Apple Must Go Into Medical

[Arthur Hanson]

Apple is up against the law of large numbers and needs mega markets to grow. US medical offers the best market for it to achieve significant growth. They shoudl partner with Mark Cuban's Cost Plus Drugs which offers generics for pennies on the dollar, sometimes a single penny, to start this drive. Apple having the most stable, secure and intuitive ecosystem is ideally placed to make significant gains in this four trillion dollar market that is bloated by special interests, waste, inefficiency and sometimes outright corruption, and fraud. Apple already has a start in this with the Apple Watch. With robotics and automation combined with significant opportunities to wring out inefficiencies, this offers Apple the opportunity to add significantly to its addresable market and bottom line while making this country a chance to improve the quality of a medical system that provides lower quality than it should. Just joining with systems like Cost Plus Drugs would offer substantial increases in value and grow the market substantially.

 

[nghanayem]

No. I don’t need or want Apple, big tech, or any company controlling everything I do. I also sure as hell don’t want them selling medical data to advertisers or insurance firms.

 

[Arthur Hanson]

No. I don’t need or want Apple, big tech, or any company controlling everything I do. I also sure as hell don’t want them selling medical data to advertisers or insurance firms.

The insurance firms and advertisers are the problem, they both add tremendously to the cost. Just look at all the medical ads aimed at a population that doesn't have a real clue that the advertisers are usually pushing high cost options with a huge advertising budget to finance. Medical desperately needs reform. The individual doctor's office should not exist in cities for it's a high cost, inefficient model for it can't offer a full spread of expertise or justify the cost of the equipment to do a good job. Medical in this country is high cost, low quality and is driving us into bankruptcy.

 

[Arthur Hanson]

No. I don’t need or want Apple, big tech, or any company controlling everything I do. I also sure as hell don’t want them selling medical data to advertisers or insurance firms.

If people want inferior care delivered by an inefficient model on every level like US medical that is their right. The model we have delivers 37th in quality at the world's highest cost for a major country.

 

[jngreenlee]

Medical care in [US] is high-cost and high-quality once you are in value-add services where it matters like cancer treatment, proton beam therapy, and all sorts of things (for laughs from the right-wing peanut gallery I'll throw in "best gender treatments in the world!").

It feels like low quality at the clinical/PCP level because HITECH Act, part of ARA in 2008/09, mandated meaningful use with $44k bonuses per physician (in freshly printed bytes) for provider networks or systems that embraced EMHR systems like EPIC (founder/CEO Judith one of Pres. Obama and Biden's biggest donors, still milking it) and Cerner (now Oracle Health, do I need to teach anyone about Uncle Larry?).

You can go Google this next fact...EMRs have not increased quality of care over a placebo. They have instead:

• -Made doctors/PCPs spend more time on the computer and less time talking to you
• -Increased the IT costs of any PCP practices, which is why your local doctor is getting absorbed into Optum/etc.
• -Opened a pandora's box of targeted ransomware, due to asymmetrical costs, (forced to use EMRs, disclose breaches, HHS/HIPAA fines)
• -Created an upward cycle of spend on security software->get breached anyways->cybersecurity insurance pays the response costs->rates go up
• -Made nurses retire in droves
• -Didn't help or stop COVID
• -US lifespans are decreasing now that we are past the big wave of EMR adaptation, this will begin to show up in studies with backlash
• -I won't go on

A simple pre-surg checklist philosophy has had more impact on health outcomes since ACA than any "interoperability" dream. Paper was always good enough and local enough. People aren't cattle, and a scrawled note can be more effective than logging into the mainframe to make a notation. EMR adaptation was just another lobbyist-run moonshot with temporary economic boosts for the medical tech industry (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6771182/)

PS - Want a scare, look at what HHS/CMS is expecting the tech people to figure out next...it's just a huge bikeshed, and here's one tiny corner of it: http://hl7.org/fhir/R4/diagnostics-module.html

 

[Arthur Hanson]

The semi sector has already created wearables that could if fully utilized spot many problems early when they can be treated easily and at low cost. MRIs are coming down in cost as is much medical equipment, especially outside the US where all medical cost are artificially kept sky high by a number of means by special interests. Doctors and nurses could be massively leveraged by tech in numerous ways to lower costs dramatically, but this is blocked by profiteers who care more about pay and P and L than the health of the people. US medical has become the largest criminal organization in the world charging two trillion dollars in excess cost compared to other countries with superior care and results.

