Thin Left Tails @thinlefttails

reps, reps, reps New York, NY Joined March 2011

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Thin Left Tails @thinlefttails

3 years ago

@mariots Correlation vs. causation? Are these U.S. births? What about impact from big immigration wave that is comprising a big portion of eligible members turning 65?

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Thin Left Tails @thinlefttails

5 years ago

@InnocenceCapit1 @SecretCapital_ Exactly - demand side (and resulting impact to unit economics) completely different. Waste is recurring and scheduled, better pricing power given regulatory capture and higher barriers to entry, etc.

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Thin Left Tails @thinlefttails

6 years ago

@tsludwig On that last point, you need to strike out solo as a 40/50 year old vs. early 30s in public investing. More friction costs to recreate the near to medium term economics as you’re likely a senior partner at that point and doing well if you can start a new firm...

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Thin Left Tails @thinlefttails

6 years ago

@tsludwig Structurally apples-and-oranges. Deal attribution to a specific investor is often murky which makes it difficult to raise money once you leave, track records take longer to build given duration of investment periods (you’re also not making the buy decision as a VP), etc.

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Thin Left Tails @thinlefttails

6 years ago

@william_lou Fire up the slander pawddddddd

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Thin Left Tails @thinlefttails

6 years ago

@verdadcap FinTwit praises “behavioral edge” donkeys who claims time arbitrage is a moat. Yet roasts guys with 10 year money with enough dry powder to own the entire biz

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Thin Left Tails @thinlefttails

7 years ago

@BluegrassCap Content isn’t free. Lots of friction costs from raw news to end product. Incremental margins are theoretically 100%, but sucks for news which has a short self life

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Thin Left Tails @thinlefttails

7 years ago

@YahooCASports Areyoustupidareyoudumb

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Thin Left Tails @thinlefttails

7 years ago

@william_lou Slander pod @Swarlayzers

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Thin Left Tails @thinlefttails

7 years ago

@bruceymonkey @DavidP4AD Are there bad apples? Sure. But this system enables an innovation engine that produces the vast vast majority of new drugs and therapies in the world

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Thin Left Tails @thinlefttails

7 years ago

@bruceymonkey @DavidP4AD Bad analogy; you’re losing the forest through the trees. For every one drug that passes the bar of science (it actually works) and regulatory scrutiny (FDA), there are 99 that fail to get there with zero return on investment ($ and time). This is an empirical fact

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Thin Left Tails @thinlefttails

7 years ago

@bruceymonkey @DavidP4AD You can’t pay the inventors or biotech because they selfishly sold the rights to Novartis after determining they do not want the risk or effort or billions of $ of taking it through trials, commercialization, etc.

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Thin Left Tails @thinlefttails

7 years ago

@bruceymonkey @DavidP4AD Inventors paid by biotech. Biotech paid by pharma. Pharma commercializes and sells the drug. You pay Novartis because they own the rights to a drug for which they paid massive amounts of money to acquire (with all previous stakeholders parting with the drug rights for big $)

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Thin Left Tails @thinlefttails

7 years ago

@DavidP4AD This narrative around “tax payer funded science” is a false and misleading. Yes, most compounds (science projects) spin out of academic research, but the vast vast vast majority of the cost and effort is taking it from an idea through full trials, FDA approvals, etc.

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Thin Left Tails @thinlefttails

7 years ago

@MikeBertaut @dp_oneill @khemp64 @WestHealth Perhaps. Or better management (out of necessity) with what you have. The gov’t has been long complicit in cost shifting so don’t want to put all the blame on the payers, but can’t argue there’s a ton of waste in this system given misaligned incentives and inefficiencies

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Thin Left Tails @thinlefttails

7 years ago

@abhaypande1 @HayekAndKeynes No dispute that these are the highest cost patient cohorts, but this is directionally the same for other nations. The delivery mechanism in which care is delivered to these patients is the issue (treat vs. prevent, oversupply of hospital care vs. community-based)

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Thin Left Tails @thinlefttails

7 years ago

@TheGuapoGringo @HayekAndKeynes Also - empirical data would suggest we don’t have a supply issue relative to the rest of the world. The most cited is hospital beds per capita, which suggests the US is massively over-bedded compared to other countries.

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Thin Left Tails @thinlefttails

7 years ago

@TheGuapoGringo @HayekAndKeynes Not sure this is true for non-economic goods like healthcare. Lots of research to suggest supply drives additional demand (this belief is why Certificate of Need apps exist in the US). More access to healthcare = more unnecessary utilization

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Thin Left Tails @thinlefttails

7 years ago

@HayekAndKeynes Incentives. Fee for service in a cost-plus system where rationing service is a faux-pas. Results in a system with uncapped spending and an economic incentive to increase utilization

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Thin Left Tails @thinlefttails

7 years ago

@BluegrassCap Early in a supply-constrained industry where the moat develops over time (network effect business before critical mass). You generate decent economics along the way given demand > supply and race to establish a moat at run-rate