Out-of-Pocket is a healthcare education company founded by Nikhil Krishnan that helps people understand how healthcare works and how to navigate it in practice. In this episode, a16z investing partner Jay Rughani and Nikhil discuss why health insurance is losing its role as the default way people access care. They explain how rising costs are pushing more consumers to pay out of pocket for diagnostics, preventive care, and navigation. The conversation also looks at what this shift means for startups, AI-powered tools, regulation, and access as healthcare continues to move beyond insurance.
Out-of-Pocket is a healthcare education company founded by Nikhil Krishnan that helps people understand how healthcare works and how to navigate it in practice. In this episode, a16z investing partner Jay Rughani and Nikhil discuss why health insurance is losing its role as the default way people access care. They explain how rising costs are pushing more consumers to pay out of pocket for diagnostics, preventive care, and navigation. The conversation also looks at what this shift means for startups, AI-powered tools, regulation, and access as healthcare continues to move beyond insurance.
Resources:
Follow Jay Rughani on X: https://twitter.com/JayRughani
Follow Nikhil Krishnan on X: https://twitter.com/nikillinit
Read Out of Pocket’s 2026 Predictions: https://www.outofpocket.health/p/out-of-pockets-2026-predictions
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