I often engage in light hallway conversations with my students in between classes. Recently, while discussing the wealth accumulated by some tech entrepreneurs, I said half-jokingly that we didn’t have any trillionaires yet…
Actually, since the heydays of the modern-day pioneers of the Silicon Valley, it has produced hundreds of billionaires, a selective group of several dozen actually have accumulated tens of billions, and probably a few are pushing the 100-billion-dollar mark…but no trillionaires yet.
This reductive measure of success — the financial metric — will likely add a new trillionaire benchmark in the coming decade, but this coveted space will, in my estimation, be reserved for those select entrepreneurs able to finally disrupt the health care industry in the United States first, and then globally.
For starters, Americans are getting a rotten deal in health care. While American citizens spend over twice as much in health care (about $10K dollars per every American) than their French, Italian, Canadian or Australian counterparts, Americans are not living twice as long; in fact, they are living less. By all measures of the market economy, this is the perfect definition of a rotten deal. More often than not we are prepared to spend more to get more, but not to get less. Presently, the debate over health care reform occupies a central place in our public discourse, yet three critical issues remain silent:
- About the services that should be provided to every American, the answer seems simple: why not provide to everyone the same health care services that our congressmen and senators enjoy? I have never heard them voice concerns about pre-existing conditions, premium hikes, lifetime limits, or the services they enjoy for themselves and their families. So the benefits question seems settled. If they are our representatives from the people, by the people, and for the people, what is good for them should be good enough for the rest of us, as well, right?
- While most industries have enjoyed huge productivity increases during the last 4 decades as a result of the introduction of new technologies across all segments of their value chains, health care costs have continue to rise higher than inflation. More alarmingly, this industry has not produced any consumer surplus, as has been in the case in other industries — in part due to regulation, in part due to the massive size of the health care industry and the power of its lobbying effort. The latest statistics put health care expenditures in the US at pushing close to 20% of GDP, or about $3.4 Trillion in 2016, growing at a pace close to 6% annually. In other words, the US health care economy, if a nation, would comfortably have a seat as a member of the G7, and it certainly would have been part of the G20 meeting last week in Hamburg, Germany.
- I often wonder when price lists for the most common services will be published and visibly displayed in our medical waiting rooms or on the web sites of our health care providers of choice. Or when we will be able to enjoy comprehensive rankings of disparate medical specialties in much the same way we are able to enjoy rankings of restaurants, or auto mechanics. Obviously, those providers in my neighborhood offering best-in-class services (5 stars) at the least expensive prices (single $ sign) with over 500+ reviews (quality assurance) will suddenly enjoy a competitive edge!
Presently, most medical treatments are marketed as kinds of art forms, rather than as routine, often technologically-driven processes. Why? Because, to justify high costs, medical practitioners need to emphasize the uniqueness of individual anatomies and circumstances, and de-emphasize the inconvenient fact that 90% of bone fractures, mole removals, and dental cavities are treated in the exact same way. This marketing dynamic is further facilitated by a widely shared natural fear of death, or at least our aversion to pain and suffering. In other words, we allay our qualms about overpaying with the justification that ‘it’s our unique life’.
At a time where disruptive technologies mimicking human knowledge are applied to disparate domains, such as self-driving vehicles or human tissue/organ image diagnoses (radiography/ pathology), we should rightfully wonder how many ‘low hanging fruit’ in the health care are ready for disruption.
Every day, millions of tissue samples, biopsies, x-rays, CAT/MRI/PET scans, et al are diagnosed by highly paid professionals throughout the world. I deeply believe that all that human talent should be liberated from the boring and repetitive task of diagnosis so that they can make higher value added contributions to medical science and in consequence to society. It is my hope that this will both (a) significantly improve our health care space at a superior price-performance point, and (b) empower medical professionals to migrate to new frontiers of health care, thereby enabling higher contributions to health care and to society.
Along these lines, I am calling for the world’s first trillionaries to search for interesting market entry points and compelling value propositions, supported by innovative business models to disrupt specific sectors of the health care industry. Myriad innovations that break information and knowledge asymmetries will finally bring the democratization that has disrupted many other industries to health care. A global market of 8 Billions consumers by 2026 and 9 Billions for 2042 — all with the same bones, organs, and for the most part the same health care needs – are awaiting your irreverent disruption of the health care status quo.
Who wants to be a trillionaire?
Until my next posting – Carlos B.
 According to the OECD, the life expectancies at birth in Australia, France, Italy, and 22 other OECD countries all score over 80 years, while the US just scores 78.9 years. https://data.oecd.org/healthstat/life-expectancy-at-birth.htm.
 Artificial intelligence (AI), Big Data and Machine Learning are just a few of those emerging technologies.
 A reductive benchmark, to be clear, because not all contributions to society can be measured monetarily or in terms of accumulated wealth.