it is the unintended consequence of well-intentioned decisions. To prevent hunger,
governments subsidized staple crops to ensure food security. The food industry, opti-
mizing within these constraints, produced ultra-processed that became the global diet.
Healthcare systems, designed to treat symptoms rather than prevent disease, evolved
into an economic structure that profits from chronic illness, not health.
The result is a self-perpetuating cycle: the food industry creates disease, and the
healthcare industry manages it. The food system optimizes for profit, not nutrition.
The healthcare system optimizes for recurring revenue, not long-term health. Once
rare, chronic disease now causes 74% of all deaths worldwide. This is not an isolated
failure—it is a systemic inevitability.
This is not a conspiracy. There is no singular villain—only incentives. Every actor in
this system is optimizing within the structures they have been given. Left unchanged,
these forces will continue driving public health toward collapse.
The only way forward is to realign incentives so that health becomes inevitable—just as
disease is inevitable under the current system. Food companies must profit from selling
food that nourishes rather than harms. Healthcare companies must be rewarded for
improving health, not just managing disease. Policymakers must act to shift financial
structures so that public health becomes the default outcome of economic optimization.
The system will change—either by design or by crisis. The choice is ours.This paper shows that these outcomes are not the result of bad actors but of systemic misalignment-a structure in which every participant optimizes for their own constraints, producing mass harm as a byproduct.
The food system does not optimize for nutrition; it optimizes for efficiency and profit, leading to an overproduction of cheap, hyper-palatable, inflammatory foods. The healthcare system does not optimize for health; it optimizes for revenue, making chronic disease a more valuable economic asset than prevention. The result is a self-sustaining feedback loop in which food creates illness, and medicine monetizes its management.
This is not a conspiracy. There is no need for malice-only incentives. The system does not need villains to function as it does; it only requires that each actor follows their economic imperative. Without intervention, these forces will continue to drive public health toward collapse.
The solution is not to fight companies or institutions but to redesign the incentives that shape their behavior. If food companies profit from nutrition, they will optimize for it. If hospitals profit from prevention, they will prioritize it. A system designed for health will produce health as naturally as the current system produces disease.