Thread

By @coachemma

Fall 2025

About the author

@coachemma is the founder of Dream Grad Academy (www.dreamgradacademy.com), an educational platform dedicated to providing beginner Bitcoin learning services for individuals and communities partnering with @myfirstitcoin and @TheBTCMentor. She holds a doctorate (DrPH) in community health and a Master of Public Health (MPH) in health education & behavioral science, bringing over a decade of experience in program administration spanning higher education, public health, healthcare, and disaster sociology. As a health sciences researcher, educator, and Bitcoin advocate, @coachemma believes that Bitcoin (sound money) and decentralized protocols like Nostr can be powerful tools to empower individuals on their health journeys and help communities build healthier environments for wellbeing.

Preamble

This long-form article examines how many chronic diseases in modern society might have an underexamined stress component deriving from unsound money (fiat), and explores how a return to sound money could potentially help alleviate negative stressors that lead to disease onset. It presents a theoretical understanding on the topic, building on past works on health and bitcoin such as Saifedean Ammous' The Fiat Standard chapter on Fiat Life, Fiat Food by Matthew Lysiak and Ammous, Bitcoin and Beef by Tristan Scott, and The Hidden Cost of Money by Seb Bunney.

The article is divided into three parts:

1. Part I: The Inflation Syndrome: How Bad Money Creates Sick Bodies
2. Part II: Diagnosing the System: Money as Root Cause, Not Symptom
3. Part III: The Bitcoin Prescription: Digital Currency and Sovereign Tools for Better Health

Through this three-part exploration, @coachemma invites readers to consider a paradigm shift in how we understand the relationship between monetary systems and health, proposing that the path to healthier societies may require not just medical innovation, but sound money and decentralized protocols.

Value for Value: If you find this article insightful, your support is greatly appreciated. Any sats zapped to this article will help @coachemma develop this writing further into a book capturing experiences from clinicians, developers, individuals, and communities working in these spaces, and support scholarly research and education related to Bitcoin, health, and Nostr that engages students in these important areas.🧡

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Introduction

From chronic disease and drug overdose epidemics to homelessness and mental health crises, healthcare's most pressing challenges might share an unexpected connection that few dare to examine: how money and monetary systems shape health outcomes. This article explores a provocative hypothesis: the departure from sound money to fiat currency potentially creates systemic stressors affecting population health. By analyzing modern money and Bitcoin as a potential alternative monetary network, we examine how decentralized currency systems might influence individual health outcomes, social determinants of health, and healthcare delivery systems and innovation.

The global monetary landscape is undergoing a profound digital transformation, creating new possibilities for addressing mounting socioeconomic challenges and healthcare crises through innovative financial solutions. Many people today are struggling with the growing cost of living, including insurmountable household debt, failing healthcare systems, and other associated socioeconomic problems, prompting individuals and jurisdictions to explore alternative solutions. For example, on September 19, 2025, the Mayor of Vancouver, Canada, announced the creation of a new bitcoin-backed fund designed to provide mental health support for firefighters. This initiative aims to prevent suicide and address other challenges resulting from their highly demanding profession (CTV News, 2025). Additionally, major corporations now hold bitcoin on their balance sheets while nations explore its potential for payments and reserve assets to increase revenues. Despite growing institutional adoption, widespread misunderstanding persists about Bitcoin's fundamental purpose as a peer-to-peer electronic cash system that eliminates intermediaries and features a mathematically fixed supply of 21 million coins (My First Bitcoin, 2025).

If you've been hesitant about Bitcoin due to concerns about fraud or environmental impact, consider that Bitcoin is not 'crypto' that has been at the centre of many scandals and is actually driving innovation in renewable energy adoption, addressing a major concern (Ibañez and Freier, 2023, Gladstein, 2024). It's empowering mothers in developing countries with financial access to purchase essential supplies that combat child malnutrition and other challenges. Bitcoin also supports numerous initiatives that promote health, wellness, education, and social causes (Bitcoin Babies, 2023 & Federation of Bitcoin Circular Economies, 2025).

These real-world applications demonstrate that Bitcoin's impact can extend beyond its financial properties, creating ripple effects that can positively influence health and social outcomes. Thus, the central thesis of this article proposes that bitcoin, as money resistant to debasement, may fundamentally transform health outcomes, healthcare systems, and individual monetary sovereignty. While acknowledging Bitcoin's short-term volatility and the speculative nature of some connections explored here, this analysis focuses on bitcoin's potential to store value and its possible effects on reducing financial stress—a significant but underexamined health determinant.

