Systemic cracks emerge, healthcare hurdles loom
The intricate interweaving between U.S. federal healthcare insurance, private insurance plans, and huge medical costs has caused the U.S. healthcare system to face long-standing contradictions of high costs and low efficiency. Recently, the unfortunate passing of UnitedHealthcare CEO Brian Thompson has drawn more attention to the role of insurance companies in medical services. According to reports from The Washington Post, Thompson admitted that many Americans view insurers as 'obstacles', criticizing their stringent prior authorization and denial policies that affect patients' rights to receive necessary treatment. This controversy again reflects the chronic issues of the U.S. healthcare system: excessive bureaucracy and entanglement with commercial interests, which not only stifles price competition but also makes it difficult for patients to find balance between insurance claims and treatments.
Simultaneously, the vast market size further highlights the root of the problem. The U.S. healthcare insurance market is estimated to reach $1.4 trillion this year, with giants like UnitedHealth Group, CVS Health, Anthem, and Humana monopolizing nearly 70% of the market share, which also limits the reforms that policy adjustments and the market can bring. After the pandemic, the continuous rise in healthcare demand and costs has made the public more aware that simple reforms within the traditional financial system may be inadequate.
Web3 and crypto: Can they break the cost and accessibility bottleneck?
As blockchain and cryptocurrencies mature, the emerging Web3 thinking is being seen as a potential way to restructure healthcare. Similar to the concept of Bitcoin's 'de-intermediation and bank self-service', if promoted in the medical payment and data management industries, it could provide an alternative to the U.S. healthcare model, which is currently dominated by multiple intermediaries such as insurance companies, healthcare institutions, and government subsidies. For example, through the immutability and transparency of blockchain transactions, huge administrative costs in policy reviews and payment processes can be reduced, and smart contracts can automatically execute cost settlements, minimizing errors in claims and disputes.
At the same time, regarding DeFi (decentralized finance) solutions that have emerged from the Web3 and crypto markets, they provide patients and medical institutions with more flexible financing options, such as microloans and cross-border payments, reducing the chances of patients delaying treatments due to waiting for insurance approvals. For groups lacking complete credit history or financial channels (similar to 'unbanked individuals'), decentralized lending platforms can also assist them in raising funds for treatment or purchasing supplemental insurance. This model of 'redefining medical payments' allows for a balance between cost and accessibility among a broader user base.
Data sharing and incentives: Reshaping the healthcare experience
In addition to payments and insurance, Web3 also holds significant potential in medical data management. In traditional healthcare systems, personal medical records are often scattered across multiple institutions or insurance companies, greatly increasing the risks of redundant examinations and misdiagnoses. If a decentralized medical record platform is established through blockchain, patients can control their complete medical records through private keys, enabling quicker and more accurate access to information when authorizing doctors or research institutions.
At the same time, to encourage patients to contribute data for pharmaceutical, AI analysis, or public health research, Web3 also offers incentive models that reward individuals with crypto tokens, shaping a new 'patient-research-insurance' ecosystem.
On another level, in response to complaints about 'expensive premiums and lengthy reviews', blockchain insurance platforms can utilize smart contracts to automatically execute approval procedures and record the process immutably on-chain to prevent insurance companies from unilaterally making things difficult or misleading. More importantly, if the data can be processed in a standardized format, insurance billing can become more scientifically transparent, reducing conflicts of interest between institutions and insurers.
Source: iThome. Taiwan actually began developing a 'shared platform for insurance technology applications' as early as 2019; through the method of 'alliance chain', it has created the largest financial blockchain in Taiwan, the 'Claims/Security Alliance Chain'.
Regarding the above content, Taiwan actually began developing a 'shared platform for insurance technology applications' as early as 2019; through the method of 'alliance chain', it has created the largest financial blockchain in Taiwan, the 'Claims Alliance Chain', which has now become the most important application for multiple insurance companies, many hospitals, and hundreds of thousands of policyholders. In 2023, it launched 'Claims Alliance Chain 2.0', continuing to optimize and provide more diverse financial services.
Source: Global Life Claims Alliance Chain 2.0 Operation Manual
Policy challenges and possible futures
Of course, to enable Web3 and cryptocurrencies to be implemented on a large scale within the U.S. healthcare system, there are still challenges such as regulatory compliance and market habits. High compliance costs, data privacy issues, and currency volatility risks are all current reality problems. However, the market's demand for reform and the younger generation's openness to insurance and payment methods are driving various parties to attempt breakthroughs. More and more startups and research institutions have also entered this industry, actively testing waters from decentralized data-sharing platforms to establishing health reward mechanisms using crypto tokens.
In fact, the public outcry and anger triggered by the death of the former UnitedHealthcare president further highlight dissatisfaction with the cumbersome and inefficient U.S. healthcare system. If blockchain and crypto technologies can be used to reconstruct payment and management models, it may help alleviate the dilemmas of U.S. healthcare reform. This does not mean that crypto can immediately repair the entire structure, but at least it offers a direction of 'more cost-effective and user-friendly'. If all parties, from government to private sectors, are willing to try this innovation, perhaps we can truly break free from the existing impression that 'insurance companies are obstacles', moving towards a 'patient-centered' new era of healthcare.
Further Reading
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[Disclaimer] The market has risks, and investment should be done with caution. This article does not constitute investment advice, and users should consider whether any opinions, views, or conclusions in this article align with their specific situations. Investment based on this is at one's own risk.
The article 'How can Web3 repair the broken healthcare system in the U.S.?' was first published in 'Crypto City'.