
The problem with startups is that they can’t solve the big problems. - krausejj
http://remarkedly.com/2012/01/27/the-problem-with-startups-is-that-they-cant-solve-the-big-problems/
======
skue
Just because you don't see startups tackling these things doesn't mean it's
not happening. Maybe you just need to look harder...

For your point #1, it's called a PHR (personal health record) and it's been
done by many players including many startups, plus Google (who gave up because
no one used it) and Microsoft (which still has one).

The problem is NOT the government. (In fact, find podcasts or video of the CTO
of HHS Todd Park or the CTO of the USA Aneesh Chopra, and then tell me that
it's the government that's holding back health entrepreneurs. Seriously, go
google these guys.) The problem in healthcare is the lack of engagement from
many consumer/patients plus a private industry reluctant to standardize. The
Feds are trying to lead the way. If you're a vet, you can get access your
medical records from the VA via their Blue Button initiative, and the
government is encouraging other systems to follow (and some have).

Yesterday 1200 people attended a free Health Care Innovation Summit in DC with
the heads of HHS and CMS (including Todd and Aneesh) on stage actively
supporting healthcare innovation and entrepreneurship. I know because I was
there as the CEO of a small health IT company that's solving some of those
"big problems." Check out hcidc.org in the coming days for a video archive of
the event.

New companies ARE changing healthcare. (That's actually the point of
Obamacare!) Check out the many health startups from Blueprint Health,
RockHealth, and HealthBox.

In other words go look before you assume that none of us are solving big
problems. Not all of us make gamified, location-based, social networking
buzzword bingo solutions for mobile.

Edit: fixed Aneesha's title

~~~
chintan
> The problem in healthcare is the lack of engagement from many
> consumer/patients plus a private industry reluctant to standardize.

I don't think patient engagement is an issue -- there are gazillion health
related niche disease communities/blogs on the Internet. The challenge for
consumer oriented startups is to scale beyond their specific niche to become
successful in terms of revenue or as a widely used App/Service.

For all health IT startups targeting to the enterprise -- Good Luck with the
PBU (Payer, Buyer, User) problem.

------
greenyoda
Not every startup is a couple of guys working on an iPhone app. Startups have
definitely solved big problems. For example:

\- Amazon.com, when it was a startup, figured out how to allow you to buy just
about any book in print and have it delivered to your home. They had to build
or lease warehouses, contract with delivery companies, and do all sorts of
things that were not just hacking or technology.

\- Apple, when it was a startup (two guys working in a garage) figured out how
to design an easy to use personal computer and get it manufactured at an
affordable price.

Actually, I'm uncertain about whether I really want the problem of centralized
healthcare records to be solved. If it is, it means that my healthcare records
could easily fall into the wrong hands (look at how many data breaches there
have been at banks, for example).

~~~
Dove
_Actually, I'm uncertain about whether I really want the problem of
centralized healthcare records to be solved. If it is, it means that my
healthcare records could easily fall into the wrong hands_

Making sure this doesn't happen is part of the problem definition. I'd expect
something like client-side encryption to be an essential piece of the puzzle.

------
pg
The examples he gives are not truly big problems; they're medium-sized ones
made artificially hard by regulations.

Dropbox is probably solving a bigger problem technically than any of the
examples he gives.

~~~
Sandman
You're mistaking _big_ with _technologically complex_. The author of the
article clearly states that there is no complex technology involved in solving
these problems. Yet, they are big. They're big because solving these problems
would make our everyday lives significantly easier (much more so than a photo-
sharing app, for example). But unfortunately, as you correctly point out,
regulations prevent people who would be willing to provide a solution from
doing so.

