FatFIRE and Healthcare: An Insider’s Perspective on What Money Can (and Cannot) Buy
As a pharmaceutical chemist with a focus on clinical operations in US academic institutions, I regularly interact with doctors, administrators, and other healthcare professionals. Across this spectrum, there’s a wide range of beliefs about how money can influence health outcomes. Here’s a balanced, insider view based on personal experience and observations.
What I don’t support or purchase
– Non-approved experimental treatments: I don’t pay for these. In my view, they’re often ineffective at best and dangerous at worst. There isn’t a secret conspiracy among the wealthy to access “better” treatments. The pharmaceutical industry is generally incentivized to bring approved therapies to as many patients as possible, and getting FDA-approved options onto the market remains the primary objective.
– VIP hospital services: I don’t pay for VIP hospital experiences. They tend to be scams in my view—paying for a larger room or a more “personal” administrator while treatment quality remains the same. Doctors have told me they find it frustrating to divert time to VIP patients when their schedules are already demanding.
– Generic “get rich quick” healthcare schemes: I avoid programs that promise easy fixes, miracle cures, or shortcuts around evidence-based care.
What I do spend on, and why it can matter
– FDA-approved products not covered by insurance when clinicians see potential benefit: I have funded medications out-of-pocket when doctors believe they can meaningfully help a patient. For example, during a relative’s chemotherapy, antiemetics (such as Merck’s Emend) were not covered by insurance for a specific regimen. The oncologist felt they would be beneficial, so we paid OOP. I believe it contributed to a more tolerable treatment experience, even though I don’t have a counterfactual to prove it.
– Concierge primary care: I pay for a concierge primary care setup. This model often allows same-day appointments, longer visit times, and access to MDs who can coordinate rapid referrals if needed. My PCP is affiliated with a major academic hospital, and I suspect this affiliation can help streamline specialist access when required. While I can’t quantify it, I perceive that referrals and care coordination can be faster in this arrangement.
– Donating to local academic hospitals: I donate to support research in specific disease areas and to foster relationships with specialists. In practice, this can contribute to faster access to expert opinions and potential referrals, though it’s not a guarantee and is influenced by multiple factors.
A pragmatic view on “big rocks” in health
– Fundamental health principles remain critical: Regardless of financial resources, the core strategies—eating a healthy diet, exercising regularly, and maintaining mental health—are foundational. There is a spectrum of products and programs claiming to optimize health, but prevention and lifestyle choices are consistently evidence-based cornerstones.
– Scams vs. nuance: There are certainly scams in the health-adjacent space, especially in the fatFIRE arena. Yet there is nuance beyond simple slogans like “eat more broccoli” or “get a blood boy” (a reminder that credible health decisions should be grounded in evidence, patient-specific factors, and clinical judgment).
Questions I’m happy to answer
– How does concierge care impact scheduling, access to specialists, and perceived quality of care?
– In what scenarios have insurance gaps driven out-of-pocket decisions, and how were those choices made?
– How do donor relationships with academic centers affect patient navigation and wait times, if at all?
Bottom line
There is value and risk in how money intersects with healthcare. Some out-of-pocket decisions—when guided by evidence and clinician input—can improve a patient’s experience and outcomes. Yet expensive “extras” do not guarantee better care, and there are legitimate concerns about access, fairness, and the potential for inequities. The most reliable approach remains prioritizing proven prevention, evidence-based treatments, and thoughtful collaboration with trusted healthcare professionals.
If you’d like, I can tailor this to align with a specific fatFIRE healthcare setup or explore particular questions you have about access, cost, and clinical decision-making.
