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Michael Hunter, MD

Michael Hunter, MD

3 years ago

5 Drugs That May Increase Your Risk of Dementia

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Laura Sanders

Laura Sanders

3 years ago

Xenobots, tiny living machines, can duplicate themselves.

Strange and complex behavior of frog cell blobs


A xenobot “parent,” shaped like a hungry Pac-Man (shown in red false color), created an “offspring” xenobot (green sphere) by gathering loose frog cells in its opening.

Tiny “living machines” made of frog cells can make copies of themselves. This newly discovered renewal mechanism may help create self-renewing biological machines.

According to Kirstin Petersen, an electrical and computer engineer at Cornell University who studies groups of robots, “this is an extremely exciting breakthrough.” She says self-replicating robots are a big step toward human-free systems.

Researchers described the behavior of xenobots earlier this year (SN: 3/31/21). Small clumps of skin stem cells from frog embryos knitted themselves into small spheres and started moving. Cilia, or cellular extensions, powered the xenobots around their lab dishes.

The findings are published in the Proceedings of the National Academy of Sciences on Dec. 7. The xenobots can gather loose frog cells into spheres, which then form xenobots.
The researchers call this type of movement-induced reproduction kinematic self-replication. The study's coauthor, Douglas Blackiston of Tufts University in Medford, Massachusetts, and Harvard University, says this is typical. For example, sexual reproduction requires parental sperm and egg cells. Sometimes cells split or budded off from a parent.

“This is unique,” Blackiston says. These xenobots “find loose parts in the environment and cobble them together.” This second generation of xenobots can move like their parents, Blackiston says.
The researchers discovered that spheroid xenobots could only produce one more generation before dying out. The original xenobots' shape was predicted by an artificial intelligence program, allowing for four generations of replication.

A C shape, like an openmouthed Pac-Man, was predicted to be a more efficient progenitor. When improved xenobots were let loose in a dish, they began scooping up loose cells into their gaping “mouths,” forming more sphere-shaped bots (see image below). As many as 50 cells clumped together in the opening of a parent to form a mobile offspring. A xenobot is made up of 4,000–6,000 frog cells.

Petersen likes the Xenobots' small size. “The fact that they were able to do this at such a small scale just makes it even better,” she says. Miniature xenobots could sculpt tissues for implantation or deliver therapeutics inside the body.

Beyond the xenobots' potential jobs, the research advances an important science, says study coauthor and Tufts developmental biologist Michael Levin. The science of anticipating and controlling the outcomes of complex systems, he says.

“No one could have predicted this,” Levin says. “They regularly surprise us.” Researchers can use xenobots to test the unexpected. “This is about advancing the science of being less surprised,” Levin says.

Adam Frank

Adam Frank

3 years ago

Humanity is not even a Type 1 civilization. What might a Type 3 be capable of?

The Kardashev scale grades civilizations from Type 1 to Type 3 based on energy harvesting.

How do technologically proficient civilizations emerge across timescales measuring in the tens of thousands or even millions of years? This is a question that worries me as a researcher in the search for “technosignatures” from other civilizations on other worlds. Since it is already established that longer-lived civilizations are the ones we are most likely to detect, knowing something about their prospective evolutionary trajectories could be translated into improved search tactics. But even more than knowing what to seek for, what I really want to know is what happens to a society after so long time. What are they capable of? What do they become?

This was the question Russian SETI pioneer Nikolai Kardashev asked himself back in 1964. His answer was the now-famous “Kardashev Scale.” Kardashev was the first, although not the last, scientist to try and define the processes (or stages) of the evolution of civilizations. Today, I want to launch a series on this question. It is crucial to technosignature studies (of which our NASA team is hard at work), and it is also important for comprehending what might lay ahead for mankind if we manage to get through the bottlenecks we have now.

The Kardashev scale

Kardashev’s question can be expressed another way. What milestones in a civilization’s advancement up the ladder of technical complexity will be universal? The main notion here is that all (or at least most) civilizations will pass through some kind of definable stages as they progress, and some of these steps might be mirrored in how we could identify them. But, while Kardashev’s major focus was identifying signals from exo-civilizations, his scale gave us a clear way to think about their evolution.