Part I: The Inflation Syndrome: How Bad Money Creates Sick Bodies

"I wondered if the patients I was seeing in the hospital—those suffering from preventable lifestyle diseases, chronic conditions and dependencies—were influenced by the money-related stresses of modern life."

This observation from a nursing student during our introductory research meeting captures a critical but overlooked connection between monetary systems and health outcomes. Her clinical experiences had led her to question whether underlying financial pressures contribute to the chronic conditions filling hospital wards. The questions multiply when we examine the broader picture: How many patients forgo preventative treatment due to financial constraints that could have kept them out of the hospital? How many people endure the chronic stress of multiple jobs while worrying about housing costs? How many feel compelled to acquire rental properties, which can be an added stress, simply to protect their wealth from currency devaluation? And more broadly, how does constant currency debasement force behaviors that compromise our well-being?

The Foundation Crisis: From Gold to Credit

Modern fiat monetary systems are fundamentally different from what has historically been considered money—gold. We've moved away from a gold standard—where "layer-1" money was physical gold, as Nik Bhatia explained in his book Layered Money—to today's system of fiat currency, which is really just credit in disguise. Modern money works as an IOU that passes through complex networks of banks and central authorities, creating significant counterparty risk (see Figure 1 for a simplified version of these layered credit systems).

Figure 1 adapted from: Merhling, P., (2012) The Inherent Hierarchy of Money

Throughout history, societies converged on gold as money due to its natural scarcity, resistance to deterioration, and stable stock-to-flow ratio: new supply was slow to increase significantly compared to existing reserves. Gold served as an effective store of value that could be exchanged and preserved across generations. While gold faced challenges in transportability and authentication, leading to the development of gold certificates and eventually modern credit-based systems, this evolution created new problems.

Today's money circulating in the economy is fundamentally fiat credit rather than an object of final settlement. It functions on the basis of collective trust in the issuing authority, typically a central bank or government. The current fiat monetary system affects both individuals and organizations in major ways. When people work jobs and save money, or when businesses—whether for-profit or non-profit—try to operate, they're all subject to decisions made by central banks. These central banking authorities control the money supply, but they face a difficult balancing act: their policies affect inflation and economic growth (Mathai, nd) in ways that can sometimes conflict with each other, creating uncertainty for savers and businesses alike. Central banks can increase the money supply through monetary techniques like quantitative easing, treasury purchases, and bank reserve requirements (Mathai, nd), leading to currency debasement that diminishes purchasing power without consent.

The Physiological Cost: A First Principles Analysis of the Potential Mitochondrial Tax

This shift away from gold-backed currency has transformed money into a credit system that inherently depreciates, creating economic instability. Since research directly linking monetary standards (gold vs fiat etc.) to health outcomes is sparse, studies instead focus on downstream economic effects. While establishing causation remains difficult, we can build understanding by synthesizing evidence from multiple fields. Drawing on research in stress physiology, public health, and behavioral economics provides insights into how economic structures potentially influence human health and well-being:

1. Chronic stress can harm human health through changes in physiology, elevated cortisol, systemic inflammation, and compromised immune function (Shchaslyvyi et al., 2024).
2. Financial worries can be associated with stress responses in some populations (Ryu & Fan, 2023).
3. Inflation systematically erodes stored wealth without the holder's consent (mises, 2019)
4. People who live in societies with higher economic inequality tend to work more and experience a worse work-life balance (Filippi et al., 2023).

Connecting the Chain to Health Outcomes: The logical sequence above directly links monetary policy to potential health consequences:

1. Money is the most easily tradable good that gives people buying power, helping them exchange goods and services so they can make a living.
2. When the expansion of money supply causes inflation, it reduces the purchasing power of currency. This then can lead to a general increase in prices of goods and services (Shostak, 2022).
3. Individuals face a choice: accept the decline in purchasing power or expend additional energy or resources to compensate.
4. This dynamic requires time, cognitive resources, and physical energy that could otherwise support health-promoting activities.
5. Thus, the unpredictability of monetary policy that impacts monetary supply in the market creates ongoing uncertainty about future purchasing power.

The "Mitochondrial Tax" Hypothesis: This reasoning suggests what we might conceptualize as a "mitochondrial tax"—not a literal cellular assessment, but a systematic increase in the energy demands placed on human biological systems to grow purchasing power to maintain their living standard and hedge against inflation. The metaphor captures how monetary debasement may force compensatory behaviors that drain cellular energy reserves. The extent to which the 'monetary tax' impacts individuals can vary greatly based on environmental, personal, household, social, and cultural factors (see Figure 2).

