Let’s see, some people are too enthusiastic while others are too pessimistic.
I think the right point is somewhere in between. This is definitely a greate promise but risks are there too. Though, I don’t believe risks are big enough to prevent it from doubling or tripling from the current levels.
This article is excellent—it clearly lays out Oscar Health’s disruptive potential in the health insurance industry.
I would like to add another perspective: To fundamentally solve the problem of low profitability in health insurance, it’s not enough to engage patients more deeply—insurers must influence the value structure of the therapies themselves and promote outcome-based pricing.
Oscar’s strength lies in its platform, data, and user interface. But to grow into a true healthcare giant, the next step should be to vertically integrate therapies that offer high-value care at low cost.
Take cancer treatment as an example. The current mainstream approaches rely heavily on high-cost, often low-yield therapies (chemotherapy, targeted drugs, immunotherapy). No matter how much insurers try to control costs, it’s hard to change this structural burden.
But if Oscar were to partner with a truly cost-effective, disruptive therapy, it could reshape the entire value proposition. For instance, I have developed an Intra-Tumoral Chlorine Dioxide (ClO₂) Injection Therapy—a novel treatment that involves direct injection into solid tumors, causing rapid necrosis. It has no systemic toxicity, extremely low production costs, requires only outpatient procedures, and delivers significant clinical outcomes.
This therapy introduces the possibility of outcome-based pricing in cancer care. We are currently launching clinical studies in Mexico, Germany, and Italy, with plans for a 1,000-patient clinical trial in the U.S. Preliminary results show stable efficacy, good safety, and ultra-low cost.
If Oscar were to support, integrate, or even invest in such a therapy, it could lead the way in building a value-based oncology care ecosystem. This would not only reduce Total Cost of Care but unlock an entirely new avenue for profit growth.
In short, Oscar’s next leap forward might not come from acquiring hospitals—but from partnering with therapies that redefine the cost-effectiveness frontier. If they are first to integrate such innovations, a 10x return might come sooner than expected.
It doesn’t really look like loss ratio is actually declining. Customers that do not have excess income and HDHP plans probably don’t use their insurance as much as other customers would which might lead to the ratio being somewhat lower than other insurers.
At the end of the day, if Oscar is expanding into the same space as other insurers operate, they’re eventually going to be working with the same customers. Since you can’t charge premiums based on pre-existing conditions, scale is truly the only way to offer a lower priced product. Additionally, the PBMs are typically where most money is made for insurers, due to them eating up most of the margin between the costs they charge customers and the negotiated prices that they get drugs at. I’m not sure how Oscar will be able to be price competitive when trying to acquire more employers.
It’s also weird that the founder Mario was ousted as CEO and replaced with an entrenched industry vet, kind of a red flag, especially for innovation.
Interesting company and good pitch. I’m debating if this could be in the too hard pile or if I get there likely only go for small stake. Dealing with all the unknowns and future laws is tricky.
Maybe you could elaborate to help others understand your concerns. Do you have knowledge of the insurance industry that can help us to assess this potential investment.
I'm not sure if it is going to win. OSCR gets 95% of their revenue from ACA subsidies. I'm not an expert myself, just seems like the author hasn't done enough research into this for me to have thought it was a quality research piece.
Really enjoyed the article — it got me interested in digging deeper into Oscar’s business model. One thing that stood out to me was how different the go-to-market motion is for SMBs (B2B) compared to the ACA (direct-to-consumer, self-serve) model.
Do you have any insight into how Oscar plans to tackle this shift, and whether they have the capabilities and infrastructure to execute effectively in the SMB space?
Interesting and promising pitch. I’m curious to hear what others think about Oscar Health. I’m considering investing in it.
Let’s see, some people are too enthusiastic while others are too pessimistic.
I think the right point is somewhere in between. This is definitely a greate promise but risks are there too. Though, I don’t believe risks are big enough to prevent it from doubling or tripling from the current levels.
This article is excellent—it clearly lays out Oscar Health’s disruptive potential in the health insurance industry.
I would like to add another perspective: To fundamentally solve the problem of low profitability in health insurance, it’s not enough to engage patients more deeply—insurers must influence the value structure of the therapies themselves and promote outcome-based pricing.
Oscar’s strength lies in its platform, data, and user interface. But to grow into a true healthcare giant, the next step should be to vertically integrate therapies that offer high-value care at low cost.
Take cancer treatment as an example. The current mainstream approaches rely heavily on high-cost, often low-yield therapies (chemotherapy, targeted drugs, immunotherapy). No matter how much insurers try to control costs, it’s hard to change this structural burden.
But if Oscar were to partner with a truly cost-effective, disruptive therapy, it could reshape the entire value proposition. For instance, I have developed an Intra-Tumoral Chlorine Dioxide (ClO₂) Injection Therapy—a novel treatment that involves direct injection into solid tumors, causing rapid necrosis. It has no systemic toxicity, extremely low production costs, requires only outpatient procedures, and delivers significant clinical outcomes.
This therapy introduces the possibility of outcome-based pricing in cancer care. We are currently launching clinical studies in Mexico, Germany, and Italy, with plans for a 1,000-patient clinical trial in the U.S. Preliminary results show stable efficacy, good safety, and ultra-low cost.
If Oscar were to support, integrate, or even invest in such a therapy, it could lead the way in building a value-based oncology care ecosystem. This would not only reduce Total Cost of Care but unlock an entirely new avenue for profit growth.
In short, Oscar’s next leap forward might not come from acquiring hospitals—but from partnering with therapies that redefine the cost-effectiveness frontier. If they are first to integrate such innovations, a 10x return might come sooner than expected.
Great piece. Mark Bertoli coming onboard is a huge signal too.
Do you like long dated call options on this or just hold the stock long?
Interesting read and definitely a disruptive company that brought in something special that scaled exponentially. Will also be watching this company
It doesn’t really look like loss ratio is actually declining. Customers that do not have excess income and HDHP plans probably don’t use their insurance as much as other customers would which might lead to the ratio being somewhat lower than other insurers.
At the end of the day, if Oscar is expanding into the same space as other insurers operate, they’re eventually going to be working with the same customers. Since you can’t charge premiums based on pre-existing conditions, scale is truly the only way to offer a lower priced product. Additionally, the PBMs are typically where most money is made for insurers, due to them eating up most of the margin between the costs they charge customers and the negotiated prices that they get drugs at. I’m not sure how Oscar will be able to be price competitive when trying to acquire more employers.
It’s also weird that the founder Mario was ousted as CEO and replaced with an entrenched industry vet, kind of a red flag, especially for innovation.
Interesting company and good pitch. I’m debating if this could be in the too hard pile or if I get there likely only go for small stake. Dealing with all the unknowns and future laws is tricky.
This article was very disappointing. Not enough details on the insurance industry and why OSCR is poised to win and the political risks involved.
Maybe you could elaborate to help others understand your concerns. Do you have knowledge of the insurance industry that can help us to assess this potential investment.
I'm not sure if it is going to win. OSCR gets 95% of their revenue from ACA subsidies. I'm not an expert myself, just seems like the author hasn't done enough research into this for me to have thought it was a quality research piece.
Really nice piece, clear, full of data and honest with both possible.upsides as well as risks
Hey Oguz,
Really enjoyed the article — it got me interested in digging deeper into Oscar’s business model. One thing that stood out to me was how different the go-to-market motion is for SMBs (B2B) compared to the ACA (direct-to-consumer, self-serve) model.
Do you have any insight into how Oscar plans to tackle this shift, and whether they have the capabilities and infrastructure to execute effectively in the SMB space?