~~~
pg
I'm not confusing the two; he's misusing the phrase "big problems." In
ordinary usage, when people talk about solving big problems, they mean hard
problems. If you said "back in the 1960s NASA was willing to take on big
problems like landing a man on the moon," no one would argue that what you
were saying was false on the grounds that it didn't make our everyday lives
significantly easier. Someone might claim (probably accurately) that there
were more important problems the government should have focused on instead,
but no one could honestly claim you were misusing the phrase "big problems."

~~~
frasertimo
Ok you're right, but why argue the semantics in this case?

The author's point is that too many start-ups are creating fun apps that give
little moments of joy rather than ones that noticeably and significantly make
life easier or better for people. You can criticize the author for trying to
be controversial and write something he knows has a good chance of making the
front page of HN; as we've all probably noticed posts with this general
sentiment are definitely in vogue right now on HN, but I think it's worth
moving on from that and noting what he defines as big problems.

I think all the problems he lists we can agree are 'big' in the sense that
they create a lot of confusion and inefficiency in society. In the case of
medical records, 'solving' that problem could literally save countless lives.

On a related note, I disagree with the author there are big problems in
society that start-ups can't solve. I think there are plenty. For many I'm
guessing the idea behind 'Kill Hollywood' springs to mind. For me, it's the
ubiquity of advertising in society. Personally, I'd love to see Facebook,
Google, and co trying to change the world to reduce the concentration of it in
our lives, unfortunately it looks like they're more interested in the
opposite.

~~~
edanm
"Ok you're right, but why argue the semantics in this case?"

The logic of the article is that great minds are working on small problems in
irrelevant startups. However, these great minds are great at certain fields,
like technology. They are not particularly great at politics, for example,
which is necessary for many of the problems listed in the article.

Put another way, if I want to make the most good in the world, and I'm a great
programmer, what should I do, build the next Dropbox (something I'm capable
of), or try and fix government regulations which cause inefficiencies in
parking bills? Never mind what helps the world the most, take into account my
chance of succeeding.

------
lrobb
oddly, I would hardly classify the administrivia you listed as "big
problems"... Those are first world middle class problems.

Why the downvotes?

TRULY Big problems:

Every year 15 million children die of hunger. ... 1 in 5 children in Africa
die of malaria ... 1 million people die of malaria

I would hardly classify "having to fill out the same form every time I go to
the Doctor's office" as a "BIG" problem.

~~~
FelixP
To be fair, medical errors are a "TRULY" big problem, and I'm sure that
poor/inaccurate/incomplete record-keeping isn't helping things.

~~~
7952
If doctors had access to perfect data on their patients medical history would
they actually use it?

~~~
BadCookie
No. My doctors regularly don't read the forms I fill out before the visit. (I
know this because they ask the same questions that were on the forms and act
surprised at the answers.)

------
jholman
I think the point is interesting, and I definitely question the social value
of the social-media startup, and I hate to be the guy in the room arguing for
what amounts to a modern-day aristocracy, BUT...

In a sort of roundabout delayed fashion, startups ARE leading to tackling big
problems.

<http://spacex.com>

<http://teslamotors.com>

<http://gatesfoundation.org>

<http://startupeducation.org>

<http://ubuntu.com> (maybe stretching it a bit)

<http://omidyar.com>

~~~
mvzink
This list is really a non-sequitur.

First, I honestly can't count Ubuntu.

So besides that: Gates Foundation, Startup Education, and Omidyar are
essentially charity. Yeah, they are technically start ups, but...

The other two's problem domains are really exceptions in the realm of "big
problems": we've been doing space travel, we've been doing electric cars—these
startups just do it better, but they aren't solving any new big problems.
(They are solving many interesting technical problems along the way, of
course.)

It's also interesting that every one on that list (still discounting Ubuntu)
was started with a pile of money by a previously successful entrepreneur. (And
SpaceX and Tesla by the same entrepreneur, by the way.)

~~~
jholman
Whoa, whoa. Those aren't startups. Those are organisations tackling big
problems that are all funded by the wealth generated by startups.

Did you ignore the words "aristocracy", "delayed", and "roundabout" in my
comment?

~~~
mvzink
Aha, that went over my head. Apologies! In that case: excellent point.

