Consider the Placebo Health Institute, my latest healthcare startup. We operate out of a Four Seasons in Honduras, where regulatory oversight is, um, a little more flexible. Patients are met at the airport and whisked to our sleek, modern, brightly lit medical floor. They’re introduced to a well-spoken surgeon and anesthetist, both with perfect teeth and vaguely British accents. After signing a stack of liability waivers, they’re put under general anesthesia. Three hours later, they wake up with a bandage and a few stitches. We might even make a small incision or two, for authenticity.
Our margins are spectacular because only one in ten patients actually gets the operation. The other nine get the full surgical experience, minus the surgery. Nobody knows which treatment they received.
The absurd part is that this might work about as well as some real surgeries.
In sham-controlled trials of vertebroplasty, a procedure for spinal fractures, patients who received fake procedures improved about as much as those who received the real thing. Similar results have been found for some knee surgeries. Apparently, the elaborate theater of surgery can itself be therapeutic.
Obviously, plenty of surgeries work. But for some elective procedures treating chronic pain, how much of the benefit comes from the operation, and how much comes from the surgeon, the anesthesia, the hospital, and the patient’s belief that something expensive and medically sophisticated just happened?
Placebo Health Institute eliminates 90% of the actual surgery while retaining the expensive theater surrounding it. Patients get better, surgeons get paid, and we pocket the difference. General anesthesia and unnecessary incisions have risks, but that’s what the liability waivers are for.
This is probably a stupid enough startup to get funded in 2026, provided I put AI in the name. Let’s call it the AI-Native Placebo Health Institute. Our proprietary foundation model optimizes surgical intervention rates, reducing unnecessary procedures by 90%.
The model is a random number generator, of course.