3 ms·

A Review of the Clover SPAC

27 points by prostoalex 6y ago

AlexandrB 6y ago
SPAC + dubious product sounds a lot like Nikola. We'll see if this goes the same way. The valuations being thrown around are shocking though. A lot of Kool aid going around in investment right now.
- snarkypixel 6y ago
  Just wanted to point out that there are good SPAC too. Hyliion, OpenDoor & Virgin Galactic come to mind. If you haven't heard of HYLN, check it out. It's currently in a massive dip due to many people cashing their early SPAC price + many people associating Nikola with HYLN because they're both in the EV truck industry, but HYLN has actually amazing tech, great founder and I've talked to many truckers who cannot wait to retrofit the new engine in their old truck.
  - chorsestudios 6y ago
    OpenDoor and Virgin Galactic both went public through Chamath’s SPACs. It might be a little early to judge if they are good SPACs, we’ll see how they are performing several years from now.
danhak 6y ago
We're gonna fix healthcare...because...technology. Let's throw in some buzzwords like "machine learning" into our one-pager for good measure. As if nobody in this $2.5 trillion industry has heard about software before. Healthcare costs and waste are not a technology problem. They are a policy and incentives problem.
- Pyramus 6y ago
  > Healthcare costs and waste are not a technology problem. They are a policy and incentives problem. This statement is so broad that it cannot be true and here is an obivous counter example: A high percentage of doctor visits (think 4/5) does not involve physical checkups and could be done remotely - independent of policy and incentives. Identifying these 4/5 (say) patients is a trillion dollar technology problem that is currently being approached from many different angles: symptom checker and triage, telemedicine and online doctor appointments, etc. Notable teams working on it are ada and Babylon, among many others.
  - dfee 6y ago
    > A high percentage of doctor visits (think 4/5) does not involve physical checkups and could be done remotely - independent of policy and incentives. Having spent a few years in HealthTech building a couple companies, I can say that yea, that is a policy and incentives problem.
  - entee 6y ago
    As an example of why remote visits are a policy problem, ask yourself why video visits weren’t common before the pandemic even though we’ve had the technology in various forms for literally decades (Skype was founded in 2003 as just one example). Turns out, it’s an incentive and policy problem! Video visits weren’t reimbursed the same way (I’ve personally had to haggle with my insurer when a video primary care visit wasn’t tagged with a COVID exception and cost me multiples of the usual $25 copay). See also this article: https://www.managedhealthcareexecutive.com/view/as-the-covid-19-pandemic-drives-record-telehealth-use-what-s-your-long-term-plan- https://www.managedhealthcareexecutive.com/view/as-the-covid... Relevant section: “ prior rules and regulations pertaining to telehealth, such as those regarding HIPAA regulations and payer coverage standards, were relaxed to encourage telehealth use” Also ask yourself why the Obama administration literally had to pay doctors to adopt computerized medicine records. Did the government have to pay Walmart to computerize it’s supply chain in the 1970s? No! It had the right incentives. Does square need to pay small merchants to adopt their cash registers and digitize their menus? Not really, they make the clear case that the digital menu drives more sales. Why do you think doctors needed the extra push? Because the market doesn’t pay them to be efficient record keepers, or penalize them for not doing so. That’s just 2 examples, there are dozens more. Virtually nothing in healthcare is a technology problem except for new treatment development. 4 years of working in the sector taught me this. There are places tech can help, (one example is maybe somewhat improved patient management in a managed care context, though that’s a super competitive market) but the big systemic problems are there for regulatory and incentive reasons. I hope I’m wrong, but pretty sure I’m not.
    - Pyramus 6y ago
      > Virtually nothing in healthcare is a technology problem except for new treatment development. Again, that's a heavily over-simplified view. You are absolutely right that incentives and policy play huge roles (even more so in the US). I agree that my online doctor example was not the best choice. However, my point stands that there is a fair share of difficult technology problems that will meaningfully contribute to healthcare: 1) Symptom checking: Identify the state of a patient prior to the point of care. 2) Triage: Prioritise treatment options in conjunction with 1) 3) Assisted decision making: Improve professional decision making, especially for rare diseases. 4) Patient follow-up: Manage the process after care has been received. 5) Symptom tracking / monitoring: Quantify disease severity over time. 6) Adherence to medication: It's estimated 50% of medication is not being taken. 7) Personalised medicine: Match treatment/prevention options to patients (e.g. genetics, gender, circadian rhythm) ... These are some broad themes from the top of my head, of course there are many more disease specific problems, e.g. the early detection of Parkinson in voice samples, automation and delivery of CBT for insomnia, the list goes on.
- vp8989 6y ago
  This was pretty much my takeaway after having worked in healthcare tech for ~2 years. The real purpose of the business was to make sure doctors got every $ they were "owed" in as efficient a way as possible, but basically every employee would claim that they were "fixing healthcare".
BryanBigs 6y ago
Brand New Day, with its 43,000 members, is probably doing somewhere on the order of $430 million of revenue this year (43k members x $1k in premium per year) Ehhh...isnt that $43m?
- sgron 6y ago
  I believe that was a typo and it's actually around $1k/patient month or closer to $10k/patient year.