------
sakopov
ADP (www.adp.com) is a company which provides pretty much all of the mentioned
services. My employer uses them as the corporate portal for W2s, vacation/sick
time and etc. The user experience is terrible and the site won't render right
in anything but IE. But these guys thrive because there is no competition.
This is obviously not your typical trendy and entertaining niche to be in. It
doesn't appeal to most people, like a picture of video sharing service. It's
hard to break into the market. Most startups these days are after quick money.
They'll roll out, get a decent user-base and sell out the moment they can.
Creating a startup in this niche would require a lot ass-busting work and PR
to get paying clients.

~~~
pyre
If you poke at their JavaScript, you'll notice that they intercept every
keypress and handle it explicitly (i.e. having a list of alphanumerics that
are 'ok' to pass through on text boxes) rather than letting the browser handle
the keys that don't need to be special cased. It really seems like someone
decided to convert some 'green screen' apps to the web (or else someone with
only 'green screen' experience decided to do web programming).

------
pagejim
We could look at the OP's point and take it a bit further to ask, What are the
biggest problems humanity faces today and how can software contribute and co-
operate with other disciplines to tackle these problems? Most of the problems,
that humanity today faces are in some way or other linked to Geo-Politics,
unequal distribution of resources/wealth/well-being among the world
population, non-optimized consumption of natural resources and we are running
out of them and so on and so forth. So can software or software startups think
about finding the problems they are trying to solve by taking into mind the
global perspective? Or are they even willing to? I am not a startup guy and I
don’t even have many friends in the community, so I am not in a position to
answer this question, but I am sure others here can.

But problems alone can’t take up whole of the domain of human interest. So,
the second part of the question, would be, what are the most interesting
problems/technologies software could solve teaming up with other disciplines?
I guess, many people are already working on such things, but the tech is still
not mature enough or marketable enough, to be presented to the world, e.g.
Google Xlab.

------
stfu
I for one am quite happy that my health, working history and government
database profiles are not (yet) interlinked. Sure, it would make things a lot
easier... BUT

~~~
jodrellblank
BUT what?

~~~
ams6110
You want the government snooping around in your medical history?

~~~
dangrossman
Do governments with socialized healthcare not have access to their citizenry's
medical histories? I wouldn't have a problem with it.

~~~
coopdog
Only people with a need it get access, eg doctors

It's not a huge deal over here but imagine trying to run for office with an
abortion from your 20's in your medical history if the opposition knew about
it

Or politicians 'requesting' donations from directors of big companies or else
their socially embarrassing medical issues like HIV (one in 20 people in the
USA!) or plastic surgery history get's 'anonymously leaked'

Medical records can actually be a pretty huge source of power and that's
certainly one thing the government should have as little as absolutely
required of. All I have is a couple of broken bones in mine but I'm sure there
are good people who could be swayed by bad people with the wrong information
in the wrong hands

~~~
aboodman
Hm. CDC says the number is 1 in 300:

<http://www.cdc.gov/hiv/resources/factsheets/us.htm>

------
ABrandt
There's actually a fairly decent chance that you do have a secure way to
access your medical records online. About 38% of patients in the US have a
record in an Epic (disclaimer: my employer) EMR system. If you're part of that
population, chances are good that you have access to Epic's MyChart web portal
[1]. Each organization brands this portal as their own so I recommend asking
your doctor's front desk staff about it.

And more directly to the OP's point, Epic certainly was once a startup (3
employees 30 years ago, 5000 today) that has tackled some very big problems.

I don't refute that there are many more startups working on products that
won't quite save the world, but is that such a bad thing? P.T Barnum was
organizing circus acts while his contemporaries Carnegie, Rockefeller, and
Morgan were shifting the very foundation of our society (literally and
figuratively). Doesn't mean Barnum doesn't have a legacy of his own though.

[1] - Here's an example: <https://mychart.clevelandclinic.org/>

~~~
absconditus
The industry is much different today than it was when Epic was small. Even
established companies now struggle to keep their clients from migrating to
Epic. Epic's ability to connect different hospitals and physician practices
trumps most other functionality.

------
bhewes
My only question is which of the three problems is actual a technical problem?
All three seem to be if anything political problems.

~~~
krausejj
that's the point... we are very efficient at getting restaurant reservations
or booking flights or doing video chats with random people around the globe,
but we can't apply technology to the most basic, fundamental problems that we
are actually facing

~~~
bhewes
You are right. My argument would be that the fundamental problems may not be
solvable. Though I think in smaller countries the problems can be mitigated
effectively. Example I believe in Singapore you can pay your taxes online.

~~~
dangrossman
Probably 95% of individual returns in the US can be handled by one of the
high-end copies of TurboTax from your local office supply store. If Intuit can
build it, so could the IRS and offer it as a web app. They could also put the
data from W2s, 1099s, etc they receive online for you to view and
automatically fill out most of your return with it.