Empirical Support: A comprehensive scoping review published by Movsisyan et al. (2024) in Lancet Global Health found consistent negative associations between inflation and multiple health outcomes, including dietary quality, mental health, substance abuse, and overall well-being. While this doesn't prove the specific mechanism, it supports the broader hypothesis that monetary instability correlates with health deterioration.

Financial Stress Cascade Effects: The psychological mechanisms become clearer when we examine three specific pressure points created by fiat monetary systems:

Primary Stressor: Continuous money supply expansion makes simple savings inadequate for wealth preservation, forcing individuals into active financial management roles regardless of their expertise or preference.

Secondary Complexity: Wealth protection requires engaging with sophisticated financial instruments—stocks, bonds, real estate, commodities—each carrying unique risks and demanding ongoing attention. This transforms peaceful savings into complex risk management.

Tertiary Uncertainty: Central bank policy timing and magnitude remain largely unpredictable, creating persistent anxiety about factors beyond individual control that significantly impact personal wealth.

Limitations: Several important caveats apply to this reasoning:

• Individual stress tolerance varies significantly based on personality, social support, and coping mechanisms.
• Some people may thrive under financial pressure rather than suffer health consequences.
• Stress-related diseases existed before fiat currency systems, indicating multiple causation pathways.
• The relationship may be correlational rather than directly causal.
• Other social and environmental factors may mediate these effects.

Research Implications: This exploratory analysis generates testable hypotheses:

• Do populations using more stable non-fiat monies like bitcoin report better health outcomes?
• Can we identify dose-response relationships between inflation rates and health indicators?
• How does self-custody of a fixed supply currency like bitcoin impact individuals' stress levels compared to traditional monetary systems?

Bitcoin as an Alternative Monetary Framework: A Comparative Analysis

Theoretical Foundation: If we accept that monetary predictability reduces financial stress, then a new money and monetary system with Bitcoin's design characteristics warrant examination as a potential alternative to fiat systems. However, this comparison requires acknowledging both theoretical advantages and practical limitations.

Bitcoin's Structural Properties:

Comparative Stress Analysis: This structural difference suggests divergent pathways for financial stress:

• Fiat Currency Pathway: Discretionary monetary policy → unpredictable purchasing power changes → forced financialization → chronic uncertainty about wealth preservation
• Bitcoin Pathway: Algorithmic monetary policy → predictable supply schedule → reduced need for complex hedging strategies → potential reduction in policy-related uncertainty (See Figure 3)

Critical Limitations of This Analysis: Several factors complete this theoretical framework:

Volatility Paradox: While Bitcoin eliminates monetary policy uncertainty, it introduces extreme price volatility that may create different but equally significant stress responses. Daily price swings could generate more acute anxiety than fiat inflation.

Technical Complexity: Bitcoin self-custody requires specialized knowledge about private key management, hardware wallets, privacy and security practices. The cognitive load and risk of permanent loss through technical errors may offset gains from monetary predictability.

Access and Adoption Barriers: Bitcoin's technical requirements may exclude populations (e.g. elderly etc.) greatly affected by monetary stress, potentially exacerbating rather than reducing financial inequality.

Regulatory Uncertainty: Government restrictions on Bitcoin usage introduce policy risks different from, but potentially comparable to, fiat monetary policy changes.

Empirical questions: This comparative framework generates specific testable hypotheses:

• Do the stress-reducing effects of monetary predictability outweigh the stress-increasing effects of price volatility?
• How do technical competency levels moderate Bitcoin's psychological impact?
• What individual characteristics predict positive versus negative stress responses to Bitcoin adoption?

Preliminary Observations: While anecdotal, there are several YouTube interviews of people who have adopted bitcoin into their lives and report its benefits, some reporting reduced financial anxiety for the future, improved wellbeing and more.

For example, see Dr Satoshi, a real physician-led podcast known as the Signal: https://youtube.com/@doctorsatoshi

Theoretical Case Study: Financial Sovereignty and Self-Reported Well-being Outcomes

Consider James Thompson, a 37-year-old man who experienced three years of homelessness while struggling with opioid addiction. His experience illustrates the complex relationship between monetary systems and personal well-being in circumstances of extreme vulnerability.

Thompson became homeless after losing his construction job following a workplace injury. Pain management led to opioid dependence, depleting his savings and resulting in homelessness. Living on the streets, he experienced extreme financial instability—a complete lack of monetary reserves, inability to safely store value, and vulnerability to theft.

Traditional financial systems excluded him entirely. Without an address, maintaining bank accounts became impossible. When obtaining temporary work, Thompson was forced to use check-cashing services that charged substantial fees, further eroding minimal earnings. Conventional finance, designed around stable residency and credit history, provided no viable solutions.

