Zero Disease

However, with his new book, Rifkin causes us to reflect , he also covers the correlations between environment and health, he illuminates us on how the doctor/patient relation is changing in the dynamic of a new community of distributed health. Rifkin reaches this considerable result described also as the “Commons of Health”.

Why not imagine, in fact, beyond the Commons of Information, the Commons of Energy, also the Commons of Health? “A Commons in which modern technologies of distributed and interactive information permit Dr Gille Frydman, founder of ACOR (Association of Cancer Online resources) to develop a model of participative medicine in which different subjects converge in a sole Commons. Patients, researchers, doctors, financers, producers of medical equipment, therapists, pharmaceutical companies and health professionals, would all be committed in collaborating to improve the care of the patient” (Rifkin, Society at Zero Marginal Cost, page 343).

This is not a remote or an unrealistic hypothesis. “Patientslikeme”, a social network of over 200,000 e-patients already fights 1,800 diseases. An important achievement they have obtained has been exposing the scandal of lithium-based pharmaceuticals used for Amyotrophic Lateral Sclerosis. A study based on information received online showed how these drugs were totally uninfluential in the treatment against ALS. Such an example shows how the “open source” approach in medical research can produce important results, as opposed to competitive research, through which data remains trapped under a vertical, limited and secretive system.

In medicine, more than in any other sector, it becomes increasingly fundamental to dispose of “big data” with adequate algorithms, following the crowdsourcing model in order to identify sanitary models at low marginal costs and yet with very high efficiency. In the chapter “Everyone is a doctor” of his latest book, Jeremy Rifkin reminds us that, nowadays, the Internet counts with hundreds of health Open Source Commons. Rifkin consequently highlights that “everything suggests that their number will increase significantly in the coming years, when in various countries the electronic storage of health data will make health care support services more fluid and efficient... The big data, that will therefore be made possible to generate in the United States as in all other countries, will form a pool of information that, if properly exploited by open source Commons oriented health by patients, may, subject to appropriate safeguards on confidentiality, revolutionize the health sector” (Rifkin, Ibidem, page 348) .

Hence, the message launched from the collective of sensitive and intelligent doctors interpreting Rifkinian thought, among whom are Dr. Angela Meggiolaro, Dr Bruno Corda and Dr Angelo Barbato, completes the vision of a society of zero emissions, waste, kilometres and of a zero marginal cost economy.

The “Zero” vision expressed in the book-manifesto Zero Zone, written by professor Livio de Santoli and myself, thanks to the contribution of Angelo Barbato, has permitted us to trigger the spread of awareness around the Zero Disease concept. This occurs in a scenery in which the internet of things and the Third Industrial Revolution bring the centre of health care precisely onto the territory, calling for the necessity to increase prevention as a “Pillar” of the distributive model of health in medicine in the zone.

The new vision highlights that the traditional model based in the hospital has become ineffective for the treatment of chronic diseases which are increasingly diffused due to the lifestyles and occupations imposed since the Second Industrial Revolution, and which can be reduced by enhancing the prevention pillar. Telemedicine, home care, fight against chronic diseases, doctor’s actions on the territory’s schools and public administrations and especially the adoption of proactive methods by the citizen-patients, will increasingly revolutionize how we deal with health, moving the focus from the institution to the area.

This new health model of the third Industrial Revolution will revolutionize the current paradigms of health care, reaching extraordinary and very rapid results, mainly through prevention. The new care model is the heart of the book ‘Zero Disease’. The realization of such a possible future depends entirely on us, starting from public administrations and health care enterprises. Notwithstanding citizens and their propulsive aggregating force which lead increasingly rapidly towards a biospheric, empathic, collaborative and sustainable lifestyle, where Community becomes Zero Zone.

Angelo Consoli

Director of the European Office of Jeremy Rifkin

President of CETRI-TIRES (Third Industrial Revolution European Society)

Co-Author with Livio de Santoli of the Manifesto-book “Zero Zone”.

1. The wellness and health management in the ideological framework of Jeremy Rifkin

Bruno Corda Angelo Barbato

Jeremy Rifkin is one of the world’s most recognized economists who in his recent work

has stressed the progressive rise of a new economic system, gradually alternating and replacing capitalism. The engine of this transformation is the digital revolution, allowing the internet of things. Telecommunications’ Internet of things (or, more properly, the Internet of Things or IoT), is a neologism referring to the extension of Internet to the world of objects and concrete places

. The internet of things is made up of a network between the energy internet, the communication internet and the logistics internet

. Rifkin summarizes his economic thinking in three basic paradigms (energy, communications and logistics), stating that in the evolutionary change of these archetypes, man becomes the star of a new industrial revolution.

The first industrial revolution (about 1760-1870) was an economic transformation process or industrialization of society in which the agricultural and craft-trade systems became modernized and industrialized. Characterized by the generalized use of power-driven machines and of new, inanimate energy sources (such as fossil fuels - steam engines), the scheme was favored by a strong component of technological innovation. This was additionally accompanied by the phenomena of growth, economic development and profound socio-cultural and even political changes. This first industrial revolution began in the textile (cotton), metallurgical (iron) and mining (hard coal) industries.

The insurgence of the second industrial revolution (about 1870-1970) is conventionally set to 1870 with the introduction of electricity, chemicals and oil.

The third industrial revolution (1970) refers to the effects of mass introduction into industry of electronics, telecommunications and informatics

.

In recent years a new generation of scholars and specialists have began to realize that the management and centralized control of commerce is giving way to peer production and horizontal distribution. The scale of property exchange on the market is becoming less important than access to goods and services on the network. Additionally, conscience is rising around the social capital as true economic value rather than the market capital.

The main result will be a more equitable society based on sharing and cooperation between citizens and a sustainable economic model, particularly from an environmental point of view.

