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'Silicon Valley Is Missing Unicorns Because It Doesn't Understand Poor People' (cnbc.com)
An anonymous reader writes: Silicon Valley might be hunting unicorns in the wrong places. According to one top federal health official, entrepreneurs and investors are overlooking one massive population: Low-income Americans who qualify for Medicaid. That's a big mistake, given that new funds are available for those that are bringing IT innovation to the space, said Medicaid chief medical officer Andrey Ostrovsky. "My gut is that it's a big opportunity with $500 billion in federal spend every year in a system that hasn't evolved technologically much since 1965," Ostrovsky said. "There are unicorns sitting in there," he added.
How about an app that signals when it's time for your renewal and gives you bus directions to the closest carousel?
...good luck targeting poor people with VC money.
All the people who make $100K or less and live in Silicon Valley. Not everyone who live here is a newly minted millionaire, billionaire or zillionaire. But they're easy to forget when driving your luxury cars, living in your McMasion, and shopping at Whole Foods.
If you get in there as an entrepreneur, you'll be suffocating under a mounting of paperwork before being demonized by Democrats for trying to make a profit. And before you can build a real business, you can bet that Congress is going to pull out the rug from under your business model anyway by reforming government health care yet again. Sorry, but "here's a bucket of government money, go build something" is just not an attractive proposition even under the best of conditions, let alone when it involves poor people and a politically controversial area of public policy..
The best you can hope for at this point is that, as physicians exit the market, the big corporations that take over their functions will be able to invest some money in technology and innovation.
Oracle has already been practicing, and is perfectly poised to swallow gigatons of money while providing crap software to the medical insurance industry.
Quo usque tandem abutere, Nimbus, patientia nostra?
Silicon Valley understands poor people well enough, and doesn't want anything to do with them. It's that simple.
won't for much longer. There's $880 billion in cuts coming to offset the tax cuts being proposed. I'm in Arizona and we have a law on the books that automatically rejects anyone for our low income health care program (AHCSS) if they're single. The law was preempted when Obama threatened to withhold Medicare funds from the old folks unless we also covered the poor. The stupid thing being that the money coming from the Feds to pay for low income people's health care brought more dollars to the state than we were spending. But around here we don't like paying for poor people to have, well, anything really.
Anyway, when those tax cuts hit and the funds stop the law kicks back in and anyone single gets kicked off their health care. Period. I got a buddy with type-I diabetes who didn't have his insulin until Obama made Arizona pay for it. We're gonna go back to struggling to get his insulin now.
In most of America the only money to be made in poor people is exploiting them because that's all we're allowed to do.
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A friend of mine put together a plan to provide eye exams to seniors in nursing homes. He got to the point where he had employees lined up, made agreements with optometrists to make prescription glasses, and even got the agreements with the nursing homes. Then the coverage rules changed and the business model was no longer viable.
Silicon Valley might be hunting unicorns in the wrong places.
Endangered species weren't a good enough kill for them so they are going after our cryptozoological entities? THOSE BASTARDS!
This is why Bigfoot refuses to work in IT. ;)
Anons need not reply. Questions end with a question mark.
I blame Starbucks, quite frankly.
-- Tigger warning: This post may contain tiggers! --
What do they mean unicorns?
Cause the only unicorn I know of are fictional creatures that are basically white horses with a sparkly horn.
Healthcare has made leaps and bounds, and it has trickled out to every segment of society. Even the poorest of the poor receive medical care in hospitals with advanced monitoring equipment and by doctors trained in modern techniques. This story reeks of bullshit. The bureaucracy may still be stuck in the past, but that's government. Very few innovations have come out of government business practices. Or ever will. For very fundamental reasons having to do with difficulties in managing large organizations with multiple conflicting objectives.
Maybe you need to disavow yourself of this adolescent notion of 'unicorns', stop chasing greed, and act like human beings? I hate to break it to Silicon Valley, but they are human, not gods, so were the people that built the valley, so is every person. Such bullshit. They will be their own worst enemy, mark my words! Someday their incestuous, disctiminatory, lscking in ethics, and narrowly focused mentality is going to allow someone that doesn't suffer those maladies to stomp all over their faces.
by their bootstraps. Though it's telling that the phrase most often used to describe getting ahead in life through nothing more than simple hard work is also physically impossible...
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we do still want poor. If you come here you'll see McMansions right next to scary looking trailer homes. The rich don't like to pay for their services. How do you think they get and stay rich? So they need to keep the poor close by. We use our drug policy to control them. Chances are if you're poor somebody you're nearby has drugs on them and the way the laws work it's basically guilt by association. So if the poors get too uppity we send the cops through to bust everybody and it's 5 year minimum mandatory sentences for all (in a private prison no less).
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at least the honest ones do. The Trial Lawyers who hang onto our party because the other side wants tort reform (which, BTW, you do not want if you like having any recourse whatsoever when a mega-corp does something awful)... them not so much.
We're not going to demonize you if you don't act like a demon. If you come up with a clever scheme to siphon billions into your pocket away from actual health care then yeah, we'll demonize you. You're a demon. Stop it.
