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Businesses The Almighty Buck

'Silicon Valley Is Missing Unicorns Because It Doesn't Understand Poor People' (cnbc.com) 202

An anonymous reader writes: Silicon Valley might be hunting unicorns in the wrong places. According to one top federal health official, entrepreneurs and investors are overlooking one massive population: Low-income Americans who qualify for Medicaid. That's a big mistake, given that new funds are available for those that are bringing IT innovation to the space, said Medicaid chief medical officer Andrey Ostrovsky. "My gut is that it's a big opportunity with $500 billion in federal spend every year in a system that hasn't evolved technologically much since 1965," Ostrovsky said. "There are unicorns sitting in there," he added.
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'Silicon Valley Is Missing Unicorns Because It Doesn't Understand Poor People'

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  • Renewal App (Score:4, Funny)

    by Anonymous Coward on Tuesday May 09, 2017 @05:26PM (#54387531)

    How about an app that signals when it's time for your renewal and gives you bus directions to the closest carousel?

  • by ooloorie ( 4394035 ) on Tuesday May 09, 2017 @05:29PM (#54387559)

    "My gut is that it's a big opportunity with $500 billion in federal spend every year in a system that hasn't evolved technologically much since 1965,"

    If you get in there as an entrepreneur, you'll be suffocating under a mounting of paperwork before being demonized by Democrats for trying to make a profit. And before you can build a real business, you can bet that Congress is going to pull out the rug from under your business model anyway by reforming government health care yet again. Sorry, but "here's a bucket of government money, go build something" is just not an attractive proposition even under the best of conditions, let alone when it involves poor people and a politically controversial area of public policy..

    The best you can hope for at this point is that, as physicians exit the market, the big corporations that take over their functions will be able to invest some money in technology and innovation.

    • My company got a lot of help from Medicare when we wanted to analyze their data. There was about as much paperwork as you'd expect from a giant government entity, but everyone was nice and helpful. We were always made to feel welcome and Medicare publicly said they were glad to have us.

      Your portrayal of government healthcare, at least under a Democrat president, is far from the reality I actually witnessed.

      Oh, and I'm not a Democrat.

      • My company got a lot of help from Medicare when we wanted to analyze their data. There was about as much paperwork as you'd expect from a giant government entity, but everyone was nice and helpful.

        Why wouldn't they be "nice and helpful"?

        Your portrayal of government healthcare, at least under a Democrat president, is far from the reality I actually witnessed.

        I didn't "portray government healthcare", I outlined the risks that a business faces when dealing with the government. The very fact that you qualify th

        • Why wouldn't they be "nice and helpful"?

          You said they'd demonize us.

          The very fact that you qualify this with "under a Democrat president" means that you recognize that there are huge political risks involved.

          I was replying to your incorrect message that Democrats would be upset with someone trying to make a profit. You're moving the goalposts here.

          The question is: did you actually bet your company on a business model that relied on the federal government and Medicaid?

          It's my employer, not my personal company. You'd have to ask them about their financing discussions. But yes, it's a major part of our strategy.

          • You said they'd demonize us. I was replying to your incorrect message that Democrats would be upset with someone trying to make a profit.

            I said Democratic politicians demonize people who make profits in healthcare, not that government bureaucrats are rude to you.

            It's my employer, not my personal company. You'd have to ask them about their financing discussions. But yes, it's a major part of our strategy.

            Your strategy isn't specific to Medicaid, so it's not relevant to this discussion. That is, your service

            • On that last: it's de-identified before it ever hits our system. We see that a person was treated, but it's literally impossible for me to see what services you had (or conversely, to see a record and figure out that it was yours).
              • by Dog-Cow ( 21281 )

                Literally impossible? You're not all that good at data mining, then, are you?

              • On that last: it's de-identified before it ever hits our system.

                De-identification doesn't work in general. You could probably recover the personal identities of most of the people in your database by combining it with other data sources.

                • by pnutjam ( 523990 )
                  and again, the goalposts move...
                  • and again, the goalposts move...

                    No, this thread has simply changed topics.

                    This topic is tangentially relevant because the massive centralized collection of medical records has been made possible under Obama, and it is a serous threat to our privacy. It's another reason not to have a single payer system. The federal government should not have health care records on most Americans.

