Ben West is a startup entrepreneur based out of Madison, Wisconsin. He is also a member of the Effective Altruism community and had donated over $100,000 to effective charities before his company even started, and expects to donate millions in the future. I interviewed him to understand more about his motivations and drive and to see if he has practical advice for Huffington Post readers.

Linch: How/why did you decide to devote your life to ethics?

Ben: I read Peter Singer’s Famine, Affluence and Morality and was impressed by how easy it is to have a huge impact in the world. If you’re in the US and living on minimum wage, you are richer than 90% of the world. If you donate 10% of your (minimum wage) income you are still richer than 88% of the world, and that small amount of income will provide thousands of treatments for deworming children.

The fact that people are currently dying because they can’t afford preventive treatments that cost a few dollars is not a good thing, but it does provide an amazing opportunity for those of us who happen to live in the US.

Linch: How did you first hear about the “effective altruism” movement?

Ben: I first heard the phrase “Effective Altruism” on the blog Overcoming Bias, in reference to 80,000 Hours, an EA career counseling service. I had vaguely thought that donating a lot of money was a good idea, but I had not put any meaningful framework around that, and it was extremely exciting to find out that there are other people interested in this.

Linch: What is effective altruism, to you?

Ben: 1) figure out how to do the most good and 2) do it.



Linch: What does “earning-to-give” mean, and what does it entail? Why would somebody choose it over direct work?

Ben: Suppose you want to prevent the spread of malaria, but you yourself know nothing about epidemiology. Suppose Jane, one of the world’s leading epidemiologists, is extremely interested in preventing the spread of malaria, but she is spending a lot of time teaching instead of doing research.

Should you go back to school in the hopes that you will someday become a great epidemiologist and then be able to research malaria? Or should you take a high-paying job and use that extra money to buy out Jane’s teaching credits so she can spend all her time doing research?

Unless you’ve got one hell of an overconfidence problem, paying for Jane to do more research is almost always going to be the right solution. This approach is known as “earning-to-give”, and it may be a good idea if you have a strong comparative advantage in earning money versus the labor needs charities have.

Linch: When/what made you decide you want to “earn-to-give?”

Ben: Calling it a “decision” gives me too much credit. I happened to be making a relatively high salary as a computer programmer before hearing about EA, and that allowed me to donate a substantial amount, but I didn’t do a very comprehensive analysis of my career options.

I think 80,000 Hours can be credited with helping me actually think things through in more recent career decisions. At the time I started Health eFilings, there were a number of things I would’ve donated to if I had more money, and there weren’t a lot of effective charities in need of engineering managers (which is what I did). This seemed to indicate that I had a comparative advantage in earning, andstaying in the private sector also seemed better for some of my personal goals.

Linch: Why did you take the pledge to live on minimum wage? What did this change in your life? Did you have to give up on some hobbies?

Ben: In all honesty, I don’t think it was very well thought out. If I’m making $100 an hour at work, spending an hour cooking dinner instead of paying $10 for take out just so my expenses are below some line is pretty stupid. A better goal is something like “spend less than minimum wage on things which won’t affect your ability to earn more money”, but that doesn’t quite roll off the tongue the same way.

90% of the world lives on less than minimum wage, so while it does involve some changes, it’s not terribly dramatic. For me it mostly means going out less, although at this point I don’t really think about it much.

Linch: What was the decision like to give up a stable tech job that lets you donate a lot and instead go into entrepreneurial work?

Ben: I think the closest analogy I can draw is taking an advanced math class when you can barely do algebra. Going from a job where I knew most things to one where I knew nothing was… interesting.

And there is a pretty fine line between “being an unpaid entrepreneur” and “being unemployed”.

One thing I will say is that a huge number of my problems were quite mundane. At a big company there are people who handle all the little annoyances for you so that you can focus on what you’re best at; when you’re by yourself, you’re the one messing with email, spreadsheets and all the little things required to run a business.

Linch: Who are the most influential people in your life?

Ben: Biodeterminists will be glad to hear that I am the son of an economist and a social justice activist, and therefore am genetically predisposed to effective altruism. A lot of my thinking came from my parents.

On a day-to-day level, my girlfriend Gina is very influential. She is currently organizing a 5000 3467 person vegan festival in Madison, a math workshop in Oxford , running all the operations for Animal Charity Evaluators, and organizing an effective altruism conference in Madison, in addition to her volunteer work. She is one of the most productive people I know.

Editor’s note 7/13/2016: A previous version of this interview said that the vegan festival in Madison had around 5000 people. The final number is closer to 3500.





Linch: What’s the one book/paper/argument that you wished you were aware of 10 years ago?

Ben: I wish I was aware of how likely it is that humanity will go extinct, although in fairness to 10-years-ago-me a lot of the good information about that wasn’t available. There still isn’t an amazing resource about this, but http://www.existential-risk.org/ has a good collection of introductory material.

