xviii: med funding and the "go get it" attitude
where do public and private funds go when it comes to medical innovation and who should take the blame
Good morning,
In the past month I have been mostly writing about male problems, their struggles with masculinity and other fairytale issues. Started feeling a bit like a men’s rights activist. F that. Let’s get back to actual problems, that must be solved through more than some therapy sessions and healthy ego checks. These real problems are solved through equitable policy shifts, smart allocation of private and public funds and a drizzle of empathy.
While frenetically researching about my fav health condition, PCOS, I came across a study Apple jointly started with Harvard School of Public Health. What they do is take the data from your Apple Watch and iPhone, ask you a few questions and use this to gain scientific insight into our health, as opposed to nudging you to buy things that you don’t really need. Probably they will sell that insight back to us at some point, in some way, but at least we will live longer or something.
Part of the study is focused on women’s health and looks at menstrual patterns. When they shared preliminary findings, one of the study’s main principal investigators and assistant professor at Harvard said “(…) this natural monthly occurrence is something we should be having more discussions about”. Wow. Who would have thought. We measure how hydrated we are by the colour of our pee, but the monthly bleeding must be as meaningless as its role in human reproduction. But let’s not become cynical, just because it took medicine a couple of hundreds of years to slowly begin to acknowledge female bodies.
Call it irony or good strategy, but in a turbo capitalistic world, the largest company by market cap is the one pushing this research forward. Smells like many consultants looked into the numbers and said go. Women are the main decision makers when it comes to healthcare spending, yet the medical sector and pharma companies mainly service white males. Why does this work? How can addressing women’s needs and pains boost their ARR? Why are they not doing it? Puzzles shuffled by the patriarchy. Puzzles that feminists have to solve by explaining that equity and tailoring the world to the other half of human population makes sense financially. Especially in a world where that half is increasingly involved in the paid work force and has a quasi monopoly on non-discretionary household spending decisions. Pls optimise.
Here I wrote about how medical care and research fail women. Let’s look at how venture funds do, too. And leave on the table healthy gains in the process. Gloomy. Makes sense considering in the US only 16.1% of VC decision-makers are women. Try talking to a dude about your period cravings or about how you panicked during your regular breast self check. They immediately look around the room, muttering something about ladies’ issues and privacy. Kind of difficult to make them give you their money.
We rely on the few female investors to allocate capital. And the few truly data driven male investors, who have maybe bought once some o.b.s for their girlfriends and are not all too shy. Once again, representation proves paramount. When Roe v. Wade was overturned and women in the US were stripped of their bodily autonomy, female investors pledged to double down on women’s health innovation and leverage the private sector in order to make sure all women receive adequate health care in all circumstances. We already know that women are the better investors, so make no mistake, this was not a retaliation or activist act. These women are HBS alumnas, good with numbers and simply above the male average when it comes to research, risk aversion and self-control as per.
Case in point, women spend on average 85% more than men on health care during their reproductive years, yet startups addressing women’s health are heavily underfunded and only get about 5% of capital invested in digital health startups. For the investors among you, Christina Farr of OMERS Ventures (they raised almost $2 billions across their 5 funds) wrote a more in depth analysis of the space, why they are betting on women’s health and strongly encourage everyone to do so. This is a niche not so niche with half of the population being somewhat involved. She also brings to light an other overlooked aspect. Race.
Our medical care is not only tailored for men, but it is close to precision medicine for white males. It is easier to speak of gender equitable medicine, but what I actually mean is medicine for everyone else than the standard white 1,80 male. And I know it is hard to believe, but those guys are actually a small share of the human population. They just seem to have found a way to plaster their faces in all ads, movies, etc.