    • at least the honest ones do. The Trial Lawyers who hang onto our party because the other side wants tort reform (which, BTW, you do not want if you like having any recourse whatsoever when a mega-corp does something awful)... them not so much.

      We're not going to demonize you if you don't act like a demon. If you come up with a clever scheme to siphon billions into your pocket away from actual health care then yeah, we'll demonize you. You're a demon. Stop it.
      • The Dems just want single payer at least the honest ones do.

        Well, the vast majority of the Dems seems to want to shovel trillions into the hands of big drug companies, the AMA, and hospitals.

        We're not going to demonize you if you don't act like a demon. If you come up with a clever scheme to siphon billions into your pocket away from actual health care then yeah, we'll demonize you. You're a demon. Stop it.

        Funny, that's pretty much exactly what I would say about the crony capitalist ACA scheme.

        • by pnutjam ( 523990 )
          The ACA scheme was a poor compromise mostly lifted from conservatives. It's not what "the Dems" want, it's what they had the political capital to pass.
          • The ACA scheme was a poor compromise mostly lifted from conservatives.

            Not a single Republican voted for the ACA, so it wasn't a "compromise".

            The fact that some time somewhere some conservative penned something that was similar to the ACA in some respect doesn't mean all Republicans are bound to think it's a good idea in perpetuity.

            It's not what "the Dems" want, it's what they had the political capital to pass.

            Of course, it's not what they want. What they thought they could do is pass a flawed piece of legi

      • at least the honest ones do.

        Both of them?

    • by dbIII ( 701233 )

      If you get in there as an entrepreneur, you'll be suffocating under a mounting of paperwork before being demonized by Democrats for trying to make a profit

      Sorry to break it to you now that you are back from years in the wilderness with no news of the outside world, but there has been an election and Democrats are now irrelevant so you'll have to find someone else to blame.

      • Sorry to break it to you now that you are back from years in the wilderness with no news of the outside world, but there has been an election and Democrats are now irrelevant so you'll have to find someone else to blame.

        I'm glad you noticed that Democrats have lost both the presidency and both houses. However, Democrats haven't disappeared from the US political scene, and any business has to take into account the risk that, sooner or later, Democrats will come into office again. Furthermore, any business al

        • by dbIII ( 701233 )
          From your posting history it appears incredibly unlikely that if you are in a position where you have to deal with such matters or are aware of them first hand.
          Aren't you the guy that hates all governments and sees all taxes as armed robbery?
          • Aren't you the guy that hates all governments and sees all taxes as armed robbery?

            No, you must have me confused with someone else.

  • Too late, bitches... (Score:5, Informative)

    by Penguinisto ( 415985 ) on Tuesday May 09, 2017 @05:31PM (#54387569) Journal

    Oracle has already been practicing, and is perfectly poised to swallow gigatons of money while providing crap software [oregonlive.com] to the medical insurance industry.

  • by rsilvergun ( 571051 ) on Tuesday May 09, 2017 @05:41PM (#54387643)
    won't for much longer. There's $880 billion in cuts coming to offset the tax cuts being proposed. I'm in Arizona and we have a law on the books that automatically rejects anyone for our low income health care program (AHCSS) if they're single. The law was preempted when Obama threatened to withhold Medicare funds from the old folks unless we also covered the poor. The stupid thing being that the money coming from the Feds to pay for low income people's health care brought more dollars to the state than we were spending. But around here we don't like paying for poor people to have, well, anything really.

    Anyway, when those tax cuts hit and the funds stop the law kicks back in and anyone single gets kicked off their health care. Period. I got a buddy with type-I diabetes who didn't have his insulin until Obama made Arizona pay for it. We're gonna go back to struggling to get his insulin now.

    In most of America the only money to be made in poor people is exploiting them because that's all we're allowed to do.
    • by ShanghaiBill ( 739463 ) on Tuesday May 09, 2017 @05:55PM (#54387719)

      Arizona laws are based on the presumption that if you make the poor miserable enough, they will move somewhere else.

      • Arizona laws are based on the presumption that if you make the poor miserable enough, they will move somewhere else.

        s/somewhere else/west/

      • Unfortunately they've overlooked the fact that the poor (except maybe the homeless) can't afford to move, it's the wealthy who are mobile.

