Building for the post transparency economy: Trump’s great healthcare plan
Abstract
Trump’s Great Healthcare Plan doesn’t just mandate disclosure, it creates the conditions for entirely new market structures that can’t exist under current opacity. This analysis examines five forward-looking business opportunities that emerge not from compliance requirements but from the new economic behaviors transparency enables: real-time pharmaceutical arbitrage networks, dynamic facility routing optimization, predictive MLR trading markets, consumer health financing rebuilt around known prices, and labor-verified health access models. Each represents a business that’s structurally impossible today but becomes viable when information asymmetries collapse.
Key opportunities:
- Pharmaceutical spot markets enabling real-time drug price arbitrage across channels
- AI-driven patient routing engines optimizing site-of-care decisions against live pricing
- MLR futures markets letting insurers hedge medical cost volatility
- Consumer credit products underwritten against transparent procedure pricing
- Blockchain-verified work credentials creating portable Medicaid eligibility
The highest-return plays involve building market infrastructure for behaviors that transparency makes rational but currently impossible.
Table of Contents
When Opacity Dies, Markets Reorganize
Pharmaceutical Spot Markets: The Drug Price Bloomberg
Intelligent Care Routing: Uber for Site Selection
MLR Derivatives: Hedging the Medical Cost Lottery
Known-Price Lending: Credit Products for Transparent Healthcare
Portable Work Verification: Identity Layer for Benefits
Second-Order Effects and Timing
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When Opacity Dies, Markets Reorganize
Healthcare’s current infrastructure assumes prices stay hidden. Payment systems route transactions without price discovery. Referral patterns ignore cost differentials. Insurance products can’t differentiate on actual medical cost management because nobody knows what things cost until after they happen. Supply chains operate on negotiated contracts rather than spot pricing. The entire stack gets rebuilt when transparency breaks these assumptions.
The Great Healthcare Plan’s mandates matter less for the compliance burden than for making new business models economically viable. Once PBM spreads become public, pharmaceutical arbitrage becomes possible. Once hospital prices get published in machine-readable formats, algorithmic site selection becomes feasible. Once MLR calculations face real scrutiny, hedging instruments become valuable. The regulations don’t create these opportunities directly, they remove the barriers that made them impossible.
This requires thinking past the obvious infrastructure plays. Everyone sees the need for compliance dashboards and reporting tools. Fewer people see the entirely new markets that become possible when information flows freely. The analogy runs to financial market structure. When stock prices moved from phone calls to electronic tickers, the obvious play was building ticker infrastructure. The bigger play was building for decimalization, algorithmic trading, and market making behaviors that ticker transparency enabled but didn’t directly mandate.
Healthcare’s moving from phone-call pricing to electronic tickers. The question becomes what market structures emerge when every participant can see everyone else’s prices in real-time and route accordingly. That’s a different infrastructure stack than healthcare currently runs.
Pharmaceutical Spot Markets: The Drug Price Bloomberg
