I filmed at a Private Hospital in Zimbabwe in a fairly affluent area. We toured their hospital, which had theatres, consultation rooms, and also a Centre for Regenerative Medicine.

My level of surprise comes from the fact that in the West, we are always sold an image of Africa which is negative, and to be honest, I’d bought it. I was expecting to see standards that were below anything I’d seen before however this clinic was largely superior to any NHS hospital I have ever been in my life.

There was an intentionality behind the entire clinic where they thought about what the patient would want, and they built everything around that. Everything from the food on the menu, an open garden, and knowing their patients by name. They even had a VIP section for their more affluent people or ministers who don’t want to be seen by the public.

The BIG disclaimer is that this was a private hospital that does cater to the upper 2% hence they can invest in their services, and not a lot of people in the country can access it.

My trip illustrated to me that there is so much opportunity to improve healthcare services in Zimbabwe because of the large gap that exists. This is a gap between the private and public sectors, a gap between the private sector and other private services globally. Those who can afford private healthcare in Zimbabwe are global ‘customers’, they expect a level of service they receive in London or Dubai to also exist in Harare. This poses its own set of challenges.

I’d love you to watch the episode and let me know your thoughts

Watch the Full Video Here:

Let me be honest before I made this video, I thought BUPA was just a slightly fancier version of the NHS. A place your employer pays into so you can skip the waiting list and get a nicer waiting room.

I was wrong.

BUPA is one of the most quietly sophisticated healthcare businesses on the planet. No shareholders. No stock price. And yet £16.9 billion in annual revenue spanning insurance, hospitals, dental clinics, aged care, and data. Lots of data.

Here’s what actually surprised me.

The structure is the strategy. BUPA operates as a provident association, meaning profits don’t go to shareholders, they go back into the business. On paper that sounds wholesome. In practice it gives them a structural advantage most healthcare companies can’t replicate. They can play a long game that listed companies simply can’t afford to play.

They’re not just selling insurance. They’re buying the whole chain. This is what vertical integration looks like in healthcare. BUPA doesn’t just pay your hospital bill, they increasingly own the hospital. And the clinic. And the data from both visits. That’s not a health company, that’s a platform.

But it’s not all clean. There are real tensions in the model, between their provident roots and their commercial ambitions, between the promise of private healthcare and the reality of what gets covered. I got into all of it.

The business of healthcare is rarely what it looks like on the surface. BUPA is a masterclass in that.

I broke the whole thing down, company structure, revenue streams, how they spend the money, and what founders can take from the model, in this week’s video.

👇 Watch it here: The £16.9B Company Most People Don’t Understand

https://youtu.be/RVvi_anKasw

If you’re building in healthcare, or just trying to understand how the money actually moves in this industry, this one’s worth your time.

Malone

Hey friends,

This week Microsoft launched their CoPilot Health system. This is a personal health AI tool which makes life easier for patients. They feel this is a step closer to “medical super intelligence”.

Why now?

Microsoft acquired a company called Nuance in 2021 and this was an early move into the health space. It didn’t make sense at the time however in hindsight they acquired a company that had penetration across 77% of US hospitals for $16Billion. They weren’t necessarily paying for the company but for the systems and connections on the back end.

Fast forward to today, they are launching Co-Pilot Health which is the front consumer end facing. People are already using general AI to search for their health queries so the companies are servicing a demand which is already there.

OpenAI, Microsoft, Amazon and AnthropIc can all acknowledge that if they are able to tap into the health space this is big business. The stickiness of a customer and trust one will build with the systems will be great if they can help consumers in their times of need.

I’m also very bullish on they’ve seen the “permissionless” era trend and they too believe they can have a slice of the piece. By permissionless I’m referring to how back in the day you’d have to go through Hollywood to be a movie star, now you can make your own YouTube channel. Or you’d need a record deal to make music, now you can blow from tiktok and soundcloud. I think healthcare will see a similar trend. Previously you needed a health institution to tell you about your health, soon we won’t and rely on your personal companion that knows you better than a single episode of care. Critics will be opposed to this future however when their is problems with workforce being unpaid and overworked, patients struggling to see a clinician, the solution that seems to solve people’s problems will win. This is already happening as Co-pilot receives 50million health enquiries a day…

If you want to hear more of my thoughts I share them in my most recent YouTube video. I’d love to hear your thoughts on this topic too!

