Brave Care Has Closed

Brave Care’s Model and Shutdown

• Company ran pediatric urgent-care clinics with insurance and cash-pay options.
• Several users report excellent experience: easy online booking, minimal paperwork, good communication.
• Commenters suggest the underlying service (pediatric urgent care) can be viable, especially when backed by large health systems.
• Failure is attributed more to VC expectations and execution: rapid growth, high build-out costs, COVID whiplash, cash management, and possibly a misstep in trying to build a custom electronic health record (EHR).

Disrupting U.S. Healthcare Is Hard

• Multiple comments stress structural barriers:
  • Insurer-driven reimbursement rates, complex billing, administrative overhead.
  • Heavy regulation (HIPAA/ERISA/EMTALA/ACA, state rules, Certificates of Need).
  • Government subsidies and risk-adjustment mechanisms that entrench incumbents.
  • Large capital requirements and reserve requirements for insurers.
• Consensus that both provider and payer sides are difficult to “disrupt” without massive capital and long timelines.

Who Has Power: Insurers vs Providers

• One view: insurers dominate, underpay providers, deny claims, and introduce inefficiency.
• Counterview: providers hold more market power, set prices, and insurers mostly pass through costs, with statutory caps on insurer margins.
• Debate extends into details like anesthesia billing, Medicare vs commercial insurance, and Medicare Advantage risk coding; no clear consensus is reached.

International Comparisons and Regulation

• Some argue high U.S. costs stem from overregulation and limited supply of doctors and clinics.
• Others counter that peer countries are more regulated yet cheaper due to single-payer or strong price regulation and monopsony drug purchasing.
• Drug R&D funding and generic drug timing are discussed; several note that the U.S. effectively subsidizes global innovation.

Costs, Outcomes, and Chronic Disease

• Agreement that the U.S. spends more and pays providers more.
• Disagreement over whether worse outcomes reflect system design versus population factors (obesity, gun violence).
• Several commenters emphasize that managing chronic disease and obesity is itself part of healthcare performance, and that weak primary care and misaligned insurance incentives worsen outcomes.

Future Directions and System Design

• Proposed fixes include: public option or Medicare-for-all, national expansion of integrated HMOs (e.g., Kaiser-style), stronger antitrust, cheaper medical education, better rural coverage, and lifestyle/obesity interventions.
• Some note that voters and Congress ultimately determine policy; others highlight private equity and profit motives as central problems.