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Comment by tn13 | Hacker News Reader

It sounds very contradictory. In most of the heavily regulated industries such as healthcare or insurance, one of the economic efficiencies are a better understanding of the complex law, startups can not solve this inefficiency in their favor.

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I'm not saying you don't need to understand the regulations and law - you absolutely do. But you do have an advantage in being able to be less conservative and more innovative in how you interpret them. For examples, take Uber and AirBnb - they are both pushing the boundaries of highly regulated industries. An existing hotel chain couldn't do it because they have too much to lose, and target such broad markets. But a scrappy startup can.

Finding loopholes?

Maybe sometimes, but that's strong. Just avoiding groupthink or the weight of ecosystem apathy that tends to grow out these depressing verticals that hire incestuously from other shops that have been building shitty products really slowly for years.

I don't mean to downplay the ridiculous bureaucratic and regulatory crap, but I don't think it's fair to lay the blame at it's feet either.

Honestly, health is just a Ripe For Disruptions™ as any startup-interesting vertical. Takes more stomach and open-mindedness than anything.

It's a bummer. Page/Google are being limp and lazy on this. With opportunities as broad as they have they can afford to Do Hard Things, where Hard is something a little bit out of their wheelhouse. That's okay I guess, but it's a big shame cause health IT could really use some shops with lots of leverage and actual engineering talent to help move the needle when it comes to the constantly backward standards.

[FWIW - I'm a decade and a half long healthcare startup hacker]

I'd argue they are at disadvantage. Small startups can't eat the cost of spending 2 years developing for a particular standard just to have it changed on the due date.

That's a fair argument but in practice isn't true. The pace at the larger health IT shops is FUCKING GLACIAL. I've been through getting an EMR through two meaningful use stages in a fifth the time combined than a typical larger shop might've gotten one done, with a tenth the manpower.

In verticals like this don't dismiss the advantage of being lean, nimble, and wholly stocked with incredible and enthusiastic people.

This. This. This.

I wish more people saw healthcare this way, and I guess now I'll probably use Uber and AirBnb as an analogy to help them to. THIS is the way to think about health, and how to treat it's risks and limitations.

Well-loved YCombinator startup Stripe spent a bunch of its early time wrangling with the complexity of the payments industry precisely so that their customers wouldn't have to.

Legal frameworks are definitely tractable, and investing the time to navigate them more effectively can give you the same sort of competitive advantage as mastering a technology.

Same principle, different domain.

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