In terms of public funding, in the US only about 1% of healthcare research and innovation is invested in female-specific conditions beyond oncology. A recent study ran a series of simulations looking at the return on investment we might expect, if the National Institute of Health budget for studies specifically assessing the health of women were increased. By doubling the NIH budget for research on coronary artery disease in women from its current $20 million, we could expect an ROI of 9,500%. Studies focused on rheumatoid arthritis in women receive just $6 million a year. LOL. Doubling that would deliver an ROI of 174,000% and add $10.5 billion to the economy over a 30-year timespan. Yeah, it is a bit of a long term commitment and the calculations include indirect outcomes, but not even Doug of Sequoia dreams of such returns.
How do we direct funds to investments that perform well, while doing good? It seems data is not enough to persuade our cute little men. I would argue that however smart and informed a person might be, not being able to relate could blind them. It is so difficult to alleviate pains you don’t feel. That is why we have to make space at the table for everyone. Not because it is the right thing to do ofc, but because it yields most and greed is good;). Diversity for profit.
On a different note, Mirna Funk wrote a guest article for Der Spiegel arguing that female empowerment can only be achieved, if women are financially independent. Make sure you are in charge of your money and all is good. Go work full-time and all gender gaps will disappear in thin air. She was born in East Germany to a grandmother and mother who both worked AND took care of the household.
To solidify her theory, she lays out - in 1989, on the eastern side of the wall, 91% of women were working, as opposed to the only 51% on the western side. Until today, the gender pension gap is double as high in the west as it is in the east. The pay gap is only around 6% in the former socialist German counties, while the average in the whole country amounts to 17,6%. Women in the east orgasm more often than in the west. Could not find the data source for the latter, though. Clearly, by working full-time, women have solved the gender pay, pension and orgasm gap.
The former Socialist Republic of Romania has the lowest pay gap in the EU amounting to only 3,6%. Communists made everyone equal. In theory. But oh boy, do I know how deeply engrained gender stereotypes are. The systematic sexism that governs the private and public life, despite the glorious stat. I would even argue that, on average, women in post-communist countries are more sexist, than their western counterparts. And that is because of internalised patriarchal concepts. The idea that you can do both, because your grandma did. Yes, she did, forced by an authoritarian state. Coercing someone to comply is different than solving underlying issues. And just because you are capable of enduring hardship, it does not mean you should.
Funk writes on her insta things like macht euch frei im Kopf! German for make yourself free in the head. Just get over it. Put your head down and work hard. English for work harder than men to get the same or even poorer rewards. But feminism is about having the right to be as mediocre as any other successful dude. That is equality. Same input, same output. True meritocracy.
In addition, Funk’s article completely ignores the massive impact socioeconomic background still has on financial success, even in our days, when social mobility is allegedly so high. Her answer is simple. You earn too little money to afford child care? Make more, loser.
Anyways, I also read her unhinged and hilarious piece for Die Welt on how German men are undatable and the Tel Aviv boys much more fun. I will not comment on the theory per se (even though I would love to), but here too, I felt this go get it feminism. Just stop complaining and start doing. Get what is yours. In principle, I concur. But this shifts all responsibility to the oppressed.
We cannot wait around for white males to fix medical care and research for all of us, but we can expect them to move aside, make space, ask questions and listen. That is their responsibility. And I think many of them would be willing to, if it weren’t for the irrational guilt and general uncomfortableness that comes when confronted with your own unjustified privilege. Viewing this critique as personal attack. I don’t blame the state of affairs on anyone personally and don’t need them to feel guilty. But I need them to acknowledge that the current world favours them in my detriment. And if there are arguments as of why that should not change, may they be brought forward.
Often what seems so obvious and easy, changes once we go below the surface. Showing investors data might not always compel. Their gut feeling aka male centric bias will weight in. Remains to be seen, if this funding gap can be solved by increasing the number of female investors and the capital available to them. Socialism did not make everyone equal and chill and allowing women financial independence is not the holy grail. Social structures are more complicated than that. And that is when you add the drizzle of empathy. Our human magic.
What an unsatisfying post today. A bunch of issues and no concrete explanations, nor solutions. Those are the toxic confusions patriarchy creates. Let me know, if you have more answers. Unthread the thread.
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