The most bang for our healthcare buck occurs in providing improvements in socioeconomic factors–preventive, systemic changes that result in improved quality of life. Those changes have occurred naturally over the past two centuries as a function of fossil fuel related improvements in public health and complexity.
Yet most of our current healthcare interventions occur at the top of the pyramid above, in costly, high-tech clinical interventions. If fossil fuels are constrained in the system, then both the top and the bottom of the healthcare hierarchy become disordered, requiring change. Healthcare is one of the last bubbles in the US economy. We need new goals and a new healthcare system that is focused on justice and the good of the whole, rather than profits and personal freedom.