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Brave Care Has Closed

bravecare.com

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Re: Brave Care Has Closed

#11

Post by vasco »

donw wrote: post #10
xyst wrote: post #4

Earlier quoted context omitted.

Very difficult to disrupt American healthcare when health insurance companies determine your rates, direct pay patients often the most vulnerable, and instead of focusing on patient care you have to focus on stupid administrative tasks to deal with different types of health insurance plans/pharmacy benefit managers/vendors. Thanks to decades of neo-liberalism (the idea of deregulation and "free market" economy). Amer…

... are you joking? Healthcare is one of the most regulated industries in the United States. Want to be a doctor? You've got the aptitude, the knowledge, the mindset, and the will, but a government-guaranteed cartel of medical schools won't let you in, so too damn bad. Learn to code. Want to open a clinic? You really only need about a half-million in hardware to operate at the level of a 1980s hospital, but regulator…

How come it's cheaper in places where everyone has insurance?

Re: Brave Care Has Closed

#12

Post by dragonwriter »

gerdesj wrote: post #6
readthenotes1 wrote: post #3

Given the highly escalating price of medical care, it's astounding that a provider that isn't required by federal law to provide no-cost indigent care can go bankrupt. [1] makes it sound like they were assuming a never-ending stream of venture funding and didn't make a sustainable business. It'd be interesting to see where the money went. [1] https://www.oregonlive.com/business/2022/09/portland-pediatr...

"federal law to provide no-cost indigent care" Could you explain "indigent" here, please. It looks like a typo.

It's someone looking at the EMTALA requirement for emergency departments to provide stabilization without regard to ability to pay without also realizing that the US has public health insurance for the medically indigent.

Re: Brave Care Has Closed

#13

Post by gerdesj »

btilly wrote: post #8
gerdesj wrote: post #6

Earlier quoted context omitted.

"federal law to provide no-cost indigent care" Could you explain "indigent" here, please. It looks like a typo.

Any homeless person can walk into an ER and get care. What will happen to the bills? Effectively it is no cost care for those who are sufficiently poor.

Cool - that sounds a bit like our NHS.

You also said "What will happen to the bills?" - what does that mean?

Cheers Jon

Re: Brave Care Has Closed

#14

Post by mkmk »

readthenotes1 wrote: post #3

Given the highly escalating price of medical care, it's astounding that a provider that isn't required by federal law to provide no-cost indigent care can go bankrupt. [1] makes it sound like they were assuming a never-ending stream of venture funding and didn't make a sustainable business. It'd be interesting to see where the money went. [1] https://www.oregonlive.com/business/2022/09/portland-pediatr...

Patient acquisition costs, perhaps?

Re: Brave Care Has Closed

#15

Post by snitty »

xyst wrote: post #4
toomuchtodo wrote: post #2

Kudos to their founders and team for trying to disrupt this space. https://www.ycombinator.com/companies/brave-care https://www.bizjournals.com/portland/news/2021/10/07/brave-c... | https://archive.today/Qd8fQ https://techcrunch.com/2019/09/09/yc-backed-brave-care-raise...

Very difficult to disrupt American healthcare when health insurance companies determine your rates, direct pay patients often the most vulnerable, and instead of focusing on patient care you have to focus on stupid administrative tasks to deal with different types of health insurance plans/pharmacy benefit managers/vendors. Thanks to decades of neo-liberalism (the idea of deregulation and "free market" economy). Amer…

>Americans have allowed corporations to form massive entities (in health insurance, UHC + optum bank + optima rx comes to mind)

This is more an anti-trust problem than deregulation. In the 80s Robert Bork and some others led a charge within the court system to rewrite federal anti-trust law without actually rewriting the laws. The result was that merger/acquisition guidelines were loosened, and the focus was on whether the result would cause the consumer to pay more money. And thanks to the way health care is paid for, it's a little complicated to make that case.

Re: Brave Care Has Closed

#16

Post by jawns »

Don't get the wrong idea about this announcement.

The problem is not that pediatric urgent care is not a viable business.

The problem is that it's not a great VC-funded business.

VC investors are hoping for huge growth and eventually earning back multiples of their investment.

That's going to be really hard to do in this segment of the health-care market.

