An article in the Wall Street Journal discusses how uncertainty surrounding the future of the ACA is creating challenges for health tech startups. One of the companies we profiled recently, Pillsy, is said to be focusing more on selling its products directly to consumers -- online and through pharmacies -- rather than through healthcare providers.

Other startups are finding it harder to attract funding. Perhaps that's because too many healthcare tech startups and healthcare tech investors are focused on opportunities they believe are created by healthcare laws and regulations. If your business plan is designed to exploit laws and/or regulations, then you risk disruption by new policies and legislation. Plus, you tend to compete by lobbying government officials and agencies. The opportunities created by laws and regulations could be called artificial markets as they are man-made and imposed by government rather than naturally occurring.

In contrast, companies that design their business plans around customer needs and direct marketing are less dependent on government decisions over which they may have little influence. They compete by developing products that are responsive to customers' needs and expectations. These natural markets can be served in many different ways. It's up to the creativity and perseverance of the health tech startups to transform raw customer needs into ongoing, profitable businesses.

So which is preferable?