Did Voice-as-a-Platform fail because of monopolies? Or is healthcare failing patients because of monopolies?

Monopolies. They are everywhere while supposedly nowhere thanks to anti-trust laws. Did monopolistic practices prevent voice-as-a-platform from realizing it's true potential? It felt incredible 5-7 years ago with turning lights on and off or asking for quick factoids. I'm often reminded of this SNL Alexa skit. But did large tech companies hinder the growth of voice because they were more focused on how voice helped their suite of products instead of allowing voice to be unburdened by the bottom line? Also, distance can matter. And when private equity is buying up all of the local practices, should we be worried about costs of future care?

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Welcome to the February 26 Edition of The Digest.

What happened to voice-as-a-platform?

Amazon released the Alexa in 2014. Apple released Siri in 2011. But other than controlling the lights and volume, is there a future for voice? The prospects aren't, well, promising, with the recents layoffs of the Alexa team at Amazon. So what happened? Ranjan Roy writes: "It's seven years later, and in many ways the Echo's ended up the "glorified clock radio" Benedict Evans called it in 2019. The difficult thing to reconcile is my family still uses it tens, if not hundreds, of times a day. It should not be a failure. But as Amazon just laid off thousands in the division, former employees call it a "a colossal failure of imagination," and "a wasted opportunity," and as no one talks about voice-as-a-platform anymore, it certainly feels like it is." Link

Positive Correlation: the closer you are, the better you are.

We are more connected than ever. Unless you are a patient trying to connect with a doctor you trust. An interesting paper from a few years ago did a review of 108 studies about the effects of distance on healthcare outcomes. Particularly interesting within the findings was that while distance does matter, there are certain situations where distance doesn't matter as much. Instances such as cancer care, or simply, a patient deeply connected to their doctor through trust.

This isn't exactly new news but it also doesn't seem to really be resolved yet. We revisit the ideas here regularly. Link

Monopolistic healthcare...fueled by PE?

"The United States spends nearly twice as much per person on healthcare than all other wealthy countries. Some of that added cost results from higher utilization. But, for decades, policy experts have pointed out that higher costs are mainly the result of higher prices for hospital services, drugs and medical care.

The question isn’t why health systems, pharmaceutical companies or private equity investors pursue market control. The question is why payers (businesses, the government and insurers) with comparable market power and influence haven’t taken on these monopolies or reined in exorbitant healthcare prices."

The author states two factors slowing down the process, both controlled by doctors. Doctors don't like ordering unnecessary tests and they understand the financial burden that families experience while seeking care. Second, doctors like autonomy. It's cultural. While PE buyouts look lucrative, it's often at the expense of the doctor determining how best to run their practice. Link

SNL Alexa Skit