After connecting with a recovery program offering housing support, Thompson began rebuilding his life. A counsellor introduced him to Bitcoin as self-sovereign money: Unlike traditional financial services requiring identification, address proof, and good credit—all barriers for someone with his background—Bitcoin required only a smartphone and internet access.

Thompson began receiving small Bitcoin payments for odd jobs through a recovery program embracing alternative payment methods. For the first time since becoming homeless, a store of value that couldn't be physically stolen, didn't require permanent addresses, and wasn't subject to predatory fees. He was also saving money that appreciated in purchasing power over time (see Figure 4).

The psychological impact was significant. While still in recovery and dealing with housing insecurity, Thompson experienced reduced stress markers once he established a small but growing bitcoin savings fund. The ability to store value securely without institutional gatekeepers provided financial agency that was absent during his homeless years. More importantly, Thompson found that as his bitcoin savings grew, he began to envision a future beyond mere survival. He started exploring interests he had abandoned during addiction—photography and community gardening—activities that brought meaning beyond the daily struggle for basic needs. The financial stability bitcoin provided allowed him to redirect energy from constant worry about money toward personal recovery and discovering what truly mattered to him.

Thompson's case highlights the transformative potential of layer-1 money for vulnerable populations. By providing financial inclusion where traditional systems create barriers, Bitcoin offered him value preservation without institutional gatekeepers. His stress improvement stemmed not only from addiction recovery but also from gaining true ownership of stored value protected from both physical theft and predatory fees, ultimately enabling him to pursue personal fulfillment rather than remaining trapped in survival mode (see Figure 4).

Citation: U.S. Bureau of Labor Statistics. (2025). Consumer Price Index for All Urban Consumers: Purchasing Power of the Consumer Dollar in U.S. City Average [CUUR0000SA0R]. Retrieved from FRED, Federal Reserve Bank of St. Louis: https://fred.stlouisfed.org/series/CUUR0000SA0R ; Coinbase. (2025). Coinbase Bitcoin [CBBTCUSD]. Retrieved from FRED, Federal Reserve Bank of St. Louis: https://fred.stlouisfed.org/series/CBBTCUSD

While Thompson's case is just one theoretical case study, there is growing evidence of Bitcoin's impact on well-being. Droves of personal accounts shared on platforms like the "Life with Bitcoin" podcast and Suman Kumar's Reclaiming Sovereignty: How I Fell in Love with Bitcoin document individuals experiencing more empowerment with their money, reduced financial stress, and improved sense of sovereignty through Bitcoin adoption. These testimonials highlight patterns worth formal investigation. To properly understand the relationship between Bitcoin adoption and well-being requires rigorous research examining:

• The specific psychological mechanisms through which financial sovereignty might reduce stress.
• Comparative outcomes between Bitcoin adopters and non-adopters with similar socioeconomic backgrounds.
• Long-term effects on various well-being metrics beyond anecdotal reports

Such research could help identify which populations might benefit most from Bitcoin adoption and what complementary support systems might maximize positive outcomes.

Part II: Diagnosing the System: Money as Root Cause, Not Symptom

Beyond Income Distribution: The Monetary Foundation

It has been documented that the social determinants of health, factors related to where we live, work, and play—education, housing, transportation, etc.—account for up to 80% of addressable health risk factors, significantly outweighing clinical care influence (Hood et al., 2016). This growing recognition has sparked increased attention to social determinants across healthcare and public health systems. However, as we focus on these socioeconomic layers, we must examine one of the foundational yet overlooked components: the soundness of money itself. Scott Wolfe, a global and community development professional with over two decades worth experience and coordinator of the Federation of Bitcoin Circular Economies, eloquently puts it in his essay entitled: "Going Further Upstream on the Social Determiants of Health. A Call to Action."

"we must paddle further upstream to fix money." (Wolfe, 2024).

While extensive research connects income inequality to health outcomes, the intrinsic nature of money as a social determinant remains largely unexplored—a critical gap this analysis seeks to address. In my previous article (Apatu, 2024), 'Bitcoin & Public Health: Addressing the Debt Money Crises' published in Bitcoin Magazine, I highlighted the importance of socioeconomic factors to population health outcomes through attention to the Frieden Health Impact Pyramid. To make the biggest impact in population outcomes, we need to address the base layer of socioeconomic factors, including looking at the quality of money—in other words, its soundness. The 'soundness of money' refers to its ability to maintain stable value over time and reliably serve as a store of wealth. Sound money resists devaluation, maintains purchasing power, and provides economic stability. When money lacks soundness—through inflation, currency debasement, or manipulation of monetary supply—it may directly impact people's ability to access healthcare resources and maintain quality of life.

