justinbaker84

Usually when I get the spam you are describing sent to my gmail account it looks like some spammer managed to send obvious spam messages from a server on an authoritative domain like a university.

I agree that this is the best possible solution in the american healthcare system for any chronic issues.

For accute issues like getting in a car accident going through the established system is still the best option.

They also hate talking to people who manage $200K per month advertising budgets. Even at that level advertisers just get very low wage support staff in India who can't do much.

A lot of clinics are administering the generic form and it is still very expensive.

I took it and started out with a small dose. The impact of that dose wore off eventually and the plan at my clinic was to raise it over time.

I am concerned that maybe there isn't a dose where you can stop taking more and keep the results. I am worried that everybody will need to keep taking more as they build up more tolerance to it. The study that showed how effective the drug is was 60 weeks long.

That is a long time, but it doesn't show what happens if somebody plans on staying on the drug for years.

That is not what happened to me. I took it for 2 months and then I wanted to get off. I did not go back to normal. Mentally I felt like I needed more food and more junk food than I ever did before using the drug.

My hypothesis is that it supressed my body's natural production of whatever chemical in my brain helps me not go overboard with food. With that supressed by the drug I had an uncontrollable desire for food and currently I am fatter than I was before taking the drug in the first place.

This is exactly what happened to me. The clinic I went to recommended starting out with 1/10 the normal dose for the first month to make sure I would tolerate it. Then we would move up each month.

It worked so well I didn't want to move up so for month 2 I stuck with 1/10th the amount. During that month the effects wore off so I had to take more to get the same impact. I chose to just quit.

2 months after quiting I am 7 pounds fatter than I was when I started with the drug. I suspect that most people will need to keep taking more and more of it to get the same benefits they got from the recommended dose. I am really concerned this is going to lead to a bigger health crises than the one it purported to solve.

I've been a freelance marketer (I do google ads) for 8 years now. The thing that made all the difference for me was building a good website for myself and then buying google ads on keywords that indicate people are looking for somebody like me.

I have gotten all my clients that way.

1 click from a search ad on the first page of google is worth more to an advertiser than all the impressions derived from the all the lame sites you trudge through.

Source: I've run a digital ad agency for 8 years.

You figured correctly.

I understand there is some exaggeration here, but this take is far more accurate than the parent comment.

Yes but if you look at the balance sheet they have about 6 billion in net assets (assets minus liabilities) so the value of the company itself is really more like 5.6 billion. This is a little tricky because company valuation in many cases is a combination of the value of owned assets and the expected value of the actual operations of the company.

So he really extracted more like 2% of the value of the operations of company itself.

This is a very well articulated comment. Thank you for laying this out so clearly. I don't know any hedge fund types so it is helpful to hear from somebody who does.

You are absolutely right. I worked at a big agency where I managed a team that ran the search ads for a fortune 500 tech company. That was usually how it worked. I tried to communicate up the chain that the dinners and outings on Google's dime are a clear conflict of interest, but nobody wanted to hear it.

By far the most dissapointing thing was that the client often just wanted to go with Google's recomendations or they had even worse ideas. Even when we really tried to look out for the best interests of the client it was like fighting an uphill battle both ways.

Another problem is that anything that isn't direct response is hard to measure so it's tough to make a clear and compelling case. Anybody can chalk up any hare brained idea to brand value and it is tough to push back on that when the client doesn't really care.

Because any challenge will lose. It is in their terms of service that what they are doing is legal. But nobody is going to read 70+ of legalese just to set up a campaign.

The issue is that they have not been good faith actors for many years now.

As explained by other comments above there is a hidden setting you need to change to get Google to actually run your ads in the areas you selected.

These are excellent tips. I have been managing Google Ads full time for about 12 years and I run a small agency. I can confirm he is right about all of this.

The challenging thing about this advice is that for most people it feels unnatural to do the opposite of what Google recommends. Usually people need to get ripped off a few times before they accept that fact that Google is no longer a good actor.

Cool, enjoy getting almost no new business creation in the world. I'm sure you will love living in a world where incumbents pretty much have total control over everything.

They are just screwed.

I once worked with a company that was willing to do pretty much anything and spend pretty much anything to get back on Google and nothing worked.

You can create a new account but Google has a million ways to understand what you are doing.

Choosing another agency only works if you have them create the account. That is not a good option because then they own it and they pretty much always abuse that ownership by telling the client the account spent more than it did.

For example they normally say they spent $10K when really they only spent $7K so they charge the client $10K plus fees and make an absurd amount of money.

Also the client cannot take their account to another agency if they want to fire the existing agency.

This is a big problem because the entire field is based on looking at historical performance of the account and making adjustments based on that data.

I understand where you are coming from, but good luck running a business without advertising. Especially if you want to create a new business.

The main problem is that most advertising is annoying or irrelevant to the user. Google search ads are usually the least hated of all ads because they are relevant and not annoying. If other ad systems could do a better job of adopting those qualities then people would not mind advertising as much.

Government scale funds are about 1,000x this amount. For example the US "defense" spending for 2022 is 778 Billion - billion with a B.

And defense spending is less than 10% of overall government spending in the US when you include state and local spending.

I think you are correct when thinking about the long term future of the ecosystem, but if your business gets crushed because you can't advertise on Google then it doesn't feel so good.

Engineers on Hacker News don't understand how much of the advertising world runs through Google. Not being able to advertise on Google is like saying you can't do any backend engineering at your company you can only do front end.

The problem is they have a near monopoly on search, a duopoly on video, a near monopoly on display etc.

It is very difficult to advertise without them. Engineers have a lot of options when building. Any company that wants do advertise does not have such a wide range of options.

I manage about $210K a month in ad spend and the support I get is terrible. I would gladly pay a fee to get good support.

It is great that engineers can choose between multiple services, but advertisers have far fewer options. Getting banned from Google means you lose Google search, Youtube, almost all of the display ads on the open web and most of the ad slots on android apps.

It is devastating and there is nothing you can do about it.

I have been managing google ads for 12 years and I have never seen a suspended account win an appeal.

I think a more relevant take is "how are they going to accomplish this with only $50 million?

California can't even build high speed rail with a budget in 10s of billions of dollars and more than a decade of time.

100% Agree.

I hire UI/UX professionals on UpWork. That is the best solution I have come up with. It is totally worth it to pay somebody $70-$100 to review your site or app for an hour and give you actionable advice.

Yes everybody goes through something like a broker. I run a small agency that manages google ads for small to medium businesses and I frequently get contacted by people who tried to do it themselves and got terrible results.

Great job! Your site did a fantastic job of putting this into context for me.