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Comment by danboarder | Hacker News Reader

At face value this appears to be a huge opportunity for innovators to take on the whole existing healthcare industry here in the USA.

In reality I think many healthcare entrepreneurs either get caught in the existing framework (and dependent on it), or find the regulatory and other hurdles too hard here.

That said, I still think there is a LOT of room to improve cost efficiency here, and the right entrepreneur could do it. It's been done in other stagnant segments of the economy... I would like to see an Elon Musk-type entrepreneur open efficient hospitals here like this guy is doing in India.

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A huge problem in the US is all sorts of really really bad laws. For instance to open a new hospital you have to get permission from other hospitals in the area.

That's the opportunity. Eventually regulatory capture and corruption will become so great in the US that it really does become impossible to actually provide the care. Nothing will make it through the wall of parasites.

The opportunity is in helping Americans get real healthcare outside their borders. Take a glance Uber's way. You'll know you've got it right when there's serious talk about making it illegal to travel abroad to obtain medical care. For the safety of the people and the necessary good of the lowly American doctors, of course.

I think that it is already forbidden in some countries to get specific medical treatments abroad. It is so wrong, and I would not be surprise if it is going to happen in U.S.A. too.

impossible?

> For instance to open a new hospital you have to get permission from other hospitals in the area.

This sounds like a terrible law. Where can I look for more information on this?

http://en.wikipedia.org/wiki/Certificate_of_need

Thank you -- very interesting.

It sounds that way if you're a short-sighted conservative type or a hospital union rep, and makes sense until you realize that there is a glut of hospital beds in most places in the US. Care is shifting from institutions to outpatient environments, and has been for 40 years.

That excess capacity tends to be filled up with old and poor people on government health programs, and people needlessly hospitalized are likely to get more sick as a direct result of their unnecessary hospitalizations.

regulations forced my doctor of thirty years into selling his business. Talking to him it pushed a lot of single and dual doctor offices into selling. Electronic records keeping was the bogeyman that pushed a few over the edge, between the software costs and the manpower to get all the documents into that now required form they just didn't have the money.

Top it off with his worst payers were not the insurance companies but government based.

Government regulation, from deciding what insurance must cover for all people to not being able to shop across state lines was very much responsible for the rapid increase in healthcare. It didn't help much when we got sold out by Washington under the guise of Affordable Care to the drug, insurance, and hospital, companies. ACA was payoff for campaign contributions, that is why no one read the damn bill.

I think someone like Elon Musk is capable of doing such a thing. But the complexities of the law around the medical industry definitely don't make it easy and even after you're up and running, infiltrating a lobbyist dominated niche is the next hurdle.

I'm not sure if you've heard the story but there is an American inventor by the name of Thomas Shaw. He invented the first safe, retractable syringe that was more reliable than any existing solution. Companies tried copying his design and managed only to produce sub-par copies, it's an interesting read. http://www.washingtonmonthly.com/features/2010/1007.blake.ht...

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