I don't need to make an argument. Call your doctor and ask him how much he pays for his malpractice insurance.
I used to know some people in healthcare tangentially and the answer is $50,000 to $250,000 A YEAR depending on specialty etc.
Sometimes the practice will pay these costs for you, so the doctor might not be paying it directly but the money is coming from somewhere.
My friends told me malpractice insurance was generally about a third of your salary. And this includes people like pharmacists and physicians assistants too. So if much higher than world average doctor salaries in the US are any part of the reason for high medical costs, lawsuits are a third of that
Medical school definitely needs to be less expensive to lower salaries. It's also pushing doctors towards specialities that pay more and leaving us with a thortage of GP's
The problem is everyone gets paid too much. Our doctors salaries are far out of line with most countries , we have the strictest drug pricing laws in the world, and people love to sue. We also have a significant portion of the population paying no medical bills while the rest is overcharged to compensate. On top of that our health insurance is full of middle men like "PBM's" that do nothing but raise costs.
The combo means docs, drugs, treatment, and insurance are all more costly.
A fix is hard to come by but would work something like this.
1)subsidize the cost of medical school increasing supply of MDS
2)pass laws to protect physicians from frivolous lawsuits or at least limit damages.
3)disallow drug companies from advertising, ban rampant kickbacks to doc's that prescribe their drugs
4)ban anti competitive practices that prevent insurance companies from negotiating prices directly with manufacturers.
5) provide healthcare centers of last resort(the ER) compensation for patients unable to pay.
My last point is state specific and really controversial but it's based on what I've personally seen.
States with a lot of illegal immigrants spend an enormous amount for healthcare at the ER for these people. Around 1/4 of the people that came into the ER I was familiar with were likely illegal
and over 90% either gave a fake name or never paid. The majority of those costs are passed on to those with insurance. I lived in an area with probably 3% of the population were undocumented.
Since the ER is healthcare of last resort they are forced to treat you even if you give them completely false info with no intention of paying. Illegal immigrants know this and preferentially go to the ER because they get treated without probing questions or need to pay. They also already have fake ID's in most cases so giving one to the hospital isn't a big deal. This enomous cost gets buried because it's politically unpopular to say and because the hospital just raises prices in everyone else to compensate.
Do the professors get paid to use tophat? If so I will avoid them at any cost. What a perverse incentive to take money from students and put it directly into the professors wallet
Does it bother you that the majority of student see mandatory subscriptions to all of these services as a giant ripoff?
I mean, you could save every student maybe 600 a year if the university purposely used books that are one edition out of date. That's the same as lowering tuition around 5% at most places. Would this really affect the quality of education in any meaningful way?
"Strategic partnership" sounds like another way of saying the university gets some money out of the deal at the expense of their students pocket books.
How is this justified from the position of someone who maintains relationships with these companies?
What startup founders don't realise sometimes is that marketing is more important than having the best product.
I've had the luck of being on both development and marketing ends and high quality marketing can definitely sell a product that's slightly inferior to the competition 10:1
If you need big names attached to your product early the best way is to give it out for free to those first strategic customers. Why would anyone turn down something useful and free.
If you can't tell why another startup beat you out when you had a better product it's garaunteed to be marketing related.
Did you take a step back and evaluate marketing strategies? I ask because my last company marketed a product to small businesses and it took us about 4 months and significant churn before we saw any positive returns in our marketing efforts. If you have that much money left it seems premature to throw in the towel without redoing your marketing strategies a few times.
In my experience spamming inboxes and flyers were a fool's errand compared to the marketing power of tageted online ads and customer referrals(offering free month for referring a new customer or similar). Non targeted "spamvertising" makes your company look cheap and desperate before people even try your product.
I expect to find a flyer illegally placed under my windshield wiper or jammed in my front door for a maintinence dude or a smoke shop, but not for any business software I would seriously consider using.
Do you have metrics on how many emails were actually delivered? Not how many the mail server reports, but which email services were actually forwarding your mail to places besides the spam folder? Where did you get your email lists? AFAIK, renting email lists is largely considered a joke in today's marketing circles.
Did you try offering a free trial period to start out? Target users at company domains over those @ Gmail or Hotmail? It's easy to code something that offers free trials only to people without a personal email address. How about sending mail directly to the target companies address to their hr manager? What about old fashioned cold calls? Sometimes they work better than you would think. Did you reach out to companies that expressed interest but didn't convert to paying users?
Did you try visiting local businesses in person to pitch your ideas and get feedback? Some business owners will be fairly helpful saying "yeah this sounds great but when I go to your site it doesn't look like we need this at all". Or "can I sign up my employees without assigning an email address to each one?" " I just want you to make the page printer friendly so I can post the schedule on the door like we've been doing for 20 years"
Was there A/B testing of all marketing materials including emails, flyers, page text, ad text, value proposition (free first month, 10% discount for year subscription, free use for less than 5 people)? Did you try getting individual franchisees to sign up then go to their main corporate office and talk about how much it's helping some of their restaurants?
Did you go to local chamber of commerce and small business leader meetups? Not start-up meetups, regular SMB meetups. This is generally how small business meet each other and is a perfect place for local vendors to get a foot in the door to the local B2B market. Even with the internet a ton of deals are made the old fashioned way between local partners. Dinner and a handshake is key to getting a lot of local businesses.
Why did it take until V2 to know you would need to use text messages? I used to work in the service industry for years and it's immediately obvious to me that smartphones cannot be a requirement. Did you think everyone working min wage as a greeter at Walmart when they're 60 would even know how to use a smartphone? This seems like a pretty glaring lack of market research.
I disagree that launch is a one time bump and that timing is of any importance. I find it rediculous that you ran advertising of any sort before the product was officially launched. Anyone checking out your site would do it the same day they saw the ad and discard you immediately if the product wasn't available. I can't think of a single start-up that would be materially affected by the time of year they decided to go live. Maybe if you're mowing lawns I guess?
It sounds like your market research amounted to asking people and googling things on the internet when this should have been done by getting hard numbers, aka trying to sell the product rather than predict something without data. I can tell you from working with numerous small business clients that low cost items (less than around 400 a month) are purchased at any time of year by lower level managers with little oversight. In the grand scheme of things the monetary investment is low enough that the companies are unlikely to care about budget whatsoever. We worked with small businesses of all kinds and this is common across any industries I've seen.
Not to completely trash you guys, but announcement says little about the actual cause of failure besides "yeah marketing didn't work good". It also mentions considering pivoting with different co-founders!! As if the other founders were part of the problem. That's a pretty scandalous thing to say about the other guys that poured blood and sweat into this with you for over a year.
That, combined with giving up with a mil in the bank and the, IMO, bad marketing blunders makes me think this shutdown is more an issue with co founders not getting along than anything else.
You could have easily scaled back operations to make that million last several years to give you some time to work out your conversion rates. Giving up when you've already built the project because you are having trouble selling it seems like a poor use of the rest of your investors money. Selling an existing product is far easier than building one that doesn't exist.