[angersock]

Houston, Boston, and San Diego are all good spots.

That said, it's a moribound industry. Don't do healthcare if you can avoid it--you'll get paid better as a developer nearly anywhere else, and it won't be a third as frustrating.

[AnimalMuppet]

I agree with the "frustrating" comment. FDA regulation can be seriously demoralizing.

[jklein11]

Can you explain how healthcare is a moribound industry?

[angersock]

I've gone into length on this elsewhere, but a few questions sum it up:

How is money made in healthcare? Is it made by administrative paperwork and compliance? Is it made by selling drugs and treatments aggressively? Is it made by finding ways of cutting corners and increasing efficiency of care so hopsitals can pay less? Does any of that have anything to do with the perceived quality of life increase for a patient? Insofar as it does, what market forces exist to keep those things in check?

Who actually pays for healthcare? Under what circumstances? How much administrative overhead is introduced to make that happen and protect against fraud? How much of that overhead does your software have to deal with/take into account?

How resistant are healthcare systems to change? Is there any significant difference in the mindset of physicians today than there was back when they mocked folks for washing hands before delivering babies? What roadblocks exist to prevent systems from wasting time with crazy ideas from motivated and noisy physicians--and how do those roadblocks impact people doing software?

Who are the main players in healthcare IT? How did they get there? What measures have they taken to decrease competitiveness in their sectors, and how have they achieved vendor lock-in? To what degree, if any, can hospital systems work to circumvent or reinforce that lock-in?

What does the regulatory environment look like? How long does it take to do a "simple" FDA 510k filing (personal experience suggests a year and change depending on how you do bookkeeping, but that's neither here nor there)? What standards must you comply with? Are those standards public, or do you have to pay money for each and every one?

I could go on, but this should help.

[whb07]

I talked to a startup at Pycon that was trying to grow under the Medicare Advantage program. I asked how this would help in reigning in costs to the tax payer, and she kept repeating “oh we will save money because we are given a max $ amount per patient, and so it’s in our benefit to save money”.

Well, that is true only for the startup. The dollars they save are the profits they make up to a max of 15%. But there are no long run incentives to overall reduce the tax bill per client as they will always ride close to that allotted amount set by Congress.

The startup representative took offense when I pointed out that at no point would they ever return money back to Medicare. That they would always consume every allotted dollar allowed by law.

Just another rent seeker by a different name.