> If you've ever had the displeasure to experience the healthcare system, you'd learn too that "professionals" are indoctrinated in a system that doesn't update their knowledge, keeps their knowledge in silos, and overall is inefficient and not getting people access to the most recent/best information/knowledge.

This is crankery. Not all doctors are the best medical practitioners, but I will always trust a random medical doctor more than a random “health” startup.

Your statement is equally a "crankery" if you've never had to deal with or experience the healthcare system. Unless you educate yourself on a topic to try to understand what's going on with yourself (unless it's something very simple), then you'll likely have as good of odds deciding if a doctor is good at what they do/figuring something out, as does a "health" startup. The systems of indoctrination are real and human error is a huge problem, likewise, doctors are selected primarily for their memorization skills and not critical thinking. - so if it is something more than simple, - good luck. They will listen to you for symptoms (assuming your self-awareness is adequate to notice everything important and your ability to share those symptoms is adequate) to then match up what might be going on, and then send you for testing, further specialist opinion, or whatever else. Technology will replace most of the processes in health - and that is good. Another example is using AI to analyze x-rays and MRIs for issues. Your family physician will depend on the report to decide if there's anything that needs to be treated - I have had more than one MRI reports where on second look by a different doctor they spot something that the original didn't.

> Some "random guy that's making a startup" presumably would do things to be safe, and ethical, no?

That's a very risky assumption to make. Ethics are often secondary considerations for engineer and business thinking (for better or worse). To the point that people advocate the removal of ethics courses from university STEM curricula (not sure how widespread this viewpoint is, but I've heard it my entire adult life, so this whole century).

I should have clarified/furthered my thoughts - and it's true you shouldn't by default trust a startup to do things safely or ethically, you should certainly do your due diligence that they aren't making claims that can't be backed up, nor are following processes (etc) that can do more than what is a pre-existing level of acceptable risk/harm.

Presumably however, if they're/a startup is expecting to survive in the long-term they'd need to be leveraged and connected with safety and people with the appropriate knowledge, because they should be scrutinized more thoroughly if they're involved with health. Otherwise they're going to die off - and hopefully without hurting too many people or getting too big, like where we could reference Theranos.

Anecdotal evidence, but I personally know quite a few people with mental health issues who’ve found psychiatrists very helpful. I don’t know anyone who has received significant help with mental health from a tech startup. Startups are great, but they aren’t the answer to everything.

Many of the tech startups currently are platforms to connect people to services - like psychiatrists.

So directory services? Great, but then they have nothing to do with the actual healthcare, so your original comment on private market care doesn't apply.

Sorry but I don't understand how my comment on the private market doesn't apply? I think there is definitely difficulty in seeing the underlying aspects of where innovation comes from, mainly because the "lowest hanging fruit" is what will get investment money first, and part of that lowest hanging fruit will scale quickly too - meaning it'll be what gets the most mainstream exposure - so that can skew people's view about private vs. public.

Do you have much experience personally dealing with healthcare systems to reference?

What about the last 15 years leads you to believe that we can rely on startup founders to care about safety and ethics?

I can only imagine there are a lot of health tech companies we could find/reference who have received VC money, and who haven't hurt anyone - who are aware of the ethics and are good people. Of course there will be people who are naive, perhaps the "mercenary" type who see an opportunity, get money, and try to push for growth and marketshare without caring about health and safety first; Theranos seems to be one of these situations.

You first argue that the free market is suited to solve these problems, then criticize the health-care industry for problems caused by its competitive nature.

I want to address your point here, but I have no idea what it is.

There's an educational complex (including for/with medicine-healthcare), a manufacturing line of people's education towards "higher education." I am not saying this is inherently bad, however it has allowed indoctrination and stagnancy in practices to take hold in some areas - and which other means of education haven't caught up (via the private/"free" market) to counter-balance this for the mainstream masses to use and benefit from; programming has easily become a decentralized task with platforms like Codecademy, as one example.

There is also a difference between healthcare in countries like Canada vs. the US, where you can compare how "free market" the different systems are - see where more innovation has occurred or stagnated due to policy or other.

My point is that it's dangerous to blindly trust professionals - professional titles that were/are created and maintained through systems that include indoctrination - and just because they have a degree in something doesn't mean you should trust them (on a simpler level, just because someone has their driver's license - doesn't mean you should assume or trust they're a good driver). And obviously I'm not relating this type or level of trust to say someone who's gone through schooling who's a brain surgeon, to trusting someone else who just claims to be a brain surgeon but has no references or experience.

The problem with indoctrination is there is new knowledge and tools being developed every year, however that knowledge is not distributing - it takes far too long, in part, because of indoctrination.

There's indoctrination within individual organizations/companies as well, with like Theranos, where the VCs and controllers must not have understood the science themselves - or had trusted parties they could refer to outside of the company - and so it could grow to the scale it did.

The free market can counter these complexes, it's just not going to be a simple endeavour, it will be complex. And just because the free market can solve these issues, doesn't mean there shouldn't be societal changes and rules enacted, and doesn't mean that this same free market and say health-care industry can't be part of creating problems that then need to be addressed.

> Some "random guy that's making a startup" presumably would do things to be safe, and ethical, no?

I assume the exact opposite of nearly every startup.

Good - as you and everyone should - however, in the context of a health startup, and if the startup wants to have a long existence, they're not going to last very long if they're hurting people? I didn't mean to imply to blindly trust, like you shouldn't blindly trust any doctor you see.

> Some "random guy that's making a startup" presumably would do things to be safe, and ethical, no?

“They ‘trust me.’ Dumb fucks.”

In context I was speaking of health-related companies, that generally are scrutinized more - you can't create a medication and just start giving it to everyone, and you can't claim a medicine does something it hasn't been proven to do in studies, etc.

And once again, Facebook et al, ties into health as social is health. Facebook did some experiments/research specifically to see the impact of showing more positive or more negative posts to people, on a large scale, and without people expressly knowing or asking to participate. They should have gotten into huge trouble for this. How would you prevent this otherwise than having good whistler-blower laws, along with substantial rewards for doing so? Is the best option have someone else notice the problems and develop competition that is a better solution? It's difficult of course to compete with things like network effect and economies of scale, so then it will take more effort, more ambition, more passion, and perhaps more resources and time to reach the same scale - if that scale is even healthy.

Soylent and Theranos are two recent counterexamples that come to mind. In the former case, a company made many claims they have since dialed back; and in the latter case, outright fraud, though it may not have started out that way.

23andMe were shut down for a period by the FDA.

There are of course plenty of healthcare startups that are working within the established boundaries of the existing system, but if you want to push those boundaries, it's going to take a while for regulations to catch up, and in the meantime caveat emptor.

Can you give more information on Soylent being fraud?