Is the disruption in healthcare that we think is going on, have been told is going on, make assumptions on, not really on? This is the contrarian argument posited by Dan Munro:
- Training of doctors, supply and demand is as it was. Training of US doctors is expensive, and doctors tend to go to the better paid specialties in order to pay down education debt faster. And patient demand for acute procedures will always outstrip doctor supply.
- Squeezing down the small stuff doesn’t radically impact demand. In the US we have been pounding down insurers (6 percent) and low-acuity/primary care, but ignoring the heavy spend on hospitals (31 percent) and clinical services (20 percent). Are the big slices of the pie resistant or too controversial to cut?
- Startups aren’t a good source of disruption. Now this will have the D3H crowd reaching for the Maalox, but healthcare hasn’t hit the equivalent of an Apple, Microsoft or Google yet. Munro’s article of faith here is that the profit motive has to be taken out of it in the long development cycle (government research seems to be ideal) but the money comes from somewhere. Every taxpayer a VC? Oh yes, practically all startups and early-stage ‘disrupters’ are still running on OPM (other people’s money) but at least (largely) that is private.
- The system is performing as designed. Technology helps but it’s a patch on the flawed system.
His conclusion is that the disruption won’t come from the bottom or the sides, or even from Sand Hill Road (Menlo Park California, where the biggest VC whales spout) but from K Street (the street in Washington, DC where the government lobbyists lounge). Certainly to be debated. The Big Disruption That Isn’t Happening In Healthcare (Forbes)