[SMrF]

What you say makes sense, but I think there can be reasons. For our military customers we offer an air-gapped version of our app early on because it was easier for customers than getting an ATO. Also as a bootstrapped company it was a lot cheaper than FedRAMP. I'm guessing I'd lean on a similar strategy if I had a health care startup.

[tptacek]

Most health care companies get along just fine in AWS, just for what it's worth.