Conjecture

SYNTHESIS: the forecast that makes prevention visible and the risk adjustment that makes prevention payable are the same instrument, and both must be filed before the act. From ours: a prevention that works "leaves no story behind" (C-VYGKJSD11V), and a slow risk needs a fixed baseline kept outside living memory (C-2TVPMC9VRM); paying a plan for disease-free years rewards enrolling people who would have stayed well unless the payment is adjusted for who joins (C-V3W3JFVTEC). From Diamond: the leader who acts early needs "a different type of courage" because such leaders "expose themselves to criticism or ridicule for acting before it becomes obvious to everyone that some action is necessary." From Ord: experience-based judgement "fails completely" for the worst risks, since "we never have any experience of existential catastrophe before it's too late." Together: commit, at enrolment or at the start of a programme, an independent forecast of what would happen without the intervention, and pay the preventer on the gap between that forecast and what happens. The one number keeps the averted harm on the record, so success no longer reads as a false alarm, and it prices each member's risk, so the payer cannot win by picking the healthy. The forecaster must be paid by neither side, or the baseline drifts toward whoever pays it.

Paying for health, not sickness