Obsessing Over Problems, Predicting the Future, and Why Healthcare Should be a Product (Not a Service)
Obsessing Over Problems, Predicting the Future, and Why Healthcare Should be a Product (Not a Service)
Our 3 Big Ideas this week are inspired by Adrian Aoun and Forward:
Be problem-obsessed, not solution-obsessed.
How to predict the future from first principles.
Why healthcare should be a product—not a service.
Forward is turning healthcare from a service into a product to dramatically reduce the cost of healthcare and reach 1B+ people globally. Before founding Forward, Adrian served as the Director of Special Projects for Google CEO Larry Page, founded Sidewalk Labs, and served as an advisor to the White House on the President’s Council of Advisors on Science and Technology.
Be problem-obsessed, not solution-obsessed.
One aspect of how Adrian Aoun runs Forward that fascinates me is his obsession with being problem oriented—not solutions oriented.
“I’ve always been fascinated with problems more than solutions. And so, I actually walk around Forward and tell people, ‘Solutions don’t really matter. Problems matter.’”
In Adrian’s eyes, there’s nothing redeeming about obsessing over ideas or solutions. For one, no idea is ever right or final. We know this because every time we ship an idea, we learn what’s wrong with it and what can be improved, and we iterate on it. So in the end, at best, every idea is merely the foundation for the next, better iteration of that idea.
“So by definition, whatever idea you have, let’s just agree it’s crap. You just don’t know why it’s crap yet. And so, we just took the stance from day one, that we were going to focus on problems, not on solutions.”
It’s easy to treat ideas as precious and valuable. We tend to consider our ideas as part of ourselves—they are ours, inextricably linked to us. This makes it incredibly difficult to actually debate ideas, because attacking an idea often feels like you’re attacking the person who had the idea—even though we know that’s utter nonsense.
“We have this concept at Forward, which is that we love to beat up ideas. And some people get really uncomfortable with that. They’re like, ‘What do you mean you’re beating up my idea.’ We have type of meeting called The Jam where we work through problems and we attack idea. We attack them! And that makes people really uncomfortable by default, because we’re so trained to believe that ideas matter more than problems.”
Keeping our attention focused on the problem we’re solving helps puts ideas into context. Every idea is merely a stepping stone toward toward a better idea. What matters is the problem, not any one solution. So we’re free to pit ideas against one another, ruthlessly, in the name of progress toward solving our problem.
For Forward, that problem is how to get healthcare to billions of people and build the world’s most scalable healthcare system.
How to predict the future from first principles.
Another aspect of Adrian’s background I found fascinating was his work on the President’s Council of Advisors on Science and Technology. In that role, he helped the advise the White House on how to think about science and technology.
“What I was asked to do is basically predict the future. What’s the future of transportation? What’s the future of education? What’s the future of food?”
He had to “come up with the definitive right answer on something that’s a very long-term question.” Which is a fascinating skillset.
To do this, he doesn’t try to predict technology. He just tries to predict the limit of where things could go from first principles—by considering two extreme ends of a given spectrum and picking which extreme is most likely.
Here’s an example we walked through together during our conversation:
Q: A hundred years from now, do you believe healthcare is more likely to cost a billion dollars per person or zero dollars per person?
A: More likely zero than a billion dollars.
Q: Do you think that healthcare is going to use all of your available health and biomarker data or none of it?
A: All of it.
Q: Do you think you’re going to see your doctor once a year or once per minute?
A: Probably once per minute, at least digitally.
Q: Do you believe healthcare is going to happen in one place in a city called a doctor’s office or that healthcare infrastructure will be everywhere?
A: Likely everywhere.
In just a few simple questions, we start to see that it’s likely that the cost of healthcare will decline, that it’s going to make use of more and more of our data, that our health will be assessed minute-by-minute rather than once or twice per year, and that the infrastructure of healthcare will be much more ubiquitous than it is today.
The goal here isn’t to be exactly right, but directionally right. It’s to quickly determine the most likely path of travel by selecting between two counterposed extremes.
“Look, I can’t tell you when. I can’t tell you exactly what it’s going to look like. But I can give you a rough sketch of where it’s going.”
That’s how you predict the future from first principles.
Why healthcare should be a product—not a service.
The most provocative aspect of Forward’s strategy is also the simplest:
“We only have one insight at Forward that we believe that nobody else believes. And it’s that healthcare should be a product, not a service. That roughly everything in healthcare should be a hardware and software problem, not a human problem.”
It’s provocative because the entire healthcare industry today is a service. Meaning you request an appointment with a doctor, who sees you one-on-one, whenever you think you need “healthcare.” So all care is gated by the number of doctors and the time they have available to see you, because all care happens one-on-one.
This makes healthcare extraordinarily expensive. It’s why in the U.S. today, nearly 20% of GDP is healthcare-related, and that number is growing by 6-7% year after year. It’s predicted that in roughly a decade, at that growth rate, healthcare will account for 40% of GDP.
Healthcare has failed to realize that humans don’t scale—only software and hardware do. This is why Forward’s goal is to create hardware and software for every problem—from weight management to cancer screening—because that’s the only way every doctor can scale to reach 10x more patients.
The easiest way to think about Forward is this: They’re turning a service into a technology product, one component at a time.
“When I was at Google, I worked on the search engine. Every time I sat down, I could write code that literally went out to 3-billion people later that day. When a doctor sits down to work, they can affect one person. One. That’s fucked up.”
“If you build doctors better tools, what you realize is that they will get out of dealing with your flu and sniffly nose so they can move into more interesting stuff. If they’re doing to go to med school for 10 years, why are they dealing with your running nose? It’s absurd. Have them deal with cancers. Have them deal with heart disease. Have them deal with the stuff that matters, not your runny nose.”
Forward’s goal is bringing down the cost of healthcare so that they can reach 1B+ people globally. They know the only way they can do that is if they help scale healthcare, by turning a one-on-one service into an infinitely scalable set of hardware and software.
Until next week,
Daniel Scrivner
Listen, watch, or explore more of this week’s episodes:
Forward’s Adrian Aoun | My Favorite Books, Tools, Habits and More
Listen Now | Watch Now | Episode Guide | Transcript
Forward: Bringing Healthcare as a Product to a Billion People | Adrian Aoun, Founder & CEO
What a jerk.