Semler Scientific's decision to dive headfirst into Bitcoin, potentially raising $500 million to acquire more of the cryptocurrency, is raising eyebrows, and rightfully so. We are unfortunately living in the age of the greatest technological disruption. Blockchain is the solution that’s going to change it all—for supply chain, for protecting patient data, you name it. That’s all great, but is a healthcare company doubling down on Bitcoin really the best way to serve patients?

Let's be clear: innovation is vital. Concepts such as reliable data sharing and simplified payment mechanisms are promising. For Semler, the real endeavor isn’t cutting-edge finance — it’s healthcare. That’s the real change — delivering reliable diagnostic tools such as QuantaFlo while creating healthier results for patients. And so we ought to be asking whether $500 million dumped into Bitcoin really serves that mission.

Innovation vs. Essential Care

Consider the opportunity cost. That $500 million could pay for a considerable amount of research and development into new diagnostic technologies. It would go a long way to increasing access to care in underserved communities. It could improve existing products and services. Instead, it’s perhaps being used to pursue speculative gains in the world of crypto volatility. Is this truly the most effective use of resources for a company that should be totally focused on fixing our broken healthcare system?

Investing in Bitcoin is inherently risky. Its value is notoriously volatile. What if the market just sinks through the floor? Would this investment threaten Semler’s mission of providing affordable, accessible healthcare? Would it make them reduce investments in safety or wait on breakthrough federal health initiatives like all-payer claim databases and pragmatic trials? This is not merely a bottom line consideration — it relates directly to the health and well-being of actual human beings. If Semler cannot deliver care, then lives are at stake.

The ethical implications are undeniable. When a healthcare company makes speculative investments, such as in crypto, Web3, or the metaverse, more important than its core mission, a clear conflict of interest exists. Realize that their motives are more about financial gain than truly doing what’s best for their patients. Are they really doing what’s in the best interest of your patients?

The Ethical Tightrope

Semler’s chairman called the company a “zombie company” before its foray into Bitcoin. Profitable, but stagnant. As energizing as the Bitcoin move may be for its stock price, is this a long-term play?

Here's where the "unexpected connection" comes in: think about the dot-com bubble. Businesses pursuing the newest web fad—which was usually gone within months—sometimes with catastrophic consequences. Are we seeing a similar phenomenon here? Have we been romanced too much by the siren call of “disruption”? So let’s be clear and return to first principles—those of sound financial management and ethical responsibility.

Even their current situation is not ideal. The DOJ’s settlement of $29.75 million for violations of anti-fraud laws involving QuantaFlo is no small matter. Their plan is to borrow against cash and Bitcoin held on Coinbase’s platform. This decision adds to the financial pressures they are under right now. Those negotiations started immediately after they increased their Bitcoin balance sheet by $88 million. With this move, it calls their priorities into question as they settle.

From Zombie to Crypto-Zombie?

Ultimately, we need to consider the impact on all stakeholders: patients, employees, investors, and the broader healthcare community. Will this Bitcoin bet pay off for them, or will it mainly enrich Semler’s executives and early investors?

If other healthcare companies follow suit and begin pouring money into volatile assets, they’ll risk straying from their original mission. The impacts of this change would be catastrophic. If not, we’ll surely see an increase in the quality of care. This occurs every time resources are diverted from proven basic services that would otherwise make care more accessible.

Maybe Semler will prove everyone wrong. Perhaps Bitcoin will go to the moon, and Semler will make him the healthcare visionary. The risks are huge, and the risk of blowing back in our face with unintended consequences is highly plausible. We have to raise hard questions and hold performers accountable. It’s time to put these principles into action because our health – and the future of healthcare – may well depend on it.

Even their current situation is not ideal. The DOJ settlement of $29.75 million related to anti-fraud law violations concerning QuantaFlo is a serious issue. While they intend to borrow from Coinbase, using cash and Bitcoin as collateral, it highlights the financial pressures they're facing. The settlement talks began shortly after they added $88 million to their Bitcoin treasury, which raises questions about their priorities during the settlement process.

Who Really Benefits From This?

Ultimately, we need to consider the impact on all stakeholders: patients, employees, investors, and the broader healthcare community. Will this Bitcoin bet benefit them, or will it primarily benefit Semler's executives and early investors?

What does this say about the future of healthcare?

If other healthcare companies follow suit, investing in volatile assets instead of focusing on their core mission, the consequences could be dire. We could see a decline in the quality and accessibility of care, as resources are diverted away from essential services.

Maybe Semler will prove everyone wrong. Maybe Bitcoin will skyrocket, and Semler will become a healthcare powerhouse. But the risks are substantial, and the potential for unintended consequences is very real. We need to ask tough questions and demand accountability. Our health – and the future of healthcare – may depend on it.