It's a technology issue, just one the IRS has to tackle, not a startup.

~~~
bhewes
It is still a political problem as the IRS has not already done it even though
the tech is available. But you are right it is not something a startup can do.
Though a startup could develop web apps for states. God help them if they do.

------
thinkcomp
Sure they can. You just have to devote a lot of effort to do the additional
analysis necessary. Most entrepreneurs simply aren't willing.

There are such things as intractable problems, but payments, health care
recordkeeping and government are not among them.

I do like the fundamental point of the post, though. There should be more
attention paid by startups to serious problems.

~~~
DavidAdams
I agree with you that they can, but I think the point of this essay is that
startups can't solve these problems on their own, using only technology and
chutzpah. In order to solve "health care recordkeeping" you have to get
governments and large companies on board with the process. You can lead a
horse to water, and all that. There are going to need to be a lot of people at
the table, and for the most part a startup isn't going to have the political
juice to make it happen.

~~~
ams6110
You will never succeed if your plan is to get government "on board" with the
process. What needs to happen is to get government OUT of the process.

~~~
coopdog
Government may be incompetent, inefficient and slow, but at least they won't
cut corners on security. For sharing tweets or something a startup can get the
infrastructure done pretty quick, for something more serious (eg tax info) you
really want a proper security team and proper insurance and legal advice.

VC's and advisors need to provide a platform to give startups those tools. For
security using Google AppEngine or the Amazon cloud, combined with automated
penetration testing tools, combined with some kind of cheap application
security testing (does it exist yet?) might get enough of the way there, but
would you really trust something so flimsy, run by two kids out of college who
are working it out as they go, with your serious data?

~~~
ams6110
You don't appear to know how security really operates in federal government
software. They hire Booz-Allen-Hamilton for millions of dollars to come in
with 200 consultants and produce a massive report declaring their software
meets all "certification and accreditation" requirements. This document then
goes on a shelf somewhere and government workers continue to email all kinds
of PI data around in Word and Excel attachments because the software is so
obtuse it's the only way they can actually get anything done.

------
jsilence
Please excuse me when I point out that the mentioned big problems are big
first world problems. The true big problems are how we as humanity cope with
growing world population in the face of dwindling ressources. Desertification
and water scarcity, climate change. Having shelter and food, water. Reducing
the toxification and killing of mother earth. Global justice. Our standard of
living feeds off of the uncounted lives of other humans (and animals). Simple
examples: the poor people mining Coltrane for our newest gadgets under
inhumane conditions and the children in Ghana burning our electronic waste in
the open, inhaling the toxic fumes, to get a little metal to pay for food.
These are challenges on massive scale.

So. A place to store my birth certificate? Srsly? Not really a problem.

------
ilaksh
These issues are structural.

Its as if our institutions are just now upgrading to Dungeons and & Dragons
Pathfinder edition while leading-edge companies are running the Skyrim engine.

We need common semantic data formats and automated systems based on them for
processing data and enforcing regulations where necessary.

We also need these data formats and systems to be designed to ensure a certain
level of distribution and guard against over-centralization, both on a
corporate (antitrust) and personal (income inequality) level. Another key
requirement is for the data formats and systems development to be continuous
and agile.

Part of the problem is the belief in, and acceptance of, not only deadly force
but a monopoly on force, in the form of centralized government. Common data
formats are a critical missing component which should be agreed upon, but
governments currently bear too much resemblance to large criminal
organizations to expect them to really facilitate innovation.

I believe we need to iterate on the core of our social institutions, starting
by reexamining basic premises. For example, if nearly every group is simply
competing against all of the other groups for profit, how can an individual
group come to the conclusion that completely revising their data systems to
handle a new common format is a priority?

I'm not saying that we can't have competition, but I am saying that we need to
look very closely at the fundamentals of the way the system works and try out
some different frameworks.

------
tkiley
Every company that has ever tackled a big problem was once a startup. Startups
can't solve big problems _right away_ , but some (mine included) intend to get
there some day.

Right now, my company is a tiny star in the oligopolistic slow-moving galaxy
of the US healthcare system. We grew 10x in 2008-2009, and grew 10x again in
2010-2011. We're still gathering steam, but we (and healthcare companies like
us) are crafting the building blocks that will one day grow into the solution
to this big hairy problem.

------
krmmalik
Interestingly enough, i was thinking along the very same lines just yesterday,
and most of this week. I have spent the last week going back and forth to the
bank to open up a new bank account and failed multiple times. Simply because
they dont accept certain types of proof of address, nor printed copies.
Unfortunately i moved into the house with my then fiance so all bills are in
her name except the ISP bill but it is emailed to me electronically. I had no
choice but to print out, but the bank did not accept it citing "its a copy".

These kind of problems in 2012 should be easy to solve, and yet here we are.
Why is there not a decent banking service out there that is well aligned with
how we do business in 2012? Why im a stuck with the big powerhouse that are
like big ships when it comes to steering direction. i.e pathetically slow.

I also thought similar things with Car Repair and servicing. I think that
market is utterly ripe for disruption and hasnt had any real innovation (from
an organisational point of view), in a seriously long time.

These are just two problems that come to mind since they're very fresh on my
mind recently, but im sure there are many others just like they were pointed
out in the blog post.

------
Havoc
So in short: Start-ups are dynamic while big companies are powerful. Red tape
problems need both.

I tend to agree though: The minor inconveniences listed by the author aren't
"big problems". We've got an endless list of _proper_ big problem. AIDS,
global warming etc. You don't fight those problems with the same tools as one
would for red tape - you need actual innovation...which I gather start-ups
occasionally achieve.

------
luckyisgood
How about solving small, but important problems? There are countless examples
of people using tech to improve people's lives in a way that matters.

Just look at the winners of this year's Microsoft Imagine Cup:
[http://www.imaginecup.com/blogs/imagine_cup_finals/default.a...](http://www.imaginecup.com/blogs/imagine_cup_finals/default.aspx)
\- Apptenders, team from Croatia, built a physical therapy app for Kinect that
helps children with cerebral palsy, quote: "KiDnect is a Kinect-based solution
for on-premise and remote physical therapy for children, especially those born
with Cerebral Palsy. This software has the ability to monitor a child’s
exercises to ensure they are being completed correctly, and then provides
statistical analysis to the therapist."

I would argue that the problems of the world are solved by solving small
important problems, one at a time. And there's a world of opportunity for
every startup to do just that!

------
yurylifshits
Some other big problems:

    
    
        Prisons
        Retirement for not-so-rich people
        High schools
        Government procurement
        Shipping (in developing countries)
        Customs (in developing countries)
        Utilities prices in Northern countries
        Digital democracy (removing corporate influence on elections)

