Blaming the insurance companies strikes me as the political equivalent of yelling at the cashier.
Insurance is one of the oldest industries in the US, which means they have accumulated many (probably well meaning, but ultimately stupid) regulations over the years.
For example, to be taxed as an insurance company (e.g. avoid paying tax on premiums that will partially be paid out in the future), most states assign a maximum profit margin.
That means, in order to make more money as an insurance company, it's perversely in their best interests to increase the cost of medical care as much as possible. Medical care is not like cat bonds that might wipe out your risk pool, so it's just a cashflow game.
That's not to say there isn't any downward pressure. On a day to day basis, individual claimants eat more into that margin than was budgeted, so a company might have to raise rates higher than their competitors (essentially they have some pressure to deny claims), but there is very little systematic pressure to reduce overall costs. Also, marketing budget does not count towards profit, which is why insurance companies are in this rat race of brand advertising to steal customers from each other. With auto insurance, for example, upwards of 40% of your premium is just going out the door as ad spend.
Anyway, I would assign a lot of blame in this perverse incentive scheme to poor regulations.
If I were the one making the decision, I'd change American healthcare with one big thing, modeled on the Japanese system... price controls. Japan's system is more or less like ours, but with one key difference - a government panel sets the prices for all medical goods and services. Providers and insurers have to make their profits within that price structure. This incentivizes both to reduce costs, for the sake of their own profits.
Of course, this would be called radical socialism or some such stupid in America, and Democrats aren't even talking about it (Republicans have no ideas at all on health care). But it's politically a much lower threshold than single-payer (throwing out the whole framework and starting over, basically). And it demonstrably works - Japan's system costs less than half what ours does per capita, with better outcomes.
The motivation of insurance is to keep the cost of treatment less than the income from premiums -- it doesn't have anything to do with how healthy people are.
> the motivation of insurance is to keep the cost of treatment that they cannot avoid liability for less than the income from premiums
Sometimes that aligns with keeping people healthy, but other times that aligns with women not getting routine prenatal screening and thus increasing the infant mortality rate.
What could we do to make this the basis of the system? Without driving doctors away from patients who have bad prognocices?
Unfortunately, they probably won't want to. People frequently change insurance, so the most likely outcome is they'll have to pay for an expensive treatment, but never see the savings.
This is currently playing out for some new expensive new gene therapies.
For the mentioned new gene therapy treatments, people have been asking congress to come up with a new model for how to pay for treatment. Here's a recent opinion piece by a Louisiana Senator where he lists off the proposals he's heard: https://www.statnews.com/2019/06/12/paying-for-coming-genera...
A testament that the demand for healthcare services is not only about health results. Albeit there are grave challenges about the way Kaiser or HMO's have supposedly better health results.
We just raised a series B and are hiring engineers (very remote friendly)!
That was the entire point of the article (written by the founder). What was the point of this comment?
“To succeed, an offering must create value for all entities involved in the exchange—target customers, the company, and its collaborators.”
I believe the point of this comment is 'do market research before quitting your job'. The author could have learned their presented points while operating this as a side project concurrent to their existing job.
This. It is very hard to get real world experience. $40k is cheap compared to a bootcamp that won't teach him even 1/10th of this life experience.
Btw, actual figure is not $40k, but one should consider it close to $100k+ if you factor in that he used up his "make my parents support shelter, food, living expenses, car". Depending on the cultural background, they wont be doing this many more times. If you consider how much he lost on the (bay area) salary he otherwise would have earned, add another $100k
If WebMD owned 20% of his product, for say $300k in Seed Money, he could have used that Runway to build something really cool.
And WebMD would have an incentive to promote his site and help bring free users.
I'm going to try and get this in front of them using my contacts, but it is a long shot.
In the story she describes the project as "fun" before he asks what she'd pay. At that point he probably should have picked up that she was being kind and was not in fact seeing a product she was interested in buying.
He probably could have figured that out by asking doctors before he built the thing.
Which is the entire point of the article, made very explicitly.
I think he should target not WebMD audience, WebMD doesn't provide searchable and visualizable database of trials and outcomes, but more professional crowd: research institutions and universities, government, pharma corps, pharmacists, hospitals, and charge some subscription fee (e.g. $200/m), and it would be totally different story.
"try to use other peoples' money next time (smiley face)" A++++ douchery. Nicely done.
>It had been a bit of a working assumption of mine over the past few weeks that if you could improve the health of the patients then, you know, the doctors or the hospitals or whatever would pay for that.
This person uses the "X% of Americans" line, so they live in the United States, right? The one in North America that views healthcare as a business to wring money out of? They definitely should have done more market research if they could type that with a straight face.
But hey, hindsight is 2020 and they only spent $40k on some very valuable firsthand experience. Sounds like a win if they're planning to run businesses in the future, but for ideas without a clear path to making enough money to sustain themselves, try to use other peoples' money next time :)