The Policy Stack

Dan O'Neill reflects on 15 years in health technology, services, and policy after discovering that most healthcare administrative problems could have been solved decades ago. He shares lessons on why business model problems masquerade as technology challenges, how organizational inertia perpetuates inefficiency, and why "slapping AI on it" won't fix structural issues rooted in misaligned incentives.

Nikita Singareddy reflects on building technology for America's most complex healthcare system after discovering that 20% of Medicaid enrollees lose coverage due to bureaucratic failures. She shares lessons on why every government case is an "edge case," solving policy problems before building tech solutions, and maintaining an enrollee-first approach across 56 different state systems.

Kody Kinsley speaks with Lisa Bari to reflect on leading North Carolina’s $26 billion health agency through COVID-19, Medicaid expansion, and a behavioral health crisis. He shares lessons on making impossible choices, driving reform under pressure, and turning crises into opportunities.