[1] https://www.kff.org/medicaid/medicaid-financing-the-basics/#...
[2] https://usafacts.org/answers/how-much-does-medicare-cost-the...
For example, Medicare is launching a new program in July that pays a fixed rate for achieving defined outcomes, like lowering blood pressure or cholesterol. Medicare's explicit goal here is to create incentives to automate the repetitive parts of care delivery with software. (Much of preventive cardiology is surprisingly algorithmic and guideline-driven, so this is more plausible than it seems.)
This reverses the incentives of the current system, where CPT codes incentivize doing more "stuff" (but not necesarily delivering the most effective care efficiently).
If you're a software engineer who cares about health, and have been sitting on the sidelines till now, I think the next few years are a really interesting time to make a contribution.
The obvious points are medicines and equipment. To some degree, these are actually the most justifiable parts of the industry that should be for profit.
The parts that are far less justified: - The insurance industry surrounding healthcare. Obamacare brought in some regulation that drastically slowed the growth of healthcare costs. - The education industry surrounding healthcare. Becoming a doctor in the U.S. is incredibly expensive. You rack up massive loans, you’re racking up interest on those loans for years, well into your late 20s (including the loans you racked up for your undergrad), and then you’re spending the first decade of your career all the way to the late 30s, just paying those loans back. You’re one of the most sought after professional in the world and yet it takes you until your late 30s to basically break even. The upshot of that is you charge a ton not just to pay back your loans but to justify spending so much time and energy on a career that means you start being money positive for the first time in your late 30s. - Insurance. The American legal system that does not place any penalty on frivolous lawsuits essentially inserts a significant cost due to bad actors on everyone. Personally, I’m not clear on what this cost actually is and how significant it is, but if you talk to doctors and hospital administrators, they seem to believe it’s incredibly high. - Hospitals being for profit. I actually think for profit hospitals are more efficient than non profit ones, but the problem here is what they prioritize. A non profit hospital system may prioritize family care and regular checkups to keep people healthy and prevent them from falling sick in the first place. A for profit hospital probably prioritizes surgeries and elaborate procedures that make a lot of money. And that’s before we get to spending on customer acquisition, either due to fancy buildings etc or just straight up advertisement and marketing.