It's time to build healthcare products that cost less, and improve patient health outcomes
Did you know that 66.5% of all bankruptcies in the US were tied to medical issues (either because of high costs for care or time out of work)?
On a personal level I was thinking about my interactions with the system over the past 10 or so years. In that time I've navigated a cancer diagnosis, diagnosed a son with ADHD/Autism and all the ancillary support systems, helped family work through many (some severe) mental health challenges, wrangled more financial claims than I can count, seen chronic diseases, shopped for wheelchairs and accessibility vans for my mother-in-law, and worked through genetic screens, and births for 3 children. I've been fortunate to live in urban environments close to centers of excellence. And I've had the means to pay out of pocket for additional support when it was needed. And still the variance in quality and preventable issues/errors has been unacceptably high.
US costs are increasing
The US spends more on healthcare than any other high-income country. In 2021, health spending in the US exceeded $4 trillion (18.3% of 2021 GDP). This is double what other developed nations spend - and for generally worse outcomes.
As a percentage of family income our healthcare expenses have steadily increased since the 1950s: from about 5% in the 1950 to ~15-20% in the 2020s. Over 20% of Americans have medical bill problems or are paying off medical debt.
Doctors hate the system
The stats I've seen indicate burnout is a real issue. Much of this has to do with the arcane technologies they use daily - specifically the electronic medical systems. These are systems that are expensive to maintain, prohibitively expensive to switch out, and in which the builders themselves have little incentive to innovate.
Patients don't trust the system
Fewer than half of Americans have confidence in the medical system - in 1966 this number was 76% and fell to 34% in 2018. Medical errors are a leading cause of death in the US, with estimates ranging from 250,000 to 440,000 deaths per year due to preventable medical errors.
But there's cause for optimism
This optimism is not so much due to any regulatory shifts or governmental innovations, so much as a summing of large forces spanning a range of technologies.
Life science innovation will accelerate
CRISPR and other gene-editing tools are giving us read/write access to the human genome. The CRISPR gene-editing market is expected to grow from under $2 billion in 2022 to $15 billion by 2030. Costs of genomic sequencing have outpaced Moore's law for over a decade, bringing costs down to below $1k for a human genome.
At the protein level DeepMind's AlphaFold has predicted structures for nearly all catalogued proteins known to science, over 200 million structures.
AI and LLMs
A 2022 study showed GPT-3 performed at or near passing level on the United States Medical Licensing Examination without any specialized training. AI systems have shown comparable performance to radiologists in detecting breast cancer in mammograms.
Data/Consumer wearables
Telemedicine usage increased from 11% of US consumers in 2019 to 46% in 2020. Consumer devices and digital health is expected to grow 15% (CAGR) from 2023-2030, from $200 billion today, to over $650 billion by 2030.
Where do we go from here?
I'll bet there exists an opportunity inside of patient self-serve models focused on three specific aims:
- Improved outcomes (e.g., improved access to quality care, engagement, identification of high risk/needs populations)
- Reduce overall costs
- Increase engagement (e.g., remote patient monitoring, wearable/consumer tools, habit changes)
My hope is that a set of Entrepreneurs, Innovators, Scientists and Clinicians & Care Givers will leverage these forces to bring needed innovation to the industry.