Entrepreneurial Opportunities For Real Health Care Reform

Well, there it is. After decades of aborted attempts and months of shrill anger disguised as debate, the House and Senate have finally passed a health care reform bill. The changes the bill writes into law will protect millions of people from the worst abuses of the insurance industry. But for my money, it's only one half of the story of how "health" is changing in this country. I think the even more exciting opportunity for building a healthier country is all about the bottom up.

Our health system isn't just broken because insurance is broken -- although that doesn't help. Our health system is broken largely because our food system -- in terms of both our relationship with food and the business of food -- is broken.

In the middle of last century, the food production business began to mimic the industrial manufacturing process. Big factory farms took over the process of food production and focused on "monoculture," growing single specific crops (mostly corn and soy) -- in the process pushing out small local farmers.

Unfortunately, the decline in health we're experiencing now -- and particularly the explosion of obesity and related disorders -- has a lot to do with the unintended consequences of "scale" when you apply it to food. Just like in other industries, companies that achieve economies of scale can offer the same goods for less money. When it comes to food, though, the reduction of the cost of food has made unhealthy, highly-processed corn and wheat-based foods the cheapest.

This change in the way we eat has happened alongside changes in how we work and live. More and more of our workforce is in sedentary professional or service jobs. More and more of our entertainment is in front of screens. And the combination of the change in food and the change in lifestyle has produced the reality that for the first time, the generation coming of age today is expected to have a shorter lifespan than its parents.

Our health care system has been largely based around treatment, rather than prevention. Indeed, an inordinate percentage of our annual health care budget is spent on end-of-life care. What's more, an amazing amount of our spending is used to treat preventable diseases. The new bill, following mostly the same logic, is focused on redressing the biggest inequities and problems in the system when it comes to getting treatment.

When it comes to changing the food system, however, there is incredible activity happening among bottom-up entrepreneurs. Of course there are the Whole Foods, Odwallas and other companies you know who are putting "natural" and "organic" on the consumer map. There are also groups like the Slow Money Alliance (one of our Ideas for Change in America finalists), who are trying to create new infrastructure for investing in local food systems.

At the same time, there is an even more developed startup ecosystem around changing lifestyles. While many of this generation are still focused around "losing weight" as the root of good health, the best ones (like DailyBurn) are all about making it easier to make good choices.

When people do get sick, a growing number of companies are expanding the options about how they address the situation. HelloHealth, for example, creates an entirely different ecosystem in which doctors and patients can connect together -- often without insurance middlemen, and sometimes without even being physically together.

I think that these companies are really just the tip of the iceberg. With better information available about both the origins and consequences of the food we eat, the opportunity for companies to make the information accessible in ways that help us change behaviors is vast. Stack that with new ways to connect with health care professionals, and you have some serious change I can believe in.

Photo Credit: borman818