Linch: I’m always a little astonished when talking to you. You seem extremely knowledgeable about everything from pure math to infinite ethics to macroeconomics, etc. How do you balance learning more about things that might be valuable in the future vs. learning more about and implementing based on immediately actionable information?

Ben: Poorly? I like thinking of “pure” topics, but I would be surprised if they turn out to be very useful. Then again, pure math has a history of becoming applicable in ways no one expected, so who knows.

Linch: How do you push yourself to work as hard as you do? How do you prevent burnout?

Ben: I have a lot to say about this, but briefly: if you view something as “pushing yourself”, it’s probably not sustainable. A recent review of the literature summarized this as “People with high trait self-control do not appear to attain goals through inhibition of problematic desires but instead through forming habits that allow them to achieve goals without experiencing unwanted temptations.”

Implementation intentions are one thing which is easy to do; they are very useful for me personally, and there’s a lot of evidence supporting them more generally.

“I used to spend 12 hours a day typing, and now I spend 12 hours a day using voice recognition with a weird infrared tracking thing on my head and pedals for my feet. Who cares? The same work still gets done.”

Linch: I know you are doing all of this despite having chronic pain related to overuse of computers. If you’re comfortable with sharing, can you tell us how you work so hard/persevere through a physical disability?

Ben: Paul Graham said:



Imagine the stress of working for the Post Office for fifty years. In a startup you compress all this stress into three or four years. You do tend to get a certain bulk discount if you buy the economy-size pain, but you can’t evade the fundamental conservation law.

I think this is true more generally of being successful in life, not just with startups.

I’m proud that e.g. the analytics platform (Epic’s analytics platform) I made when I was 20 is now used by almost every major healthcare organization in the US, when most people don’t get that sort of opportunity until their 40s if ever, but compressing two decades of work into two years definitely took a toll. Specifically, I’m not really able to use my hands anymore since I spent so many hours typing without rest.

It’s definitely annoying that I can’t hold open a book or use chopsticks anymore, but here’s one of the things I’ve wondered about: do people who believe in consequentialist ethics recover from disabilities faster?

If some pandemic breaks out that humanity isn’t ready for, mother nature isn’t going to say “well you guys gave it a good shot, so I will suspend the laws of biology for now” – we’re just all going to be dead. Consequentialist ethics is about accepting that fact – accepting that “trying really hard” doesn’t count for anything. And being lazy doesn’t matter either. As long as you get things done, who cares how hard you had to work?

That may or may not be the correct way to view the world, but I feel like it’s a helpful one. I used to spend 12 hours a day typing, and now I spend 12 hours a day using voice recognition with a weird infrared tracking thing on my head and pedals for my feet. Who cares? The same work still gets done.

Linch: Give me the elevator pitch for your startup. I know why you decided to do a startup at all, why this one in particular?

Ben: One of the basic premises of effective altruism is that you can’t figure out the best charity to support simply by sitting in a chair and stroking your chin while thinking deep thoughts. You just aren’t smart enough. You need to go out into the world, measure the impact of different choices and change your mind based on what you find. (I.e. follow the scientific method.)

Now consider our product: The federal government has put a bunch of regulations in place to incentivize physicians to provide better quality care. This is an admirable goal, but one of the problems is that compliance rates are extremely low since complying requires filling out a bunch of paperwork. Our software fills out the paperwork for physicians, in addition to helping them find patients who aren’t receiving the appropriate care.

The shift from paying physicians based on how much care they provide to how good of care they provide is a phenomenal change in the US healthcare system, and I’m extremely excited about our role in that change, but the fundamental piece of evidence we need to track is “are our customers happy?” The answer, so far at least (knock on wood), is “yes”.

Linch: Why did you decide to stay in Madison for your startup instead of moving to a larger hub like SF?

Ben: The University of Wisconsin – Madison has the third highest R&D expenditures of any university in the US, and half of that is life sciences. That’s led to a lot of health technology startups in the Madison area like Epic, who now has about 10,000 employees in the Madison area, and blockbuster drugs like warfarin.

There’s a real dearth of data about how location affects success, apart from truisms like “being near smart people helps”, so I have difficulty saying with any confidence what the correct decision is. I can with confidence say: 1) there is a lot of capital at the Seed and Series A levels in Madison; 2) there are a lot of smart people with biotech and health tech experience in Madison; 3) cost of living is vastly lower in Madison than in SF.

Linch: How has your income changed since starting Health eFilings?

Ben: “Income” is hard to measure in a startup since so many of your assets are illiquid, but to the extent it’s meaningful my expected income is about 20 times what it was in my previous job (“expected” meaning the expected value incorporating the probability the company will sell and how much it will sell for).

The short version is: starting a company was the right decision.

Linch: Where do you plan to give to?

Ben: Consider humans and chimpanzees. Chimpanzees might go extinct, or they might not, but that’s basically independent of anything chimpanzees do. It’s entirely dependent on what humans do. If humans decide to extinguish chimpanzees (intentionally, or just as a side effect of us destroying the environment) there is nothing chimpanzees can do. Chimps can’t even tell if we’ve made that decision.

