Ross Mayfield's Weblog

Health Reform: Taking the Wrong Risks

This week the NY Times explores how failing to pass health reform will have an impact on innovation -- and archetypal Silicon Valley startups.

In the cradle of American innovation, workers are making career choices based on co-payments, pre-existing conditions and other minutiae of health insurance. They are not necessarily making decisions based on what would be best for their careers and, in turn, for the American economy ― that is, “where their skills match and where they can grow the most,” as another Silicon Valley entrepreneur, Cyriac Roeding, says. Health insurance, Mr. Roeding adds, “is distorting the decision-making.”

...Only 46 percent of companies with three to nine employees offer health insurance, down from 56 percent a decade ago, according to the Kaiser Family Foundation...

Without health reform, entrepreneurs will continue to take the wrong risks. Starting a company is the art of making do without resources. This often means limiting your own compensation and forgoing health insurance at the start. When recruiting employees, its difficult in the early stages of a company to offer health benefits that are comparable let alone competitive with those of larger companies. This despite the fact that when a startup employee gets sick, it can have a broad impact on the productivity of the company overall.

As the economy is recovering there is no better time to start a new company. Silicon Valley is getting back to what it does best, we need Washington to do the same.

Advertising is not Democratic

I was disturbed to read a pandering post by a Google employee that decries Michael Moore's documentary Siko and offers advertising as a means for the U.S. health care industry.  Others were, and Google's official position that was no position.  Dan Farber has been following the story, and added this update:

Update 2: Now we have an explanation from Ms. Turner regarding how to read her post. She just meant to state Google’s position that “advertising is a very democratic and effective way to participate in a public dialogue.” I won’t argue with the idea of advertising as democratic. Anyone with the money or winning bid can get their message out into the ether.  But ads tend to be one-sided sales pitches without footnotes, not a public dialog. If we want a public dialog, having the two opposing sides in a public debate would be a far better way to educate the public.

I will argue with the idea of advertising as democratic.  It is the opposite.  Spending isn't speech.  Sure, U.S. health care can buy ads to be placed in context alongside public discourse.  But not everyone can.  It concerns me that the bright people at Google could be talking themselves into believing that either advertising is democracy, let alone that it helps democracy.

If the U.S. health care industry really wants to respond to Sicko, they will engage in, if not host, online communities for civic dialog.  However, most online communities these days are powered by advertising. Community hosts and ad networks have to balance against the very strong incentives to smudge context and placement until where the line between paid and unpaid content are blurred.  A balance is struck, not unlike between editorial and publishing in traditional media, but with a very big difference in that the audience has the choice to go elsewhere with a single click.  Or create their own without the influence of advertising. 

Sprinkles: simple global health

Sprinkles is an innovative non-profit effort to end vitamin and mineral deficiencies, one of the greatest preventable causes of illness and premature death throughout the developing world.  Their approach borders on being too simple, little packets of micronutrients you can sprinkle on any semi-solid food as a delivery mechanism.

"Iron-deficiency anemia continues to be a pervasive and largely unaddressed global health problem, affecting more than two billion people or roughly one third of the world's population." -- Dr Stanley Zlotkin

They have already proven the concept.  In Mongolia after two years of the program, anemia decreased by 38%.  When you consider Vitamin A deficiency is the leading cause of child blindness, Iodine deficiency the greatest cause of preventable mental retardation and Iron deficiency even has a direct impact on GDP, up to 2% loss, basic nutrition is a very big problem.  Sprinkles have been provided in 18 countries with distributed local manufacturing through technology transfer and their goal is to reach 50 milion children in five years.

I had a great conversation with Sprinkles founder and nutritionist Dr Zlotkin at a conference last week.  Their initative is ready for scaling perhaps with the help of philanthropists that read this blog.

Why I'm not blogging

Work is nice and busy, but really it's something else.  Two weeks without a cigarette.  I'm not prepared to really blog about that yet, but it's simply amazing how much I used to blog and smoke at the same time.