, no cause will gain traction.
Rule II. Spending money helps others
Money (after tax) can legally flow to these destinations: consumption, saving/lending, investment, and gifting. All of these strengthen the economy, making it possible to afford healthcare and other services and products.
Consumption directly pumps money into the economy, supporting businesses and creating jobs. Saving allows banks to lend money to businesses, governments, other organizations, and individuals in need of cash so they can use it for productive purposes and expand our economy (buying bonds and direct lending are in the same spirit). Investment channels money to promising companies and commodities—a process that efficiently allocates capital, instills competition, and drives economic growth. Gifting supports recipient entities in pursuing various causes. Therefore, when spending money, we are helping others in one way or another.
Rule III: Greater wealth brings a greater willingness to invest in health
Time is a currency endowed to us, indispensable for buying everything valuable, many of which cannot be purchased even with any amount of money. The balance and quality of the time we have are ruthlessly dictated by our health.
As we accumulate more wealth, we become more willing to spend money in exchange for time, such as purchasing services to save time and investing in things that improve health. By nature, investment in social determinants of health (e.g., better food, housing, and education) as well as in healthcare are transactions wherein people use money to buy time. Therefore, it’s no surprise that wealthy countries spend much more per capita on healthcare than other countries.
Greater wealth leads to a greater willingness to invest in health. This rule creates exciting opportunities for scientific discovery and technological advancement in healthcare. However, it also poses risks for misguided decisions, fiscal unaccountability, and public policy failures, which can burden Americans with a substantial opportunity cost—perhaps we could have been healthier with the money we spent on healthcare.
Understanding money will give us a sword to pierce through the smoke screen, a vehicle to reach the bottom of the rabbit hole, a lens to appreciate the economic reality of transactions, and a compass to guide choices and decision-making in healthcare and in general. Get wealthy, stay healthy! Onward until next time.
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