Health also has a pension plan

Health also has a pension plan. And contributions begin long before retirement.

by Àngels Salvador Vergès (Orthopaedic Surgeon MD, PhD, and 3D bioprinting Specialist). Member of the Board of Directors at InnoHealth Academy.

Health systems are designed primarily to repair. We diagnose, treat, and rehabilitate. We do it well. But the part dedicated to anticipating, identifying risk and acting before disease appears, remains far too small.

No one questions the need to save during working life to have a pension. With health, we do the opposite: we spend it over 40 years and hope that some remains by retirement.

But health, like a pension, is built with small, constant contributions. The difference is that here, contributions are not money: they are habits, monitoring, early detection, and environments that care.

Yet not everyone has the same opportunities to “contribute” to health. Social, occupational, economic, and environmental conditions decisively influence the ability to maintain healthy habits and access prevention. Unlike an individual pension plan, here part of the contribution is necessarily collective: it depends on policies, environments, and services, not only on personal decisions.

At the Living Lab Pirineus, we propose shifting some efforts toward earlier stages of life and acting on social and environmental factors as well, so that future generations reach old age with a lower burden of accumulated disease.

The return does not always go to those who invest. It often appears years later and may benefit a later stage of the same person, a different service within the system, or a future generation. This gap between investment and outcome is one of the structural difficulties of prevention.

What will happen if we don’t 

Digital prevention tools are already being developed, whether we take part or not.

→ According to Rock Health, in a 2025 US survey, the proportion of adults who reported ever using an AI chatbot for health information rose from 16% to 32% in a single year. Among AI users, 64% interacted with it for health queries weekly or more frequently.¹

→ Large technology companies (Amazon, Apple, Microsoft, Meta) have entered health through acquisitions, partnerships with public health systems, and proprietary product development.²

→ The core issue is not merely technological but also one of governance: who designs, implements, and controls these tools, for what purpose, and under what regulatory framework. Digitalisation alone does not improve health outcomes; it requires coordinated action between the public sector, professionals, citizens, and the technology sector. Before deploying these solutions at scale, we must assess their benefits, risks, equity, and acceptability, involving users from the earliest design phases.³

Our proposal: five concrete commitments

1. Data and governance. Integrate, where relevant, information from electronic health records, wearables, the exposome, and genomics. All with data minimisation, security, traceability, effective individual control, and compliance with GDPR and the progressive rollout of the European Health Data Space.
2. Digital health twin. Integrate different dimensions that must be interpreted together: clinical factors, lifestyle, social and environmental conditions, cognitive and emotional factors, and, where justified, genomic information. This is not about labelling the person, but about representing a dynamic trajectory that helps anticipate risks.
3. Predictive engine and conversational assistant. Provide personalised guidance through accessible, everyday interaction, with continuous clinical validation, professional oversight, and referral mechanisms when needed. The professional is part of the decision and correction loop, not merely a reviewer of the final output.
4. Evidence-based Think Tanks. Six domains (sleep, physical exercise, nutrition, psychological wellbeing, genomics, and addictions) periodically update the evidence and criteria underpinning the model. The aim is to detect obsolescence, bias, and potential drift, and to adapt to new knowledge and needs.
5. Hybrid and proximity-based action. Combine the app and contact centre with family physicians, nurses, and social workers operating as a proactive team. Technology facilitates monitoring, but interpretation, accompaniment, and relevant decisions still require human intervention.

These five commitments form a system aimed at preserving health capital: data allows us to observe its evolution, prediction helps identify risks, and human action transforms this information into proportionate and useful interventions.

Why the Pyrenees?

Because Cerdanya, Alt Urgell, Pallars, and Berguedà concentrate some of the challenges that will increasingly affect European health systems: an ageing population, territorial dispersion, significant distances, unequal connectivity, small professional teams, and people at risk of digital exclusion.

These conditions make the Pyrenees a particularly demanding environment and, at the same time, a valuable one for testing the model in real-world conditions. If it demonstrates usefulness, safety, and acceptability here, it will generate learnings potentially transferable to other rural or similarly characterised territories.

A health pension plan is not a financial product.

It is a metaphor for a longitudinal health model that aims to do three things:

• Builds health capital through healthy habits, protective environments, relevant data, and continuous monitoring throughout life.
• Manages risk to prevent disease where possible, delay its onset, or detect it early.
• Activates a personalised response when needed, aiming to reduce the disease burden and preserve autonomy and quality of life for longer.

The Living Lab Pirineus aims to act as a territorial testing ground to develop, evaluate, and adjust this model in real conditions, with the participation of citizens, professionals, and organisations from the territory.

Three questions for reflection:

→ In your environment, what proportion of effort goes to anticipation and what to repair?

→ Who accompanies the health trajectory of people who do not yet have a diagnosed disease?

→ If the public system does not provide a reliable, transparent, citizen-governed infrastructure for managing this data, in whose hands will this function end up?

If you are in the Pyrenees or are interested in the model, get in touch:
info@innohealth.academy   http://www.innohealth.academy

References

1. https://rockhealth.com/insights/the-tortoise-and-the-hare-of-care-health-ai-insights-from-rock-healths-2025-consumer-adoption-survey/
2. Kraaijeveld, S. R., et al. The Increasing Influence of Big Tech in Health and Medicine and the Need for a Public Health Ethics Perspective. https://doi.org/10.1093/phe/phaf005
3. Van Schyndel, C., Hannes, K., Laes, E., & Lambrechts, N. (2025). Digital solutions for disease prevention: perspectives of citizens, care providers, companies and governments. International Journal of Integrated Care. https://doi.org/10.5334/ijic.icic24211