When money loses soundness through inflation or monetary debasement, it exacerbates socioeconomic inequalities and negatively impacts health outcomes by reducing purchasing power for essentials, particularly affecting those on fixed incomes or with limited assets.

Sound money—currency maintaining purchasing power and value stability over time—is characterized by scarcity, durability, fungibility, portability, and divisibility. Healthcare professionals addressing social determinants must consider how monetary system integrity and incentives, not merely wealth distribution, form the foundation for many other social determinants (see Figure 5).

The Moral Dimension of Money

Money serves as more than an economic tool—it functions as a complex system reflecting and shaping collective values, priorities, and ethical considerations. By facilitating indirect exchanges of human energy (time exchanged at work for money) for goods and services, money acts as a moral cultural code of exchange.

The integrity of this monetary system is paramount. Sound, uncorrupted currency enables effective market pricing while providing individuals with a store of value that doesn't depreciate over time. Throughout history, various money forms have been subject to debasement, leading to economic instability and forcing people to seek opportunities in regions with more stable currencies.

As we've seen, money serves as both a monetary tool and a moral code, with its integrity being essential for economic stability. But to fully grasp how money functions in our society, we must examine its origins. The historical evolution of monetary systems reveals competing theories about money's emergence—theories that provide crucial insights into our current financial challenges and potential solutions.

Competing Theories and Unified Understanding

Drawing on Lyn Alden's book Broken Money, it can be understood that there are two primary theories that explain money's origin: The Credit Theory posits that money is debt owed to another person in exchange for goods, while the Commodity Theory argues that money emerges naturally from scarce, salable goods widely accepted through time and space.

The concept of money as a ledger provides a compelling theoretical framework that transcends the traditional credit vs. commodity debate. This unified view acknowledges that money's essential function is maintaining a record of obligations and claims within society. However, our current centralized monetary systems suffer from several critical weaknesses:

First, centralization creates inherent vulnerability, as it concentrates power among a small group of institutional actors who may act in their own interests rather than for the broader public good. Second, fiat monetary systems lack transparent mechanisms for ensuring scarcity, potentially enabling excessive money creation that erodes purchasing power. Third, the current system's gatekeepers often create barriers to access, particularly for the global unbanked population.

In contrast, a permissionless distributed ledger secured by energy-based proof of work introduces several significant advantages: it provides immutable, censorship-resistant record-keeping that operates without requiring trust in centralized authorities; it establishes a predictable, algorithmically determined monetary policy that cannot be altered by political pressures; and it enables global access to financial infrastructure for anyone with internet connectivity, regardless of socioeconomic status or geographic location.

This approach represents a fundamental rethinking of monetary systems that aligns with both historical understandings of sound money and modern technological capabilities, potentially addressing persistent issues of financial inclusion, monetary stability, and systemic risk that plague conventional monetary arrangements.

Bitcoin's Superior Monetary Properties

Bitcoin's case as a superior monetary system stems from several key characteristics addressing fundamental fiat currency flaws:

Fixed Predictable Issuance: Unlike fiat currencies created at will by central authorities, Bitcoin has a mathematically guaranteed cap of 21 million coins. This fixed supply and issuance (see Figure 6) makes Bitcoin inherently resistant to inflation, preserving purchasing power over time. The predictable issuance rate (halving approximately every four years) creates a transparent monetary policy immune to political manipulation.

Decentralized Governance: Bitcoin's consensus mechanism distributes decision-making across thousands of network participants rather than concentrating power in central banks. This prevents arbitrary monetary policy changes that often benefit certain groups at others' expense. The network's open-source nature ensures transparency, allowing anyone to verify the money supply and all transactions.

Global Accessibility and Permissionless Innovation: As a borderless system, Bitcoin enables financial participation for an estimated 1 billion people without access to traditional banking services. Transactions occur 24/7 without intermediaries, reducing friction in global commerce. The permissionless network allows continuous innovation without requiring centralized approval.

Energy-backed Security Model: The proof-of-work consensus mechanism anchors Bitcoin's security in real-world energy expenditure, creating objective costs for attacking the network. This energy commitment transforms electricity—a universal resource—into digital scarcity, providing more concrete foundation than faith-based fiat currency backing.