~~~
known
<https://en.wikipedia.org/wiki/List_of_unsolved_problems>

------
Locke1689
Is it possible that we see these as big problems partially _because_ they
can't be solved by startups? If these could be solved by startups then they
would no longer be big problems and some other problems would pop up which
couldn't be solved by startups and would be referred to as the "big problems."

~~~
krausejj
i definitely think it's possible.... but i still think it's a pretty big
problem when basic medical information is harder to access than last week's
restaurant reservation

~~~
Locke1689
I definitely think that's true, but I think that your own construction of the
problem supports my point. Last week's restaurant reservation is easy to
access because it's a problem that can be addressed by startups. In other
words, the reason why medical information is a "big problem" is that it hasn't
been vulnerable to the same advancement that we perceive in other industries,
mostly due to its barriers to entry. Without those barriers to entry it
wouldn't be a "big problem," it would just be another thing that gets better
with advancing technology.

------
substack
At the civic level, check out some of the projects that the Code for America
folks are up to: <http://codeforamerica.org/projects/>

------
jakegottlieb
I don't think it's true. With 5 programmers we were able to accomplish what 50
did at method integration. We created a better interfaced, more thought out
integration. We just soft launched and here is a link to our YC post
<http://news.ycombinator.com/item?id=3521108>. Most startups don't have e know
how but we are all pretty seasoned in creating businesses. I wouldn't really
call it a startup but in a literal sense of course it is.

------
nhangen
I agree with the sentiment that too many startups are working to solve
problems that don't really exist, but what irks me even more is that so many
of today's startups are working not to make the world a better place, but to
find better ways to serve advertising.

