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Silicon Valley Is Too Focused On Taking the Easy Path in Health Care (cnbc.com)
Silicon Valley investors are increasingly looking at health space, but they are mostly eyeing for opportunities on the fringes of the traditional health care system to avoid long and complicated regulatory cycles, an analysis on CNBC shows. As a result of this, these start-ups will not help low-income and chronically ill patients who need innovation most. From the article: Founders often talk about about how challenging it can be to break into the multi-trillion dollar medical sector. Health care startups face regulatory hurdles, long sales cycles and a high burden of proof -- and that means it can take more than a decade to make a return. As a result, many venture-backed entrepreneurs are looking instead at opportunities on the fringes of the health care system, such as cash-only health services that don't require insurance or tests and apps that aren't regulated by the U.S. Food and Drug Administration. For tech investors, these opportunities hold the chance of an outsized return in five years or less. That often valuations on par with consumer Internet start-ups. [...] Many entrepreneurs acknowledge this, but justify their approach by promising to focus on more at-risk groups once they've nailed the product.
They've figured out that the regulations they're always pushing for make it near-impossible to compete with established companies and hurt innovation.
"No man's life, liberty, or property are safe while the legislature is in session." -- Judge Gideon J. Tucker
I bet you three fiddy that Silicon Valley wants to tackle these problems, but its the INVESTORS that control the pocketbooks of Silicon Valley that don't want to take the risk on. The long game, pfffft, what's that? Humanity? Pffft!
Why sell to people with no money?
The current situtation in healthcare is stupid.
I sent my genome to a server in eastern europe to get a detailed health report because the FDA won't let 23andme present all of the information. Doctors are actively fighting this democratization of information. Fuck them.
AI and machine learning have done a better job at diagnosis than humans for decades, but aren't widely used. WHY?
Fuck the system. I will get the images, and the data - or sensors that I own will - and they will be processed outside of the reach of the FDA.
Procedures? Medical tourism is a thing.
Nobody has a more strongly vested interest in me being alive than..me.
The internet is coming for medicine, the same way it came for software "sales", music, movies, and retail.
What a time to be alive!
..don't panic
Most of the "health" startups seem focused on weeding out the weak, as in "let X voluntarily track your activities and single you out for unaffordable health premiums if you aren't young/healthy/kid-free enough to meet our wearable device targets." So yes, if it seems that the chronically ill are being pushed off the map, well it's by design.
" promising to focus on more at-risk groups once they've nailed the product"
I totally believe you, pal.
If Slashdot were chemistry it would look like this:Cadaverine
"Silicon Valley" is going to do things that are profitable. Expecting anything else is unrealistic, as nice as it would be.
"First they came for the slanderers and i said nothing."
Business wants easy way to make money. News at 11.
They just need to admit to themselves that it's about the money. Once they nail their "low hanging fruit," they're going to diversify... by finding more low-hanging fruit.
They aren't brain surgery. They aren't even primary care. All that model disruption business is about sweeping away old, inefficient systems that support simple and relatively discrete transactions: systems that sell me a book; give me a ride from A to B; or provide someone to mow my lawn for me. The entrepreneur in these scenarios focuses on achieving speed, scale and convenience rather than managing complex, ongoing and labor-intensive processes.
Healthcare services may be inefficient and mind-numbingly bureaucratic, but people are going to be intensely skeptical of anything that aims to shut down their local hospital or physical therapy clinic. The one core function that certainly could be constructively disrupted using the standard Silicon Valley model is prescriptions: drugs and medical devices. Those areas are fiercely defended by their respective industries, who have maximizing consumer expenditure down to a science.
The one success story in the article doesn't really fit the classic Silicon Valley creative destruction narrative. It amounts to what is called in other parts of the country "concierge medicine", but with some added high-tech frippery to appeal to well-heeled Bay Area clients. There are lots of gaps in the US health care coverage, but unfortunately they mostly center around under-serviced poor and rural populations. Lower cost services would be welcome in those segments, even if substandard.
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There's an excellent chance we're going to move to single payer in the next 20 years. The big money isn't in care, it's in being a middle man that skims 10% off the top. A shift to single payer gets rid of most if not all of those middle men...
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I'm not sure where you get that idea from. Infant mortality rate was through the roof in primitive societies and as soon as humans moved from nomadic tribes and started building cities, the chronic diseases of civilization became widespread. Up until recently, diseases such as cholera, polio, small pox, measles, etc. were extremely common and were only made rare or eradicated through innovation. Sure back in primitive societies, if you didn't die early in your life you could certainly live to be 80 and I'll grant that people were on the whole healthier because almost all work involved physical labor and even if you had the equivalent of an office job, you still needed to walk to work. However, the chances of any person actually living to 80 was far, far lower. If the various diseases and lack of treatment didn't kill you, invading neighbors would probably do it quite well. So unless you're proposing we abandon civilization and go back to hunter-gatherer groups, your assertion is just wrong.
