Daniel Ek

After two decades running Spotify to well over 700 million active users and more than 300 million premium subscribers, Daniel Ek became executive chairman on January 1 and returned to building. Spotify began in 2006, launched in Sweden in late 2008 and reached the U.S. in 2011; Neko Health similarly spent five years developing before launching in Sweden in 2023, followed by the U.K. and now the U.S. “Maybe I just have a high pain tolerance.”

Neko’s wedge is a vertically integrated, $499 preventive-health visit with positive unit economics. In roughly an hour, it measures 53 blood markers, captures more than 6,000 high-resolution body images, evaluates cardiovascular and other established indicators, and delivers the results through a clinician. Ek calls it “the most valuable hour you can invest in your health.” Neko co-founder Hjalmar Nilsonne is the brainchild and handles most of the work; Ek is not its day-to-day CEO.

More than 100,000 scans have produced an early health signal: roughly 1% of members had a serious, previously undiagnosed condition discovered. Ek says members with the worst starting health status have improved the most, while explicitly stopping short of claiming conclusive population-level outcomes. Neko recommends annual visits, but he says it is too early to know what broad adoption would do to healthcare budgets.

Dermatology illustrates why Neko views multimodal, longitudinal data as the product rather than a one-off checkup. The average person at Neko has roughly 950 moles; Neko indexes them all, uses AI to flag risks, layers clinician and specialist review on top, then compares every lesion across visits. Even an exceptional doctor “can’t possibly remember” how hundreds of moles looked a year earlier.

Ek’s tentative diagnosis of America’s healthcare failure is an incentive-duration mismatch. Employer-linked insurance may retain a member for only two or three years, while preventive investments can require 10–20 years to pay back; the system therefore remains oriented toward acute symptoms. His response is pragmatic rather than sweeping: lower diagnostic costs and create enough outcome data to make long-horizon ROI legible.

The data strategy extends beyond Neko’s own sensors into wearables, research and continuously upgraded diagnostics. Neko already allows Apple Health imports, has completed four clinical trials, has two underway and another four planned, and expects Gen 2 to keep expanding rather than remain a static product for a decade. Ek’s view is that making 10x or 100x more healthcare data available could enable conclusions that today’s relatively small datasets cannot support.

On AI, Ek favors both open and closed models, declines to take a strong position on pacing, and raises compute as an additional risk variable beyond static model classifications. Spotify uses frontier and fine-tuned models because cost, efficiency and control differ by task; meanwhile, a system using 100,000 GPUs may be much more powerful than an open model running on a home PC. His larger complaint is that the industry undercommunicates AI’s “crazy positive stuff,” from personalized music to earlier disease detection.

🔗 Original source & video: Daniel Ek: Life After Spotify, Broken Healthcare Incentives, Catching Disease Early & AI’s Potential