The classification scheme Kardashev employed was not based on social systems of ethics because they are something that we can probably never predict about alien cultures. Instead, it was built on energy, which is something near and dear to the heart of everybody trained in physics. Energy use might offer the basis for universal stages of civilisation progression because you cannot do the work of establishing a civilization without consuming energy. So, Kardashev looked at what energy sources were accessible to civilizations as they evolved technologically and used those to build his scale.

From Kardashev’s perspective, there are three primary levels or “types” of advancement in terms of harvesting energy through which a civilization should progress.

Type 1: Civilizations that can capture all the energy resources of their native planet constitute the first stage. This would imply capturing all the light energy that falls on a world from its host star. This makes it reasonable, given solar energy will be the largest source available on most planets where life could form. For example, Earth absorbs hundreds of atomic bombs’ worth of energy from the Sun every second. That is a rather formidable energy source, and a Type 1 race would have all this power at their disposal for civilization construction.

Type 2: These civilizations can extract the whole energy resources of their home star. Nobel Prize-winning scientist Freeman Dyson famously anticipated Kardashev’s thinking on this when he imagined an advanced civilization erecting a large sphere around its star. This “Dyson Sphere” would be a machine the size of the complete solar system for gathering stellar photons and their energy.

Type 3: These super-civilizations could use all the energy produced by all the stars in their home galaxy. A normal galaxy has a few hundred billion stars, so that is a whole lot of energy. One way this may be done is if the civilization covered every star in their galaxy with Dyson spheres, but there could also be more inventive approaches.

Implications of the Kardashev scale

Climbing from Type 1 upward, we travel from the imaginable to the god-like. For example, it is not hard to envisage utilizing lots of big satellites in space to gather solar energy and then beaming that energy down to Earth via microwaves. That would get us to a Type 1 civilization. But creating a Dyson sphere would require chewing up whole planets. How long until we obtain that level of power? How would we have to change to get there? And once we get to Type 3 civilizations, we are virtually thinking about gods with the potential to engineer the entire cosmos.

For me, this is part of the point of the Kardashev scale. Its application for thinking about identifying technosignatures is crucial, but even more strong is its capacity to help us shape our imaginations. The mind might become blank staring across hundreds or thousands of millennia, and so we need tools and guides to focus our attention. That may be the only way to see what life might become — what we might become — once it arises to start out beyond the boundaries of space and time and potential.


This is a summary. Read the full article here.

Tomas Pueyo

Tomas Pueyo

2 years ago

Soon, a Starship Will Transform Humanity

SpaceX's Starship.

Source

Launched last week.

Four minutes in:

SpaceX will succeed. When it does, its massiveness will matter.

Source

Its payload will revolutionize space economics.

Civilization will shift.

We don't yet understand how this will affect space and Earth culture. Grab it.

The Cost of Space Transportation Has Decreased Exponentially

Space launches have increased dramatically in recent years.

We mostly send items to LEO, the green area below:

I always had a hard time remembering that LEO stands for Low-Earth Orbit. Now I imagine a lion orbiting the Earth, and that did the trick.

SpaceX's reusable rockets can send these things to LEO. Each may launch dozens of payloads into space.

With all these launches, we're sending more than simply things to space. Volume and mass. Since the 1980s, launching a kilogram of payload to LEO has become cheaper:

Falcon Heavy is the heavy rocket from SpaceX. Notice this is a logarithmic scale! The Falcon Heavy was SpaceX’s biggest rocket yet. It will soon be superseded by Starship.

One kilogram in a large rocket cost over $75,000 in the 1980s. Carrying one astronaut cost nearly $5M! Falcon Heavy's $1,500/kg price is 50 times lower. SpaceX's larger, reusable rockets are amazing.

SpaceX's Starship rocket will continue. It can carry over 100 tons to LEO, 50% more than the current Falcon heavy. Thousands of launches per year. Elon Musk predicts Falcon Heavy's $1,500/kg cost will plummet to $100 in 23 years.

