Smart Apps vs. Obamacare.

• Author: Beato, Greg
• Position: Patient Protection and Affordable Care Act

The Affordable Care Act locks in the status quo, but new technology is making health care cheaper and more individualized.

Health care costs in the U.S. have been rising so steadily for so long that containment barely seems possible. Even optimists don't dream of cutting the price tag. As its official name--the Patient Protection and Affordable Care Act--suggests, Obamacare aims for affordability, not radical reduction.

But at a time when we're all walking around with more computing power in our pockets than NASA used to send Apollo n to the moon, perhaps we should be setting our expectations higher. Is it really so hard to imagine, in xo years or so, the advent of advertising-sponsored health care? Or at the very least, bulk-purchased cardiology readings for a Netflix-like $8.99 monthly subscription?

The device that could potentially enable such scenarios already exists. The Alivecor Heart Monitor, approved for over-the-counter use by the Food and Drug Administration in February 2014, is a shell that fits over iPhones and Android devices. It converts electrical impulses from a user's fingertips into ultrasound signals, which are then picked up by the phone's microphone and processed using Alivecor's app. Users can email the single-channel electrocardiogram (ECG) produced by the Heart Monitor to their physicians, or they can pay a small fee to Alivecor directly through the app for analysis by a cardiac technician or board-certified cardiologist within 24 hours.

Currently, the heart monitor costs $199.The ECG analysis ranges from $2 to $12 a pop. In comparison, two researchers who published a study in the February 2014 issue of JAMA Internal Medicine queried 20 Philadelphia area hospitals about the fee they charged for an ECG--and found prices ranging from $137 to $1,200.

So Alivecor's fees are already quite nominal. But imagine if, say, Google or Amazon decide to incorporate such functionality more seamlessly into their devices. ECG analysis would likely be offered for free or near-free, in return for opt-in consent to share this information with advertisers and other third parties. When you have a heart attack in the future, the beta-blocker coupons will arrive faster than the ambulance.

In 1997, Harvard Business School professor Clayton Christensen introduced the concept of "disruptive innovation," the process by which a "simplifying technology" combined with a "disruptive business model" upsets established markets and radically broadens...