It should be noted that while Bitcoin is not without its challenges, it still offers significant advantages over traditional monetary systems. The volatility that creates short-term stress may be a necessary phase in the adoption of a new monetary technology, potentially leading to greater stability as the market matures. The technical barriers to self-custody are being addressed through ongoing innovation in user-friendly wallet solutions and recovery mechanisms. Regarding environmental concerns, Bitcoin's energy usage increasingly favors renewable sources as miners seek cost efficiency, potentially becoming a net positive for green energy development (Rudd et al., 2023; Hutabarat & Poltak Hamonangan, 2025).

As we consider Bitcoin's role in the future of money, we must weigh these challenges against the problems inherent in our current monetary systems: perpetual inflation, centralized control, financial censorship, and exclusion. The question becomes not whether Bitcoin is perfect, but whether it offers a sounder foundation for monetary systems than the alternatives. Readers are invited to consider this balance of trade-offs in forming their own conclusions about which monetary paradigm better serves humanity's long-term interests.

Part III: The Bitcoin Prescription: Digital Currency and Sovereign Tools for Better Health

Now that we have explored how money has been abstracted away from layer-1 money and highlighted how money's soundness is a critical determinant of health, we next shift gears to briefly discuss healthcare systems and new, decentralized innovations that can empower individuals and healthcare systems to improve health outcomes.

Before centralized healthcare systems and lab science in the mid-20th century began dominating Western healthcare, particularly in America and Canada, healthcare was more decentralized (Duffy, 2011). Local doctors, nurses, midwives, and other healthcare professionals maintained more direct patient relationships, house calls were common, and communities had greater autonomy in healthcare decisions. The doctor-patient relationship was sacred and unmediated by third parties (Lynaugh, 2012).

While this system wasn't perfect, it empowered individuals to make health choices based on personal needs rather than institutional protocols. In current Western systems, third-party insurers can dictate what type of care can be given and this creates an asymmetry of care (Fabes et al., 2022). Thus, third-party payment systems may, in some cases, distort the doctor-patient relationship by introducing financial incentives that may not prioritize optimal patient outcomes.

As @thebitcoinyogi, Jon Gordon, of Satoshi Health Advisors aptly notes, insurance companies currently function as intermediaries who may prioritize cost considerations over pure medical necessity when influencing treatment decisions. This creates situations where the agent (doctor/provider) must balance the needs of multiple principals (the patient and the insurance company) that could lead to suboptimal care decisions. Importantly, these limitations manifest in both universal insured care systems and nonuniversal systems, albeit in different ways.

Having more decentralized ways for people to seek and find care could improve healthcare outcomes. With Bitcoin as a payment mechanism, healthcare providers like DirectMed Clinic (Direct Med Clinic, n.d.) and various other healthcare and allied health professionals now accept bitcoin payments (Satoshi Health, n.d.) enabling more direct patient care. By allowing patients to save in appreciating money, this could provide a means to save for future health events while potentially reducing the approximately $1 trillion in administrative costs in countries like the United States (Sahni et al., 2023).

Decentralization can restore elements of patient-centred approaches while maintaining modern medicine benefits by:

• Reducing administrative costs.
• Enabling direct patient-provider relationships with transparent pricing.
• Creating portable, patient-owned health records that travel with individuals across providers.
• Allowing patients to selectively share health data for research without surrendering ownership.
• Supporting medical privacy through encryption while enabling necessary emergency access.

The Communications Layer and Healthcare and Health

Given that communication and the transfer of data and information are critical to healthcare systems, it is imperative to explore other decentralized solutions that are being built on platforms.

Nostr: New Communication Infrastructure for Health

Nostr, an abbreviation for 'Notes and Other Stuff Transmitted by Relays'—represents a significant advancement in internet communication protocols, offering a decentralized approach prioritizing censorship resistance and user sovereignty through ownership of cryptographic key pair identity (Nostr - Notes and Other Stuff Transmitted by Relays, n.d.). Unlike conventional social platforms where companies control user data and identities, Nostr empowers individuals through cryptographic key ownership, enabling complete control over digital presence across independent relay networks (see www.nostr.com for more).

In healthcare applications, Nostr's architecture offers compelling possibilities:

Patient Data Sharing: The protocol could transform patient data sharing by enabling individuals to securely grant temporary access to medical information using cryptographic permissions, maintaining privacy while streamlining information exchange for effective consultations.

Decentralized Health Education: Nostr could serve as infrastructure for platforms where medical professionals communicate directly with the public without information gatekeepers.

Scientific Community Benefits: Researchers could develop more transparent peer-review systems, fostering open scientific discourse and reducing opacity in traditional publication processes. Nostr's capacity for direct connections presents innovative funding pathways for medical research falling outside conventional grant structures.

Patient Communities: The protocol enables resilient support network formation for individuals with chronic conditions, creating spaces that are stable regardless of commercial platform policies or shutdowns.