The new paradigm will lead to a progressive market decline as we know it today, parallel to the development of a sharing economy based on the cooperation of the consumer who meanwhile also becomes producer (prosumer). This is the first new economic system to make its appearance since the birth of capitalism and socialism at the beginning of the 1800. A free economy is emerging, a mix between capitalism and collaboration. In 2050 Jeremy Rifkin predicts that capitalism will still exist, but it won’t be the sole economic system. Young people today collaborate with all sorts of things, produce and share their videos, their music, their news.

Online training courses are open and free, all this with marginal costs equal to zero. In fact, when producing a video, the marginal cost to distribute it to a billion people is virtually zero.

We're starting to see a new economic system in which there aren’t only producers and consumers, owners and workers but also prosumers; millions of people who access the Internet platforms of things and are able to produce, consume and share any virtual service: news, knowledge, music, video. We are bypassing the great twentieth-century organizations at almost zero marginal cost: free of charge, in abundance and outside the market. This is a revolution.

What will happen to Multinationals?

Many of the big and vertical ones of the twentieth-century have already been destroyed, as has happened, is occurring and will continue to take place in the music and video industry, in editorials and in television.

At the same time, thousands of other new companies have emerged in the economy of sharing. Not just Google, Facebook and Twitter, but thousands of profit and nonprofit companies that are building the sharing economy, thereby enabling young people to share what they create.

It 'a very destructive process to the market economy as we know it today, but it is only the beginning of a revolution towards the democratization of economic life.

Germany is leading this revolution, and even small countries like Denmark and Costa Rica are doing well. Germany is ahead in the internet of energy with 27% of the energy produced by sun and wind. It will be over 35% by 2020 and 100% by 2040. The costs of technologies for energy production are significantly reducing as has happened in the computer industry. A solar watt costed $ 150 in 1970, now it’s charged 64 cents and it will drop to 35 within 18 months. Once Germany has paid off the investment expenses, the marginal cost of energy produced will be close to zero. The sun and the wind do not send any bill to be paid to the Germans. It's free. Germany is heading towards an energy system at zero marginal cost that will make the economy more productive and efficient in the world, hugely benefitting its businesses and families.

China, too, has begun to change its energy policy with investments starting at 82 billion dollars in 2015 to digitize the electric grid smart. Millions of Chinese will be able to produce solar and wind energy in their home and share it in the national electricity grid.

In electrical engineering and telecommunications, a smart grid (intelligent network) is the combination of an information network and an electrical distribution network in a manner allowing to manage the power grid “smartly”.

Precisely the "intelligent" characteristic must be highlighted under various aspects or features as the efficient distribution of electrical energy for its more rational use, minimizing any overloads and variations in voltage around its nominal value

.

Digital smart grid is a concept which, carried from the power supply, will be increasingly developed in the computer network connections. This has implications not only for Wi-Fi, broadband and big data. It is needed to move towards the trend of digitizing the three major paradigms of the economy: energy, communications and logistics (including transport systems).

There are no longer virtual or natural boundaries facing the great global problems such as population growth, food resources, over-exploitation of land resources, pollution of the planet and consequently uncontrolled problems at the limit of survival , of space and of the biosphere’s balance. These represent problems towards which consciousness is growing, issues we can no longer postpone, or worse, ignore.

A new global and social consciousness is inevitably making its way, demanding a complete change of paradigms. Vertical and power relations will gradually give way to relations of cooperation and sharing of forces.

Empathy and assertiveness, keywords of sharing and collaboration, will integrate the necessarily narcissistic, closed and conservative communities of all sizes and places.

As masterfully described by Jeremy Rifkin, history shows that a shift in energy, communication and logistics represents the dawn of a substantial economic revolution in all societies of the world. Consequently, as always happens during great changes, it is crucial for the future of society to seize the opportunities of such shifts, renewing and adapting their inner world to a new global vision. At present, the history of man and of civilization has reached a global dimension.

The paradigmatic events of the third industrial revolution described by Jeremy Rifkin have produced the greatest evolutionary acceleration in human history. As always, it is up to man to know how to seize new opportunities. The faster man makes this happen, the deeper and more aware the willingness to change themselves will be.

The first big change is radical, the gradual transition from a self-centered individual awareness to an open and multifocal collective. In summary, the ability to combine oneself with others and with the surrounding world is needed. This three-dimensional view, which effectively defines the so-called biosphere consciousness is the new interior condition absolutely necessary to be able to rapidly take advantage of the great benefits that this revolutionary global process can generate.

Not knowing how to seize this great opportunity, or worse, not wanting to participate in the change can result in unfavorable social events, which are already perceivable, if not visible.

History is continually proposing this.

Individuals and companies are therefore becoming increasingly collaborative, more involved, more empathetic, more attentive to the world in which they live in. The change will impact our lives more rapidly the more we are active participants.

This will happen in the production of goods, but above all in the collective sphere of relations, so-called services. First and foremost, is health, where the value of empathy is one of the anchors of the modern conception of the doctor-patient relationship.

The doctor-patient relationship has always been the cornerstone and the centerpiece of the "cure" process in all its stages, from prevention to diagnosis to therapy.

In some national contexts, such liaison has gradually shifted towards the establishment of mathematical sterile space protocols of production chain in the Health "Companies", sometimes operated by speculative organizations. These companies are both public and private. Speculative, in this context, because the “enterprises”, rather than focusing on the "production of health", end up feeding themselves and their survival.

Why are the delivery systems for health care services continually reviewed? What is constantly changing? Why do public health systems tend towards privatization and not vice- versa? Why is an important profession such as health care more than any other at the centre of debates and controversies? Why is one of the most important services that every state should give priority to so different from country to country?