I’ve had this idea on my mind for months and thought I would speak it in to existence so others can join the conversation and we all learn something more together.
The problem:
According to some estimates, the healthcare spending in the USA will reach $4 trillion. Around 75% of these healthcare dollars are spent on managing and treating of chronic diseases (obesity, diabetes, heart disease, kidney disease, cancer, osteoporosis, sarcopenia, etc.).
The cause:
The fact is that most of these diseases stem from people not having healthy habits such as bad eating (drinking) habits and no physical activity (the result being altered body composition). There are other bad habits (like smoking) but the effect of smoking on the overall personal health is lower than being obese.
The majority of the effort is put towards treating and managing of these diseases instead of prevention. The system is therefore battling and trying to fix the ‘downward spiral’ that in most cases starts with obesity. Obesity (lack of healthy eating habits and physical activity) is the major cause for diabetes, which is a major cause for heart disease, which is a major cause for kidney disease, etc. The further you go, the more debilitating is the disease effects are, which in turn result in less physical activity, and here we go again.
What if:
Suppose any Agent would be able to create accurate body composition data. Body composition data is the result of both eating (drinking) habits and the amount of physical activity. It can be categorized in to three parameters: fat mass, fat free mass, and water. The water in our bodies fills 2 compartments, the intracellular (ICW) and extracellular (ECW) water, which is water inside and outside of our cells.
All of the above mentioned parameters are the holy grail of human health. Most of the chronic diseases (and their associated costs) stem from these parameters not being in their ‘healthy state’. Therefore they can be used as direct predictors of ‘general’ human health and therefore healthcare costs.
Interesting Fact: In Heart Failure, Kidney Failure, Lymph-edema, ECW significantly increases before any of the symptoms occur (swollen legs, arms, fatigue, breathing problems, etc.). The same parameter change can be seen in Corona Virus patients where ECW in their lungs increases and breathing problems begin.
The hurdles associated with current solutions:
We can see that the current healthcare insurance companies (payers) are already conscious of the problem. They realize that prevention is far more important and is the key to prevent the ‘downward spiral’ of comorbidity that contributes to most of the costs, and some payers are already pushing ‘incentive programs’ to increase physical activity of their customers for instance.
United Healthcare is using FitBit watches to track behavior and financially reward participants for achieving desired goals (such as walking 10000 steps each day). Such approaches (and similar) seem to have a hard time taking off in the healthcare sector because of the lack of data (anyone can eat 5 hamburgers after they achieve 10000 steps) and the fact that the initiatives are risky, meaning that they require the companies to financially reward people in advance and not knowing if the calculations for the expected costs are accurate. This involves very high initial investments in long studies.
To me, it seems that accurate body composition data is just what the Healthcare Insurance Company needs to increase its ‘receptivity’; sense the behavior patterns of its customers on the edges, predict costs, use different incentive mechanisms to steer toward healthy behavioral patterns. This would result in lower healthcare costs (insurance premiums), higher productivity rates (regular employers), customer satisfaction, etc.
(My theory is that just due to the fact that payers aren’t able to have proper data inputs on the edges, this ‘pathology’ of the system alone results in higher Healthcare Insurance premiums. With incentives to achieve better body composition parameters, the change would be tremendous.)
Neutralize the beginning risk with a ‘self organizing (healing)’ system?
The tech capable of measuring accurate body composition data (fat free mass, fat mass, and hydration ICWECW) is currently confined only to hospitals and different medical centers. I am aware that many companies are trying to make this tech accessible, so the question is when not if this tech will ever be at the palms of our hands.
My question 
; do you think it would it be possible to create a hApp that would incentivize people people to stay healthy with good diet and enough physical activity ? The first thing that came to mind when thinking about this was Steemit (I still don’t understand where the money comes from and started reading the whitepaper). Maybe something similar, where people would be incentivized to keep body composition parameters intact, be rewarded for helping others achieve goals, different peer pressures instead of writing ‘quality’ posts (like on Steemit). Maybe the financial reward would be an agent-centric NON FIAT currency that would be able to handle the complexity of the changing environment. From what I think I understand about agent-centricity so far is that it enables you to manage complexity far more easily (like increasing/decreasing supply based on certain parameters, like in Holo for instance).
Do you think it’s possible to create a system that when for instance, with proper incentive mechanisms (game theory), a hundred people join, their average body composition data improves for lets say (10%). When the next 100 join, the same average can be drawn, and so on, and so on. With a ‘self healing’ system like this (if possible to construct) Insurance Companies would automatically ‘eat up’ the ‘self healing’ system because there would be zero risk in in getting involved. The data proves that the average body composition of the participants always improves, and would therefore know that the costs will be lowered, without them spending a single dime on trying to themselves financially incentivize individuals. Once in one payer would reap the benefits, others would have to do the same thing and try to compete, or else they will be no more.
My thinking is that this would open the doors for payers to slowly increase incentives from their own pockets and significantly change the relationships between the participants of the whole healthcare sector. With prevention standing before curing and management of diseases, USA’s $4 trillion healthcare bill would be significantly lowered (not counting the increased productivity).
So the hApp idea is basically a ‘self-healing’ hApp that would get ‘engulfed’ by the Insurance Industry.
There is much to explore on this topic and would invite others on this forum to join the conversation and share your thoughts. Please feel free to criticize my written thoughts, it is only the wind that makes the pine stronger 
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