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Writer's pictureAmir Hayeri

The Missing Middle: Why Healthcare Fails to Serve the 'Healthy' Population

Updated: Apr 26, 2023

Our current healthcare environment operates around the edges. This may sound strange, considering how often we talk about healthcare and how much we spend on it.


The vast majority of healthcare spending and attention goes toward the chronically ill and end-of-life care. In the United States, 75% of the $2.2 trillion spent annually on healthcare is used to manage chronic illness. When we look at healthcare spending across a person’s lifetime, nearly half of a person’s healthcare spending occurs in the latter stage of life.


The other population who get significant investment into their health and wellbeing are high-performance athletes. The sports tech sector is booming, with new devices and software used to monitor an athlete’s bodies during training and competition. Some of them monitor performance, but more are dedicated to optimizing health with the goal of keeping the athlete at peak performance and reducing the risk or severity of injury.


You know which population isn’t getting the attention and resources of the healthcare industry it needs - the healthy middle.


Who is the “healthy middle?”


You, quite likely. I am. The healthy middle is the large portion of the population who feel generally healthy, but don’t really know what’s going on inside their bodies. We aren’t facing an acute or chronic illness and we aren't high performance athletes. As we get older, we start to feel tweaks and twinges, but that’s just life, right?!


Maybe. Maybe not.


The healthy middle is already on its path from general wellness into ill-health. Healthcare traditionally hasn’t focused on exploring this quiet path of the healthy middle. Between wearables and AI, we’re understanding better what’s happening in our bodies and the early, undetectable - to human senses - indicators of a growing health risk. Yet the healthcare industry doesn’t know how to work with us during this long, critical stage where high impact prevention can prevent cellular degeneration, keeping us healthy longer.


If we invest in proactively managing the health of the healthy middle, we can reduce the volume and proportion of healthcare spending needed late in life. We might even need to reimagine what healthy aging looks like.




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