FWIW I'm not sure I agree that it's getting harder (though sure, consolidation is a challenge). That said, for the moment let's concede that it is and I'll argu

FWIW I'm not sure I agree that it's getting harder (though sure, consolidation is a challenge). That said, for the moment let's concede that it is and I'll argue that's fine. Harder isn't a bad thing. For the last decade in healthcare we've had a small array of large players with strong footholds and really shitty projects, and a huge array of small players with small footholds and really shitty products. Harder means you have to do a very good job to win, which will probably lower the noise floor among the $NOTBIGCORP crowd and may make that road for growth even more plausible for folks doing something really excellent.