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Another thing to consider: in the US (assuming you plan to market in the US), 2/3 presidential candidates have proposed variants of socialized health care. The "conservative" candidate is a "maverick", who is not averse to doing similar things.

This doesn't bode well for long term planning. In 4-5 years time, who will the buyers be? Doctors, hospitals, or some American version of NHS? What regulations will you need to satisfy?

If the healthcare system is taken over (in any sense) by the government, expect major rent seeking from various special interest groups. M$ may purchase a "M$ software only" law, or hospital administrators may purchase a "don't let software steal our jobs" law. (Such laws will, of course, go by such names as "Helping Children not Die of Cancer Act").

In short, I'm saying that unless you are a lobbyist, stay away from this market for a few years. Do your real estate thing, come back to healthcare once the market settles down.

Wow. Pretty cynical take on American politics. :) Not saying that you're entirely wrong, but every industry has regulatory burdens to deal with. Real estate has their own challenges, including predatory lending laws, etc.

I'm not saying to avoid it because of regulatory burden, but because of unknown regulatory burdens.

You can plan for known regulatory burdens. For instance, in the automotive industry, just add millions of dollars worth of safety testing to your R&D budget. If the business plan still works, run with it, and calculate odds. In the defense industry, make sure you hire lots of lobbyists.

It's the unknown unknowns, not the known unknowns that will kill you.

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