When good ideas make bad business • Hacker News Board

Re: When good ideas make bad business

#271

Post by achillesheels » Fri, Jan 03, 2020, 10:01 PM UTC

gonational wrote: post #250

planetzero wrote: post #209

Earlier quoted context omitted.

"This is precisely why we need universal healthcare. The incentive structure of private markets don't properly value human life." Government-run healthcare isn't a panacea that will 'value human life' any more than the insurance companies. You are still a number in a database somewhere. Most new drugs come out of the US and socialized governments create generics at a fraction of the cost, because they don't have to p…

Take all my karma... Implementing something like what you describe, IMHO, would have the greatest positive impact on the health and welfare of Americans, of anything this century. I have a friend who is very high up in one of the largest health insurance providers in the US, and I have often debated over the years with this person that same point, that the insurance layer is what creates the model for inefficiency, a…

“Consumer driven healthcare” as the academic researchers call it. It is bewildering why we don’t have diagnostic labs doing email marketing campaigns, for instance. This is driven, I think, by an outmoded concept of the security of doctor’s knowledge. Now, doctors are so behind the ball and play defensive to protect themselves from malpractice. The idea that an individual cannot make educated decisions which are market driven (ie price driven) for most mild conditions is incomprehensible.

Re: When good ideas make bad business

#272

Post by jonny_eh » Fri, Jan 03, 2020, 10:02 PM UTC

harikb wrote: post #261

victor106 wrote: post #218

Earlier quoted context omitted.

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

A better way to put it is that health insurers don't want you to get "sick". So anything to prevent that is usually money well spent. That's why vaccines are so easy to get.

Re: When good ideas make bad business

#273

Post by MadWombat » Fri, Jan 03, 2020, 10:06 PM UTC

beat wrote: post #179

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…

I'd like to imagine "laziness" isn't the reason doctors write the prescriptions they do.

She basically just told him that if she treats her patients better they will visit her less. This is not laziness, this is malevolence.

Re: When good ideas make bad business

#274

Post by wiggler00m » Fri, Jan 03, 2020, 10:09 PM UTC

"I had ten more meetings with doctors all over the Bay Area—surely not all of them were ruthless capitalists like Susan."

10 meetings is inadequate. You should be willing to do 1000+ meetings if you really want this to fly (or prove it cannot).

You could also explore other business models (ie. rather than charging the practice directly find another way to make money).

Even if it fails, valuable experience, not a waste. Cool idea, and admire your initiative.

Re: When good ideas make bad business

#275

Post by reggieband » Fri, Jan 03, 2020, 10:13 PM UTC

danieltillett wrote: post #254

reggieband wrote: post #151

> I had literally nothing to say to that. I think this is literally why salesmen exist. One of my good friends is a real estate agent and he is helping me find a house. My job is to complain about every place we see. Every single time he finds a way to spin my complaint into a positive or something constructive. Roof leaky? You can get it fixed for $X dollars and we can work that into an agreement. For a great salesm…

A lack of money from the customer can’t be overcome. In your case if you can’t afford any of the houses there is nothing the great salesman can do. Of course a great salesman qualifies their prospects before attempting to sell.

In the specific case of the article, the developer was reacting to the doctor saying: "So I’d sorta just be, like, donating this money if I paid you for this thing, right?" This was not a price objection type statement.

Also, selling houses to people who did not have enough money for a house was the basis of an entire financial crisis. It looks like creative salesmen found a way around that.

You can argue some extremes if you want but exceptional salesmen are expected to sell ice to eskimos and sand to arabs. And I would expect them to handle the pretty simple objections raised in this article, especially those around price concerns.

Re: When good ideas make bad business

#276

Post by qaq » Fri, Jan 03, 2020, 10:35 PM UTC

planetzero wrote: post #209

omegaworks wrote: post #187

Earlier quoted context omitted.

This is precisely why we need universal healthcare. The incentive structure of private markets don't properly value human life.

"This is precisely why we need universal healthcare. The incentive structure of private markets don't properly value human life." Government-run healthcare isn't a panacea that will 'value human life' any more than the insurance companies. You are still a number in a database somewhere. Most new drugs come out of the US and socialized governments create generics at a fraction of the cost, because they don't have to p…

The drug things is partially BS. The top 10 big Pharma (in random order)

GlaxoSmithKline British

Eli Lilly US

Sanofi French

AbbVie US

Roche Swiss

Pfizer US

Novartis Swiss

Merck & Co US

AstraZeneca British/Swedish

Johnson & Johnson US

(edit spacing)

Re: When good ideas make bad business

#277

Post by celestialcheese » Fri, Jan 03, 2020, 10:35 PM UTC

JamesBarney wrote: post #253

cosmic_shame wrote: post #138

Earlier quoted context omitted.

Well in the case of this particular product that offers medical advice, the info may become outdated fairly quickly. I suspect there is some amount of liability associated with offering potentially out of date medical advice that isn't worth the tiny revenue stream.

It's just a programatic meta analysis. And no one's get sued for having an out of date meta analysis.

It's America - people get sued for far, far less.

Re: When good ideas make bad business

#278

Post by lotsofpulp » Fri, Jan 03, 2020, 10:39 PM UTC

harikb wrote: post #261

victor106 wrote: post #218

Earlier quoted context omitted.

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

This is incorrect. How can they kick you off the insurance plan? Also, the ACA has provisions to prevent one insurer from having to shoulder the costliest patients via some form of cost sharing with all the others.

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Premium-S...

Re: When good ideas make bad business

#279

Post by mbesto » Fri, Jan 03, 2020, 10:42 PM UTC

cal5k wrote: post #247

TheOtherHobbes wrote: post #237

Earlier quoted context omitted.

Not necessarily. Doctors can still have individual discretion over their choice of IT service provision (etc) under single payer. The only thing single payer does is eliminate insurance company opportunism. It doesn't suddenly convert the entire healthcare system into a dystopian concrete monolith. Although if it did it would make OP's job far easier, because if you could prove there were cost and health outcome bene…

> because if you could prove there were cost and health outcome benefits on a national scale you would be able to convert the idea into a viable business with a single corporate sales pitch, instead of trying to sell to every doctor individually. As someone who ran a healthcare business in Canada, I can tell you that this is absolutely not the case. Single payers are outrageously conservative buyers... sure, you may…

> As someone who ran a healthcare business in Canada, I can tell you that this is absolutely not the case.

Correct me if I'm wrong, but doesn't Canada have publicly funded providers? I'm all for single payer, but with a completely privatized provider network. Make the free market compete for the government's dollars. Technology should theoretically reduce costs because it more automation generally means higher profits.

provider != payer

Re: When good ideas make bad business

#280

Post by lotsofpulp » Fri, Jan 03, 2020, 10:44 PM UTC

allcentury wrote: post #58

uj8efdkjfdshf wrote: post #35

Realistically, while I feel that the author is on the right track with this data driven approach to evidence based medicine, the fact remains that the advantages/disadvantages between drugs within the same class of medicine tend to be negligible compared to drug costs. There are then other specific concerns that must be considered eg pregnancy/breastfeeding, liver failure, kidney failure and often what ends up is tha…

I had the same thought: Sell this product to insurance companies so they can recommend cheaper/safer drugs to their customers, or show the more expensive one and if it truly had better outcomes. Everyone benefits from that. That said, the medical establishment is a tough tough domain to move.

Insurance companies already have teams of doctors and pharmacists analyzing studies to ensure they are pursuing the most effective and cost effective healthcare. They’re called Pharmacy and Therapeutics (P&T) Committeea.