#1 The Historical Accident That Shaped Modern Healthcare

The marriage between employment and health insurance wasn't carefully planned but emerged as a workaround during WWII wage freezes. Companies couldn't offer higher wages, so they added benefits instead. This quick fix has now become a permanent fixture, limiting choices and creating unnecessary complexity in our healthcare system.

For healthcare tech founders generating $2M+ in revenue or with substantial funding, this historical structure creates both challenges and opportunities. Your innovative solutions often face adoption barriers because they must fit within a system designed around employment-based insurance rather than patient needs.

I've observed many promising healthcare technologies struggle not because they lack value, but because they can't navigate the constraints of our employer-based insurance model. Breaking this link could create space for more patient-centered innovations that better serve everyone involved.

#2 Misalignment of Incentives: The Root Problem in Healthcare

Healthcare's fundamental challenge is that different stakeholders have conflicting goals. Payers focus on reducing costs, providers bill for services rendered, and patients seek quality care at reasonable prices. Your healthcare tech solutions often get caught in these competing priorities.

From my experience advising healthcare startups, I've seen how this misalignment can derail even the most promising innovations. When your technology increases quality but doesn't fit neatly into existing payment structures, adoption becomes an uphill battle. It's not just about building something valuable—it's about navigating complex incentive structures.

For your healthcare tech company to thrive, understanding these misaligned incentives is crucial. Solutions that help bridge these gaps have the greatest potential for adoption and impact. The founders who can align incentives between key stakeholders will win in this market.

#3 Beyond Incrementalism: The Problem With Layering Solutions

One pattern I consistently see with struggling healthcare tech companies is adding new tools on top of broken systems. This "incrementalism" approach results in more complexity without solving underlying problems.

As one healthcare tech founder recently shared with me, "We built an amazing AI diagnostic tool, but clinicians barely use it because it doesn't integrate with their workflow." This illustrates a common challenge—creating solutions that add to clinicians' burdens rather than lightening them.

Instead of layering new technologies onto existing systems, consider what might be possible with a fresh start. Some of the most successful healthcare innovations have come from rebuilding models from the ground up rather than patching outdated systems. If your solution requires clinicians to do extra work without clear benefits, adoption will remain low regardless of your technology's quality.

#4 Human-Centered Healthcare Design: What Patients Really Want

While we often assume patients want the latest technology, research consistently shows they prioritize human connection in healthcare. When developing healthcare tech solutions, remember that technology should enhance human relationships, not replace them.

I've advised numerous healthcare startups that initially focused on automating patient interactions through kiosks or apps. However, patient feedback often reveals a desire for more human contact, not less. The most successful healthcare technologies support and enhance human connections rather than eliminating them.

Your healthcare innovation may need to find the right balance between efficiency and personal touch. Solutions that make providers more present for patients—rather than more distant—tend to see higher adoption rates and greater satisfaction from all parties involved.

#5 Rebuilding Primary Care Outside the Insurance Model

What if primary care operated on a membership model rather than fee-for-service billing? This shift could free clinicians to practice medicine proactively rather than reactively. For healthcare tech founders, this represents an enormous opportunity.

By separating primary care from traditional insurance models, we could create space for innovations focused on patient outcomes rather than billable services. Technologies that support ongoing patient monitoring, proactive interventions, and preventive care would suddenly have viable business models.

I've seen promising startups struggle because their preventive solutions don't fit within reactive payment models. A reimagined primary care system built around membership could create fertile ground for technologies that genuinely improve health outcomes rather than just facilitating transactions.

#6 Reimagining Healthcare Without the Employment Connection

"Fall in love with the problem, not the solution. What are the problems that people are having out there? Let's really understand the problems and only then can you start to build potential solutions for it." - Jason Spacek

The most transformative change would be decoupling health insurance from employment entirely. This shift would open tremendous opportunities for healthcare tech founders to create more flexible, patient-centered solutions.

With insurance choices no longer limited by employers, consumers could select plans and providers that best meet their specific needs. Technology platforms facilitating these choices would become essential, creating new market opportunities for innovative companies.

For healthcare tech founders, this evolution would mean developing solutions that serve individual consumers rather than navigating complex B2B sales to employers or insurance companies. Direct-to-consumer healthcare technologies could flourish in a system where individuals have greater choice and agency.

Moving Forward: Opportunities for Healthcare Tech Founders

As healthcare tech founders, you're positioned to lead this transformation. By developing solutions that align incentives, enhance human connections, and support new payment models, you can help create a more effective healthcare system.

The most successful founders I work with focus first on deeply understanding problems rather than pushing solutions. They validate that their innovations address real needs before building complex technologies. 

By taking this approach, they create solutions people actually want and will adopt. The greatest opportunities may lie not in adding to the current system but in reimagining fundamental components of how healthcare is delivered and financed.

Conclusion

The healthcare system as we know it today is built on historical accidents and outdated structures that no longer serve patients, providers, or innovators effectively. As healthcare tech founders, you have a unique opportunity to not just work within this system but help transform it.

By focusing on human-centered design, aligning incentives, and reimagining fundamental structures like the connection between employment and health insurance, you can develop solutions that truly make a difference. The most successful healthcare technologies won't just add another layer to existing processes—they'll help reshape how healthcare is delivered.

What structural changes in healthcare would best support your company's growth and impact? How are you working to align incentives between patients, providers, and payers? 

I'd love to hear your experiences in navigating these complex challenges—share your thoughts in the comments below!