Unless humanity goes extinct from something else first, we will almost certainly develop artificial intelligences which are to humans as humans are to chimpanzees. Once that happens the die is cast: maybe humans will go extinct, or maybe we won’t, but the decision is out of our hands.

The future of all of humanity rests on that first superhuman AI being created safely, and we may only get one shot at it. I would like that one shot to go well.

(Wait but why? Has a better written introduction to AI safety.)





Linch: What qualities do you think are important in becoming a successful startup entrepreneur?

Ben: Besides being interviewed in the Huffington Post?

Everyone has strongly held opinions on the answer to this question, but it seems really hard to find any evidence for any of those answers. There are things which seem to be associated with success in any field (e.g. high IQ), and those provide an easy answer, but a more interesting question is “what qualities indicate someone will be more successful as an entrepreneur than they would be in other fields?”

One answer is that entrepreneurship is good if you are a “jack of all trades”. E.g. if you are a great salesman, then you should probably work in sales; if you are good engineer then you should probably work as an engineer; but if you are mediocre at both sales and engineering then maybe you should be an entrepreneur.



Linch: Do you have any advice for aspiring effective altruists?

Ben: I recommend checking out 80,000 Hours website resources to see if you should consider a career change to have more impact. I also recommend the book “Doing Good Better” by Will MacAskill as a good introduction to effective altruism. Have an open mind, and be willing to change your mind about what causes seem most important and what solutions most effective. Learn about important problems in the world and think critically about them ― are they neglected? Is there a tractable solution? Think about your skills and how they might be used to help solve one of these problems.



Linch: Do you have specific, non-obvious advice about how our readers can achieve job growth/career success, whether for aspiring effective altruists or otherwise?



Ben: One thing which has shaped my view of career progress, and informed how we treat people at Health eFilings, is the notion of “sponsored-mobility”:

the sponsored-mobility perspective suggests that established elites pay special attention to those members who are deemed to have high potential and then provide sponsoring activities to them to help them win the competition. Thus, those who have early successes are more likely to receive sponsorship, and those who do not are likely to be excluded from such support activities. Once identified as potential elites, the chosen individuals are given favorable treatment to make them even better and differentiate them even further from the non-elite group.

The insight of the sponsored mobility model is that career progress is cumulative. Suppose you have two people, and one of them has a 1% higher GPA in high school. That better person might get into a 5% better college, which gives them a 10% better first job, which leads to a 20% better second job,… and 40 years later they are 10 times more successful than their fellow alumni, all because of that 1% initial advantage.

This means that it’s crucial for your employer to “sponsor” you. If you feel like your boss doesn’t appreciate you that’s not just a short-term headache – that means that your boss is going to pass you up for training opportunities, which will cause you to miss promotion opportunities, which will cause you to miss even more learning… it will have a permanent impact on your career success.

There are some measures of how well career sponsorship correlates with career success (0 is no correlation, 1 is perfect correlation):

Predictor Correlation with salary Training and skill development opportunities 0.24 Career sponsorship 0.22 Being male 0.18 Being white 0.11 Proactivity 0.11 Conscientiousness 0.07

You can see that this is not just a hypothetical thought experiment – career sponsorship is more important than personality traits people often assume are relevant to career success like proactivity and conscientiousness.

For Health eFilings, this has led me to continually ask “how can I sponsor my team members?” How can we take someone that used to be getting 10% better per year and move them to getting 20% better per year? 50%? 100%?

One piece of the answer is Pearson’s Law: “That which is measured improves. That which is measured and reported improves exponentially.”

Do you know what your boss thinks of you? How does that compare to her impression of you last month? Are you getting more things done than you used to? Are you able to handle bigger projects? Is your defect rate going down? Are your communication skills getting better?

Everyone here who reports to me has a biweekly record of their progress in areas which are important to them and the company, and they can see themselves improving. I spend a significant fraction of my time doing this, but it’s completely worth it.

If you aren’t somewhere where you are receiving regular feedback about your progress, I would encourage you to think about what you can do to fix the problem. The management of your organization may be receptive to changing things, and if not, we are always hiring.

Linch: Wow! Health eFilings sounds like an amazing place to work and all of our readers should sell their firstborn for the opportunity to work there. Are you really hiring?

Ben: Yes we are! As of this writing, we are hiring sales directors, Technical Implementation Dir.’s, and senior engineers. A full list of jobs can be found on our careers page.



Linch: Do you have any closing thoughts for our readers?

Ben:

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Ben West worked for eight years at the Healthcare IT organization Epic before founding his own company, Health eFilings. You can learn more about him from his podcast with 80,000 Hours.



Health eFilings automates filing PQRS payments for physicians. You can learn more about them on the website (http://healthefilings.com/). They’re also hiring.