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Comment by AngeloAnolin | Hacker News Reader

Reading this article and seeing all the startups sprouting in the field of health care and medicine tells me that there's still a lot more areas to innovate and disrupt in this industry.

One big issue though are that lobbyists who wanted to keep prices high - to squeeze in as much profit as they can out of these. Drugs, Antibiotics, Procedures, Medical Professionals. I know it would be far-fetched to standardize and at least provide some level of transparency across all facets of operation in this field, but that would be a good start.

Analyze the data, and find ways where things can be improved incrementally.

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One way to disrupt the industry might be to have everyone be in one giant insurance pool, perhaps paid for via taxes, and then give everyone access to health care via some kind of non-profit entity.

Sounds crazy, right?

It worked well for my family and I during the many years I spent in Italy, which has health care costs that are something like half of what they are in the US in terms of GDP.

Yup, it's worked nearly all over the modern world, for years and years. The last thing I want in healthcare is more startup maniacs trying to "disrupt and innovate" when there is a clearly viable alternative.

This is the same in Canada - universal health care administered in each province.

Although I seemed to have noticed a lot of increase as well in terms of pricing and services.

There's just really no cure for an appetite of greed.

All this value being captured by middlemen “sprouting” up could also simply mean more money out of the pockets of healthcare customers, who already are going bankrupt paying for all of this inefficiency. The US healthcare industry is a raging river of money coming directly out of the wallets of consumers who have little choice. Not surprising that it attracts middlemen with spoons ready to dip into the river.

This is correct. The healthcare industry does not lack middlemen.

> Analyze the data

How are you going to get it? Even Google has huge regulatory issues around touching health care data. Medical records are some of the most highly regulated pieces of information around. A startup would have to have very deep pockets (or a few lawyers as founders) to have any chance IMO.

I'm in the industry right now, and while there's certainly room for innovation and improvement (our company was one of those originally), anyone considering it should know that this industry is a huge legal and regulatory quagmire, which makes diving into it difficult if you're not already familiar with it.

Despite knowing a lot about how it works after being in the industry for several years, I don't think I'd have the stomach to take a stab at a startup in this field myself. I've already had to deal with it over the years as an systems engineer and I'm pretty sick of it.

Also, if you're planning to do business with the big companies in this field, at least from the standpoint of my company, they really drag their feet with signing any business deals with you, and just about every company doesn't really want to pay you to do anything. We've had multiple companies back out of contracts (or act like they're going to sign once things are negotiated, then don't), even after we've done significant development (in one case building a whole system for them) and not pay us for our work, and then have the gall to ask us for parts of the code afterwards.

The only reason we did that work also, is because there are some crazy hard deadlines with open enrollment and the process drags so much that by the time everything is signed the software basically already has to be complete immediately upon signing if we wanted their business or else it would miss the open enrollment window (or pre-open enrollment, or whatever else hard deadline they had).

Also, the industry has been upended and thrown into chaos with Obamacare, and if the Republicans ever succeed in repealing/replacing it, then it will probably be thrown into chaos again. This creates an opportunity for startups that can move much quicker than these behemoth companies can move in reaction to these things, but it also means that you could be building a business on top of quicksand, and might have to make significant and expensive changes yourself in a few years if it changes underneath your feet as well.

Elisabeth Rosenthal's "An American Sickness" is one of the best overviews of the many aspects and incentives for pricing in healthcare.

https://www.anamericansickness.com/

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