Costing a leg

Day 54: Thursday

Morning, Tim!

Silly Josephine…

Tim as you well know I work in healthcare. Thinking about healthcare as a business feels kind of grimy at times — you are making money off of those who desperately need help, many times in order to live. That said, having worked with a lot of Catholic hospital systems, the usual saying goes “No margin no mission”. In order to operate, in order to help all of those people, they need to have the financial backing to do so. They certainly have a lot of write-offs each year, essentially donating care back to communities; but it’s no news that in the U.S., healthcare is expensive, and many people are paying all they can afford in medical bills.

I’m not sure how I’m supposed to think about making money off of others’ misfortune. In one hand, I’m helping them extend life; in the other, the cost of that extension is often a poor quality of life, constantly fretting about bills and work.

I recently came across some articles about financially backing legal cases. I asked a friend of mine with a law degree to explain in a bit more detail, but the gist is that there are many wrongs done to people – e.g. abuse, discrimination, etc. – done by a corporation that has quite a bit of money. If the individual were to sue, there are legal ways for the corporation to spend those dollars quickly prolonging and “drowning” the individual, making it effectively impossible to sue in many cases. There are some lawyers who will work on a contingency basis, not getting paid until the individual does — but they typically have caps far smaller than would be necessary to take on a corporation.

The linked article discusses financially backing some of these cases. Now I certainly don’t have enough money to bankroll anyone’s legal case, but the idea still intrigues me. If real harm was done, shouldn’t there be some recompense paid? The same problem we saw above begins to arise, though – in order to operate like this, the financial backer would need some form of compensation, thus taking a portion of what would go to the individual. There’s this feeling of doing good while simultaneously lessening the good done.

I’m not sure there’s any way around it within healthcare. Hopefully make it cheaper to deliver care, I suppose. It’s just unfortunate that there’s a cost to doing good.

Until tomorrow,

Zak

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Defend your base (Drawing challenge; business models)

Day 33: Tuesday

Morning, Tim!

Thank  you for the beautiful imagery yesterday. I could be referencing either your poem, the star across Milan, or perhaps (and here’s the frontrunner…)

The choir members are hilarious.  They’re all adults, some of them quite elderly, but they act like little children […] This meant that yesterday, instead of just chatting during mass, they also told each other to be quiet in between conversations.

This is perfectly like children. It’s kind of a beautiful thing.

Tim have you ever ridden a Segway? I’m going to ride this one to now discuss business models…

So working with early stage companies I come across a variety of ways businesses provide value, ranging from “outsource the humans to other humans” to providing new datasets (e.g. by monitoring something previously not monitored [patients/staff/supplies/etc.]) to making existing datasets useful (e.g. predictive analytics; visual dashboards), among many, many others. It’s a great chance to think about where there are gaps in the market — where there are meaningful problems that there are no real solution for. It has also provided an interesting case study on business models.

Walking through some history, you had mom and pop stores selling things locally — groceries, shovels, bicycles, flowers. Enter Walmart, who truly displaced many of these locally owned stores and sold the same goods. So how did they succeed? They had more shelf space then anybody else, and became a one stop shop — the stores were much larger than what they were displacing and each sold “everything”, at least in that seemingly at that period in time. Having the convenience of going to one store for your cereal, orange juice, and kid’s Christmas present was only part of the story, though. Because Walmart had such scale, they were able to negotiate with suppliers to lower prices; not only could you get Cheerio’s and a rocking horse, but you could do so cheaper than you would be able to anywhere else. That’s part of why Amazon is so interesting current day – by putting your inventory online, you have effectively infinite shelf-space; and by having  (free) Prime 2-day (or 1-day/same-day/2-hour depending on location) delivery, you also begin to chip away at the immediacy constraints of traditional retail. Among many other reasons, it’s why Amazon has an interesting business model.

