There are some incredibly large interests in the space that wield intense power and control over various markets. There is also a profound degree of inefficiency in a lot of what’s happening.
The question is whether many of those inefficiencies are technology problems or if they are intentionally constructed for the many reasons these things are created.
I feel like there needs to be almost a Walmart size company pushing down on prices with that kind of scale before many of these structures will be broken, and unfortunately that doesn’t appear to be the direction most things are going (oh they exist in scale, just not direction). I was hoping Amazon’s entry into the market would do it. It didn’t.
Might be time for a different direction in health care entirely. Kaiser had it right, but I don’t think they executed well and they are largely a company rooted in past thinking in how they are structured.
Combining health care and subscription with ongoing medical care is definitely the direction of things to come. The fundamental shift needs to be moving the system from fixing problems to keeping people actually healthy, and that means that healthy people need to pay for the system or the entire thing gets it’s incentives inverted (as it is now). This is a fundamental shift, but if it were done right it would be a massive company and really change the world. I’ve been looking in to how to build this over the last year and know I want to go in this direction.
And there is also a ton of interesting businesses in generics.
Just some thoughts from someone who has been in many aspects of the medical industry over my career. Hope it inspires some good discussion with my favorite community.