Originally published in Second Opinion, a newsletter for healthcare founders, operators, and investors.

If the United States’ healthcare sector were its own country, it would be the third largest economy in the world. By any rule of capitalism, a market that size should have minted a titan. Software gave us multiple trillion dollar platforms. Retail, search, advertising, even payments each produced a generational tech giant. And yet healthcare has not produced a single $100 billion healthtech company. 

Why? The short answer is that technology, for the most part, hasn’t actually created value in healthcare. It shuffled it, bureaucratized it, and in many cases destroyed it. The longer answer is that might all be changing now.