 

[cheesehead]

Healthcare is already becoming increasingly unaffordable in many regions. While I do see the technical opportunity, I am doubtful whether Apple (or any other big tech player) entering this market would help to bring down overall cost.

 

[hkwint]

It's a terrible idea, as Apple stands for everything which _caused_ the problems when it comes to the high cost of healthcare.

https://www.harvardmagazine.com/2020/05/feature-forum-costliest-health-care

An Harvard article cites 3 solutions:

-Standardisation. Apple really is the most proprietary anti-standard company you can think of.
-Corporate greed / elite prices. Apples patent wars with Qualcomm show, they will use anything to up their earnings. Apple will always try to drive prices of their iPhones higher. For long, they asked more money for almost the same service as the competution.
-Too much expensive technology. The iWatch can maybe detect high blood pressure, but existing medication is not affordable for many. So diagnosis doesnt lead to a simple treatment.

Of course, for cheaper healthcare, the patent system has to be reformed; and Apple and Microsoft are actively blocking such attempts; and have done so for years.


Also, Apple can't deal with liability, with Antenna gate they blamed their customers for their defective products. Philips switched from electronics to starting the fabless industry with TSMC along the way, to chip design and to medical, and they know what liability means.

Apple not so much.
Apple is no solution to any problem, it only makes things worse. All they can do and have done last 20 years is copy technologies from other companies, improve it and sell it for more money.

 

[Arthur Hanson]

Apple does have the most stable, intuitive and secure platform of the major players that do business worldwide. Apple would not do the medical itself, but provide a platform for reseach and collaboration and provide health monitoring for individuals to spot problems early when they are easy and inexpensive to treat. Already the cell phone is the platform for many health monitoring and testing devices like the EKG device that does it at a very, very small fraction of the cost in a hospital. I use a blood pressure and heart rate monitor weekly and a scale that besides weight, monitors fat, muscle mass, bone mass and several other measurements. Oximeters and other divices that cost about twenty dollars. It would be nice to have a platform to give us our health status real time to prevent a minor condition from becoming a serious, expensive condition. Prevention is far, far cheaper than serious health problems. Health monitors of all types have become cheaper and have more uses thanks to the world of semis. Apple may not be the best solution, but better than the insurance and medical companie that have given us the expensive. low quality mess we have for most. It you have a better solution, please post it. Apple would not be a medical company, but a platform for the monitoring devices needed to what our condition is and spot problems early when they are far cheaper to work with.

When you see a tidal wave of medical ads, this is much of what you are paying for.

 

[blueone]

It's a terrible idea, as Apple stands for everything which _caused_ the problems when it comes to the high cost of healthcare.

https://www.harvardmagazine.com/2020/05/feature-forum-costliest-health-care

An Harvard article cites 3 solutions:

-Standardisation. Apple really is the most proprietary anti-standard company you can think of.

I think proprietary technology is a good thing in many cases. I like a lot of Apple's software better than the Android features, Messages being a good example. I used Android phones for business side-by-side with my personal iPhones for years, and I like IOS phones better. Yeah, iPhones generally cost more. That's a market economy for you, better usually costs more because of the value pricing strategy. Industry standards are often compromised specifications molded by corporate political decisions. A single team can often out-perform a standards committee by a wide margin.

-Corporate greed / elite prices. Apples patent wars with Qualcomm show, they will use anything to up their earnings. Apple will always try to drive prices of their iPhones higher. For long, they asked more money for almost the same service as the competition.

Singling out Apple for patent infringement chasing is silly. Most high tech companies engage in this, including IBM, Arm, and Intel.

-Too much expensive technology. The iWatch can maybe detect high blood pressure, but existing medication is not affordable for many. So diagnosis doesnt lead to a simple treatment.

I agree with this point.

Of course, for cheaper healthcare, the patent system has to be reformed; and Apple and Microsoft are actively blocking such attempts; and have done so for years.

Apple and Microsoft are just two members of a very large crowd that include the Pharma companies.

Also, Apple can't deal with liability, with Antenna gate they blamed their customers for their defective products. Philips switched from electronics to starting the fabless industry with TSMC along the way, to chip design and to medical, and they know what liability means.

