It’s your birthday, Covid is everywhere, and it’s just you and your flatmate sharing the cake. You know he has a sweet tooth and will inevitably accuse you of cutting unfairly when you split the cake unevenly.

But this is your favorite cake, the thought of voluntarily giving up even a single gram of that deliciousness, now that lock-down has taken everything else away from you, horrifies you.

Your flatmate’s staring, ready to judge the slice you hand him. Then it dawns on you, there’s a simple way out of this: you could do the cutting, it is your birthday after all, but let him pick the half he wants. If you’re inaccurate, it’s your loss, there won’t be grudges, and you can keep the one person you’ll be spending all of the lock-down with from secretly resenting you for your cake greed.

The problem & the solution

This is a classic mechanism design problem, and one with a particularly effective and simple solution. When we were starting Even , we were faced with the problem of engineering a new system of incentives that could lead to better health outcomes, decreased prices, and good profit margins for healthcare providers. We explored and simulated various “mechanisms”, and eventually converged on one where healthcare providers would join together to provide health cover themselves, as a subscription product. This enables us to avoid the “fee-for-service” model, which encourages unnecessary services (i.e. treatments and surgeries) to be provided and billed, and can lead to increased consumer prices, as well as health complications.

The Subscription Model

In a subscription model, instead, hospitals and healthcare providers would prioritise reducing costs and improving the effectiveness of treatment, over increasing the number of procedures, and would be incentivised to keep customers healthier, as opposed to the fee-for-service model, where healthier customers lead to reduced revenue.

Where We Fit In

The emphasis on thinking from first principles and on mechanism design carries over into our tech, and we think our focus on technology is what makes Even different in an antiquated industry where good code and UI/UX are often missing. We think of ourselves as very much a technology company operating in the healthcare industry.

With all the stories of dated stacks, nightmarish tech debt and bloated tech teams, we feel very fortunate to be able to build from scratch, with complete freedom over our org structure (a “mechanism” in itself) and our tech stack.

In our short existence, we have already taken a stance on a few things:

  • We think transparency on salaries and titles helps avoiding unfairness and resentment and encourages a more meritocratic system.
  • Small cross-functional teams and a strong integration between tech and design. We want everyone to have a large impact on the tech and the product and keep the communication bandwidth low (right now there are 6 people in the tech team and 3 in the design team). But we are also hiring!
  • Focus on building the things that make the product special, use open source or existing services everywhere else. As an example, we have been running on a “serverless” infra from day 1, our costs (both monetary and devops) are incredibly low and reliability is high.

Culture of the Tech team

  • Experimenting a lot.
  • Building features in-house whenever possible.
  • FOSS > proprietary, allowing more control over the end result.
  • We have a say in all (tech & non-tech) decisions.
    • Choosing flutter for our app was not a top-down decision.
  • Being serverless whenever possible.
  • Full freedom to choose our own work setup (including laptop & OS). Guess where the tech team sits .

A glimpse into the future

While we are much closer to the start of our journey than the end, we have already built things we are proud of, including the portal enabling India’s first completely cashless and “claimless” hospital experience, used in Bangalore’s top hospitals and clinics.

This blog will be documenting our journey and our design choices from a technical standpoint, as we build up our stack and we develop an in-house EMR platform, a telemedicine platform, a consumer facing mobile and web app for managed care, as we refine our hospital portals, create a platform for medical data analysis, and much more.

So, enough with this non-tech chatter, we’ve got some great content coming up!