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The confluence of robotics and medicine will eventually result in some sort of Autodoc appliance that will diagnose and repair most common issues. Now *that* is a trillion dollar market.
The VCs I talked to, who were interested in this sector, all started sitting on their funds ever since Trump came into power. It's just not clear how these programs will be affected.
Today it's all about who you ARE and WHO YOU KNOW.
This is a very unfortunate trend, today you're basically invisible to the entire industry unless you got 20+ years experience + are the same age as your experience, plus have amazing references and are willing to work overtime without extra compensation.
Doesn't matter if you can code their socks off, doesn't matter if you even won prizes and awards for your skills, the only thing that matters if you have some papers from your accredited school, and some networked friends that can vouch for you.
And god forbid if you're over 40, you're doomed buddy.
What this world is coming to - is for you and me to decide.
It's not just health care that could use reform, but local government as well. We're stuck using antiquated software systems which use old databases. Software used to manage Autopsy Records, Park Picnic Registration, Incident Response Systems, Office of Emergency Services, Voter registration, DMV Database, Even simple HR applications like PeopleSoft.
Walk into any Local, County, or State Gov't's IT shop and point a finger, you'll find something that needs replacement ASAP.
Maybe they ate all the unicorns
It must have been something you assimilated. . . .
I know it must just be me - but I read the summary, and then, in total confusion, actually looked at TFA.... and I have to admit that I don't understand a word of it.
Could someone give a short primer on whatever vocabulary is being used here? I didn't even see anything that would tell me what a 'unicorn' is in this context - I'm guessing it's not a horse with a pointy horn, but that's a better guess than anything else I can come up with.
Any help is appreciated.
I think developers keep forgetting we don't all have tablets and $1000+ laptops. Some of us Linux guys are still rocking decade old laptops. Luckily, they still make software for 32-bit, including the latest kernel version. The distro you choose may decide to stop making 32-bit versions, but as long as the kernel and application developers still compile for 32-bit, it won't really matter, especially with the way OpenSUSE works. Much better than Ubuntu.
If you read the details on the money he's offering (called the "90/10 Rule"), it's 50% to 90% of the cost to build new software and 50% to 75% of the cost to maintain it, with theoretically the rest to be provided by your state...?
I appreciate that they're trying to get something going, and they're working within some insane limits put on them by contradictory mandates, but this is not a proposal to get quality work done. Implying this is a good deal does not help his credibility. This is a proposal for charity work (which is fine... just don't pretend this is a deal VCs are going to jump on).
It's a hard world, but real quality work requires a financial return of a multiple of the cost to make something, not a fraction of the cost to make something.
The whole idea that Silicon Valley VCs are somehow *looking* for unicorn companies or unicorn ideas is totally ass-backward.
Silicon Valley VCs believe they can *create* unicorns by throwing money at them. They aren't looking for them per-se. They are looking for the "right team", the "right investment", etc... The actual idea? Maybe a company can pivot to an idea before the iron grows cold and they are off to the next team. Or not.
A billion dollar valuation (aka unicorn) simply means VCs have managed to get some 3rd or 4th round chumps to dump a bunch of money into a company for a microscopic share of equity. The smart investors either came in early, or have financing structures with warrants that are dilutive (meaning they didn't actually invest at unicorn levels) unlike the employees that usually promised fully diluted shares some day. The whole fiction of unicorns is simply a media creation and has nothing to do with the market potential of a company. Like Enron or Adelphia accounting, it's a fiction that only has to do with the esoteric machinations of valuation and financing a startup.
I suspect the main reason nobody is pivoting towards medicaid recipients is that silicon valley companies probably don't think they can compete with the fraud levels that are out there. If some SV company thought they figured out a way to skim medicaid dollars, they probably can't hold a candle to what people are already doing to the system. It's hard to beat scammers at their own game (esp if you are trying to play fair). On the other hand, maybe a Uber-like company might want to tackle this, but I don't know if that would be a good thing.
Somebody gets it. There's a company that sets up tents in poor areas. I looked into it. If you're in another poverty program you qualify. With Medicaid expansion under Obamacare, a lot more people qualify. I don't work for them, I just see what they're doing. It's like they're a giant Section 8 landlord and the government just issued a lot more vouchers, so they're sopping up that money. It's probably better than a regular customer because the gov is paying the bill... for now.
Some Silicon Valley companies did try and get into medicine with systems like 3D medical imaging. But the danger is litigation. One company had a fancy bezel around their screens that had a subtle silver/gold grid pattern to look scientific and futuristic. Radiology medics started using this pattern as reference coordinates for marking down radiation beam targets for cancer patients. When this pattern was updated, all their coordinates were off target. That lawsuit was settled only with a large compensation payout.
Then all data must be protected according to HIPAA standards. Every network component has to be certified from servers to routers. It would have to be the same level of protection as required by those three letter agencies:
http://www.hipaajournal.com/180000-patient-records-dumped-online-by-the-dark-overlord-8800/
http://www.hipaajournal.com/unencrypted-hard-drive-stolen-from-lsu-health-new-orleans-2200-individuals-impacted-8799/
Yes, there is profit to be made with modernizing medicaid
But no, that profit won't be earned by the poor people on medicaid. It's not the dependants of a system that can profit from rebuilding it. They can't even shape it.