I don't understand your point here at all.

Apple is no solution to any problem, it only makes things worse. All they can do and have done last 20 years is copy technologies from other companies, improve it and sell it for more money.

Yeah right. Hundreds of millions of people around the world are just fools for buying Apple products. If success was as easy as your statement implies, there would be a lot more Apple-like companies in the world.

 

[Daniel Nenni]

Healthcare in the US is horrible. Disruption is necessary. I don't care who does it Apple, Tesla, Nvidia, whatever but it must change. I trust my iPhone with my life already so why not Apple?

 

[jngreenlee]

@Arthur Hanson , I think you mostly want to receive some justification matching your opinion, which might be that it's time to move the kids' trust fund entirely into $AAPL. Nothing wrong with that. I am confident that even if this thesis is wrong, $AAPL (along with $MSFT) will continue to print money in some other way.

Time will tell whether Apple does anything more in the health space, and then we in the clinical/tech space will more time to discover whether their efforts can actually impact the root factors of your complaint about health services. I think it's a stretch, but that's just me. Watch for Apple hiring anyone that's filed a 510(k) before, that would be your tell. Hope it helps!

 

[Arthur Hanson]

I don't own Apple and never have. I know many in health care have no problem with massive mark ups. Mark Cuban's cost plus drugs sells many, many drugs for pennies on the dollar. I know of systems and industrial engineers that have worked in medical and call it the most corrupt, inefficient system they have ever seen and see it as an area as ripe for massive reform and it has been this way for years.

 

[jngreenlee]

@Arthur Hanson You may like this, I got a briefing on it today. This (or related startups) could become an Apple target. Israel is leading in sensor tech. Having De Novo clearance is a good indicator. The sensors can eventually be shrunk and integrated into all types of Apple products. This is the only solution to receive FDA clearance for the simultaneous detection of cardiac and pulmonary health biomarkers through the use of light waves (nano-vibration motion detection).

Products - Donisi

donisihealth.com

I'll reinforce my explanation that medical industry (products and administration) are "corrupt and inefficient" due to the regulatory bureaucracy. I'm not saying to change that, it just is what it is, and it's not going to be taken apart. This creates a huge moat for companies that have cleared FDA 510(k) or the EMHR/revenue platforms I explained above that have the scale to stay up with CMS/Interop/HL7 type of demands.

You'll also like this one, it would be an easier IP integration for Apple, but waiting to see if it can be cleared in the US:

Startup to build factory for ‘wearable’ that tracks oxygen consumption through sweat

Yopi has developed a monitoring device worn on the wrist to measure cardiorespiratory fitness; startup plans to recruit 70 employees at Sha’ar Hanegev plant in southern Israel

www.timesofisrael.com

Make it a great weekend!

 

[tonyget]

Apple is not the company known for offering "bang for the buck" products，which is what the public most needed when it comes to health care.

 

[hkwint]

I think proprietary technology is a good thing in many cases. I like a lot of Apple's software better than the Android features, Messages being a good example. I used Android phones for business side-by-side with my personal iPhones for years, and I like IOS phones better. Yeah, iPhones generally cost more. That's a market economy for you, better usually costs more because of the value pricing strategy. Industry standards are often compromised specifications molded by corporate political decisions. A single team can often out-perform a standards committee by a wide margin.

Singling out Apple for patent infringement chasing is silly. Most high tech companies engage in this, including IBM, Arm, and Intel.

I agree with this point.

Apple and Microsoft are just two members of a very large crowd that include the Pharma companies.

I don't understand your point here at all.

Yeah right. Hundreds of millions of people around the world are just fools for buying Apple products. If success was as easy as your statement implies, there would be a lot more Apple-like companies in the world.

You didn't read the Harvard magazine article I linked to, did you?

I don't live in the US, the statement of Arthur Hanso I reacted to was that Apple will make healthcare cheaper.

The Harvard article says 3 things are needed:
-Standardisation,
-Less corporate greed
-Less 'expensive technogy with low usage'

Nobody cares if you like Apples proprietary standards or not. The thing is, as the article mentions, interoperability makes things cheaper. That's why old USB A chargers were always cheaper then Apple lightning chargers. And that's why nuts and bolts are cheap.