Why Big Tech Is Obsessed With Healthcare (It's Not What You Think)

https://youtu.be/WRIFwh-YQiA

People are making healthcare decisions in the same way they choose everything else. Looking at reviews, word of mouth, branding, or simply just vibes. The same decision-making process to choose a coffee shop is being used to decide on picking their doctor, therapist, supplements, or sometimes people self-diagnosing themselves.

I think it started with the trust that was broken during COVID. This was trust with big institutions broadly, and healthcare unfortunately fell victim to this.

Guidelines changed weekly, one minute we were locked down and the next minute we weren’t. Amidst all this chaos, people ultimately had time and decided to take matters into their own hands. This was by doing their own research.

This behaviour did not stop once the pandemic ended. If you give people keys to have autonomy over their health, chances are they won’t give it up that easily. Healthcare-related searches on Google, TikTok, and Reddit are still on the rise and the wellness economy is exploding.

Healthcare has now become a consumer brand, and the people who win in this space are the ones who acknowledge this. They will be able to see that the psychology behind choosing a new coffee shop is going into healthcare decisions. Healthcare providers will be able to move forward with the times and help their patients.

This sounds like a great ideal, will it happen? I’m not sure traditional health systems will be able to keep up with demand. This is because the systems are so stretched and reacting to issues that come their way. This leaves a huge gap for others to enter the space. I believe OpenAI, Amazon and Anthropic are aware of this change, hence why there was a big push towards Health AI this year. They acknowledge that people are sitting up at 2 am and ultimately, the trust dynamics have changed. If they can be present for people in their darkest hour ultimately they gain the trust and respect.

This is a huge grey area in healthcare at the moment because it feels like navigating uncharted territory, and i know critics will say this is not safe. However, I think the trust dynamics and consumer expectations with healthcare have changed so patients will take matters into their own hands.

I have a longer video where i break this topic down even more here. I’d love to hear your thoughts

🔴Watch here: Why You Trust A Stranger on TikTok More Than Your Doctor

Welcome back to another edition of the Business of healthcare. We have 18 subscribers currently, if you are one of those people thank you so much for being part of this community.

This week I visited Neko Health, a company founded by Daniel Ek (Spotify Founder) and Hjalmar Nilsonne. When I started documenting my journey, this was one of the clinics I really wanted to get on the series. This was simply because I feel like they are really pushing the boundaries of what healthcare means. I caught up with the lead GP and learned a lot from the experience.

1. Subjective vs Objective: In medicine there are many metrics that are subjective such as how things sound, smell, and feel. There are many different ways to interpret these clinical markers. Neko has found a way to allow us to track this data and with repeated scans over the years you can have a longitudinal data set of your heart sounds so we can truly see if things have changed.

2. Prevention as a business model: Prevention is better than cure is something as old as time. People have known for decades that this is the way forewards yet it is rarely practiced. This is largely due to the business models in healthcare do not incentivise prevention. A large part of western health systems are reactive, we wait for things to happen and then react. People can make money when an intervention is done, however people are not paid for preventing a stroke?
   Neko is allowing consumers to pay directly to get insights about their health that will prevent them from going to hospital in the future. When you charge the consumer in this way, the service and the product has to be 10/10 to justify the spend. The experience has to be leagues about the traditional health experience so that by the time the consumer leaves, price is the last thing on their mind.

Where does the future of Neko lie?

I believe we are still in phase 1 of Neko and what they can truly do. Their moat will be around the data that they capture. Critics state that there is a lot of ‘worried well’ people who engage with this service, the reframe Dr. Sam uses in the episode i filmed with him is those who are engaged with their health. Everyone going through a scan is essentially building up a database of what ‘normal’ looks like. This data becomes extremely valuable when it is longitudinal. When we can see how a disease progressed over the years or how early warning signs of heart sounds changing before catching something else. This is where the beauty for Neko will lie.

