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Comment by RodgerTheGreat | Hacker News Reader

You can't make an MVP of a cure for cancer.

You can't "crush code" and build a space elevator in a hackathon.

You can't hustle your way through a robot that collects, folds, and stores all your dirty laundry.

You can't build an O'Neill cylinder with a 2-year horizon of profitability.

Some problems are hard, expensive, and do not lead to fame or fortune in the short term. Startups are not structurally equipped to solve these problems, and perhaps public corporations aren't either. As it turns out, it is much easier to make money by solving (or inventing!) easy problems, and our culture currently views making money as a proxy for creating value for society. If you want a more exciting and ambitious future, we will all need to think further ahead than the next quarterly earnings report.

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"we will all need to think further ahead than the next quarterly earnings report"

Good news! People are already throwing billions of dollars at companies with no earnings and no apparent prospect of them. I guess that problem is solved.

”You can't make an MVP of a cure for cancer”

That’s linear thinking. Yes you can.

It is possible to tackle any of the engineering challenges I listed in an incremental fashion. That isn't the point.

The context of a "Minimum Viable Product" is a mental model of products, markets, and profitability. There is a fundamental difference between the goal "cure cancer" and the goal "make money from a cancer cure". The perverse incentives and loopholes of the latter are a serious impediment to the former.

You don't think you can make money from a cancer cure and cure cancer at the same time?

Even if you could -- the statements "can make money doing X" does not imply "can build an MVP for X".

Not OP, but no - the profit motive is the main perverter of the pharmaceutical industry. By talking a profit you ensure that your cancer treatment will not cure cancer - too few people will have access to cure the disease and millions will still suffer and die needlessly. I guess a few rich, first worlders would live, so it's not all bad.

People celebrate Jonahs Salk because not only did he develop the polio vaccine but he rejected his opportunity to massively profit from it because it was more important that patients have access.

No company that develops a cancer cure these days would do that. Their shareholders would revolt, their boards would fire their exeutives, their stock prices would plunge, and their competitors would pile on.

What to do if you have a cure is an imaginary problem. Regulators set minimum standards for efficacy which involve a treatment being just barely statistically significant. The problem is not burying cures, because playing the game of "make believe a treatment is better than placebo" is infinitely simpler than coming up with a cure. The cures people believe in are like the infamous 200 mpg carburetor.

I'm pretty sure he's making reference to the large pharmaceutical companies that earn more by treating problems than fixing them.

The incentive is to continuously charge these people for the rest of their life. They make more money if you stay sick, so they can keep treating you.

If you are cured, then the flow of money stops until you get sick again.

People always state this like it's some dirty secret, but it's an ongoing calculation for any given pharmaceutical company. If they think a cure is within reach, then they try to go for it, because if they focus purely on treatment and a competitor discovers an easily findable cure, then they make no money on the treatment.

If, however, after a lot of work, a cure seems elusive, it makes sense to focus on treatment. Both for the sinister reason that people pay more over a lifetime for treatments, but also for the less sinister reason that it's usually much easier to develop treatments than cures, and having a treatment and not having a cure is strictly better than not having a treatment and also not having a cure.

Sure but,

What is stopping them from discovering a cure, patenting it, and then never manufacturing it?

Many countries would ignore the patent and manufacture it, driving people to medical tourism, and then the patent will expire in 18-23 years anyway.

Patents run out and they are made public. If you go through the expensive process of developing a drug, you're likely to want to get a return on that. If there is enough evidence for the cure to work that a company wants to bury it, they're more likely to not patent it.

Also, this presupposes that the companies are actively trying to do evil. In reality, most people would rather have cancer cured than not cured. The profit motive can bend these incentives, but I think the caricature of a company full of amoral sociopaths making decisions to maximize human suffering are kind of... unrealistic.

No. They said the exact opposite of that.

Indeed. For instance, suppose you thought you had a path for a general cure for cancer, but getting regulatory approval for use on humans would be too expensive and time consuming.

So cure dog cancer. Regulatory burden would be far less, and everyone would love you (if it works...).

Can you expand on this?

I'll give an example to expand on. What if disease was connected to neuron signatures in the brain? The brain is the central organism and the ruler of everything. It controls functions like breathing and sleep and so on. You could have technology that modulated breathing for example or games that prescribed shots of dopamine or made you more intuitive. Going further, maybe you could have realtime gene splicing that connected to other API's that worked with the brain. This is the future.

I think my problem is RodgerTheGreat said "You can't _____" and your response was "Yes you can."

Neither one of you provided anything by way of supporting details, citations, etc. At least RTG expanded a little, but even that was just an explanation of why they felt the way they did, nothing even approaching proof.

say what? This article just hit the front page https://news.ycombinator.com/item?id=21865579

You can't get it through the FDA trials, though.

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