Building Health Sovereignty

Example efforts at the intersection of nostr, bitcoin, and health include: @illuminodes, #saludprotocol, @NosFabrica, Tim Bouma's #safebox, @runstr, Wellnessally.me, @SOUNDHSA, and @MedSchlr powered by #Alexandri @gitcitadel and more are building new ways to empower people in their health journeys.

By building healthcare services atop Nostr and bitcoin's foundation of digital autonomy and censorship resistance, stakeholders could pioneer interaction models emphasizing patient agency, direct patient-provider relationships, information accessibility, and collaborative research beyond centralized system limitations.

These emerging applications demonstrate how financial sovereignty and health sovereignty become intertwined. When people control their money through Bitcoin and their data through Nostr, they gain unprecedented autonomy in managing health journeys. This convergence addresses root causes of health while empowering individuals to take greater responsibility for well-being.

With the shift toward decentralization giving more power back to individuals, it becomes imperative for users to receive proper education about potential risks and protective measures. This empowers users to make informed decisions, weighing the trade-offs for themselves and utilizing decentralized applications when appropriate for their needs.

While decentralization may create more diverse and disparate systems, collaborative frameworks and care pathways can be established as needed to ensure continuity of care. These connections can bridge independent systems while still preserving the benefits of decentralized control.

Areas for Research and Development

Further research and development can help uncover how Nostr can be leveraged to improve health outcomes in several key areas:

Incentive Mechanisms: Designing systems that encourage participation and contribution to decentralized health networks.

Patient-Controlled Health Records: Investigating secure cryptographic methods for patients to maintain ownership of their health data while sharing it selectively with providers.

Interoperability Standards: Creating protocols that enable different decentralized health applications to communicate effectively.

Resilient Health Infrastructure: Examining how decentralized systems can maintain healthcare operations during network outages or emergencies.

Final Conclusion: The Path Forward

Decentralized systems are not a panacea but they do offer a competing way to provide healthcare in appropriate cases. While concerns around quality standards are valid issues, these could be addressed through collaborative efforts between healthcare professionals, health advocates, and technology experts to develop strategies such as web-of-trust systems that help maintain quality and provide guidance regarding low-evidence interventions.

Bitcoin's price volatility in the short term may indeed create challenges for payment in some emergency situations. However, in contexts where bitcoin's volatility is actually more stable than local currencies, it presents a viable solution. Furthermore, bitcoin savings could be viewed as a long-term way to build health reserves, allowing patients to accumulate value over time to prepare for future healthcare needs.

This exploration reveals how money's fundamental nature impacts health systems and individual well-being. Bitcoin represents a paradigm shift from stress mechanisms embedded in fiat monetary systems toward sound money principles that could transform social determinants of health and healthcare delivery.

The chronic debasement of fiat currency imposes what in this paper is termed a "mitochondrial tax" on our bodies. As stored economic energy continuously loses value through inflation, we're forced into compensatory behaviors—working longer hours, taking additional stress, and disrupting natural rhythms—all placing excessive demands on cellular energy systems. This manifests in chronic inflammation, mental health issues, disrupted circadian rhythms, and compromised cellular function, which contribute to rising metabolic and chronic diseases.

By eliminating the persistent stressor of monetary debasement, Bitcoin could function as "Money medicine"—restoring natural alignment between human biological systems and the monetary environment. The convergence of Bitcoin's sound money properties with decentralized communication protocols like Nostr opens possibilities for reimagining healthcare delivery outside traditional centralized systems.

Projects exemplifying this emerging ecosystem—where financial sovereignty and health sovereignty intertwine—potentially address root causes of health disparities while empowering individuals throughout their health journeys. The possibility that sound money might address individual disease and systemic health challenges represents a revolutionary shift in conceptualizing both economic and medical interventions.

Furthermore, jurisdictions and communities could explore bitcoin use to:

1. Provide Bitcoin education and custody support: Community organizations could teach individuals how to create Bitcoin savings accounts and safely self-custody their assets for healthcare emergencies.
2. Create bitcoin funds for healthcare needs: Establish dedicated bitcoin reserves to support specific healthcare programs
3. Establish Bitcoin-funding grants and fellowship programs to support research, scholarship, and development in healthcare and health sciences, leveraging Bitcoin and Nostr technologies to advance the field.
4. Implement bitcoin compensation options: Employers can offer Bitcoin payment options as part of compensation packages for healthcare workers. Companies such as Block Rewards are on the forefront of helping businesses integrate such offerings in their payroll.
5. Enable bitcoin payment acceptance: Encourage healthcare providers to accept bitcoin as payment for medical services, potentially reducing transaction costs.
6. Establish government bitcoin reserves: Provinces and states could create bitcoin treasury funds to finance future healthcare infrastructure, technology, and fund staff salaries, which would help cover budget deficits.