We've got a wonderful pediatric urgent-care place in our area, backed by the best children's hospital in our metro region, and it seems to be doing great. But does that mean it could ever grow at the rate needed to satisfy VC investors? Probably not.

Re: Brave Care Has Closed

#17

Post by IG_Semmelweiss »

toomuchtodo wrote: post #2

Kudos to their founders and team for trying to disrupt this space. https://www.ycombinator.com/companies/brave-care https://www.bizjournals.com/portland/news/2021/10/07/brave-c... | https://archive.today/Qd8fQ https://techcrunch.com/2019/09/09/yc-backed-brave-care-raise...

Most people outside of healthcare will have a hard time disrupting anything until they realize the goverment has tilted the rules in favor of status-quo.

Healthcare insurance in the US is heavily subsidized, and no number of revolutionary care delivery models will put you on level terms with the behemoth of US govt insurance subsidies.

Your only hope as a non-provider is to come in with your own a-la-carte insurance that is able to take those subsidies, while you set your moat and innovate in the delivery front.

Re: Brave Care Has Closed

#18

Post by nradov »

donw wrote: post #10
xyst wrote: post #4

Earlier quoted context omitted.

Very difficult to disrupt American healthcare when health insurance companies determine your rates, direct pay patients often the most vulnerable, and instead of focusing on patient care you have to focus on stupid administrative tasks to deal with different types of health insurance plans/pharmacy benefit managers/vendors. Thanks to decades of neo-liberalism (the idea of deregulation and "free market" economy). Amer…

... are you joking? Healthcare is one of the most regulated industries in the United States. Want to be a doctor? You've got the aptitude, the knowledge, the mindset, and the will, but a government-guaranteed cartel of medical schools won't let you in, so too damn bad. Learn to code. Want to open a clinic? You really only need about a half-million in hardware to operate at the level of a 1980s hospital, but regulator…

You're confusing cause and effect. Health care used to be cheap because it couldn't really do much beyond treating some minor injuries and infections. Until about a century ago, what we had was barely a step above witch doctors. Health insurance or lack thereof only started to become a major issue when care delivery started to become more effective and expensive.

Re: Brave Care Has Closed

#19

Post by skissane »

donw wrote: post #10
xyst wrote: post #4

Earlier quoted context omitted.

Very difficult to disrupt American healthcare when health insurance companies determine your rates, direct pay patients often the most vulnerable, and instead of focusing on patient care you have to focus on stupid administrative tasks to deal with different types of health insurance plans/pharmacy benefit managers/vendors. Thanks to decades of neo-liberalism (the idea of deregulation and "free market" economy). Amer…

... are you joking? Healthcare is one of the most regulated industries in the United States. Want to be a doctor? You've got the aptitude, the knowledge, the mindset, and the will, but a government-guaranteed cartel of medical schools won't let you in, so too damn bad. Learn to code. Want to open a clinic? You really only need about a half-million in hardware to operate at the level of a 1980s hospital, but regulator…

> Healthcare is one of the most regulated industries in the United States.

And yet other countries have even more regulation, and manage to deliver cheaper and more equitable healthcare overall, with better public health outcomes when measured at the national level

For example: in Australia, the federal government is a near-monopsony purchaser of prescription drugs, so it has enormous negotiating power with the pharmaceutical companies. By contrast, in the US, the federal government’s role in purchasing drugs is much smaller: the end result is higher drug prices, although the downside of Australia’s model is it can delay availability of new drugs. (Those with unlimited ability to pay can still purchase drugs privately at whatever cost the manufacturer will sell them-you can even get bureaucrat approval to import unapproved drugs for personal use if you can find a senior clinician willing to assist you in it.)

Re: Brave Care Has Closed

#20

Post by dgfitz »

jawns wrote: post #16

Don't get the wrong idea about this announcement. The problem is not that pediatric urgent care is not a viable business. The problem is that it's not a great VC-funded business. VC investors are hoping for huge growth and eventually earning back multiples of their investment. That's going to be really hard to do in this segment of the health-care market. We've got a wonderful pediatric urgent-care place in our area,…

Geriatric care will be the gold rush of the 2040s. If I knew a solid way to invest in that, I would.
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