        Perhaps it's just that the summer weather makes Arizonans so miserable that they want to hurt people.

        • Unfortunately they've overlooked the fact that the poor (except maybe the homeless) can't afford to move, it's the wealthy who are mobile.

          This is a true point. It would actually make sense to fund bus tickets out of the area in a cynical way. Essentially saying we won't pay for the poor to stay but we will help them leave.

          • Re: (Score:2, Funny)

            by Anonymous Coward

            Unfortunately they've overlooked the fact that the poor (except maybe the homeless) can't afford to move, it's the wealthy who are mobile.

            This is a true point. It would actually make sense to fund bus tickets out of the area in a cynical way. Essentially saying we won't pay for the poor to stay but we will help them leave.

            This sounds like a good idea, trains may be cheaper though. I think if we can identify all the poor, maybe with a little badge or something, then we can round them up once there's enough to fill the first train.

            • They do this for illegals in Belgium and probably other Western European countries. You get a one-way ticket to your home country plus a bonus.
          • by taustin ( 171655 )

            This is a true point. It would actually make sense to fund bus tickets out of the area in a cynical way.

            Florida did that for a while, with bus tickets to California.

            The lawyers (on both sides of the lawsuits) thought it was a wonderful idea.

        • we do still want poor. If you come here you'll see McMansions right next to scary looking trailer homes. The rich don't like to pay for their services. How do you think they get and stay rich? So they need to keep the poor close by. We use our drug policy to control them. Chances are if you're poor somebody you're nearby has drugs on them and the way the laws work it's basically guilt by association. So if the poors get too uppity we send the cops through to bust everybody and it's 5 year minimum mandatory
          • by stdarg ( 456557 )

            You're describing a pretty good, workable system for maintaining social order, but that's not really how it is. The people in those McMansions don't want to live next to poor people. And violent criminals who come mostly from the ranks of the poor are completely out of control. And mainstream politicians are propping up thug groups like black lives matter to put pressure on cops NOT to bust everybody.

      • by their bootstraps. Though it's telling that the phrase most often used to describe getting ahead in life through nothing more than simple hard work is also physically impossible...
    • The stupid thing being that the money coming from the Feds to pay for low income people's health care brought more dollars to the state than we were spending. But around here we don't like paying for poor people to have, well, anything really.

      What was being rejected was not the subsidy.

      What was being rejected was the 4 year sunset on the subsidy, where the state had to take over the burden, at 25% a year, until it was shouldering 100% of it, and the fed was no longer giving the state any money whatsoever.

      One year down the road, and it would have been about break-even, but two years down the road, it would have been a sucking chest wound in Arizona's economy, and in four years, it would have transitioned into a giant cancer.

      The problem is that th

      • then take it away from the old people. They use _way_ more health care and didn't pay nearly enough in Medicare taxes to cover what they use. Screw everybody or screw nobody. Arizona's flush will billionaires who retired here (you'd be surprised how many). We wanted our cake and to eat it too. We wanted free money for the old people that vote and to abandon the working poor who can't make it to the polls.

        You're problem isn't you drank the Kool-Aid, you're problem is you don't have the political will or
        • And the Feds enforced like mother fucking crazy. We don't want them to enforce. We hire those people to be maids, cooks, and farm hands.

          Do you personally have maids, cooks, and farm hands?

          Most of the people concerned about illegal immigrants accessing ACA health care for free are not rich people in border states with dozens of maids, cooks, and farm hands, doing nothing more than sitting around swimming pools sipping margaritas, and bitching about the tax rate. They are instead poor people in the U.S. who are concerned about foreign labor undercutting their ability to get manufacturing and other low skill blue collar labor jobs.

          One of the

    • by bongey ( 974911 )

      Obamacare made situation much worse in the long term. Obamacare provided a blank check to hospitals/drug makers to charge whatever they wanted and the insurance(private) or tax payers(medicare) will end up footing the bill.Example insulin prices more than doubled since Obamacare was introduced. Anyone paying attention to the AMA comments about latest healthcare reform, should just ignore their comments. The AMA and the doctors/hospitals they represent have vested interest in making sure the insurance pay

    • by pnutjam ( 523990 )
      Well, to be fair, they are exploited as slowly as possible, because their time is worthless and it's the one thing they can invest.
  • Silicon Valley might be hunting unicorns in the wrong places.

