Before you can fix something, you need to understand what's broken. In this case, what's broken is approximately everything.

They say knowledge is power. In this case, knowledge is mostly just depressing. But you need it, the way you need to know your house is on fire before you can put it out.

The Daily Body Count.

Every day, 150,000 humans die from disease and aging. That's fifty nine-elevens. Per day. Including weekends and holidays.

When one thing kills 3,000 people, it's a tragedy and you start wars. When diseases kill 50 times that every day, it's called "natural causes," which is Latin for "you couldn't be bothered.".

After the first nine-eleven, America invaded two countries and spent two trillion dollars. After the fifty daily nine-elevens, humanity shrugs and wonders what's for lunch.

Where the Money Goes.

Killing each other: two point seven two trillion dollars per year.

Curing diseases: sixty-seven point five billion dollars per year.

The real bottleneck isn't research funding. It's testing which treatments actually work. Governments worldwide spend four point five billion dollars annually on clinical trials versus two point seven two trillion dollars on weapons. That's a six hundred and four ratio, which in technical terms is called "having your priorities backwards.".

On Medical Research.

Since 1970, the N.I.H. has spent over one trillion dollars studying diseases.

Diseases cured: Zero.

Of its forty-seven billion dollar annual budget, only 3.3 percent goes to actual drug trials in humans. The other 97 percent goes to studying mice, building buildings, and publishing papers nobody reads. The system operates at 2 percent of its potential capacity to save lives.

On the F.D.A.

The F.D.A. makes drugs eighty-two times more expensive than necessary. It takes 14 years and two point six billion dollars to get a drug from discovery to patient. That's longer than it took to build the pyramids. The pharaohs didn't have to file quarterly progress reports in triplicate.

Ninety-five percent of diseases have zero approved treatments because the F.D.A. is excellent at preventing any drugs from reaching people.

On What War Costs.

Humanity spends two point seven two trillion dollars every year on war. That works out to three hundred forty dollars per human on Earth for death tools.

This budget includes:

Nuclear bombs (13,000 of them, because 12,999 wouldn't destroy Earth thoroughly enough).

Bullets (many).

A.I. murder robots (the future is here and it's disappointing).

Fighter jets that cost more than hospitals.

Submarines (one submarine equals one thousand cancer research labs).

Probably some kind of earthquake machine.

Your personal lifetime contribution to the murder budget is seventy-four thousand, two hundred fifty-nine dollars. You could have bought a really nice casket instead. Or, and this is just a thought, not needed a casket quite so soon.

The interesting thing about having 13,000 nuclear warheads is that after the first few hundred, you're just showing off. You can only destroy Earth once. The remaining 12,700 are for what, exactly? Destroying Earth's ghost? It's like buying 13,000 fire extinguishers for a one-room flat.
At some point, the fire extinguishers are the fire hazard.

On What Disease Costs.

Disease extracts one hundred and nine trillion dollars from humanity annually. That includes 10 million cancer deaths per year and 2 billion people living with chronic diseases. Depression alone affects a billion people, costing five trillion dollars in lost "wanting to exist.".

If disease were a country, it would be the richest country on Earth by a factor of ten. Unfortunately, disease doesn't have a flag or an army, so nobody invades it.

Out of two point four billion people suffering from chronic disease, only one point nine million patients per year get to participate in clinical trials. That's zero point zero seven nine two percent. Half would volunteer if asked. You're turning away ninety-nine point six percent of willing participants.

On Democracy.

A Princeton study found zero percent correlation between what the public wants and what policies get enacted. Zero. Not "low." Not "disappointing." Zero. Your democracy has the same correlation with your preferences as a coin flip has with your breakfast order.

When military contractors want one hundred billion dollars, they spend fifty-five million dollars lobbying for it. That's a one thousand eight hundred thirteen percent return on investment. When you want healthcare, you have approximately zero dollars to lobby with. You spent it all on healthcare. Or you're dead, which significantly reduces your lobbying capacity.

Meanwhile, the people who regulate industries used to work for those industries. They'll work for them again after they're done "regulating." It's called the revolving door, and it spins in one direction: toward money.

On the Fixed Pie.

Money isn't real, but resources are. Earth has 8 billion human brains. Every M.I.T. graduate building missiles is not curing cancer. Every brilliant physicist designing warheads is not designing M.R.I. machines. You have a fixed number of geniuses.
You are using them to build things that kill other geniuses. Switzerland spends zero point seven percent of G.D.P. on military and has ninety-three thousand dollars G.D.P. per capita. America spends three point five percent and has seventy-six thousand dollars.

The solution isn't to print more money for medical research. The solution is to change the ratio. Take money from the killing budget, give it to the not-dying budget. This is called "arithmetic," which is apparently a controversial field of mathematics.

What This Means.

150,000 humans die daily from disease and aging, many eventually avoidable.

Two point seven two trillion dollars spent annually on weapons.

Sixty-seven point five billion dollars spent annually on curing all diseases combined.

Six hundred and four weapons-to-clinical-trials spending ratio.

Zero diseases cured in fifty years.

Zero percent correlation between public preferences and policy.

You are dying while reading this.

If this seems bad, that's because you're paying attention.

The good news is you're going to fix it. The bad news is it requires doing things. The weird news is you'll get rich doing it.

What's Next.

The following chapters explain each problem in detail:

The Daily Body Count: Why one hundred fifty thousand daily deaths don't make the news.

The N.I.H. Spent one trillion dollars Curing Nothing: How ninety-seven percent of medical research funding avoids testing drugs in humans.

The F.D.A. Is Unsafe and Ineffective: How "safety" regulations make medicine more dangerous.

The Cost of War: eleven point four trillion dollars annually, itemized.

Unrepresentative Democracy: Why zero percent of what you want becomes policy.

You Are a Meat Robot: Your body is a machine, and the parts are fixable.

And if you don't fix it, you are going to die from something that could have been cured. Personally. You. The person reading this. While the Pentagon loses another trillion dollars between the sofa cushions of its accounting department.