Conjecture

The investment thesis for healthcare is in Part I already, stated as a prediction rather than a complaint. The United States spends more on healthcare than any nation, enough that Part I says it threatens the long term stability of the economy, and ranks in the mid forties globally for life expectancy alongside Lebanon, Cuba and Chile, countries with far lower income per head. The reason given is specific and is the bottleneck: treatments for the conditions that now dominate the American disease burden, obesity, diabetes and Alzheimer's, are extremely expensive and fairly ineffective. Hence the prediction, and it is the one worth building on: the rest of the world should expect diminishing marginal utility from healthcare spending as their disease burden shifts, unless healthcare systems evolve. The burden is being exported, with China's stunting falling from 16 percent to 2 percent between 1985 and 2014 while obesity rose from 1 percent to 20 percent.

Capital mechanisms