    Endangered species weren't a good enough kill for them so they are going after our cryptozoological entities? THOSE BASTARDS!

    This is why Bigfoot refuses to work in IT. ;)

    • Silicon Valley might be hunting unicorns in the wrong places.

      Endangered species weren't a good enough kill for them so they are going after our cryptozoological entities? THOSE BASTARDS!

      This is why Bigfoot refuses to work in IT. ;)

      Considering what Silicon Valley is doing instead, is hunting "whales", I am not sure that is much better.

      • Considering what Silicon Valley is doing instead, is hunting "whales", I am not sure that is much better.

        I didn't think Twitter was still relevant.

    • This is why Bigfoot refuses to work in IT. ;)

      No, I had to stop because of air quality issues.

  • Healthcare has made leaps and bounds, and it has trickled out to every segment of society. Even the poorest of the poor receive medical care in hospitals with advanced monitoring equipment and by doctors trained in modern techniques. This story reeks of bullshit. The bureaucracy may still be stuck in the past, but that's government. Very few innovations have come out of government business practices. Or ever will. For very fundamental reasons having to do with difficulties in managing large organizations wi
  • The VCs I talked to, who were interested in this sector, all started sitting on their funds ever since Trump came into power. It's just not clear how these programs will be affected.

  • Today it's all about who you ARE and WHO YOU KNOW.

    This is a very unfortunate trend, today you're basically invisible to the entire industry unless you got 20+ years experience + are the same age as your experience, plus have amazing references and are willing to work overtime without extra compensation.

    Doesn't matter if you can code their socks off, doesn't matter if you even won prizes and awards for your skills, the only thing that matters if you have some papers from your accredited school, and some netw

  • Maybe they ate all the unicorns [etsy.com]

  • If you read the details on the money he's offering (called the "90/10 Rule"), it's 50% to 90% of the cost to build new software and 50% to 75% of the cost to maintain it, with theoretically the rest to be provided by your state...?

    I appreciate that they're trying to get something going, and they're working within some insane limits put on them by contradictory mandates, but this is not a proposal to get quality work done. Implying this is a good deal does not help his credibility. This is a proposal for cha

  • cart before horse (Score:4, Interesting)

    by slew ( 2918 ) on Wednesday May 10, 2017 @04:40AM (#54390767)

    The whole idea that Silicon Valley VCs are somehow *looking* for unicorn companies or unicorn ideas is totally ass-backward.

    Silicon Valley VCs believe they can *create* unicorns by throwing money at them. They aren't looking for them per-se. They are looking for the "right team", the "right investment", etc... The actual idea? Maybe a company can pivot to an idea before the iron grows cold and they are off to the next team. Or not.

    A billion dollar valuation (aka unicorn) simply means VCs have managed to get some 3rd or 4th round chumps to dump a bunch of money into a company for a microscopic share of equity. The smart investors either came in early, or have financing structures with warrants that are dilutive (meaning they didn't actually invest at unicorn levels) unlike the employees that usually promised fully diluted shares some day. The whole fiction of unicorns is simply a media creation and has nothing to do with the market potential of a company. Like Enron or Adelphia accounting, it's a fiction that only has to do with the esoteric machinations of valuation and financing a startup.

    I suspect the main reason nobody is pivoting towards medicaid recipients is that silicon valley companies probably don't think they can compete with the fraud levels that are out there. If some SV company thought they figured out a way to skim medicaid dollars, they probably can't hold a candle to what people are already doing to the system. It's hard to beat scammers at their own game (esp if you are trying to play fair). On the other hand, maybe a Uber-like company might want to tackle this, but I don't know if that would be a good thing.

  • Yes, there is profit to be made with modernizing medicaid

    But no, that profit won't be earned by the poor people on medicaid. It's not the dependants of a system that can profit from rebuilding it. They can't even shape it.

    If you want to give those people a say, go ahead, but that won't bring VC money to medicaid.

  • Silicon Valley doesn't understand life outside of Silicon Valley. There are a whole lot of places in the country that don't have wireless internet service yet they build products that expect it.

  • unicorns --private, venture-backed companies valued at a billion dollars or more

    source:
    How Unicorns Grow - Harvard Business Review
    https://hbr.org/2016/01/how-un... [hbr.org]

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