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Should I move forward with this $7+ Trillion idea?

I know you’ve heard the quote, “If your dreams don’t scare you, they’re not big enough.” Well, I’ve been working on a dream (or plan, rather) over the past few years that absolutely terrifies me. This is something so audacious and so radical that if executed correctly, will shift TRILLIONS of dollars and change the future of health forever. It’s that big.

My plan is to launch a new economic model for the way healthcare is financed, operated, & controlled in America (involving P2P, game theory, blockchains, cryptocurrency, etc.). I will pitch this as a 10x better alternative to health insurance and even a better alternative to Medicaid & Medicare. It’s a bold claim and I can back it up.

My question is, should I do this? When I take the step and move forward with this plan, my life (and hopefully yours!) will never be the same.

 

 

  • Unfortunately healthcare is a political monster. Anyone worth their salt can plainly see that America needs a single payer system yet we’re stuck with some arcane private public system that does not work for anybody.

    You may have a superior system but good luck pushing system to accept it without the backing of billions in special interest money.

    I know I sound incredibly jaded but when it comes to healthcare in the US I am.

    Reply

  • Healthcare is complex and you can’t fix it if you don’t understand — truly understand — why it’s broken. If you understood why it was broken you wouldn’t propose a technofix.

    Don’t waste another second of your life on this fantasy.

    Reply

    • Poster here — I do understand why it’s broken, that’s why I’ve set out on this journey over the past few years. I’ve been the CEO of a tech company that had $800M of borderline fraudulent healthcare claims processed in 2015 on our software (Yes, the FBI & OIG are aware of this). I had a bird’s eye view into many PBMs and their shady business practices. I’ve watched corrupt doctors milk millions out of insurance companies. I’ve seen the problem firsthand and now I have the solution.

      It comes down to how we pay for healthcare. When you put for-profit corporations in the middle of the healthcare experience, perverse incentives and negative influences take place on both sides of the equation. For these for-profit corporations to make a greater profit, they reduce the amount they want to pay doctors and reduce the amount of procedures they will cover for patients. Whoever thought this was a good idea?

      And the answer out of this mess involves a whole lot of techno fixes. Have you seen how fast AI is progress in healthcare? 250,000 people die each year from human medical errors. Doctors prescribe the wrong meds, nurse types the wrong orders in, someone doesn’t check for drug interactions, etc. — this can all be backed up and verified by an AI. That’s just one techno fix.

      Where the real fix comes into play is with blockchain technology. This is something I’ve been following since bitcoin was $0.02 so it’s not new to me. My idea is for a decentralized, crowdbased funding & governance platform built on the blockchain that pools money together to pay health providers directly and instantly. I’m taking the direct care model and applying it to all of healthcare. (If you don’t know about direct primary care, please google it for more info. I would call it subscription-based healthcare and it’s sweeping the nation.)

      I won’t get into detail about the blockchain’s promises, and I know there is a long way to go before this all happens, but I will say that I truly believe blockchains will transform the underpinnings of societies.

      Not everything will be solved by tech, though. There are social dynamics in play with my idea. Just like Uber became the largest taxi company without owning a vehicle and Airbnb became the largest accommodation provider without owning any real estate, my idea will be the largest health organization without owning a single hospital. The sharing economy has been resurrected into a better alternative to our current corporate structure.

      Reply

      • Thank you for responding thoughtfully.

        I still think you’re tragically mistaken regarding technofixes.

        Very basic AI can outperform doctors in diagnostics, and this has been true for a long time already. There is similar low-hanging fruit when it comes to combining pharmaceuticals in a way to minimize side effects. You don’t need deep neural networks or anything advanced to come up with accurate solutions combinatorial problems like these, basics stats is sufficient. Unfortunately, doctors don’t like it when computers overrule their intuitions and politicians don’t want to get near it, so AI hasn’t made any inroads. In the short term an AI powered version of WebMD can make a big difference, especially for people who have rare diseases with common symptoms who are likely to get misdiagnosed. Improvements in computer-aided self-diagnosis can be huge.

        I agree that putting for-profit corporations in the middle of the healthcare experience is a terrible idea, but there is a straightforward fix: medicare for all.

        The “sharing economy” is just a clever way for startups to increase their gross margins and lower their capital requirements by talking responsibility only for the platform. Uber doesn’t need to maintain a fleet of cars because the drivers “own” their cars. In practice this just means that the first days of every month the drivers hand over their entire pay check to Uber to pay them for the car lease. It’s a modern version of sharecropping. This sharing economy trend exists because the ROIC determines the value of a business, so if you can move the capital requirements off your books the business value skyrockets. I consider this merely an accounting trick: it works as a get-rich-quick scheme but it doesn’t do anything for society.

        Healthcare is provided by doctors and hospitals. The insurance companies are middle men that aren’t needed. A blockchain powered healthcare marketplace would extract value from society in the same way. If it stood any chance of succeeding, which it doesn’t.

        I suspect that because you like the blockchain technology so much you’ve been looking for a way to “disrupt” society with it. Starting out with the solution and looking for a problem you can apply it to is a recipe for failure.

        Reply

      • Ireland has for profit health companies and medical insurance is just under eur2000 annually . That’s USD 2200. That’s with for profit companies without gov subsidiary so there has to be another reason us healthcare is so expensive.

        Reply

  • I wish you all the best in your quest. I too am trying to change the way America shops for healthcare. I believe AI will certainly play a role. Good luck!

    Reply

  • I don’t know the answer you expect here, but my first thought is: you have no idea what you are talking about. Reading your comment answers, looks like you know something.

    If you have a $7 trillion idea and you know how to execute, why are you here? Move forward and fast. Healthcare is really complicated and anyone reducing insurance costs have a really good chance to succeed.

    Reply

  • Dude/Dudette, build your thing and learn from it. There’s perhaps no better life experience than working on your dream to help people.

    You will not build the version of the thing you have in mind, but you’ll earn new eyes to see life with. That’s a definite kind of richness that sees you through the negative bank balance days.

    Just don’t take out a second mortgage on your house.

    Reply

  • Ha ha, I thought you were going to propose a revolutionary new blood-testing device that only requires a drop of your blood.

    I read the detailed back-and-forth with the other poster above, and very briefly googled subscription-based healthcare. The basic concept seems to be eliminating the insurance companies and paying providers directly for subscriptions for basic services. But do these subscriptions cover expensive procedures and surgery? I understand there is theoretically gains to be made from eliminating the middleman. But the middleman isn’t only a distributor in this case, they are doing detailed assessments of patients to try to determine reasonable (or not) insurance costs. Coaching wellness isn’t going to eliminate these expenses.

    Also, I’m not sure how blockchain features prominently into this.

    All that being said, those are my questions/ comments from someone totally unfamiliar with the intricacies healthcare system. I hope you have analyzed and thought things through, if so there must be some ways of getting your feet wet in this and explore the viability of your ideas.

    Reply

  • Founder of a “direct primary care” MG. We’ve pivoted from true DPC to contracting directly with self-funded employers who aggregate members for us (their employees). Model / our company working great, but we can’t crack the fully insured market as payors are involved. Would love to chat as I think you might have the right vision on the insurance side of the equation.

    PS: love this site and want to respect the anonymity, but healthcare needs to be completely redesigned. How do we connect?

    Reply

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