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Comment by skeletron | Hacker News Reader

Many of the reviews of the Android app are quite critical of the trial and payment model, for example:

> CAUTION: After the free trial period (7 days), they will charge for an annual subscription ($102.95 US). This is OPT OUT, not opt in. In other reviews they say they will offer a refund (I will update when/if I get one) but for an app for people with executive function issues, an opt out format seems shady. Either way, I won't be purchasing this for my loved one with the opt out format for payment.

> They exploit the same vulnerability of the patients, they aim to cure! They take you in confidence and then charge you after the trial ends. ADHD folks forget things all the time and it's a challenge for them. An email reminder is not going to cut it. We have thousands of emails in our inbox. This is profiteering from the mental disability of others. Stay away. A pro-rata charge is a fairer policy for ADHD folks. Any ADHD book will be more useful for what is presented in this app anyway.

> Requires payment to be set up to use free trial... Seems a bit predatory on a mental health app for ADHD brains... We tend to forget things like canceling memberships. And of course they only tell you once you have wasted time making an account. SMH

> Why do you need a credit card to do a 7 day free trial? Why don't you take my card number if I want to continue after the 7 days? What if I forget to cancel, and forget to request refund? I see what you did there

Sounds like they're all making some very relevant points about the app payment model potentially exploiting the ADHD deficit in executive functioning, and the tendency of people with ADHD to unintentionally forget things like subscriptions and bill payments. How do you respond to these critiques?

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Thanks for highlighting this - we're trying to figure out what the best model is for our community. A lot of other apps follow a similar model, we allow people to cancel anytime and have refunded everyone that has forgotten to cancel. Some people also like having the subscription because it is a pay per use model rather than putting everyone under the same one-off bundle. We're working on extending the free trial / moving to a freemium model. Would love any suggestions on how to improve this.

The best model for your community is free and open source.

Your current model of opt-in subscriptions makes it clear you're looking for the best model for your bank account

How do you propose that they feed and house themselves? Has someone got a GitHub repo for that?

They can get a real job instead of making products that prey on people with ADHD.

There's no job shortage, so don't make excuses for them

My point is about the unbelievably privileged attitude of "you should make products for me free of charge, or else you're the greedy one". Not whether this specific product should exist, which is a different point from how it should be funded.

You're using quotes but I never said those words. Never speak on my behalf again. It's insulting.

I don't want them to do it for free. I want then to not make a predatory product. I want them to make their money through a more honest business

And if they can't do that, I want them to do nothing

Right, again, not wanting them to make it at all is a different point. You were proposing that they make it free of charge.

(As for 'quoting you', it's called paraphrasing. I'd have hoped it was rather obvious I was not suggesting that you said those exact words.)

I never proposed they make it free of charge. I said the best model for their community is free and open source. The point of saying that is to make a contrast with their current predatory model.

And thats why I don't want you quoting me or paraphrasing me. You're putting words into my mouth that I never said or even implied. And once again, I find it extremely insulting.

I'm going to make it clear so you don't do it again. I want then to make an honest business model and to stop this predatory one

> I never proposed they make it free of charge. I said the best model for their community is free and open source.

I ... they're the same picture ...

It must be 2006 again because we're having arguments online about the word free.

Usually the word free in "free and open source" is libre, as in freedom, not free beer.

Yes, but not when we're explicitly talking about how to monetise their product.

If we didn't build and charge for our app then we can't continue working on it and improving. We enable many people to get support they wouldn't be able to otherwise and significantly broaden accessibility compared to medication and in-person therapy. We're not a non-profit but we do need to improve our model.

Linux is free and somehow that has gotten decades of support.

You can do good work for "your community" without putting profits first

    Linux is free and somehow that has gotten decades of support.

Most of the top contributors to Linux and other big FOSS projects do that work as a part of their salaried jobs at various corporations.

It's shocking that the myth of Linux being created and maintained by a bunch of dedicated outlaw nerds, typing away in their basements for free in their spare time (while presumably also working 50 hour weeks at their tech jobs, to pay the bills?) persists to any degree whatsoever in 2021.

Countless huge companies rely upon Linux in major ways, and therefore fund its development and maintenance.

Sources:

https://www.linuxfoundation.org/wp-content/uploads/2020FOSSC...

https://linux.slashdot.org/story/10/01/21/230201/75-of-linux...

Posing the question: did you at all investigate the viability of a non profit organization?

I think the easiest solution is to stop providing access after the free trial until they opt-in to a subscription. That way there’s no surprise charge if they forget.

This seems reasonable.

Go ahead and collect the payment info before giving them access to the free trial, let them use the thing for free for X days, then when the free trial is up, block their access and ask them whether or not they'd like to pay for the subscription. It could literally just be one big button that says "accept." Then ideally, ask them again before each recurring charge.

Some people here are proposing an absurd amount of friction - one highly upvoted post suggested that the app should require users to re-enter their payment info before every charge. What if this app is great? What if I actually want to give them my money? Making me type in my credit card info repeatedly is nightmarishly bad UX.

Reducing friction is a good thing, even here. The important bit is just getting the user's clear consent by making it opt-in instead of opt-out.

> we allow people to cancel anytime and have refunded everyone that has forgotten to cancel

Probably not, because your users are people who will forget to cancel and then forget to tell you about that.

> Some people also like having the subscription because it is a pay per use model

What does this mean? It sounds like users are complaining that if they download the app and don't use it it charges them $100.

> Would love any suggestions on how to improve this.

Howabout when the free trial ends, at that time the user has to approve a charge before continuing to use the app.

Thanks, I appreciate your response on this, but I'd be interested in your thoughts on the following two points specifically:

- Why have you chosen to make users opt out of a subscription when the free trial ends, rather than letting them opt in?

- Why is the annual payment option pushed so hard, in favour of the monthly payment option?