These approaches could help create more resilient healthcare funding systems while empowering individuals with greater financial sovereignty over their healthcare decisions.

Bitcoin represents a new framework that offers potential solutions for healthcare challenges at multiple levels. As a decentralized, noninflationary currency, bitcoin addresses the "mitochondrial tax" imposed by fiat currency debasement, potentially reducing systemic stress on individuals and healthcare systems alike. The integration of Bitcoin with emerging technologies like Lightning Network and Nostr creates opportunities for reimagining healthcare delivery through more direct patient-provider relationships while reducing administrative overhead.

This monetary innovation could address healthcare accessibility by removing financial intermediaries and lowering costs through reduced transaction fees. Communities and jurisdictions implementing Bitcoin-based strategies—from education and custody support to establishing healthcare-focused bitcoin reserves—may create more resilient funding systems while empowering individual financial sovereignty over healthcare decisions.

It should be noted that while Bitcoin faces challenges, including scaling limitations, adoption barriers, and potential unintended consequences, its fundamental properties align with creating conditions that support optimal human health. However, the Bitcoin network has demonstrated remarkable resilience with impressive uptime and consistent value growth over its 16-year existence, suggesting its potential as a stable foundation for healthcare innovation. Despite this, substantial educational efforts and technological developments remain necessary to fully realize this potential.

This three-part article presents a preliminary exploration of theories and ideas connecting Bitcoin and health. While more research is needed to establish causal links, it's important to acknowledge that Bitcoin is already changing and saving lives in tangible ways, as evidenced in local communities worldwide. Although scientific evidence will strengthen our understanding of these relationships, we should not overlook the real-world positive health impacts that Bitcoin is already having for many individuals.

Limitations

This article presents a theoretical framework that requires significant empirical validation before drawing definitive conclusions. Several critical limitations must be acknowledged: First, the connections between monetary systems and health outcomes, while plausible, remain largely anecdotal and require more scientific investigation to establish causation. The "mitochondrial tax" concept, while a useful metaphor for understanding potential stress mechanisms, should not be interpreted as established medical fact but rather as a hypothesis requiring testing through controlled studies measuring stress biomarkers, health outcomes, and monetary system exposure.

Second, this analysis may overstate Bitcoin's potential benefits while understating its practical limitations. Bitcoin's current volatility, technical complexity, and adoption barriers could create significant stress for many users, potentially offsetting theoretical advantages from monetary predictability. The technology is in its early phases of adoption, and its long-term stability is unproven despite impressive short-term performance.

Third, the health challenges addressed in this paper—chronic disease, mental health issues, and healthcare access problems—have multiple, well-established causes including genetics, lifestyle factors, environmental conditions, and healthcare system design. Monetary systems represent just one potential contributing factor among many, and readers should not interpret this analysis as suggesting that Bitcoin adoption alone could solve complex health problems that require comprehensive, multifaceted interventions.

Finally, this preliminary exploration intentionally focuses on theoretical possibilities rather than practical implementation challenges. Real-world adoption of alternative monetary systems involves significant economic, regulatory, and social complexities that extend far beyond the scope of this analysis. The goal is to stimulate discussion and research that may help to inform future policy.

Despite these important limitations, this theoretical exploration becomes increasingly relevant as Bitcoin gains adoption at nation-state and local levels worldwide. Countries like the United States are seriously identifying ways to integrate Bitcoin into its financial landscape, while numerous municipalities and organizations are integrating Bitcoin into their financial infrastructure. As these real-world implementations expand, understanding the potential health and social implications of monetary system changes becomes more pressing. The theoretical framework presented here, while requiring empirical validation, provides a foundation for investigating questions that may soon have practical significance for populations experiencing these monetary transitions. The preliminary nature of this analysis should not diminish the importance of beginning this research conversation before widespread adoption makes such investigations more urgent and complex.

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Acknowledgements

This work has been inspired by the wisdom and dedication of bitcoiners who generously share their time and knowledge. I am deeply grateful to everyone I have encountered on this journey, whose insights and contributions have shaped my understanding and growth.

AI Assistance Statement

This article was created with AI assistance for content organization, editing, formatting, and figure visualization from textual descriptions. All figures were subsequently recreated by the author. Throughout the creation process, the author maintained complete editorial control and intellectual direction, with AI serving to enhance the clarity and presentation of the work.