From concierge to commodity: The 15-year timeline for democratic health optimization
Why proactive healthcare will follow the fastest price collapse in modern history
Let me show you some uncomfortable math. Then you decide if I'm optimistic or delusional.
In 1975, only NASA could afford solar panels. In 1990, only tech executives could afford mobile phones. In 2010, only the wealthy installed zero-emission homes. Today, all three are approaching mass-market accessibility, with price declines ranging from 70% to 99% over 15 to 50 years. Here's my thesis: I believe the same trajectory applies to proactive healthcare. More specifically, I believe the comprehensive health monitoring and optimisation currently reserved for Fortune 500 executives will cost 95% less within 15 years.
If I'm right, we're about to witness healthcare's most profound transformation: not through policy reform, but through the same economic forces that democratised solar energy and electric vehicles.
Your CEO's secret
Wealthy individuals are living 7 to 9 years longer than average. It's not genetics or luck. It's (proactive) healthcare most of us cannot access. Today, comprehensive proactive care (including continuous monitoring, regular blood panels, genome sequencing, AI-augmented diagnostics, and dedicated health coaching) costs approximately €25 000 annually out of pocket. At that price point, it's available to roughly 0,1% of the population.
This is Wave 2 of health optimisation. Wave 1, spanning 1990 to 2010, belonged to ultra-high-net-worth individuals who employed private medical staff at costs exceeding €500 000 annually. Movie stars had personal doctors, nutritionists, mental coaches, and physical trainers on retainer. It was the ultimate luxury: a team dedicated to keeping you at peak performance.
What changed? The same pattern that transformed exclusive technologies into everyday tools. Solar panels dropped 99% in price over 54 years. LED lighting fell 95% in just 14 years. Electric vehicle batteries collapsed 90% since 2010. Most dramatically, genome sequencing plummeted 99,99% over 24 years, from €95 million in 2001 to €200 today.
The question isn't whether proactive healthcare will follow this pattern. The question is how fast.
The uncomfortable timeline
Based on component technology trajectories and post-2010 acceleration patterns, here's my projection. By 2027, AI diagnostics will reduce human labour requirements by 40%, whilst wearable sensor costs drop 60% following the same curves as LED lighting and lithium-ion batteries. This brings comprehensive proactive care to €15 000 annually, expensive, but accessible to roughly 0,5% of the population. Early-adopting companies will begin piloting these programmes for senior executives.
By 2032, we reach the middle-class moment. Full AI-augmented care becomes standard, with genome sequencing included as a baseline component at €50. Insurance companies begin covering portions, particularly for high-risk patients. The price settles around €7 000 annually, making it accessible to approximately 5% of the population, a 50-fold increase from today.
The crossover arrives in 2037. At this point, prevention becomes economically superior to treatment, not just medically. Employers adopt proactive health monitoring as a standard benefit, recognising that €2 500 spent on prevention saves €50 000 in treatment costs. Availability expands to 30% of the population, a 300-fold increase from 2024.
By 2042, proactive health monitoring becomes as commonplace as owning a smartphone. Government health programmes begin coverage. The annual cost drops to €500, comparable to Netflix and Spotify combined. 70% of the population now has access to healthcare that was exclusively reserved for billionaires 18 years earlier.
What breaks the model open
Three technological shifts drive this transformation. First, genome sequencing already completed its 99,99% price collapse. What cost €95 million in 2001 now costs €200. This crucial baseline component is essentially solved.
Second, continuous monitoring rides on smartphone economics. The sensors, batteries, and AI chips in wearables benefit from massive smartphone production volumes, the same spillover effect that democratised robot vacuums and 3D printers. When Apple ships 200 million units annually, component costs for adjacent technologies plummet.
Third, AI diagnostic tools have near-zero marginal cost. Unlike solar panels requiring physical materials or EVs needing batteries, an AI model serving one patient or one million patients costs essentially the same to operate. This is Baumol's cost disease in reverse: healthcare's traditionally labour-intensive nature yielding to software economics.
Post-2010 technologies democratise two to three times faster than historical precedents. LED lighting achieved 95% price decline in 14 years. 3D printers reached 99,9% decline in 14 years. If proactive healthcare follows the aggressive curve rather than the conservative one, we're looking at 90% cost reduction over 12 years, not 20.
The sceptic's questions
I anticipate three objections. First, that healthcare regulation will slow everything. But COVID-19 demonstrated how quickly regulatory barriers collapse under pressure, for example: telemedicine adoption in 90 days, not 90 months. Moreover, many components of proactive care like wearables, AI coaching, and lifestyle monitoring require no medical licensing.
Second, that insurance companies will block disruption to protect existing revenue streams. Yet some insurers already recognise the economics. Vitality and Oscar Health are piloting prevention-focused models. More importantly, employers have direct incentive to bypass traditional insurance entirely, offering proactive benefits that reduce overall healthcare expenditure.
Third, that behaviour change remains the bottleneck regardless of technology. This is partially true, but technology increasingly solves behaviour. Continuous glucose monitors change dietary decisions in real time. Gamification drives engagement. Social accountability through connected platforms works. The technology doesn't just measure, it motivates.
The opportunity
For entrepreneurs and investors, the strategic question is straightforward: which component of the €25 000 concierge medicine bundle is ready for 10x cost reduction right now? Map each piece (sensors, lab work, AI diagnostics, human coaching) against its underlying technology curve. The answer reveals where to build.
Someone will become the Robinhood of healthcare. The company that unbundles and democratises these services, making them accessible to millions rather than thousands. That company will be built by founders who recognise that we're not waiting for a breakthrough. The breakthroughs already happened. We're waiting for assembly and distribution.
The uncomfortable math suggests Wave 3 is beginning. If you're building in healthcare, the question isn't whether this transformation happens. The question is whether you're positioned to accelerate it, or whether you'll be explaining to investors in 2035 why you missed the most predictable disruption in modern medicine.
The timeline is uncomfortable because it's uncomfortably specific. And because, looking at the data, I'm not sure how to argue against it.
💥 May this inspire you to advance healthcare beyond its current state of excellence. 🚀 Proactive innovative ideas? Let's talk!
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medium
- Why innovation in healthcare deserves nuanced thinking
- Incumbents dont stand a chance
- Software 2.0 and the doctor fallacy
- Sickcare Operating System (SOS)
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