So that’s the kind of business model stuff that’s going through my head (except a lot more detailed and nerdy) when I’m at work talking with these companies. Take yesterday for example. Doctors are highly trained, and thus are “expensive” labor in total dollars. Wanting to keep tabs on patients and visits, when Doctors take notes about visits they are effectively acting as highly trained, very expensive scribes. To help alleviate this problem, there was dictation software — you could speak faster than you could write, and so notes could be gathered quickly. Alternatively, if you put an actual medical scribe in the room, you could have notes taken in real-time, saving the doctors time entirely but now paying another person. The business model continues to move forward — if you put the scribe remotely and simply have an audio and/or visual stream coming to them they could do some from a call center; you could put that call center in a labor market where it is cheaper and also gain the efficiencies in staffing to obviate the down-town it would take an in-person scribe to e.g. switch rooms. Finally, the direction that is exciting, is in the automation of the scribing all-together. To add color, this would be technology that takes the audio and/or visual stream, parses the audio, and then algorithmically places the necessary snippets of information into the relevant fields within the system. What is really exciting about this model is the lack of marginal cost (put too simply: the cost to serve the next customer). Because it is software (outside the very small tech investment to capture the audio stream), no human is being hired to do scribing, and so you no longer scale linearly with costs and revenues, but instead have a high fixed cost up front (to get the algorithm right and have servers to process the necessary information) and then distribute it over every new customer you have.

whew. That was a really large text wall. I doubt anyone has read this far, but I’m going to include a picture and a game as a reward if anyone has.

So Tim here’s how the game works:

  1.  I’m going to draw a base (See below).
  2. You then draw a base. Then draw something to attack my base.
  3. I then draw something to defend my base, and attack your base.
  4. You then draw something to defend your base, and attack my base.
  5. Repeat steps 3 & 4 (as reasonable)

Rules:

  1. There are no rules (I kid. I just like it how it sounds intense when people say this…)
  2. Be creative

Zak’s Base

sketches-copy-7

Until tomorrow,

Zak

p.s. the title of this post was supposed to somehow capture the fun nature of the game and also the very dry nature of my post about business models. I’m imagining someone shouting “Defend our base!” in each case…and in the case of someone shouting it in business in reference to protecting, for example, their customer base, that person would be…annoying.

Bootmaking: An Italian Tradition

Day 8: Wednesday

Morning Tim!

I noticed the ‘Random’ tag on your post yesterday – thoroughly fitting; yet I really appreciated all the tidbits. A shorter note from me today, and mostly random as well (though perhaps more ‘mainstream’).

One tidbit I see you weren’t able to get to yesterday, and one that seems particularly relevant for you being in Italy, Tim, is recent research suggesting that countries are slowly moving away from their continents in many cases. Now I’m sure you’ve heard this before, particularly how geologists suggest we’ve moved most recently from one supercontinent Pangea to our current Earth structure as places have moved. The interesting part about the research, though, is the behavioral piece – specifically, the research suggests that countries moving away from their continents are actually becoming particularly specialized in the physical shapes they look like. So in your case, as Italy slowly deteriorates from Europe, Italian expertise and dominance in boot making has skyrocketed. I was surprised to see it so well researched, and a few of the examples seemed almost a stretch, but nevertheless wanted to make sure you were aware!

Google released PhotoScan to preserve old photos; the idea being in part that they could take out glare and background so that pictures of pictures turn out looking like…pictures. As opposed to something much more akin to a memory of a memory. I think this interesting, and wasted a solid 30 minutes trying to do PhotoScan inception — a picture of a picture of a picture to see how PhotoScan would handle it. I’d post it here, but the “wasted” in my last sentence is apt, as the end picture just looks like…a picture. If I had a lot of photos that this applied to my failure would actually cause joy, as it would be meeting a need. Seeing as I don’t have many of these photos, my failure was just…failure. Though perhaps it was also more evidence that automation is addressing previous needs and those more niche but likely very real (to someone).

I am going to use that as a segue to a future post; I intend to write a bit about tech & automation in the context of the US election. This is not that post, but there’s a good chance it comes Friday, so why not transition now.

Acknowledgement of a bizarre post today.

Until tomorrow,

Zak