Healthcare software has the same kinds of problems. New regulations, rules, and ways that each party in the system attempts to skirt the rules bleed into the code bases of every system.
Thats why a lot of the technology in healthcare is so far behind. One place I worked at still makes $38 mil/year on a system written in C++ and ASP. Replacing it with a modern stack has been on going process for more than 3 years with no end in site. In the mean time, new installations are being brought up with a whole new set of business rules being added that will just have to get ported later.
For national companies, state level reporting requirements are a huge burden. For instance, payment made to doctors by healthcare companies. You just hope that they pick fairly common requirements, instead of each state reinventing the wheel.
Thats why a lot of the technology in healthcare is so far behind. One place I worked at still makes $38 mil/year on a system written in C++ and ASP. Replacing it with a modern stack has been on going process for more than 3 years with no end in site. In the mean time, new installations are being brought up with a whole new set of business rules being added that will just have to get ported later.