Tech innovation has done more for the poor having healthcare than anything else. Even safety nets can't provide services to everyone that haven't been invented or are incredibly costly. Just look at the positive outcomes of Golden Rice in ensuring that some of the world's poorest don't suffer from conditions due to vitamin A deficiency.
If you don't think its fast enough, you are free to start your own company to rectify the situation. Or is everything just someone else's problem?
One problem with snake oil is that not all snake species produce eicosapentaenoic acid (EPA). This led some snake oil makers to end up producing ineffective products. So long as you can document that it's from a snake species whose oil is rich in EPA, I'll buy.
In areas where the Chinese water snake isn't available, producers switched to imitation snake oils with other ingredients, some of which have since been proven effective. Brands have included Stanley's (capsaicin/camphor), Vicks VapoRub (camphor/menthol), Capzasin (capsaicin), and ActivOn (menthol). The famous ruling against Stanley's in the Rhode Island District Court was mostly that it wasn't clearly marked as an imitation with different active ingredients.
But the other problem with snake oil is how regulations handle claims not yet proven. Silicon Valley relies on public beta before wide release. But currently a drug product can't reach the market until it's both safe and effective. There's a "supplement" marketing regime where safety is guaranteed and effectiveness is "as is," but there appears to be no "public beta" regime to sell something as a "supplement" between when it is proven safe and then switch to "drug" marketing once it is proven effective.
I have appeared before the FDA, discussing a testing protocol for a drug we were designing...when I was the CEO of a Silicon Valley VC-backed pharma company. The article even quotes a partner from NEA which is a life science investor in addition to being a tech investor.
Sure, some people try for easy wins...why not? Some people don't do their homework too -- and not just in the life sciences. And some people (looking at you, 23 & me), get the benefit of the FDA bending over backwards to try to allow them maximum freedom to experiment within the consrtraints of the law, and still don't do their homework, and cry victim when they finally have to deal with making no effort to prove the validity of their claims.
And then the article quotes one company that -- oops -- failed to do its homework.
...doesn't cut it in the realm of health care.
Silicon Valley may be noodling around the margins, but it's probably less because of the "onerous regulation" than the empty product they peddle not being able to live up to the regulations and cope with the existing complexity.
They're not showing up to a business sector that has been moribund and antiquated for decades, they're showing up to a business sector that has been highly computerized for decades, so in some sense they're competing against their Silicon Valley neighbors, too.
And too much of Silicon Valley "innovation" is just empty bullshit, an appy app, perpetually in beta, and lots of hype. Regulation means following rules, audits to make sure you're doing that and actually delivering something of substance.
That's largely because the information 23andme wants to present has not been proven to be true.
Details, details!
We need more startups like Theranos to save our healthcare system.
If you want to distribute a new life-saving medical breakthrough it has to go through (on average) 20 years of trials.
Which YOU pay for out of your pocket.
IF it succeeds you get to use it for (on average) 5 years before it goes to your competitors. They get access FOR FREE.
So WHY would anyone ever come up with a new break through?
People are dying because the federal government via the FDA PUNISHES success and helping people.
I hear the FDA is corrupt, but even if it isn't, disbanding it would save many, many lives.
Single Payer Healthcare works.
It's cheaper.
It's Medicare For All.
The vast majority of democracies with good GDP do it.
We should too.
And it's way way way cheaper.
Did I mention the cheaper part?
-- Tigger warning: This post may contain tiggers! --
[Off topic] When I see the name Silicon Valley, I can't help but think the area does anything but manufacture Silicon Hardware. Now its the land of software and venture capitalists and start-ups. More of a vultures den.
Seems like the majority of "silicon" or hardware vendors moved to Texas.
They can rename Silicon valley when they finally clean up all the toxic dumping sites they left behind...
I suspect infant mortality factors into the average life expectancy calculation?
"Tempers are wearing thin. Let's just hope some robot doesn't kill everybody." --Bender
Most of them moved to Japan or Taiwan or South Korea. Texas got the residue. (But I hear that many of the early movers moved on to China, and a few of those have started looking at Indonesia.)
I think we've pushed this "anyone can grow up to be president" thing too far.
Just found this today on HN: "Snake oil can be beneficial for arthritis and other conditions (2007)"
https://news.ycombinator.com/i...
The article being discussed is
https://www.scientificamerican...
> Snake Oil Salesmen Were on to Something
> Snake oil really is a cure for what ails you, if that happens to be arthritis, heart disease or maybe even depression
...for arthritis, heart disease or maybe even depression:
https://www.scientificamerican...
> Snake Oil Salesmen Were on to Something
> Snake oil really is a cure for what ails you, if that happens to be arthritis, heart disease or maybe even depression
When that happens, it's the end of medical innovation full stop. Who else is going to do it? Europe? Africa? The Middle East? Russia or China?
It's single _payer_. We're not nationalizing care and it's not a government take over of health care (whatever Rush & Hannity tells ya). We're just changing who pays the bills. The bills still get paid. Those jobs go from being crap jobs with shit benefits and no job security to government jobs with all the benefits and protections therein.
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