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When good ideas make bad business

tjcx.me

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Re: When good ideas make bad business

#261

Post by harikb »

victor106 wrote: post #218
wayoutthere wrote: post #178

Earlier quoted context omitted.

From a business standpoint, saving lives can actually be expensive. The longer someone lives, the more healthcare they consume. Health insurance companies are very aware of this, which is why they so frequently deny coverage for various life-saving cancer treatments. If you die while waiting for treatment, not only do they save the cost of the treatment, but also the entire cost of ongoing screening / care during rem…

The longer you live the more monthly premiums you pay, so ideally they do want you to live, but they don't want you to use any healthcare services (or use less services) while you live.

No, the moment you are diagnosed with a chronic or life threatening disease, your premiums no longer cover the medical cost. Otherwise what is the point of insurance. Moreover, many regulations prevent them from raising future premiums. So kicking you off the insurance plan or letting you die is indeed their primary concern

Re: When good ideas make bad business

#262

Post by _bxg1 »

> “And that isn’t worth something? Prescribing better treatments?”

> “Hmmmm,” she said, picking at her fingernails. “Not directly. Of course I always have the best interests of my patients in mind, but, you know, it’s not like they’ll pay more if I prescribe Lexapro instead of Zoloft. They won’t come back more often or refer more friends. So I’d sorta just be, like, donating this money if I paid you for this thing, right?”

I've never seen such a concise indictment of the American healthcare model.

Re: When good ideas make bad business

#263

Post by AndrewKemendo »

I'd go further and say, if this could provably generate ad based revenue from a non-trivial number of users, Google would build the same thing and include it in the basic search result shown in the article (with adwords suggestions) for effectively zero cost to Google.

So, even if it were financially successful, it wouldn't likely survive the competition.

Re: When good ideas make bad business

#264

Post by jergason »

elamje wrote: post #12

Very nice write up! I can easily see my own biases leading me down some of the paths you mention, so thanks for sharing. A more optimistic way to look at this situation is that you spent $40k to get to the front page of hacker news!

Agreed, this was delightful to read! I really appreciated how the author was open about naivety and blind spots. It made the contrast more apparent when they learned things. I'd love to read more by this person.

Re: When good ideas make bad business

#266

Post by WC3w6pXxgGd »

The author did not do enough market research before creating the product; he created something that didn't solve an existing demand.

From a doctor: "I always have the best interests of my patients in mind, but, you know, it’s not like they'll pay more if I prescribe Lexapro instead of Zoloft. They won’t come back more often or refer more friends."

So here's an interesting question: how do you align a doctor's pay with the outcome of their treatment?

Re: When good ideas make bad business

#267

Post by WC3w6pXxgGd »

StavrosK wrote: post #126

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 t…

Hosting a database with this data would cost thousands of dollars a month. I know from experience.

Re: When good ideas make bad business

#268

Post by pgsbathhouse »

sweeneyrod wrote: post #257
wayoutthere wrote: post #241

Earlier quoted context omitted.

This has been known for a very long time in pharma circles. Marketing budgets are several orders of magnitude higher than R&D budgets. An extra dollar spent on marketing has much higher returns than an extra dollar spent on R&D. Most of the real "hard science" R&D is paid for with NIH grants.

> Marketing budgets are several orders of magnitude higher than R&D budgets. This is a lie. Marketing budgets are approximately equal to R&D ( https://www.bbc.co.uk/news/business-28212223 ) so you're off by several orders of magnitude. > Most of the real "hard science" R&D is paid for with NIH grants. Also not true. NIH grants are ~$40 billion/year whereas industry R&D are around $80 billion ( https://www.statista.co…

>This is a lie. Marketing budgets are approximately equal to R&D

Your own source doesn't even say that. In the exact BBC article you linked:

>But as the table below shows, drug companies spend far more on marketing drugs - in some cases twice as much - than on developing them

Here's some very very basic reading on the subject that you can find in 10 seconds of googling: https://en.wikipedia.org/wiki/Pharmaceutical_marketing

In the literally first sentence on this topic:

>pharmaceutical company spending on marketing far exceeds that of its research budget

Imagine living in a society where supposedly rational, intelligent people hold opinions that don't withstand the test of a few keystrokes; opinions that quite literally aid in the needless death and suffering of others while also just generally being a complete waste of time.

Re: When good ideas make bad business

#269

Post by taurath »

So, given the author quit his money making startup to make a business that would be helpful for humanity, I assume that all of his data and IP is now in a .zip file up for auction and not actually disseminated to people who could use it right? It tells you that what people say is their motivations, especially when it comes to startups are often not at all the case.

Re: When good ideas make bad business

#270

Post by lightsighter »

gringoDan wrote: post #105
legitster wrote: post #89

I wish he could have invested more in the idea - I think it's an amazing concept but the creator pulled the plug too early. Sales cycles in B2B can take months, and in healthcare they can take years. Especially the doctor's feedback, she described the possibility of changing her habits slowly as she got used to using the tool. Unrelated: "I always have the best interests of my patients in mind, but, you know, it’s no…

Sounds like there's an opportunity to have insurance companies pay for the product. This would directly align incentives and lead to overall cheaper care for the patients.

I had the same thought. The meta-customers here are the insurance companies. If you can prove that the tool improves the performance of doctors so that they get sued less when they use it then the insurance company will give discounts for doctors on their insurance for using it. Presto! We just created a market for doctors to pay for the service.
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