I'm reiterating this because promoting an opt-in, monthly payment model (thus giving more opportunities for any unintentional ongoing payments to be noticed by the payer) seems to me to be the kindest approach to subscriptions for users with ADHD, and a model that would be most empathetic to their condition.

Thanks for the follow-up questions.

We're actually working on several different sign-ups flows at the moment including opt-in post free trial, longer free trial, web sign-up and one-off purchase vs subscription. It is not our intention to push annual significantly over monthly - we wanted to give a significant discount to yearly subscribers but perhaps the difference between the two is too large. The previously mentioned issue with scrolling is due to to a bug with small screen sizes on Android which we're working to fix.

Thanks, it's good to know that you're considering alternatives.

As you have a number of people with ADHD working on your app, I would be curious to know if any of them raised concerns about these specifics of your subscription model, during planning and development of the app?

As well as input from the team, we did a lot of user interviews and testing during development and this wasn't flagged as a concern (a lot of people were used to the model from other apps) but clearly this is something we need to work on.

You might want to look into ways to identify cases where people are used to something but not happy about it in your research process. So many things that shouldn't be normal are considered so and tolerated by people who don't do well with it to the point they don't think about it unless someone asks the right question.

This is unfortunately very true. Thank you for your feedback.

While as an ADHD’er who agrees with all the concerns expressed here on the payment model, I also think that criticism like this has to be a little measured and proportional. Some of the feedback in the comments here (not necessarily in this direct thread that I’m replying to) are going a little too far in my opinion.

Constructive criticism is useful but there are many here breaking the “take the most charitable possible interpretation” rule of HN.

So please do listen to this feedback and please do act on it, but don’t take the personal attacks and name calling in some of the comments here too seriously.

You are being polite and gracious in your responses!

I do not have ADHD diagnosis but I forget such things all the time. This is why I have reminders set up for all trials I ever start the minute I start the trial. This way I'd be reminded to cancel it (or not, in case I like it - but it'd be my decision then). I never complain about it because what's the point? That doesn't mean I like the practice - in fact, I hate it, but too many providers do it anyway.

I can assure you that absolutely no-one "likes" being charged a full years subscription in advance.

We're working on extending the free trial / moving to a freemium model.

Please. You aren't spaceX "working on" your next engine, or AMD "working on" the next processor architecture. All you have to do to end the unethical behavior is flip a few bits in a database. Don't pretend it's some kind of grand technical challenge.

You're luring in people who are trying to improve their mental health and tricking them out of their money. The product isn't even technically innovative. No idea why YC is compromising its brand like this.

While criticism can be good when constructive, I think these comments are a bit dramatic and make way too many assumptions.

I would expect that it's more financially lucrative to have a happy userbase, which translates to a good reputation and thus larger user-base, rather rip-off a few who will eventually give bad reviews and create a bad reputation. To me the current pricing model sounds more like a bad decision rather than anything else. But in any case, if I didn't like it I would just not use it, rather than throwing accusations around on malicious intentions without having any evidence.

PS: I am not even remotely affiliated with the creators of that app

If you worked towards the higher standard, of trying to avoid even the potential appearance of inappropriate action, you would never do what they did.

Deep down do you believe that they would have changed if not for this public outcry?

Make it free for 30 days THEN throw up a pay screen. You're a funded startup what's the issue here?

Agreed, and that's what I would expect too. In fact, if the app works as they claim to be, users would rush to subscribe after the 30 day trial. Yet, criticism doesn't necessarily need to be accompanied with unjustified accusations and demands. I find this attitude to be a very common pattern nowadays. Criticism can be constructive and to the point without any of these.

> To me the current pricing model sounds more like a bad decision rather than anything else.

I'd ordinarily be willing to believe that, but I can't stop thinking: this is a service with a very specific target market - people with a condition whose defining characteristic is being vulnerable to be exploited through the exact payment model that Inflow has chosen. To accept this as a honest mistake is to believe that they never thought about their target audience at all, which is inconsistent with their claims of having people with deep understanding of the condition on board.

> But in any case, if I didn't like it I would just not use it, rather than throwing accusations around on malicious intentions without having any evidence.

Startups are getting way too much mileage from Hanlon's razor.

Quite possibly. But still, what happened to personal responsibility? Having ADHD does it mean I have no judgement at all. If I evaluated the risk of forgetting is too high, I could choose not to subscribe in the first place. Or if I still think this app is important enough, I could make sure I find another way to be reminded to cancel.

What I mainly question is the demand culture, that a lot of users have towards developers - even towards people voluntarily put their time to do opensource work.

it might sound really strange, but remembering to cancel something like this is incredibly hard for me as someone with ADHD. I pay for so many things, sometimes multiple times before I can work up the energy (and memory) to take care of something like this.

I don't know the founders and have not tried the product, but I'm building a business in the consumer subscription space so I'll post a few things that might clarify why they could end up with this model even with good intentions. I'll also add that I don't know much about the science/behavior of folks with ADHD, so I won't try to talk about that piece at all.

First, the app stores are pretty prescriptive about how you handle introductory trials on subscriptions (especially Apple), which means you are usually stuck with "start trial + opt-out" as the only viable model if you're billing through the App Store.

Second, behavioral/commitment theory often shows that for apps or really any behavior change that requires some effort, a longer time commitment/investment gets people to actually invest the effort they need to actually get value out of the product. If you let people pay for a month, they won't actually put in any effort and then at the end of the month they'll be like "I'm not getting any value here" and they'll just cancel. They won't put in the effort to build the habits. So most wellness apps/products (from meditation/fitness apps to gym memberships) end up with some sort of free trial period, followed by an annual commitment (and if there's a monthly option, it's at a steep hike from the annual one).

Finally, when you're early on in the life of your startup, you're mostly trying to get to product-market fit and see whether people are willing to use / pay for what you've built. You just choose a pricing period/plan that makes sense, focus on the product, then when you get the product where you want, you go back and experiment with finding the ideal pricing plan for you and your users.

