How US Healthcare Actually Works, the WWII Tax Loophole that Broke it Forever, and How AI Can Fix it | Nikhil Krishnan, Out of Pocket

Nikhil Krishnan is the Founder of Out of Pocket, a media company that makes understanding healthcare more entertaining and accessible.

We spend 100 minutes talking about how the US healthcare system actually works, how World War II changed it forever, all the ways AI is seeing real adoption across the industry, and most common bad startup ideas in healthcare.

Thank you to Numeral, Flex, and Amplitude for supporting this episode

Numeral: The end-to-end platform for sales tax and compliance [https://www.numeral.com](https://www.numeral.com/)

Flex: Sign-up for Flex Elite with code TURNER, get $1,000 https://form.typeform.com/to/Rx9rTjFz

Amplitude: AI analytics, all you have to do is ask [https://www.amplitude.com](https://www.amplitude.com/)

Timestamps:

(1:23) How the US healthcare system works

(4:26) Why US healthcare is different from the rest of the world

(12:01) Why healthcare costs keep going up

(15:58) Core problem: is healthcare a marketplace or not?

(21:04) How money flows + Two-way price negotiation

(27:34) Why payments are seeing early AI adoption

(30:08) How AI could change healthcare delivery

(35:40) Doctor’s are trapped on a productivity hamster wheel

(39:28) How incentives shape healthcare delivery

(43:53) Healthcare is an implicit jobs program in the US

(48:45) Areas AI is overhyped, worst healthcare startups

(55:30) Consumerization of healthcare

(1:01:58) Rise of Peptides, understanding risks and downsides

(1:09:35) Why all medical software is so bad

(1:11:58) How to do enterprise sales in healthcare

(1:14:51) The battle forming between Scribes, Search, and EMRs

(1:18:33) Why we need more physician independence

(1:26:51) Starting Out of Pocket in February of 2020

(1:2912) Write to meet your audience

(1:37:54) Using AI as a content creator

(1:42:13) How to get started writing on the internet

Referenced

Out of Pocket: https://www.outofpocket.health/

Doctronic: https://www.doctronic.ai/

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