Are We Funding Sickness Instead of Health?

Healthcare systems worldwide are grappling with a common crisis: an entrenched bias towards treating illness rather than preventing it. Despite rising chronic disease burdens, worsening mental health statistics, and clear economic signals, our funding models remain reactive, designed to rescue, not prevent.

A closer examination of data from the UK and the US confirms this misalignment and suggests a pathway forward, driven by prevention, digital innovation, and a rebalanced model of care.

A Decade of Broken Promises: The UK Example

Lord Ara Darzi’s 2024 independent investigation into the NHS sounds a clear alarm: “Too many people end up in hospital, because too little is spent in the community.” His report shows that despite more than 15 years of rhetoric about moving care upstream, the share of NHS spending on hospitals grew from 47% in 2006 to 58% in 2021, while preventive health budgets were slashed by over 25% since 2015.

This graph illustrates the long-term shift in UK healthcare funding away from community and preventive services, despite changing population health needs.

The impact? Life expectancy in the UK plateaued during the 2010s, but the proportion of life spent in poor health increased, serving as a stark reminder that treating sickness later costs more and yields less.

The Global Pattern: US Spending, Misaligned Incentives

The pattern holds true internationally. According to Deloitte’s Safeguarding Medicare (2025) report, the US spends over $2.4 trillion annually on treatment, accounting for more than half of its total healthcare expenditure. Only about 20% of the budget is allocated to promoting health or preventing disease.

Deloitte projects that a shift to proactive care could:

• Save the US up to US$2.2 trillion annually by 2040
• Add more than five healthy years to the average life expectancy
• Delay Medicare insolvency, saving US$500 billion per year

Spending on health promotion is projected to grow at a rate of 10% annually, while treatment costs rise at just 1%, highlighting a strategic opportunity.

These are not just financial wins; they represent real human gains. For instance, data from the American Heart Association shows that maintaining cardiovascular health in midlife can delay the onset of disease by seven years and compress the period of severe illness by over 80%.

The Case for Shift Left, Stay Left (SL2)

Enter Professor Martin Curley’s Stay Left, Shift Left framework, a transformative model that realigns funding, technology, and care delivery.

• Stay Left: Keep people well and empowered in their own homes.
• Shift Left: Move care out of hospitals and into the community, enabled by connected technologies.

This diagram illustrates the full continuum from preventive care to acute hospitalisation, highlighting opportunities to intervene earlier and at lower cost.

Curley’s model is grounded in evidence:

• The TriTemp Thermometer case delivered 10 times the savings by reducing infection risk, eliminating disposable plastics, and cutting nursing time by 80%.
• Remote monitoring and AI diagnostics enhance early intervention, reducing unnecessary admissions and enabling timely care.

This isn’t just health tech. It’s a philosophical shift, from health insurance to health assurance.

Redesigning Incentives: From Crisis Management to Health Promotion

As Lord Darzi aptly states, “The system produces precisely the results that its current design drives.”

If we want different outcomes — longer healthy lives, lower system costs, and empowered citizens — we must redesign the architecture of care:

• Budgets must prioritise prevention, not just cure.
• Performance frameworks must reward wellness, not throughput.
• Digital health infrastructure must be embedded at every level of care.

This includes tools like:

• Patient Portals that support self-management and health literacy
• Clinical Portals that unify data across settings, ensuring clinicians can act early
• Digital Front Doors that connect individuals with tailored care plans, remote monitoring, and wellness tools

These are not future visions; they are deployable technologies that can power the Shift Left transformation now.

The Cure Is Not More Spend, It’s Smarter Spend

We are not underfunding healthcare. We are misallocating it.

Globally, we spend billions treating avoidable illnesses, while failing to invest in the upstream interventions that could prevent them in the first place. And yet, as Professor Curley notes, “Small shifts in budget from reactive, restorative care to proactive, prevention efforts can have radical impacts on outcomes and longer term costs.”

The equation is simple:

Shift Left + Stay Left = Healthier Populations + Sustainable Systems

Final Thought

We are funding sickness instead of health. But we don’t have to.

The data is in. The digital infrastructure exists. The models are validated.

What’s needed now is leadership to pivot from volume to value, from beds to better lives, and from passive treatment to proactive care.

It’s time to stay left, shift left and move health forward.