That said, it's clear in this case that this model may not be great for the target audience (in fact, even for neurotypicals, canceling subscriptions and such is still a challenge to manage). And obviously the app creators could have put more thought into it.

We ended up with an opt-out free trial plan as per Apple's rules on iOS, with a monthly plan where the yearly plan is a 25% discount if you choose it, and several reminders before the trial converts to paid. We also allow users to do a standard opt-in plan if they're not signing up through iOS (ie only need to put credit card after trial expires). We offer refunds where we can for people who got billed but didn't intend to, but Apple has to process those refunds too.

Generally supportive of you guys but want to pick even more.

> A lot of other apps follow a similar model, we allow people to cancel anytime and have refunded everyone that has forgotten to cancel.

Many ADHD people also forget or are too embarrassed to do that.

Life hack that works for some: at least on iOS and in my region one can subscribe, immediately unsubscribe and continue to use a product during its free trial period without risking getting trapped.

This hack works on Android, too. At least I was able to do that with Audible.

Charging for monthly instead of yearly after trial ends is something you can push to production in half an hour. Don't try to weasel out in front of technical audience. Liar.

Harsh but fair.

Users do have a choice between monthly and yearly.

Just gonna jump on the bandwagon here and say that, as somebody who suffers from ADHD, with all due respect, that is 100% USDA certified horseshit.

At the very least, bill monthly and make the trial not auto-renew at full price. And, since the target market is people with executive dysfunction, I'd love to see your team go the extra mile and default to pushing notifications the week before and day before a user's subscription renews, giving them ample time to cancel if it doesn't fit their budget this month.

Yep. ADHD here and I won't touch anything that auto-renews.

As someone who has ADHD and suffers a lot from forgetting to cancel subscriptions etc this would be really really good. I used to set several calendar reminders each quarter. One to sit down and work out what subscriptions I have. Another one to sit down and work out what subscriptions I have. One to cancel subscriptions. Another one to sit down and actually cancel them. A third one to work out if I’ve cancelled them…

Now I have a bunch of automations set up that ping me and say “you’ve got this subscription… are you actually using it?”

It took me a fair bit of effort to engineer but it’s saved me a whole load of money.

Please do not confuse people liking subscription and people that forget about the day when the trial ends and get charged (a non-trivial sum of over $100) against their wishes. People that like subscription certainly can use subscription, and giving them such an option is a smart move. A sneaky and underhanded move is to charge those that did not explicitly express the desire to have the subscription, but just forgot to cancel in time. Refunding after people vocally complain is fixing half of the problem. Not doing opt-out charging would be the other half.

I know many providers do not dare to give up on opt-out trials, since it brings them money. It is scary to trust your future clients - maybe they won't buy after all? But if you don't trust them, why would they trust you?

"but for an app for people with executive function issues, an opt out format seems shady" is so dead on. What an enormous red flag.

Might as well come right out and say that they understand ADHD and plan to use its drawbacks to make money from people. Considering how desperate a lot of people are for treatment, this sounds like a great monetary investment for people with no conscience.

This may be a bit harsh. I'm a bit salty as navigating the process to get treatment for ADHD is a continual reminder that most services are tilted towards providing services to already well-functioning people. I probably will try it, after all you did just remind me to cancel my free Prime membership, even though it was right there in bold on my day planner a week ago.

Argg! I also have a thing I forgot to cancel last month! Did you get your Prime one done? I'm doing mine right now.

Edit: done! Thanks.

I did it right away, half asleep. The post absolutely reminded me to. The app worked! lol

Plus my dislike of Amazon is rather motivating.

As someone with ADHD, I can confirm this model is super predatory.

I cancel all my credit cards every year just to get rid of all opt-in charges on regular basis

Billing an entire annual subscription up front, as opposed to monthly, seems especially questionable. What if the therapy doesn't work? What if it's so badly implemented that it can't work? You're still out a hundred bucks just the same, and that's just in the first year.

edit: There is also a monthly subscription option, in the Apple app store at least. It's $22 a month - so over twice as much as the annual. This does not give me to think the product here is less sketchy. And the Psy.D founder, Sachs, is a pretty blatant self-promoter of the sort endemic to the ADD/ADHD "coaching" space, if unusually well qualified by that standard: https://sachscenter.com/adult-child-psychiatrist-psychologis...

Perhaps it's less of a surprise than I initially found it that the account posting this Launch HN has thus far had nothing further to say.

also edit: Sachs is a Psy.D, not an MD. Granted, this does entitle him to "Dr." as a term of address, just as would a doctorate in physics, ancient history, or underwater basket-weaving. But, just as with any of those, it doesn't qualify him as a doctor in the generally understood sense. Again, this gives one reasonably to question, and the questions thus raised are ones for which well-prepared founders may reasonably be expected to provide compelling answers.

I just downloaded the Android app to check, and it's a similar ratio as you describe for the Apple app store: £19.99 per month if paid monthly, but £7.17 per month (as £85.99 per year) if paid annually.

And on my phone at least, the monthly payment option is also hidden behind a scroll down action: https://i.imgur.com/rV0bMTH.jpg, with the yearly subscription already selected by default.

It would seem they're pushing quite strongly this annual payment option.

It's really remarkable.

I'm not too proud to admit that I spent a long time not really taking ADD/ADHD all that seriously. That was before I fell in love with someone who has ADD. Seeing on a daily basis the effect it has on him, and the extent to which, even with effective treatment, it remains a serious obstacle in terms of executive function and followthrough even for things he plainly cares a lot about - to say nothing of subscription fees, which even people without these disorders find easy enough to forget that tools for managing them constitute an entire genre in their own right...

Well, I'm really looking forward to seeing what the founders have to say for themselves here, if anything, and wondering what reasons they could give me not to warn my boyfriend off their product in the strongest of terms.

