Andy Slavitt says the world doesn’t need another fitness tracker. In his estimation, it does not need to produce another shiny device for someone who is likely to be wealthy and white and is as unlikely as the 20-something software engineer who designed it to suffer from a chronic illness.

What it needs instead, says the guy who ran Medicare and Medicaid during the last two years of the Obama administration, is technology capable of traveling to places that technology typically doesn’t visit — the doorsteps of the disenfranchised people who lack the money to pay for it.

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