Why We Suck at Prevention (And Why It's Killing Us)

The hidden formula destroying civilization, one deferred crisis at a time

Here's a stat that should terrify you: we spend 97% of our healthcare budget fixing people after they break, and 3% keeping them from breaking in the first place.

Reliable studies suggest that every krona spent on prevention returns on average 14 kronor in savings for society. That's a 1,400% ROI just sitting there, ignored.

This isn't stupidity. It's a systemic failure that's replicated across every major challenge facing civilization.

The prevention paradox

Prevention has a fatal flaw: it works too well.

When prevention succeeds, nothing happens. No dramatic rescue. No visible crisis averted. Just... normalcy. And humans are terrible at celebrating things that don't happen.

We don't throw parades for the heart attacks that didn't occur because someone exercised. We don't give medals for the depression episodes prevented by better sleep. Success in prevention looks like absolutely nothing.

Meanwhile, every healthcare system, political structure, and economic model is built around reacting to crises. Hospitals need patients. Politicians need problems to solve. Media needs disasters to report.

Prevention doesn't generate the drama that drives funding, attention, or careers.

The time horizon trap

Prevention requires spending today for benefits that arrive years or decades later. But every decision-maker operates on much shorter cycles:

Politicians think in election terms (2-4 years)

• CEOs optimize for quarterly earnings (3 months)

• Venture capital expects returns within 5-7 years

• Individual humans struggle to delay gratification beyond weeks

The math works for society over decades. It doesn't work for anyone making decisions right now.

This creates a systematic bias against long-term thinking across every level of society. We're not failing at prevention because we're dumb. We're failing because our entire incentive structure is designed to optimize for short-term visible results over long-term invisible benefits.

The accountability gap

Here's the killer: the person who pays for prevention rarely gets the savings.

A government that invests in citizen health sees those benefits spread across decades and multiple administrations. A company that invests in employee wellness might see reduced insurance costs years later—if those employees even still work there.

The costs are immediate and obvious. The benefits are delayed and distributed. So prevention gets deprioritized every single time.

This pattern repeats everywhere:

• Climate change (spend now, benefits in 50 years)

• Infrastructure maintenance (spend now, avoid collapse later)

• Education funding (spend now, see economic benefits in 20 years)

• Pension system reforms (sacrifice now, avoid crisis in 30 years)

Why this matters now

We're hitting a convergence point where multiple deferred crises are arriving simultaneously.

Healthcare costs are consuming ever-larger chunks of GDP. Climate change is moving from theoretical to expensive. Infrastructure built decades ago is failing. Pension systems designed for different demographics are breaking.

All of these were preventable. All were ignored because the prevention costs were visible and immediate while the crisis costs were invisible and distant.

Until now.

The prevention opportunity

Here's the thing: once you recognize this pattern, you can exploit it.

I got to thinking about this during a conversation with Joakim Skarborg, who left his role as CEO of traditional investment firm Novax to start Altea Capital—a fund that exclusively invests in preventive health. Not healthcare. Health.

"We're facing a demographic shift where, in a few decades, as much as 100 million fewer Europeans will be under 65, and up to 70 million more over 65," he told me. "The math doesn't work unless we keep people healthy longer."

Joakim represents a new breed of investor who's recognized that prevention isn't just morally right—it's where the money is going. While others are still investing in expensive treatments for sick people, he's betting on companies that keep people from getting sick in the first place.

Smart money is moving toward prevention-focused investments across sectors. Not because investors suddenly became altruistic, but because the math is getting impossible to ignore.

Companies that invest in keeping employees healthy rather than dealing with sick leave are gaining competitive advantages. Countries that invest in infrastructure maintenance rather than emergency repairs are building economic moats.

The early movers who solve the prevention problem—who figure out how to make long-term thinking profitable in short-term systems—will have massive advantages over those still playing the crisis-reaction game.

The uncomfortable reality

We've built a civilization that's systematically incapable of preventing problems it can clearly see coming.

This isn't a failure of intelligence or information. It's a failure of structure. Our economic, political, and social systems are optimized for short-term reactive solutions rather than long-term preventive ones.

The organizations and societies that figure out how to realign those incentives—how to make prevention profitable and politically viable—will survive what's coming.

The ones that don't will keep spending 97% of their resources fixing problems they could have prevented for a fraction of the cost.

Until they can't afford to fix them anymore.