Hey, as an adhd person that really gets frustrated when people don't take adhd seriously -- thanks for changing your stance.

it generally only gets portrayed in the media based on how other people experience people with adhd -- never the actual experience of the person with adhd.

i hope that changes in the future, so more people can have a similar exposure to it that you've had as a loved one.

Thanks for the feedback - this is due to screen size on Android and we're current working on fixing issues impacting smaller screen sizes at the moment.

> £19.99 per month if paid monthly, but £7.17 per month (as £85.99 per year) if paid annually.

As someone who's worked on pricing models, this speaks either to very little thought to pricing or a monumental churn issue.

A hefty discount for an annual subscription is generally something like 20%, and companies with good retention only offer ~10%.

Discounting over 50% if someone chooses annual either tells me (1) this company is low on funding and desperately needs the immediate cash flow, or (2) this company can't retain customers and is really lacking product-market fit.

Old YC would have absolutely helped the founders straighten this out, but it seems YC is now just a big cash grab and rolodex in the form of Bookface.

Perhaps there is room for the following:

(Please dont kill me for the off-the-cuff idea:)

A per-login / frequency of use model;

You agree to a MAXIMUM of $100/year as WELL AS a max per month that may be charged (== to $100/12 max) -- but the idea is that if you skip a month or some amount of time you are not charged....

The usage is based on certain amount of time-in-app or somesuch....

you get the idea.

---

Anyway, as someone who has debilitating ADHD I really want to use this... but whilst not working, I can't pre-commit $100 to something that I may have too bad a case of ADHD to adopt on a regular.

I think that's a good insight, not least in that a model like that incentivizes real utility in the product. Granted, it could also incentivize dark-pattern stickiness, but there's still the seed of something worth considering here.

Granted IAP isn't that flexible, or not to my knowledge, at least. But Stripe is right there, too.

This is a good idea but we do also have limitations from the App/Play Store - definitely something we'd been keen to explore though. In the meantime, we've refunded everybody who has requested one.

That reminds me of a quip by Rachael in an episode of Friends when her and Ross [Ph.D] are at the hospital - "Now remember Ross, there are real doctors here"

> Sachs is a Psy.D, not an MD. Granted, this does entitle him to "Dr." as a term of address, just as would a doctorate in physics, ancient history, or underwater basket-weaving. But, just as with any of those, it doesn't qualify him as a doctor in the generally understood sense.

Indeed, I've had better help from a LCSW than a Psy.D, and I never called the social worker "Dr."

A LCSW is not a doctor in the US but a psychologist is.

If you aren't doing so already, you should look into if your card has virtual cards. Capital One for example does. I think it would make your current process easier.

I use Privacy[1] for this and would highly recommend the service to anybody using a bank that doesn't have an easy and convenient way to issue disposable card numbers (most US banks).

1. https://privacy.com/

It looks like Capital One does this via a Chrome extension, which you have to install (and which can presumably look over your shoulder to see all of the shopping websites you visit). I might consider installing this, deactivating it by default, and then only enabling it when I want to make a purchase. But I was hoping there would be a simple number generator in the mobile app. I guess that would be too easy!

Canceling a credit card does not cancel your obligation to pay a vendor unless you also terminate your plan with them. Some of them will try to collect, especially if you had a contract.

Sometimes I go through my bill and find opt-in services so I can call in charge backs against them before I cancel.

They can pry that money out of my cold dead hands. And I've yet to have anything sent to collections

Try Privacy.com that should help you manage your subscriptions a lot better.

There are nowadays plenty of e-banking solutions which provide you with virtual cards, which you can create and destroy on the fly and at 0 cost. It is really wonderful for this kind of scenario. Vivid is the one I've been using, I couldnt be happier with it. Theres also N26 allowing this, and Im not sure but, Skrill, Transferwise, Revolut,...

Also, as someone without ADHD, I can also say this model is predatory. Nobody should have to remember to put in a request to not be charged after a trial.

You're not wrong - but it's maybe not great to distract from the predatory nature of targeting people that are at high risk of being exploited from this model.

It's bad all around, but it's extra bad for people with adhd -- and considering it's an adhd app, it really puts it on a different level of predatory that's worth focusing on.

I tried this to get out of my gym membership and they sent the bill to collections. Luckily I called them and they didn't make me pay it. They did ban me from the gym however

This is so shady and I "could" understand it coming from a random startup... but by a startup backed by YC? And that it gets it own Launch HN thread (while others startups had to do it in the batch posts?). This is no the first time in the last months that something like this happened, unfortunately.

why do you think YCombinator isn't willing to exploit people? They're a VC accelerator, of course they are. Just because the profit motive doesn't always lead to immoral behaviour, doesn't mean that profit-motivated people aren't going to pursue immoral behaviour if it's profitable.

It's a little surprising to see YC start to risk the brand this way, though, and as others have noted in this thread, not for the first time recently - Skip the Interview, in particular, being of note in this connection, after having shut down the same day it launched due to a complete, and frankly rather easily predictable, failure of product-market fit.

Right now, and in the past, "YC-backed" has consistently been a very solid selling point, both for following rounds and in recruitment. Maybe it's just a transient bobble, and I strongly hope that proves true. Still, at this rate, I'm starting to wonder a little what "YC-backed" might come to mean a few years hence, and whether it'll still be worth the same.

The low-hanging fruit have been picked over. The easy wins of SaaS and consumer web tech have been won already, but they still have an obligation to generate the same levels of profit (have you ever seen a company gracefully shrink with its industry, especially a financialised company?), so they will start to both go for niches, and go for exploitation. Growth is always most rapid at the introduction of a new industry, and if you're a hypercapitalist (as VCs tend to be) you're going to be under pressure to see continued profit levels long after the industry can sustain them healthily.