It's quite depressing to see so much energy wasted on this problem, which
isn't a problem for consumers, but for advertisers. I'm sorry, but finding a
better ways to use mobile photo social geo to target people for ads is not
changing the world.

~~~
itmag
Yeah, but those startup people could be working in Big Finance or whatever.
Having them working on useless social apps is harm reduction :)

------
jphackworth
You don't think Apple and Google are solving big problems? They were startups
too, once. I think the flaw in your logic is that once a startup
_successfully_ solves a big problem, they quickly stop being a startup, and
become a big company. It's a mistake to conclude "startups can't solve big
problems".

------
Tichy
"Dr Socman has tagged you with measles vaccination. Please confirm." - Problem
solved?

------
winter_blue
A non-profit for the good of the people company (like Salvation Army, etc.)
could tackle these problems.

For instance for the government taxes one; a group could build a website that
handled it and offer it for free to the government.

------
alexchamberlain
The problem with these problems are that they aren't scalable. The problems
you listed are quite US centric, but startups aren't happy unless the market
is international.

------
michaelochurch
This may not be relevant, but what irks me in 2012 is how pathetic we are at
transportation. You know, moving humans around. We fail it.

If you want to go from New York to Los Angeles, you have a sub-5% chance of
paying a fair price. Most often, you'll find yourself paying a ridiculously
high price because you booked your ticket to close to the date, too far away
from it, on the wrong day of the week, or in the wrong season. Then you get
shitty service the whole way, including 40-minute security lines and $25
baggage-check fees. If you spring for business class (domestic first) you get
service that was almost as good as what coach offered 30 years ago, when
flying wasn't horrible.

Trains aren't even an option for mid-distance travel, due to the infrequent
schedules, equally absurd fares, and slow speeds (comparable to cars, except
on Acela, a "high speed" service that goes 120 mph).

We have good highways in the U.S., and people drive a lot in this country
because it's the only mode of transportation that actually works (for a family
of four, it's cheaper than air and rail, which is just fucking absurd) but
it's just not safe to drive them faster than 80-90 mph average speed, and
legally you can't even go that fast.

New York is the only city with "decent" (by American standards) public
transit, and that's still not enough to slash housing prices to where they'd
be with an extensive transit network. (Note to all: if you pay urban rents,
you'd benefit from a better public transit system even if you never used it,
because it would de-crowd the city.)

We're amazingly good at shipping electrons, but we've given up entirely on
moving humans.

~~~
Aloisius
In 1970, the price to fly coach from LA->NY was about $555 in 2010 inflation
adjusted dollars. Comparing service then to now is silly. If you pay $555 now,
you'll get decent service.

Furthermore, I think you might have a skewed sense of what a fair price is to
fly 2,500 miles. A flight from Lisbon to Moscow (about the same distance) is
more expensive than a flight from LA to NYC. It is a long way and expensive to
operate planes. Last minute tickets and upper class tickets subsidize "cheap"
fares. If you want to convert an airline over to fixed price tickets, the
ticket price would likely be considerably higher than what you deem "fair."

Finally, the way cities are built in the US does not lend themselves to public
transit. NYC has decent transit because the population density is so high as
to make it the only viable option. There are no other cities in the US like
that with the exception of maybe San Francisco which has a significantly
smaller population. In Europe, many cities are high density and have good mass
transit. Unless we encourage density, we're unlikely to see good urban mass
transit since most people would rather drive all things being equal.

~~~
nostromo
> NYC has decent transit because the population density is so high as to make
> it the only viable option.

It's a little known fact that much of the Queens subway lines were built when
the area was still mostly farmland. Check this article out:
[http://www.vanshnookenraggen.com/_index/2010/06/the-
futureny...](http://www.vanshnookenraggen.com/_index/2010/06/the-
futurenycsubway-queens-flushing-trunk-line/)

We Americans are fond of saying that we can't have muni rail because our
cities aren't dense enough. Well, reliable rail is the only thing that allows
for greater density. In some cases city planners are starting to realize this
and work with developers to add density and transit simultaneously. But it
takes real leadership (or cojones, depending on your view) to build municipal
rail that won't reach its potential for ten or twenty years -- but that's
exactly what happened in New York and it has seemed to pay of very well.

~~~
justincormack
Same thing with London, the tube was built out to "Metroland" which all grew
into London. The system was also immensly profitable back in the 1930s...