Apple is known for its corporate greed. I'm not singling this company out, I was reacting to a statement which says Apple will make healthcare cheaper.

And also it doesn't maje sense to give every US citizen an iWatch if they can not pay for unsulin or blood pressure medication.

Arthur Hansen mentions prevention is cheaper than treatment.

True, but at the same time low cost trearnent, which many US citizens cannot afford, is cheaper than hospitalization.

 

[hkwint]

Apple does have the most stable, intuitive and secure platform of the major players that do business worldwide. Apple would not do the medical itself, but provide a platform for reseach and collaboration and provide health monitoring for individuals to spot problems early when they are easy and inexpensive to treat. Already the cell phone is the platform for many health monitoring and testing devices like the EKG device that does it at a very, very small fraction of the cost in a hospital. I use a blood pressure and heart rate monitor weekly and a scale that besides weight, monitors fat, muscle mass, bone mass and several other measurements. Oximeters and other divices that cost about twenty dollars. It would be nice to have a platform to give us our health status real time to prevent a minor condition from becoming a serious, expensive condition. Prevention is far, far cheaper than serious health problems. Health monitors of all types have become cheaper and have more uses thanks to the world of semis. Apple may not be the best solution, but better than the insurance and medical companie that have given us the expensive. low quality mess we have for most. It you have a better solution, please post it. Apple would not be a medical company, but a platform for the monitoring devices needed to what our condition is and spot problems early when they are far cheaper to work with.

When you see a tidal wave of medical ads, this is much of what you are paying for.

Any company which will be a platform for health data will attempt a vendor lock in.

Why are office suites like LibreOffice and Google Docs cheap these days? Because Microsoft was forced to open up their proprietary file formats.

To make something cheap, open standards need to exist which make solutions interoperable and cause competition.

A bolt from firm A according to ISO standards will fit a nut from firm B.
Tomorrow firm C can buy the ISO standard and make better and cheaper bolts.

For cheaper healthcare, there have to be open medical data formats.

Right now in AI, when it comes to cheap, Llama is winning from proprietary big GPT models and Google / Microsoft. People train LLama models on a Raspberry Pi!

It's because Facebook open sourced the model and the weight table leaked. All researchers started using it, improving it, publishing the results for free. Thats why Llama models can reach 80% of the GPT4 quality at less than 1% of the cost.

One could give many examples, but for cheap healthcare, patents have to be severely limited, and data has to be free.

In such a world, Apple, Microsoft, Oracle and nany others wouldn't thrive.

 

[blueone]

You didn't read the Harvard magazine article I linked to, did you?

I don't live in the US, the statement of Arthur Hanso I reacted to was that Apple will make healthcare cheaper.

The Harvard article says 3 things are needed:
-Standardisation,
-Less corporate greed
-Less 'expensive technogy with low usage'

Nobody cares if you like Apples proprietary standards or not. The thing is, as the article mentions, interoperability makes things cheaper. That's why old USB A chargers were always cheaper then Apple lightning chargers. And that's why nuts and bolts are cheap.

Apple is known for its corporate greed. I'm not singling this company out, I was reacting to a statement which says Apple will make healthcare cheaper.

And also it doesn't maje sense to give every US citizen an iWatch if they can not pay for unsulin or blood pressure medication.

Arthur Hansen mentions prevention is cheaper than treatment.

True, but at the same time low cost trearnent, which many US citizens cannot afford, is cheaper than hospitalization.

So we disagree, apparently on many things. I read the article.

 

[Arthur Hanson]

The medical system we have now is the greatest threat to the US, driving the country into bankruptcy as the population ages and the efficiency of medical stagnates and the bill is now at 20% of GDP and shows every sign of growing even more. The tech sector is but one part of the solution and a radically different social and business structure is needed if we are to avoid medical costs destroying our economy and the country. In many areas the US can't compete due to the overhead of medical costs. If anyone has a better solution, post it. AI/ML and advanced automation of everything in medical from administration to surgery to health monitoring are are challenges that the tech sector can tackle for better than the entrenched mess we have now that has given us high costs, low quality and a flood of more medical ads in every communications channel we use and business models that are high cost, low efficiency and low quality system we have now that doesn't even cover everyone.

 

[jimienarosn]

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