nunie123

I just started at a health insurance startup that is doing exactly what the article recommends: simplifying billing. Patients pay for procedures "in cash", using a card debiting the insurance company's account. Because doctors charge less for people paying in cash, the insurance is cheaper than traditional insurance.

We're already operating in a few markets. It'll be interesting to see how the traditional insurance companies react once we start significantly encroaching on their market share.

I started a project last week requiring me to learn the proprietary EDI file format that CMS mandates. I was surprised to learn that in order to exchange healthcare data with our government we have to use a file format owned by a private entity. And of course you have to pay to get access to the full implementation documentation.

Co-ops are usually a republic, not a democracy. People still have specific roles, and those roles have authority to make specific decisions without getting a majority vote for that decision.

The data is being moved, it's just that the mechanism to move it was the FDWs, instead of e.g. an Airflow DAG. The FDWs are interesting because they're update-on-query as opposed to updating on a fixed schedule or update on a source system event, which is more common.

I agree with much of what you said.

However, I'm disinclined to believe there will be a trend away from a centralized data warehouse (or data lake).

There is inherent value in having a single source of truth for analytics. With modern cloud tools abstracting away the complexity distributed analytical databases, data warehousing is getting easier and more powerful.

It's true that there is added complexity in centralizing the data. But as the author of this article suggested, you're in a bad spot if your marketing team and your sales team can't agree on last month's revenue. I'm not sure how you'd solve that problem in an architecture where the data isn't getting centralized.

I agree the BigQuery and Snowflake are very nice options for an analytical database.

I've used Postgres's FDWs for an analytical DB at a past job. The reason we used them was because we needed minimal analytics for the projects, and didn't want to deal with a more complex data pipeline solution. It sounds like the author was also trying to avoid a more sophisticated data pipeline solution for as long as possible.

> I can't believe that some startup hasn't glassdoored billing practices yet by patients simply uploading screenshots of their bills when they get them.

I believe this is what Sidecar Health is working on: https://sidecarhealthinsurance.com

I'll take a look. Thanks for the recommendation!

A book for setting up data engineering infrastructure on GCP: https://github.com/Nunie123/data_engineering_on_gcp_book

It's almost done, and I do plan to spend a little effort promoting it when it's complete, but it's been a great focus for me even if no one ever reads it.

I use a fair bit of infrastructure at my job that was set up by others. It was nice to go through the practice of setting it up myself.

I learned a good bit, but also it's nice to have all this knowledge written down in a place not owned by the company I work for. If I use GCP at future jobs I'm sure I'll reference this book myself.

Yes, the bar exam requires you to learn much law you'll never use. They are a general test that covers all areas of the law.

Boards are for specific specialties. You don't take a board to be a doctor, you take a board to be a podiatrist, etc.

Personally, I think both exams are about protectionism more than anything else.

Source: have taken a bar exam, have a wife that's a doctor.

There are plenty of smart people in Texas, of course. However, it may be difficult to attract scientific-minded employees to a location where their kids will be taught on a curriculum that rejects science in some regards.

That also hints at the larger culture clash that may result from the "liberal elites" moving to the area. If this migration does happen it'll be interesting to see how the culture in Texas changes.