Tying together fifty states worth of healthcare systems and laws to provide some kind of reasonable abstract interface. On top of systems that may or may not ha

Tying together fifty states worth of healthcare systems and laws to provide some kind of reasonable abstract interface. On top of systems that may or may not have been designed with this form of use in mind. Go look up some of your own state's healthcare laws to see how bizarre they can get. Then think about how each state has organically arrived at their own set of bizarre and nebulous laws. Then imagine what the infrastructure built around those laws - adapted over time as they changed and ignored as much as possible - looks like. People surprised at this number are judging a vast and complicated problem by the (relatively) simple and pretty face plastered on top of it. I'm actually kind of impressed that the number isn't higher.