I also believe in the not too distant future Neko will launch a companion platform. Imagine an LLM that is trained on your scans at a point in time but can integrate with your daily habits. This increases the value of that longitudinal data. Ultimately they are creating a ‘health system’ within the Neko universe that understands you so well.

They have recently raised $260m and i’m excited for where they will head. I believe that healthcare should be an experience. Healthcare should feel like a high end consumer/conceirge service. This is exactly what they are doing!

Until next time friends, x

Here is a 20min breakdown into the episode

Neko Health YT Video

Malone

PS: I’m trying a new content style where I “thought dump” and I hope this makes sense for you. I’d appreciate some feedback at the end!

I think this is a really naive statement to make and AI will do to medicine what Netflix did to blockbuster

Hear me out…

It’s very clear to see that the rise of AI is unprecedented. Developments that once took decades and now taking years. Teams are doing more with less and the world is changing right before us.

One of the biggest industries in most country’s is healthcare. It’s also fairly safe to say that there is so much room for improvement in healthcare and that’s exactly where AI comes in. To oppose doctors statements about “who’s going to do the human aspect” in the current model of healthcare doctors hardly spend more time with their computers than they do seeing patients.

Broadly speaking for every 1 hour a doctor spends with a patient they spend 2 doing clerical tasks https://time.com/6313270/doctors-overworked-patients-access/ or in this case or the average contact time is 4.9 minutes per patient https://pmc.ncbi.nlm.nih.gov/articles/PMC8198090/.

Let’s assume you’re looking after 20 patients, 1hr 38 minutes of your shift is direct patient time…

This is exactly where I see AI coming in and unfortunately I think a lot of healthcare will be slow to see this change coming. Some of it is denial, denial that something can do their job better. Some of it is an assumption that AI is not going to improve exponentially, it might not work today as I’m writing this but there is nothing to suggest it won’t be working by December 2025.

If we go to first principles, in an ideal health system you want your doctors to spend as much time as possible understanding and caring for their patients. You don’t want them sitting behind a desk summarising notes. AI will be tremendous at doing these repetitive tasks.

The flip side is that even if doctors and health systems dont embrace healthcare, patients definitely will. Back at first principles when you’re unwell you want help, we’ve seen with the rise of Dr. Google in previous years that people will take the help from the place that’s readily available. With new features such as AI summaries on Google, getting your health info, assisted by AI is becoming easier and easier. Now imagine if you can integrate a system with your data from your wearables such as an Apple Watch. Arguably your “AI doctor” will have so much data about you that it can personalised and help you as an individual!

I’m excited for AI in healthcare, I think it’ll increase efficiency and fundamentally provide a better experience overall for the patient. This comes at a cost though and potentially the cost can be the role of the doctor as we know it today changing…

I hope this made sense, I decided to just share my thoughts as they came rather than try to refine it. Do you prefer this raw approach or a more refined approach

In the early 2000s, Nike dropped the Total 90 football boots. They weren’t just boots, they were a cultural moment. Every young boy growing up wanted a pair! Nike sponsored tournaments, made TV ads that felt like mini-films, and built a product identity around precision, speed, and swagger. Everyone wanted them, even if they never played 90 minutes.

The Lesson:

Nike didn’t sell a product. They sold a feeling, the idea that wearing these boots made you part of an elite. The idea that wearing these boots would make you shoot like Wayne Rooney!

Three key moves:

1. Deep understanding of user dreams (not just needs).

2. A launch campaign that felt like a movement.

3. Distribution channels that made it easy to get in on the hype.

The Healthcare Application:

When the NHS rolls out new health services (like the COVID vaccine), it often focuses on logistics, not culture. Imagine if the NHS launched preventive health checks like Nike launched Total 90s:

• Taglines that tap into aspiration (“Stronger at 70 starts at 40”).

• Engaging campaigns with faces people actually relate to.

• Early access events in communities to build buzz.

Question:

If the NHS had a marketing department like Nike, which health campaign would you re-launch first?

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