The digital surge in health...

for 5% of GDP in poor countries, 9% in rich ones and 17% in America. The industry employs over 200m people and generates more than $300bn of profits a year. But as well as being risk-averse, it is insulated from change. Patients may not know which treatments are effective. The need to pool risk among many people creates administrative leviathans, typically national-health schemes in Europe, or insurers in America and some emerging economies. Complex rules enable firms to extract high profits.

The result is that productivity growth has been sluggish. High costs mean that many people in the developing world lack access to health care. Low efficiency may cause a fiscal crisis in some rich countries over the next two decades, as ageing populations force medical bills up further.

The pandemic helped show what is possible, partly because it got people to put aside their caution. Remote medical consultation and monitoring can lower costs and increase access. The share of remote visits at the Mayo Clinic, an American health provider, rose from 4% before the pandemic to 85% at the peak. Sehat Kahani, a Pakistani firm, has helped female remote doctors treat the poor in a socially conservative society. Ping An Good Doctor, a Chinese portal, had 1.1bn visits during the height of the pandemic there.

A surge in online pharmacy would increase competition. On November 17th Amazon announced its entry into the field, which promises to disrupt America’s industry dominated by big pharma and middlemen. That is just the start. Data-rich diagnosis could help specialists in routine analysis of, say, medical scans such as X-rays. A new generation of continuous glucose monitors for diabetics benefits from recent improvements in sensors. In time artificial intelligence will lead to drug innovations. This week Deepmind, an AI laboratory, announced a breakthrough in the analysis of proteins (see article).