YC (in)famously backed InstallMonetizer in W12.

https://news.ycombinator.com/item?id=5092711

I mean, reading the description, it's hard not to get a little concerned: "a start up that's going to try to make money off of folks with ADHD" isn't a great starting place.

I think this is sort of a broader start-up problem. Some things shouldn't be monetized (period, but for the sake of the audience, I'll add: at least not as aggressively as is required for a start-up).

It’s shameful for YC to invest in this and blast it onto the front page of HN. Unethical and gross. I wish this site was community driven and not used as an avenue for YC to promote their awful investments.

Here's a counter argument: "a company making money off of folks with ____" describes the entirety of the Biomed industry. Every medical device is sold with the intention of helping people with medical issues, but they can't be free. The cost of development and production has to be covered by somebody (be that by the government, medical insurance, or private party). If it wasn't, the company making the device wouldn't have developed it in the first place.

That industry is also regulated and monitored to ensure that the interventions coming out of it are generally safe and effective. Is the same true here?

> Every medical device is sold with the intention of helping people with medical issues, but they can't be free.

Close, but a slight correction here:

Every medical device is sold with the intention of maximising profit, but they can't do nothing or people wouldn't buy them.

That more accurately portrays the priority.

So true.

If it actually works, an app like this could be worth 10x the price.

Getting rid of all the time waste, all the stress of AD is worth a lot.

Sure, but then isn't this just a "disability tax"? (I'm aware that the word disability is antiquated and not perfect here, but for the sake of being concise, this is what I wrote).

The need for this app is a problem. Insurance should cover the cost of treatment (and insurance should be affordable and available; for transparency: I'm pro medicare for all, here in the US).

Start ups have a bad habit of taking a systemic problem and trying to monetize a solution to it. In reality, the effort being put into this should be put, instead, toward making systemic changes that would make this app unneccessary.

Most of the folks on this thread seem to be objecting to the opt-out nature of their subscription service. I agree with them.

On the other hand, you seem to be objecting to the very nature of money being charged for this app or any other healthcare service?

It's gross, and I do not love this aspect of capitalism. I agree with you to that extent.

But -- again, without ditching capitalism entirely -- what's the alternative? These folks are providing a service and that costs money. Aside from ditching capitalism entirely, what alternative is there to "charging $X to fix Y?" Literally anything amounts to a chronic or acute disability tax. The cost of asprin is a headache tax. And so on.

The best capitalism has been able to do is roll these sorts of healthcare costs into insurance premiums, so we can share the cost collectively to an extent. Unfortunately I doubt an app like this is covered by any plan.

The only other solution (within capitalism) I can imagine is if the creators of this app ran their company as a non-profit org. I have considered that in the past for a venture or two. But, the money would still need to come from somewhere.

You're right, I take a more aggressive stance on this sort of thing than others might. I'm also known to say "if you can't afford to pay your workers a living wage you can't afford to do business" of many retail/service environments.

"But I need to make money, too" isn't an excuse. It wants to be, but it is not. I would agree that the biggest offender is the predatory model, but I would say that the way to do this _correctly_ is to do it free/OSS with a patreon. Let folks who use it pay what they think it's worth.

The problem is that the incentive systems don't align. Someone elsewhere mentioned that this seemed to build dependency in its users (an anti-pattern in therapeutics (and elsewhere, but let's be specific to therapeutics for now)). With something like Patreon, the incentives are much closer aligned: the app _has_ to do good in order to well, because otherwise nobody will pay for it.

Again, they (the developers) could also put their time & energy into enacting systemic change.

   "But I need to make money, too" isn't an excuse. It 
   wants to be, but it is not.

There's another way to phrase that.

   "But I would like to buy food, clothing, and pay my rent" 
   isn't an excuse. It wants to be, but it is not.

People need food and places to live. The vast majority of people on Earth aren't fortunate enough to have a year or two worth of savings to tide them over while they work on some dream project that

I would say your incentives don't align. By effectively restricting the privilege of app/product creation to those people that have a strong economic cushion, you're effectively excluding most of the people on Earth, particularly those that not already wealthy and particularly those with people besides themselves to care for.

    "if you can't afford to pay your workers a living wage 
    you can't afford to do business" of many retail/service 
    environments.

But app creators should just do it for free? Until the money maaaaybe rolls in? Most business/apps/etc fail.

> People need food and places to live.

Yeah, and under capitalism, these are linked to some capitalist idea of productivity.

We're getting a little far from the original point of this thread, but I'd argue that food & shelter & healthcare shouldn't be linked to "productivity".

I think the way that this is applicable here is that when the private sector gets involved in an issue, it can be a lot harder for the issue to be addressed by the public sector. That's a really big topic, I'd suggest reading Winners Take All[0] for a more in-depth look at this.

I'll leave this at: some things shouldn't be monetized (and this is one of them).

> I would say your incentives don't align.

I'm not sure what you mean. What are my incentives here?

> But app creators should just do it for free?

There are plenty of consumer spaces where I don't complain (publicly) about app-creators getting involved. This, being a "mental health" app, is an area where the public sector getting involved could be detrimental (see my comment elsewhere where I ask if this could be harmful in the long run).

[0] https://www.penguinrandomhouse.com/books/539747/winners-take...

    I'm also known to say "if you can't afford to pay 
    your workers a living wage you can't afford to 
    do business" of many retail/service environments.

Also, how the heck do you reconcile this with your stance that people shouldn't try and make money from their apps?

I would say, "if you can't afford to pay your developers and other employees a living wage, then you can't afford to make an app or launch a product"

I don't think you've thought any of this through, man. You have some excellent ideals and I agree with them but you need to think through the practical ramifications.

> Also, how the heck do you reconcile this with your stance that people shouldn't try and make money from their apps?

I think I addressed this in my other reply, but I'll reiterate: given the economic system we exist in, I'm not against people making money from their apps, I'm against certain areas better suited to public works being entered by the private sector (especially in a predatory way).