27 points by prostoalex 6y ago

SPAC + dubious product sounds a lot like Nikola. We'll see if this goes the same way. The valuations being thrown around are shocking though. A lot of Kool aid going around in investment right now.

snarkypixel 6y ago
Just wanted to point out that there are good SPAC too. Hyliion, OpenDoor & Virgin Galactic come to mind. If you haven't heard of HYLN, check it out. It's currently in a massive dip due to many people cashing their early SPAC price + many people associating Nikola with HYLN because they're both in the EV truck industry, but HYLN has actually amazing tech, great founder and I've talked to many truckers who cannot wait to retrofit the new engine in their old truck.
- chorsestudios 6y ago
  OpenDoor and Virgin Galactic both went public through Chamath’s SPACs. It might be a little early to judge if they are good SPACs, we’ll see how they are performing several years from now.

danhak 6y ago

We're gonna fix healthcare...because...technology. Let's throw in some buzzwords like "machine learning" into our one-pager for good measure. As if nobody in this $2.5 trillion industry has heard about software before. Healthcare costs and waste are not a technology problem. They are a policy and incentives problem.

Pyramus 6y ago
> Healthcare costs and waste are not a technology problem. They are a policy and incentives problem. This statement is so broad that it cannot be true and here is an obivous counter example: A high percentage of doctor visits (think 4/5) does not involve physical checkups and could be done remotely - independent of policy and incentives. Identifying these 4/5 (say) patients is a trillion dollar technology problem that is currently being approached from many different angles: symptom checker and triage, telemedicine and online doctor appointments, etc. Notable teams working on it are ada and Babylon, among many others.
- dfee 6y ago
  > A high percentage of doctor visits (think 4/5) does not involve physical checkups and could be done remotely - independent of policy and incentives. Having spent a few years in HealthTech building a couple companies, I can say that yea, that is a policy and incentives problem.
- entee 6y ago
  As an example of why remote visits are a policy problem, ask yourself why video visits weren’t common before the pandemic even though we’ve had the technology in various forms for literally decades (Skype was founded in 2003 as just one example). Turns out, it’s an incentive and policy problem! Video visits weren’t reimbursed the same way (I’ve personally had to haggle with my insurer when a video primary care visit wasn’t tagged with a COVID exception and cost me multiples of the usual $25 copay). See also this article: https://www.managedhealthcareexecutive.com/view/as-the-covid-19-pandemic-drives-record-telehealth-use-what-s-your-long-term-plan- https://www.managedhealthcareexecutive.com/view/as-the-covid... Relevant section: “ prior rules and regulations pertaining to telehealth, such as those regarding HIPAA regulations and payer coverage standards, were relaxed to encourage telehealth use” Also ask yourself why the Obama administration literally had to pay doctors to adopt computerized medicine records. Did the government have to pay Walmart to computerize it’s supply chain in the 1970s? No! It had the right incentives. Does square need to pay small merchants to adopt their cash registers and digitize their menus? Not really, they make the clear case that the digital menu drives more sales. Why do you think doctors needed the extra push? Because the market doesn’t pay them to be efficient record keepers, or penalize them for not doing so. That’s just 2 examples, there are dozens more. Virtually nothing in healthcare is a technology problem except for new treatment development. 4 years of working in the sector taught me this. There are places tech can help, (one example is maybe somewhat improved patient management in a managed care context, though that’s a super competitive market) but the big systemic problems are there for regulatory and incentive reasons. I hope I’m wrong, but pretty sure I’m not.
  - Pyramus 6y ago
    > Virtually nothing in healthcare is a technology problem except for new treatment development. Again, that's a heavily over-simplified view. You are absolutely right that incentives and policy play huge roles (even more so in the US). I agree that my online doctor example was not the best choice. However, my point stands that there is a fair share of difficult technology problems that will meaningfully contribute to healthcare: 1) Symptom checking: Identify the state of a patient prior to the point of care. 2) Triage: Prioritise treatment options in conjunction with 1) 3) Assisted decision making: Improve professional decision making, especially for rare diseases. 4) Patient follow-up: Manage the process after care has been received. 5) Symptom tracking / monitoring: Quantify disease severity over time. 6) Adherence to medication: It's estimated 50% of medication is not being taken. 7) Personalised medicine: Match treatment/prevention options to patients (e.g. genetics, gender, circadian rhythm) ... These are some broad themes from the top of my head, of course there are many more disease specific problems, e.g. the early detection of Parkinson in voice samples, automation and delivery of CBT for insomnia, the list goes on.
vp8989 6y ago
This was pretty much my takeaway after having worked in healthcare tech for ~2 years. The real purpose of the business was to make sure doctors got every $ they were "owed" in as efficient a way as possible, but basically every employee would claim that they were "fixing healthcare".

BryanBigs 6y ago

Brand New Day, with its 43,000 members, is probably doing somewhere on the order of $430 million of revenue this year (43k members x $1k in premium per year) Ehhh...isnt that $43m?

sgron 6y ago
I believe that was a typo and it's actually around $1k/patient month or closer to $10k/patient year.