Healthcare's 'Uber for X' Problem Is Even Worse

Remember "Uber for X"? Most are gone. Healthcare's version is even worse.

It's the founders pitching as "the next [recent exit]" who get the worst of it. We don't even pattern-match to companies that worked. We pattern-match to companies that exited.

Oak Street to CVS for $10.6B. One Medical to Amazon for $3.9B. Flatiron to Roche for $1.9B. Livongo to Teladoc for $18.5B at peak digital health. All four were excellent outcomes for the founders and teams who built them. The exits were headline-grabbing. The post-deal stories have been more complicated.

The buyers were paying for strategic fit - distribution, capitation, data infrastructure, consumer reach. The strategic buyer was the missing piece, not the business model itself.

When a founder pitches as "the next Flatiron," the experienced investor hears "I'm building toward a strategic acquisition at a high price." They don't hear "I have a business that works on its own."

Same story played out in tech a cycle earlier. The on-demand companies trying to be the next Uber mostly disappeared. The actual decade winners like Stripe, Coinbase, Databricks built something different.

Pattern-matching to last cycle's winner is a lagging indicator. Pattern-matching to last cycle's exit is doubly lagging.

The best founders aren't trying to convince me their company is the next someone. They're working to show me how it's different. The next great company in healthcare won't look like any of those exits. It will look like nothing you've seen.