> I would say, "if you can't afford to pay your developers and other employees a living wage, then you can't afford to make an app or launch a product"

I totally agree with this.

> I don't think you've thought any of this through, man.

I try really hard to be internally consistent, but I'm imperfect. I'd be interested in hearing what I'm not thinking through, because I feel like this is an area where I have.

The respond to the quote at the top of your comment: I've been reading & hearing about a lot of restaurant owners complaining that they can't afford to pay their workers a living wage for $REASONS (this happens a lot in restaurants, specifically). My response is exactly what you quoted (and I'll type it again): If you can't afford to pay your workers a living wage, then you can't afford to do business. Asking anyone to work for a sub-living wage is essentially asking for them to subsidize your business, and, in an area that differs dramatically from start-ups, these restaurant workers generally aren't given equity as compensation (which would tie their wage to the success of the restaurant).

I'll admit that my thoughts in this area are complicated, because we live in a capitalist community (at least here in the US) so there are some concessions that I have to make. Do I think capitalism is viable in the long run? No. But I also think it is a fool's errand to wait for a revolution, so I think my thoughts get a little more nuanced when it comes to working ethically within an inherently unethical system (and I'm being very liberal with what I consider ethical work, by necessity).

I'd love to keep this conversation going. I know I have a lot to learn & that there's a lot that I don't know that I don't know. Conversations like this, that challenge my ideas, can only lead to a better understanding of my concerns and thoughts.

I appreciate you taking the time to respond to my comments.

    Do I think capitalism is viable in the long run? No. But 
    I also think it is a fool's errand to wait for a 
    revolution,

Amen! Honestly, I might wait for or work towards a revolution, but I suspect that whatever replaces capitalism is likely to be a lot worse. Power coalesces, even in well-intentioned and theoretically more egalitarian systems. Their historical track record is not great.

    I think my thoughts get a little more nuanced when 
    it comes to working ethically within an inherently
    unethical system

Amen to that as well. Ethics are never easy and they always require extra gymnastics and compromise when trying to do the ethical thing in an inherently unethical system.

    > I don't think you've thought any of this through, man.

    I try really hard to be internally consistent, but 
    I'm imperfect.

I'm sorry I phrased it that way. It was glib and rude of me to type that. Clearly you've thought about this a lot.

But, I'm not sure I understand your practical alternative here.

Let's assume that Inflow is (a) actually effective and (b) they drop the questionable opt-out subscription model. Both big assumptions. I have not used the app and am skeptical to say the least. But lets assume it delivers legitimate value/relief/etc.

(Something I'd gladly pay for, and something the world genuinely needs. Doing CBT with a therapist is financially out of reach for many/most)

So, how should this app have been created? How would its creators be paid prior to the app earning money?

I have bootstrapped a product to market, and it really sucked. I went without health insurance for two years, living in the spare bedroom of a family member. And I was extremely privileged to even be able to do that: I was young and healthy and had a family I could rely on, and no dependents relying upon me. Even if I were living in a country where there was some kind of humane public healthcare system that would have been rough.

I'm not complaining. Ultimately it was an awesome experience. But that is just not a viable path to creating stuff for most people.

Obviously a lot of open source projects get created under less-dire situations, but of course there is also a lot of corporate sponsorship there.

You bring up a lot of valid questions and points, and I really appreciate the conversation!

> Let's assume that Inflow is (a) actually effective and (b) they drop the questionable opt-out subscription model. Both big assumptions. I have not used the app and am skeptical to say the least. But lets assume it delivers legitimate value/relief/etc.

These are big ifs, particularly because the incentive systems are misaligned. The incentive of the creators are profitability and growth while the incentive of the user is to manage their ADHD.

Ethics, especially concerning survival in the throes of capitalism, are complicated. I question private sector solutions for public sector problems largely because money speaks in politics and I think having money established in an area makes it _harder_ for the public sector to get involved in that area.

> So, how should this app have been created? How would its creators be paid prior to the app earning money?

Putting aside the fact that this app can't diagnose someone, can't provide alternative therapies (pharmaceutical, non-CBT if CBT isn't working, etc.), growth and profitability are not "helping users". I said this elsewhere: if this _is_ going to exist, it should be funded through something like Patreon, where payment is optional and generally is more tied to the app being functional and beneficial (users who love the service are more likely to pay, while those who do not, lose nothing but their time).

> And I was extremely privileged to even be able to do that...

You raise a really good point that I've been wrestling with a lot lately. The ability to not-charge up front is a position of privilege that locks out a lot of folks (e.g. if one is living paycheck-to-paycheck working 2 jobs, they might not be able to afford to take the time to create the next unicorn app that could put food on their plate forever). I'm sorry, but I'm not sure I have answers. I have a friend asking how to ethically be a landlord, and I can't answer her either.

(as an aside: I'd love to spend some of my time just making apps for folks without my privilege, sort of 'pass on' my privilege to those who might need it, but I'm honestly not sure how that would realistically work or how to get started.)

One of my friends likes to remind me that there's no ethical consumption under capitalism, in response to which I wonder: how feasible is ethical production under a system with no ethical consumption?

This is a solution to the main problem, which is healthcare being a steaming puddle of diarrhea and medication being gatekept by the industry and the government... for your own safety, of course.

A poor solution imo (at least for any serious cases), but at least someone is trying something.

I don't see anything wrong with it. Surely a lot of people with ADHD would be happy to pay for an app that helps them overcome their problem, and the monetary price most likely exceeds the benefit (assuming the method used by this app works as advertised). In fact the price is much cheaper than a regular visit to a therapist. The problem I see here is the current subscription model. If people are happy with the trial, and see results, they would be happy to subscribe for a monthly fee along with their Netflixes and Spotifys.