If you want to give those people a say, go ahead, but that won't bring VC money to medicaid.
bickerdyke
I've never seen a truer headline on slashdot, and I've been here since the beginning.
The story is perhaps off, but the headline, wow. The unicorns they so desire ARE poor people. People who, if UBI existed, would be creating businesses that would disrupt the $%# out of every sitting Silicon Valley giant, simply because all of the existing businesses don't provide any value to consumers, and therefore any business that didn't suck as bad as theirs would win in a free market.
Let me explain, they buy all the rich people. Straight out of college or otherwise. They buy them, put them "under their wing", vacuum up the wealth and ideas, use large piles of cash and Itellectual Property laws as violent instruments, and then move on to the next.
But they ignore all the poor people. The poor people with ideas, with genius, who can't even afford their basic needs and so are indentured to a cubicle farm or similar for life, are completely ignored. They are thought of as not a threat. But here's the crazy part, they're also thought of as not an asset, when many of them are unicorns.
Silicon Valley doesn't understand life outside of Silicon Valley. There are a whole lot of places in the country that don't have wireless internet service yet they build products that expect it.
unicorns --private, venture-backed companies valued at a billion dollars or more
source:
How Unicorns Grow - Harvard Business Review
https://hbr.org/2016/01/how-un...
-- Each tock of the Planck clock is a new world and here we are still life. --
we have an entire County government branch that handles this.
It's called the Social Services Agency
We even host events to get ideas for new ways of reaching clients, and delivering services.
We don't "privatize" this sort of thing. its bad enough the politics involved
We're a few years behind many more for-profit organizations but we do have a lot of successful "new" system deployments.
we don't need VC coming along trying to exploit the most vulnerable of our population any more than the politicians already do.
Problem:
Stroke patients with diabetes who can otherwise care for themselves, but have issues with diabetes management.
Someone who has to leverage themselves into a walker to go across the room to check their blood sugar is not going to check it. One solution is many glucometers, so one is always withing reach. This causes another problem: the glucometers do not share results, so they can never look up a past reading. It gets more complicated with multiple insulin pens, even if each pen has a one-dose memory.
This is my wife: Imagine she just checked her blood sugar, and I ask her read the result out loud. She cannot because of stroke induced aphasia. Imagine that I ask her what color (blue or red) the glucometer is, and she cannot tell me. Strokes cause brain damage. That damage often impairs verbal skills. That is called aphasia.
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Solution:
Glucometers (that use cheap test strips) that sense a Wi-Fi MAC address or BlueTooth MAC address (from the patient's phone, which is probably in the room) or a special RFID tag (which is worn in a medical alert pendant or with a LifeAlert pendant.) They can be programmed for several addresses, so that they can differentiate between different diabetics in a home. My wife and I are both insulin dependent diabetics; that was one thing we had in common that led us to date. If only her phone is around, it should assume she is the one testing. If both phones are around, it should ask who is testing with her being the default but let me change it if I want to.
They auto-set the time. Current devices assume you have a MS in Computer Engineering (I do) and assume you are more accurate than a NTP server (I am not.) They do not work for disabled people who can not read out loud, and who have difficulty controlling their movements.
They record the readings along with who and when. They record the number of errors, as this can be an indication of problems with the patient.
They should remind a patient when they have not checked their blood sugar in a while. For example, if my wife has not checked her blood sugar after 8 AM, and it's noon, then all the meters should start beeping until she grabs one of them. They should stop as long as she checks her blood sugar within a few minutes. If she does not, they should go off a second time and if she still does not check it, they should send me a text (through an email-to-text gateway.)
Insulin pens should work the same way. They remind the patient when they have not given themselves the correct amount of insulin, but can be ignored / overridden. If they are ignored or overridden, they send me a message.
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This is part of a larger problem:
The old android phones had physical back buttons, so my wife had a chance to get the button push right on the second or third try. The new ones are designed by ass holes, and make her do several gestures to bring up a back button that disappears before she can hit it. Whoever got rid of the hardware back button is going to burn in hell for the millions of disabled people they damned to being unable to use their new phones! Where's a criminal prosecution under the ADA when you need one?
then take it away from the old people. They use _way_ more health care and didn't pay nearly enough in Medicare taxes to cover what they use. Screw everybody or screw nobody. Arizona's flush will billionaires who retired here (you'd be surprised how many). We wanted our cake and to eat it too. We wanted free money for the old people that vote and to abandon the working poor who can't make it to the polls.
You're problem isn't you drank the Kool-Aid, you're problem is you don't have the political will or guts to take care of your poor. Neither do we. You do a much better job.
And the Feds enforced like mother fucking crazy. We don't want them to enforce. We hire those people to be maids, cooks, and farm hands. We bitch and moan about it all day long but in the end we turn a blind eye. Obama deported them like crazy. It's one of the things the left hit him on (that and the drone strikes).
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