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Healthcare like almost every major enterprise vertical is a wicked problem[1] and these problems are pretty much rife with far more than just technical problems. Most of the VC founded ventures are honestly quite terrible at attacking the Fortune 100 that dominates these verticals including reasons like collusion as well as regulatory capture. A $10M+ series A seems like big money to a lot of the people in tech, in the enterprise space of the Fortune 100, that's a rounding error resolved by just firing one or two middle managers. I can hardly afford good sales guys covering all the regions for long enough of a sales cycle that I could confidently ever make a single deal on that alone - the enterprise approach to relationship-focused sales and procurement cycles forces the necessity of well-networked, very expensive sales people, unfortunately. That's the kind of slow-moving, massive capital flows that are at play, and there won't be any company that can attack that problem head on because it's not a technical problem whatsoever. Even worse, because these industries are capitalized heavily as public companies, their board of directors appoint super risk averse leaders culturally and will not move forward without finding a business model that will not cannibalize existing sales. Even still, if such a technology and business model existed, it is simply very, very easy to torpedo these efforts politically within these companies because these companies are already so profitable (think Hollywood-style accounting for a second, not tech company or even i-bank style simplistic accounting) they'd rather get rid of emerging competitors than to actually innovate. After all, in the health insurance space, as long as people (and, more importantly, companies) are paying premiums and subsidizing a sufficient number of costly patients that need care, there's little reason to really try to innovate in terms of technology there. That becomes something up to healthcare providers to try to work at, but they're typically courted by a very, very well capitalized and networked cartel of healthcare companies typically founded by doctors first, not technology people. Doctors may be smart oftentimes, but they're just not technology people fundamentally after decades of practicing medicine.

I agree that the problem must be attacked, but I have my doubts that it would come from a VC funded company in the same vein as most SV companies that have done so well. And as Theranos shows, I have my doubts that the highly kleptocratic cronyism driven private government contracting space will do it either. It may very well require a completely new model that incorporates the best ideas of both funding vehicles to avoid the common pitfalls of enterprise b2b companies.

[1] https://en.wikipedia.org/wiki/Wicked_problem



<sarcasm You are violating the fundamental commandment of tech optimism: throw enough money and naive young nerds at it, you can solve ANY problem. Google is even trying to defeat mortality. /sarcasm>


Well said.




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