Given that executive dysfunction is one facet of ADHD/ADD, having opt-out is definitely preying on the users. Avoid.

Noom, a popular diet/weight-loss app, works on the same principle. I've used it. To start the free trial you need to prepare the payment mechanism. Then after X amount of days, the paid service automatically kicks in. I wasn't super-excited to discover I'd just committed a lot of money before I was ready or even fully committed to the app/service.

I suspect this is going to be the new trend for future apps, since it almost certainly delivers a higher number of paid users than other methods do.

It's fair to criticize this, but it's worth noting that this is how subscriptions work in Google / Apple app stores. You really can't do anything else.

Why do you think you can’t do anything else? There’s different trial methods. Shorter subscription periods. OPT-in models.

There are no free trial subscriptions with opt-in "continue paying" as far as I know. I mean, why would Apple and Google build that? They make more money with trial + automatic billing.

I once built such a trial option myself. You could start a free trial (just within the app, no "native trial" involved) and then sign up for the paid plan with native in-app purchases once it ran out.

It got rejected by Apple. They insisted I use the native app store trial which is opt-out.

Of course they support an opt-in model, they can't really choose to not support it. The "free trial" can just be the app giving you all the features for a week, and then the app can prompt you to sign up (opt-in) for a subscription with Apple/Google when that ends. No CC number until after the trial ends.

EDIT: I'm wrong, comment next to mine says Apple has rejected this. Maybe Google wouldn't though?

I have ADHD, so wearing my consumer hat for a moment, I guess I just don’t really care.

It’s their problem to figure out how to present their product to me in a compelling way that I am willing to pay for. I don’t open my wallet just because I feel bad for starving founders.

Yes that's true. But when we're talking about this on Hacker News, it's interesting to talk about the why. Especially when the why is "Google and Apple make more money this way".

>> After the free trial period (7 days), they will charge for an annual subscription ($102.95 US). This is OPT OUT, not opt in.

This is the norm right. I don't know ANY app that is OPT IN after the initial trial period is done. This is the Industry Standard.

Industry Standard isn't marketed specifically to people with ADHD at the exclusion of everyone else. At the point where a product is targeted at people who struggle with this, and it's still not putting thought into how they'll react, something has gone very wrong.

Industry standards for media often don't included content warnings. However, if someone posts on HN that they're building a streaming service designed primarily for people with trauma, and they don't include content warnings in front of their shows, you'd probably have some questions -- because you expect them to know their audience. To me, this launch suggests that the founders either haven't spent much time thinking about how their process actually will work with their target audience or (much worse) that they did think about it and still decided that it would be OK.

It's just really tone-deaf to have a launch HN that spends all this time talking about how the intake process for people with ADHD is thoughtless or needlessly difficult, when their app's funding model is making the same mistakes and lacking the same affordances.

yeah, this really undermines the credibility of the app. I really hope that they address this.

I managed to put together a system to keep track of renewals, and still make sure to pre-cancel them so they won't renew without me meaning to. Too many services will take your money and shut you down if you cancel renewal before the end, and I won't touch any that do. They need to be very clear on how they handle this, or it's a hard pass for me.

I would encourage everyone who feels strongly about this to feel empowered to use the App Store reporting system, or the Better Business Bureau complaint system to report exploit and manipulation by business.

https://www.bbb.org/file-a-complaint

Are you working on a competing product in the mental health space? You're clearly not a prospective patient and you don't have loved ones who you were evaluating this for. Your careful scrutiny exposes you.

FWIW this is how several diet apps work as well. Short initial free trial, followed by auto-charge lump sum subscription of 6-12mo.

Not my favorite model, but also probably not intentionally predatory towards a specific group of people.

From a business point of view it makes some sense. It extracts maximum money from customers in a niche that is inherently flakey (dieting, self-help, etc.). People often start off strong for a few weeks/months and flake out. Forcing a longer up-front commitment helps their bottom line, and possibly helps some customers stick with it since they already spent the money.

I'm not trying to defend it, but I do think it's a bit much to say it's intentionally predatory. From my view it's just app economy capitalism at work.

“Predatory” and “working for other apps” aren’t mutually exclusive.

The massive difference that you are overlooking, however, is the fact that ADHD Brains are neurologically and/or biochemically incapable of defense against this.

That inner voice telling you what to do or what not to do? ADHD brains have... well, let's just say "something else".. in its place.

> That inner voice telling you what to do or what not to do? ADHD brains have... well, let's just say "something else".. in its place.

Pretty much every description I’ve heard from people diagnosed with ADHD features the same kind of internal voice as neurotypical people describe; the “something else” seems to be between that voice and action, not in place of it.

I'm diagnosed with severe combined type ADHD (top tier, best of both worlds) which could have something to do with this, but I can't say I have ever thought of this voice and action/driver as separate things.

My natural, pre-treatment, and unmedicated sub-/semi-conscious behaviour is not at all like that of a typical person.

Thanks for the warning. I'll stick to my prescription.

Presumably for the same reason opt-in is a problem too.

maybe it's good to start putting service payments on blockchain to enable easier accounting, and not require ongoing payments.

This is totally wrong. The economics of monthly billing are awful, and completely unworkable for a new startup. You have to do annual.

Cost of Install: $7.00, for something this specific Trial Start Rate: 20%, if paywalled like this app is Cost Per Trial: $35 Conversion to Trial: 40% Cost Per Subscriber: $87.50

If they charge you $10/month, they can't get into the black on a new customer for 9 months. They have to eat support costs that whole time. It just doesn't work, when you're starting out. You must charge annual.

Medical licensing cartels charge $500-800 PER MONTH. These guys are trying to charge $100 PER YEAR.

This is an order of magnitude more effective.

Said another way: if someone is too poor for this, they're fucked. They're definitely too poor for any other treatment option. On the other hand, this will open up treatment to people who can't pay the medical cartels.

That's amazing, iterative progress.

