Our health care system dates back to ancient times. There is barely any information transferred between the various stakeholders (town doctor, nurse, hospitals, e.t.c) and it is still the patient’s job to take care of communication by bringing his/her medical file to appointments. France’s medical file project (known as the dossier médical personnalisé) has been a dismal failure, for purely political reasons. The result is an increased level of suspicion in healthcare institutions. A blockchain would offer many benefits: first and foremost, there would be no more trusted third parties wasting the public’s money on complex systems that do not work. The blockchain can help to create a healthcare system whose construction and running costs are lower. Thus enabling patients reimbursement program to be easier. Furthermore, the ability to integrate smart contracts into the blockchain enables a much more personalized service, with expenditure and reimbursements calibrated by each profile. Ultimately, the community would be rewarded with a fully functioning service, rather than opaque administration. This is not a utopia: Estonia, a country renowned for investing heavily in digital solutions, is currently creating a blockchain to store the medical files of all of its citizens.

The Media

The music and cinema industries endure a love-hate relationship with the Internet. As an example, merely consider the impressive rage with which the Recording Industry Association of America (RIAA) has taken on the so-called “pirates.” We will enter the debate only so far as to say that these are examples of material economies and that the famous law that “when we share a tangible product, it divides itself; when we share an intangible product, it multiplies” fully applies to music.

On the other hand, the problem of equitable distribution of rights is a genuine transactional problem, which is crying out for trust. But the e-reputation of the majors has suffered greatly due to the fierce battle they have waged against peer-to-peer platforms, above all among a geek population that accuses them of not giving enough back to creators and not offering a service worthy of the percentage that they take. There is, therefore, a great temptation to use

a blockchain to redistribute money to everyone and to cut out the trusted third party. The startup Muse was created to explore this idea. Its aim is to create a worldwide music blockchain, which shares out the rights between all stakeholders.

Classified Advertisements

OpenBazaar (still in beta) is a 100% peer-to-peer classified advertisements platform. Instead of having to visit a website, users download software onto their computer, which they use to access what is on offer or to sell their items, without any commission. It is a competitor of eBay and the French website, Le Bon Coin.


Collaborative transport also has its blockchain. La’zooz coordinates a journey shared service and, of course, all financial transactions on a blockchain. Just like Open Bazaar, the main benefit is to reduce transaction costs. However, it remains to be seen whether the presence of a trusted third party is still necessary for the success of a car sharing service, as it gives the user a partner to turn to and share the risks, thereby guaranteeing customer satisfaction.

The Future

There is a tension that pits the diversity of opportunities discussed above directly against the need for one unique, worldwide infrastructure that guarantees the community remains larger than any potential attackers. We have seen that the idea of having “my little blockchain, all to myself” is not compatible with the five promises. However, once a trusted third party is accepted, it is nevertheless easy to instantiate a whole subset of these technologies for individual cases. For example, for the certification

of documents (land registry, damages, property, etc.) a simpler system, implementing promises 1 to 3, is sufficient and does not entail the additional financial and energy cost related to proof of work. Nevertheless, using the blockchain to create a trust as a service model makes a lot of sense. Essentially, the beauty of the blockchain approach is to enable a small unknown entity, for example, a start-up, to offer the same guarantees

of transparency, sustainability and other trust-related characteristics that are traditionally associated with established, institutional structures (this is the competitive advantage held by large financial institutions). Once it starts registering its transactions in the international blockchain, this startup will offer a non-repudiation guarantee that is the equal of, or superior to, that

offered by a State or a bank. It nevertheless remains unclear whether the current infrastructure can host the avalanche of requests and opportunities that we have briefly alluded to here.

Consequently, we are witnessing the rise of a tree structure: a large central blockchain, available worldwide and validated by a vast community, with branches (blockchains or otherwise) operated on a simpler level by start-ups or small communities with interest in them. The interest here is that the start-up can place the ledger of its activities in the central blockchain, immediately making it trustworthy and transparent in the eyes of its customers. The ledger, meanwhile, can be managed with lighter techniques that require less of an investment regarding time and money.

This approach has given rise to several technological developments, including side chains. A sidechain is a chain of transactions managed by a sub-community, with similar encryption and authentication techniques as the blockchain, but with a simpler protocol facilitating improved performance levels. The distribution of control (the sidechain is controlled by a smaller group) lends it more agility, but the end of this side chain (the peg) is integrated within the blockchain so that the former benefits from the increased security of the latter. This solution also extends the blockchain with the addition of richer protocols, meaning that the “blockchain/sidechain” blueprint is a better direction for the ecosystem to evolve in than the creation of new, autonomous blockchains.

Can a true peer-to-peer mode survive without the presence of a large entity behind it? For Uber or Airbnb, the brand value is not on the platform but in the promise made to their customers. And it takes human resources to provide the service once the sale has been made. But on the other hand, the Internet itself functions without the presence of such an entity. Early internet detractors pointed towards the absence of an operator, which supposedly rendered it too inaccessible for the uninitiated. This is true, but community help systems have worked perfectly, and have in time replaced and improved upon the much less efficient hotlines and call centers.