We often think of the healthcare industry as succeeding because of logic. Yet recent history charts the epic failure of prevailing investment approaches to generate positive sustained at-scale outcomes. Any wide-angle view reveals the mismatch between medicine’s intended consequence and maladaptation as playing out in rising chronic disease, hospital waiting-lists, choked primary care, clinician dissatisfaction and discarded apps. In the era of abundance, why is this predicament so difficult to outrun? What perpetuates the current situation are terrible mental models. This includes the failure to move beyond industrial mindsets towards a complex systems approach. Also to recognise how the interface between policy makers and big industry has (public) health and economic metrics pit against each other. Simply pouring more money in can’t work. It will accelerate the impact of false assumptions baked in at the foundation. So how might investors and entrepreneurs architect strategies that better align commercial ambition with what human beings need to thrive? How might values and value tradeoffs be more effectively weighed? What role does the next generation of healthcare companies have in addressing the need for integrated approaches? How can we deliver positive ROI and better patient outcomes without killing clinicians on the frontline?