Let's give props to these guys for making epic iterative progress, not shit on them because they're not working for free.

The problem isn’t the cost, it’s the way folks with ADHD are being charged.

The whole point here is to help folks who are having trouble remembering to do things. Regardless of the economics, the optics here make this seem like exploitation.

Making this opt-in avoids a dark pattern. Folks with ADHD are often impulsive and strike while the iron is hot—if this has value people will opt-in.

Why are we holding this new startup to a standard we don't hold anyone else? 6 months from now when they have their economics figured out, cool, they can run that test.

Generally, giving users a toggle to get reminded when a trial is about to run out will INCREASE conversion rates.

That depends on the business, and is part of a pretty standard set of experiments you run post-launch.

With your comments you're part HN is descending into a circular firing squad of virtue signaling. These guys shipped something that could help a lot of people, over time they can improve their onboarding flow, lower cost.

Is the most remarkable thing about a really cool CBT tool for ADHD really that they have a standard trial flow?

You’re missing my point—it’s a bad look regardless of the economics.

You can have a great business model, you can have a good product, but if you can’t operate without alienating the people you want to sell to you’re probably dead in the water.

> Why are we holding this new startup to a standard we don't hold anyone else?

Most startups aren't offering medical care. Call it "virtue signaling" if you like that those which do come in for a likewise unusual degree of scrutiny, but do you think you're likely to convince anyone that way?

I won't quibble with your analysis of the unit economics involved, but I will say that's not on point - this isn't a question of CAC/LTV but rather one of perception and image. My impression of Launch HN posts is that they are intended in part to elicit this sort of analysis, and by that metric this one has succeeded quite well. It seems like these founders didn't know they had this problem to solve, and now - if they're paying attention, which I assume they are - they do know. In what way is that other than a win?

I find it strange that you keep talking past the point people are making. The problem is opt-out, and nobody is holding this company to a different standard. People hate opt-out, and in this case it looks particularly predatory.

Your comments come off as entirely unempathetic. Not everything is about bottom line capitalism.

I'm entirely and completely unemphatic. I think these are loser concerns for when a startup first launches.

These guys are moving the needle making improvements in a forward direction, and a big part of this thread is shitting on their launch, hyper-focusing on things they'll be able to change.

Launch HN threads used to be about asking thoughtful questions, having a back and forth where people learn about new spaces, and encouraging people launching their startups.

This whole thread is concern trolling of the worst kind, to eyes.

I'll bow out since clearly the bulk of the thread disagrees.

What kind of virtue signaling is congratulating a startup for their innovation before they've proven anything?

Also the word is "empathy" not "emphatic".

Don't even bother. This is just the predictable RW vice signalling which has to pop up in every thread. They can talk as much as they want about hardnosed capitalism, but you're not very good at hardnosed capitalism if you can't build a product which wins over your target market, and instead have to argue with said target market about why they should be fans of your product.

> Is the most remarkable thing about a really cool CBT tool for ADHD really that they have a standard trial flow?

I don't know - the problem is that, as an adhd person, once I learn about their bad trial flow, I'm not continuing to learn anything else about it.

That's their problem, not mine.

Appreciate the feedback and we're working on potential solutions to this. We do refund everybody who requests one and send reminder emails and notification within 2 days of the free trial ending.

Fantastic to hear this--as the OP mentioned, having ADHD makes it hard to follow up on stuff like this.

The original announcement mentioned you folks have a neuro-diverse team, which I applaud and respect. I hope you really take advantage of this to dog-food your own product and on/offboarding processes to catch stuff like this going forward.

Keep at it! I'd love to see you succeed with this product.

Thank you so much - really appreciate <3

This is a non-answer making it sound like this is some complex problem you're grappling with. Do the ethical thing and make it opt-in. Stop relying on distracted forgetful people to be so distracted and forgetful that they give you money.

What about folks who don't request a refund but don't use your product (as seems to be the issue that's getting discussed here)?

None of what you’re saying makes sense. If the product is amazing people will continue paying and attrition will be low, annual or not.

Basically the model here is like a gym, where people buy things that they don’t use as much as the price implies or is simply ineffective.

Given that the customers are executive function impaired, seems shady.

> or is simply ineffective

And 7 days is really too short to notice a sustained effect.

Indeed, but the same could be said about therapy, or anything really. Therapists don’t charge you a year up front as far as I know.

This is a good point. There are a lot of reasons you might get a small boost of productivity after starting a new therapy approach.

7 days isn't enough time for the vast majority of people to know whether the app is doing anything at all for them.

"Spend a week playing with something new and interesting that you might just hyperfocus on, and then impulsively pay us for a year's access because this time you won't lose interest in two months" feels laser-targeted to prey on ADHD behaviors.

> On the other hand, this will open up treatment to people who can't pay the medical cartels.

This is making the big assumption that a generalized set of self-directed exercises with no one-on-one personalized customization or checkins is an adequate substitute for real medical care.

I am skeptical that it is an adequate substitute. And if someone is hungry and you sell them a picture of a cheeseburger, that isn't epic iterative progress, it's just exploitative and immoral. I don't see any strong evidence that their app is actually going to work.

People with ADHD aren't famously great at consistently self-motivating themselves to do daily tasks. What are the odds that this isn't just another $100 charge for them that they can feel guilty about at 2:00 in the morning? If the founders want to argue that this is more (or even just comparably) effective than actual therapy and medication when it can't even be used as a diagnostic tool, then they need much stronger evidence than they're showing.

And I don't think that's a problem that can be solved by iteration. If they weren't marketing their product as a substitute for therapy I wouldn't be as critical (although I would still think their pricing model was thoughtless). To market themselves as if they're doing something extraordinary when, from everything I can tell from their product pages, they aren't -- that's predatory.

Self-directed exercises from a startup are not a substitute for real CBT; if they were then insurance would pay for them.

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