4 ms·

I've been in the sector for about 11 years and I've grown to take very dim view of the entire industry. There is so much money sloshing around in the industry,

by pcurve 12y ago

I've been in the sector for about 11 years and I've grown to take very dim view of the entire industry. There is so much money sloshing around in the industry, yet people are getting less and less for their dollars. Everyone loves to criticize financial and telecom companies for bad behavior but healthcare puts them to shame. You have Copay, out of pocket, deductible, co-insurance, HSA, HRA, FSA, preferred drugs, generic drugs, single source, multi source, in-network, out of network, lifetime CAP, etc. These are essentially instruments that healthcare companies use to reduce their payouts and shift costs. Where is all the money going? (no need to answer) It makes me sick that this year's SXSW focus was on healthcare. We don't need more startups and MBA types trying to 'fix' healthcare. The current healthcare problem is purely political and regulatory in nature.

mgkimsal 12y ago
While not in the healthcare space, I have the same default view of many industries. In many cases, the entrenched problems are not specifically technical in nature, and just waiting for some smart person to point out "feature X will solve Y!" and everything falls in to place. Yet... in many cases when I'm talking to startups, this seems to be the mentality. I tend to notice it in younger folk (probably moreso as I get older), but it's actually a little bit annoying (or can be - not always so). I did a bit of work with some guys who wanted to do a focused "udemy for medical students" - extremely focused content from top professors. "We really need this - no one's thought of this before!, etc". I pointed out that very likely the professors had some sort of IP/publishing tie with their universities which would at least require approval (if not in fact prevent such deals from happening). "Oh no, we've got professors lined up already - we're ready to get moving!" 3 months in... a sum total of 10 minutes of content was produced - poorly. Most of the professors, when pressed, admitted they had to get approval because they had IP deals - not specifically with their universities, but many with existing publishers (note: don't ask published medical professors to create web content for you, as it'll likely be a conflict of interest with their publisher). The team didn't want to have lesser-known professors - only top published name-brand professors... so it all died. "This was a lot harder than we thought it would be" was the final parting discussion, and was my initial point I'd made when we first started - "this is going to be harder than you think it is. the core idea is brain-dead simple - there's a reason it's not being done the way you want it done, and it's not because the two of you are the first humans on the planet to think of it". Sounds a bit harsher in retrospect when writing it, but back to healthcare - yes, the current mess is not due to a lack of smart people - it's those existing people with industry knowledge and experience not being able to work effectively.
tim333 12y ago
>You have Copay, out of pocket, deductible, co-insurance, HSA, HRA, FSA... You have that in the US but not necessarily in other countries. The UK NHS doesn't have that stuff but still managed to screw up: http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-pulls-the-plug-on-its-11bn-it-system-2330906.html http://www.independent.co.uk/life-style/health-and-families/... which suggests there are technical difficulties also.
- pcurve 12y ago
  Very interesting. "One supplier, Computer Sciences Corporation (CSC), has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap," Google "CSC" and "fraud" together and you'll find some interesting tidbits.

by pcurve 12y ago

mgkimsal 12y ago

While not in the healthcare space, I have the same default view of many industries. In many cases, the entrenched problems are not specifically technical in nature, and just waiting for some smart person to point out "feature X will solve Y!" and everything falls in to place. Yet... in many cases when I'm talking to startups, this seems to be the mentality. I tend to notice it in younger folk (probably moreso as I get older), but it's actually a little bit annoying (or can be - not always so). I did a bit of work with some guys who wanted to do a focused "udemy for medical students" - extremely focused content from top professors. "We really need this - no one's thought of this before!, etc". I pointed out that very likely the professors had some sort of IP/publishing tie with their universities which would at least require approval (if not in fact prevent such deals from happening). "Oh no, we've got professors lined up already - we're ready to get moving!" 3 months in... a sum total of 10 minutes of content was produced - poorly. Most of the professors, when pressed, admitted they had to get approval because they had IP deals - not specifically with their universities, but many with existing publishers (note: don't ask published medical professors to create web content for you, as it'll likely be a conflict of interest with their publisher). The team didn't want to have lesser-known professors - only top published name-brand professors... so it all died. "This was a lot harder than we thought it would be" was the final parting discussion, and was my initial point I'd made when we first started - "this is going to be harder than you think it is. the core idea is brain-dead simple - there's a reason it's not being done the way you want it done, and it's not because the two of you are the first humans on the planet to think of it". Sounds a bit harsher in retrospect when writing it, but back to healthcare - yes, the current mess is not due to a lack of smart people - it's those existing people with industry knowledge and experience not being able to work effectively.

tim333 12y ago

>You have Copay, out of pocket, deductible, co-insurance, HSA, HRA, FSA... You have that in the US but not necessarily in other countries. The UK NHS doesn't have that stuff but still managed to screw up: http://www.independent.co.uk/life-style/health-and-families/health-news/nhs-pulls-the-plug-on-its-11bn-it-system-2330906.html http://www.independent.co.uk/life-style/health-and-families/... which suggests there are technical difficulties also.

pcurve 12y ago
Very interesting. "One supplier, Computer Sciences Corporation (CSC), has yet to deliver the bulk of the systems it is contracted to supply and has instead implemented a large number of interim systems as a stopgap," Google "CSC" and "fraud" together and you'll find some interesting tidbits.