When good ideas make bad business • Hacker News Board

Re: When good ideas make bad business

#121

Post by irq-1 » Fri, Jan 03, 2020, 5:57 PM UTC

rjkennedy98 wrote: post #66

leggomylibro wrote: post #9

Oof. The site was practically named after WebMD, and the founder didn't do any market research on that competitor to gauge how viable the business was before quitting their job? This person probably should have known that their main competitor made $0.50/user before they quit their job. Also: >It had been a bit of a working assumption of mine over the past few weeks that if you could improve the health of the patient…

That line stood out to me also. Anyone who feels that the primary goal of healthcare in the US is to improve health outcomes is incredibly naive about how this industry (which is over 20% of the us economy) works. There is only one group in the entire industry which has an incentive to keep people healthy (insurance) and that is the most hated of the bunch!

> There is only one group in the entire industry which has an incentive to keep people healthy (insurance)

The motivation of insurance is to keep the cost of treatment less than the income from premiums -- it doesn't have anything to do with how healthy people are.

Re: When good ideas make bad business

#122

Post by opportune » Fri, Jan 03, 2020, 5:58 PM UTC

I have a family member who worked somewhere that provided tools to medical practitioners to help them determine how a patient would respond to a drug based on their genetics. They also had a hard time selling directly to clinicians, because as the author notes, they do not particularly care about patient outcomes in the abstract sense, because much like the programmer bravado, doctors have a similar one: most of the other doctors are worse than me, they need the tools but I don’t because I have a more nuanced view, I know what works for my patients better than any statistical study could tell me, etc.

The only way to make money is to get insurers to require these things, or to sell to some big hospital network administrator who you can focus your sales efforts on. I don’t think the product here was mature enough to sign a multimillion dollar contract with a hospital network, and maybe not for insurers either.

Re: When good ideas make bad business

#123

Post by the-pigeon » Fri, Jan 03, 2020, 5:58 PM UTC

mritchie712 wrote: post #83

gkoberger wrote: post #38

I'm so confused by the tone of this article. Obviously some of the jokes are parodying startup culture and are meant to be funny, however I think the "fantastic idea" stuff is meant seriously? "So I built something people wanted. Consumers wanted it, doctors wanted it, I wanted it. Where did I go wrong?" As far as I can tell, nobody wanted it except the author. The one doctor he talked to didn't, and no consumer ever…

The funny part is, he might still be wrong about it being worthless. He talked to ten doctors? There are 1M in the US. It's kind of funny to drop all that time and 40k in then give up after ten doctors say no, especially without trying to tweak the product based on feedback. I, as a consumer, find it worthless and they shouldn't have even started it, but now that you're here, might as well give it a bit more of shot…

Yeah. For investing so much time and money it seems like he gave up after a couple of bad meetings.

It takes years to figure out how to properly sell your product. He didn't find out that his product wouldn't work in the marketplace he just found out he didn't know how to sell it.

Re: When good ideas make bad business

#124

Post by stevespang » Fri, Jan 03, 2020, 6:01 PM UTC

Anyone who feels that the primary goal of healthcare in the US is to improve health outcomes is incredibly naive about how this industry works . . .

So true, the health industry doesn't give a s___t whether you live or die - - they only want their money.

My advice ? Get into vitamins and supplements, it's all a pack of lies and deceptions just like big health, it's all based on supposedly respectable, bogus "sources" of information which you make "believeable", most of the cusomers are women over 40 looking in the mirror at their beauty wasting away . . .

There is HUGE money in vitamins and suuplements and they have a monsterous lobby to fend off the AMA and the doctors so they can keep selling their snake oil . . .

Oh, and as far as painkillers go . .

Multiple research shows that Naproxen sodium has the least detrimental effect on the heart - - as all NSAID's do.

Acetaminophen or Tylenol is an serious destroyer of glutathione, one of the largest natural antioxidants in the human body, mostly in the liver.

Re: When good ideas make bad business

#125

Post by scotty79 » Fri, Jan 03, 2020, 6:01 PM UTC

> There was this giant thing called healthcare right, and its main purpose is improving health—trillions of dollars are spent trying to do this.

There was this giant thing called healthcare, and its main purpose is applying well known treatments to people whose symptoms more or less indicate that treatment might somewhat improve their condition—trillions of dollars are earned trying to do this.

Re: When good ideas make bad business

#126

Post by StavrosK » Fri, Jan 03, 2020, 6:01 PM UTC

The author says that they fired the contractors and closed the site. I can never relate to this. You built something that is at least somewhat useful to at least some people. Why not just keep it online forever? It can't cost more than $5/mo to host this, I have a server where I host around ten of my projects for less than $20/mo.

Why do people shut things down instead of just leaving them there, unmaintained? Even that is better than just taking it offline.

Re: When good ideas make bad business

#127

Post by [deleted] » Fri, Jan 03, 2020, 6:02 PM UTC

victor106 wrote: post #84

tyri_kai_psomi wrote: post #71

Earlier quoted context omitted.

The most realistic founding story so far is Bezos explanation for how he founded Amazon. It was always a business-first mindset in an area of high growth. That one short video filmed in 1997 should be a masterclass by itself.

Anyone has a link to the above video?

[deleted]

Re: When good ideas make bad business

#128

Post by ghayes » Fri, Jan 03, 2020, 6:02 PM UTC

larkost wrote: post #115

rconti wrote: post #79

Earlier quoted context omitted.

.. and the doctors he talked to felt they already had the knowledge they needed! If anything, they felt, perhaps, that this devalued their existing knowledge. And they don't make 10% more money for providing 10% better outcomes.

This is probably the root of the problems in US medicine: there is no effective feedback. The ACA (Obamacare) did a little work on this with Medicare payments to hospitals, but that is an exception in the system. What could we do to make this the basis of the system? Without driving doctors away from patients who have bad prognocices?

Take a look at HMOs, such as Kaiser Permanente. HMOs combine the function of insurers and medical providers in a way that aligns incentives (everyone pays about the same, but healthier people need less care and are thus more profitable customers). There are many problems that come with the HMO model (e.g. the potential for low quality care), but when it works, it directly solves the problem you addressed and exists in the US.

Re: When good ideas make bad business

#129

Post by nautilus12 » Fri, Jan 03, 2020, 6:03 PM UTC

Why not go after the most obvious buyer for this in pharmeceutical companies? Is it because the conflict of interest would undermine the whole idea?

Re: When good ideas make bad business

#130

Post by dougb5 » Fri, Jan 03, 2020, 6:05 PM UTC

> On July 2, 2018, GlacierMD powered the world’s largest depression meta-analysis, using data from 846 trials, beating Cipriani’s previous record of 522.

Was this analysis written up somewhere? The author links to Cipriani's study in the Lancet but not to their own.