Good Health is Bad for Business

Hal Cranmer
August 06, 2025

Many of you probably already suspected this.

“A patient cured is a customer lost.” I’ve seen that expression all over the internet. At least in the areas where I like to hang out.

Wall Street heavily invests in healthcare and biotechnology. They want a return on their investment. A healthy population that does not need drugs, vaccines, surgeries and other treatments are not good for their bottom line.

Maybe we’re being cynical? Maybe they really put the health of patients over the health of their investment portfolio.

Or…maybe not.

In 2018 Goldman Sachs, a very large investment firm on Wall Street, came out with a research report asking the following:

“Is curing patients a sustainable business model?”

The report focused on one-shot gene therapy cures, such as the company Gilead Sciences. Gilead had just come up with a gene-therapy treatment for Hepatitis C which had a 90% cure rate for patients.

At first glance these seem like money-grubbing, evil people who don’t care about your health. Yet you have to remember they have to advise their clients on the best way to make money.

The report recommended three ways biotech and other pharmaceutical companies can maneuver around this problem of making money vs curing patients:

“Solution 1: Address large markets: Hemophilia is a $9-10bn worldwide market (hemophilia A, B), growing at ~6-7% annually.”

“Solution 2: Address disorders with high incidence: Spinal muscular atrophy (SMA) affects the cells (neurons) in the spinal cord, impacting the ability to walk, eat, or breathe.”

“Solution 3: Constant innovation and portfolio expansion: There are hundreds of inherited retinal diseases (genetics forms of blindness) … Pace of innovation will also play a role as future programs can offset the declining revenue trajectory of prior assets.”

To their credit, they were still trying to figure out a way to help people and make money. And I think their solutions are playing out.

The diseases that are the most common, or the highest-revenue generating, attract the most funding and research. Cancer, heart disease, Alzheimer’s, diabetes. They all receive massive funding for research.

That’s not necessarily a bad thing. We want to help the most people with the limited resources we have.

There are lots of diseases that are not that common. If you have one of those diseases, chances are you’re on your own. Or at least the resources and research are limited.

What I believe is really flawed about this model is that many diseases are linked. They start out from the same root cause - poor metabolic health.

Heart disease comes about from a poor lifestyle.

Type 2 diabetes is most often linked to a poor diet.

Alzheimer’s is often called type 3 diabetes

Research dollars always go into a specific manifestation of the disease. They don’t go into how we can be the healthiest overall we can be.

Fixing our metabolic health overall could possibly take care of the majority of diseases at once. I guess though that would be bad for business.