Care to take a guess at how much more investment we have in the healthcare sector over other nations? Care to answer why everybody just buys our technologies and cures instead of developing their own?
Capitalism at work. We find it first, we develop it first, we bring it to market first, and we cure people first. With a UHC plan, there is no incentive to develop new cures.
By all means, shoot yourself in the foot, and then shoot the guy that develops the antibiotic to keep your foot from getting infected, too.
I'm puzzled as to how the conversation went this direction.
1) I shouldn't have brought Wal-Mart into this conversation. Retail and healthcare are vastly different, and the only analog I was pointing out was the power yielded by Wal-Mart on industry standards and how it shapes the industry. That's where the similarities end.
2) I'm not going to disagree finding something first, bringing it to market first, etc. That's obvious, and without the entrepreneurial spirit in this country we'd have no innovation.
Which was my point: The larger these institutions get the more barriers there are to entry. Start-ups can't penetrate the market and never gain any ground. There's no real competition, because to even be able to play in the market you have to do the same thing everyone else is doing in order to gain any market share at all. This is why payors and major players in the industry (McKesson, Epic, AllScripts) are incented to push their own platforms rather than those inherently interoperable.
And this is why we have legislative agendas around monopolies. Read this: http://www.southernstudies.org/2009/06/health-care-industry-monopolizes-the-south.html (sorry, don't know how to link). It's not a pure monopoly, but it is a monopoly in methodology. The innovation is therefore limited to process, areas which have serious IP challenges and can only make a small dent in the industry. I can give you literally dozens of examples of this if you're interested.
Listen, I don't think payors are bad people. They don't do the things they do because they're looking for world domination or looking to hurt people. Unfortunately though, that's exactly what happens, because the financial models don't show that it's a 5 year old child that needs a transplant.
And to your other points, it doesn't pay to invest in an infrastructure that you then give to others which is why the industry is so fragmented. McKesson didn't invest 10s of millions in their solution only to hand it over to everyone else. The end result will be a ton of different solutions that ultimately are a pain in the ass to integrate and we're back to square one.
Hopefully I've made my point. TRUE innovation is stifled now and will not improve until the bigger players lose their iron hand control over that which is required to enter the market.