In context:

Angara was the rocket that previously held the record for cheapest transportation to LEO.

People underestimate this.

2. The Benefits of Affordable Transportation

Compare Earth's transportation costs:

Source: US Department of Transportation.

It's no surprise that the US and Northern Europe are the wealthiest and have the most navigable interior waterways.

The Mississippi River is one of the biggest systems of navigable waterways on Earth. And on top of that, navigation along the US’s Mexican Gulf and East Coast is protected by a series of islands, making sea shipping easier than in the open ocean.European navigable waterways

So what? since sea transportation is cheaper than land. Inland waterways are even better than sea transportation since weather is less of an issue, currents can be controlled, and rivers serve two banks instead of one for coastal transportation.

In France, because population density follows river systems, rivers are valuable. Cheap transportation brought people and money to rivers, especially their confluences.

Look at the population. Can you see dark red lines? Those are people living close to rivers. You can guess where the rivers are by looking at the map. Also, you can see the bigger cities are always at the confluence between rivers.

How come? Why were humans surrounding rivers?

Imagine selling meat for $10 per kilogram. Transporting one kg one kilometer costs $1. Your margin decreases $1 each kilometer. You can only ship 10 kilometers. For example, you can only trade with four cities:

If instead, your cost of transportation is half, what happens? It costs you $0.5 per km. You now have higher margins with each city you traded with. More importantly, you can reach 20-km markets.

However, 2x distance 4x surface! You can now trade with sixteen cities instead of four! Metcalfe's law states that a network's value increases with its nodes squared. Since now sixteen cities can connect to yours. Each city now has sixteen connections! They get affluent and can afford more meat.

Rivers lower travel costs, connecting many cities, which can trade more, get wealthy, and buy more.

The right network is worth at least an order of magnitude more than the left! The cheaper the transport, the more trade at a lower cost, the more income generated, the more that wealth can be reinvested in better canals, bridges, and roads, and the wealth grows even more.

Throughout history. Rome was established around cheap Mediterranean transit and preoccupied with cutting overland transportation costs with their famous roadways. Communications restricted their empire.

This map shows the distance from Rome in terms of days of travel. The size of the Roman Empire was about five weeks of travel. This is not a coincidence. Source: Orbis, the Stanford Geospatial Network Model of the Roman World

The Egyptians lived around the Nile, the Vikings around the North Sea, early Japan around the Seto Inland Sea, and China started canals in the 5th century BC.

Transportation costs shaped empires.Starship is lowering new-world transit expenses. What's possible?

3. Change Organizations, Change Companies, Change the World

Starship is a conveyor belt to LEO. A new world of opportunity opens up as transportation prices drop 100x in a decade.

Satellite engineers have spent decades shedding milligrams. Weight influenced every decision: pricing structure, volumes to be sent, material selections, power sources, thermal protection, guiding, navigation, and control software. Weight was everything in the mission. To pack as much science into every millimeter, NASA missions had to be miniaturized. Engineers were indoctrinated against mass.

No way.

Starship is not constrained by any space mission, robotic or crewed.

Starship obliterates the mass constraint and every last vestige of cultural baggage it has gouged into the minds of spacecraft designers. A dollar spent on mass optimization no longer buys a dollar saved on launch cost. It buys nothing. It is time to raise the scope of our ambition and think much bigger. — Casey Handmer, Starship is still not understood

A Tesla Roadster in space makes more sense.

Starman, the roadster, and the Earth. Source.

It went beyond bad PR. It told the industry: Did you care about every microgram? No more. My rockets are big enough to send a Tesla without noticing. Industry watchers should have noticed.

Most didn’t. Artemis is a global mission to send astronauts to the Moon and build a base. Artemis uses disposable Space Launch System rockets. Instead of sending two or three dinky 10-ton crew habitats over the next decade, Starship might deliver 100x as much cargo and create a base for 1,000 astronauts in a year or two. Why not? Because Artemis remains in a pre-Starship paradigm where each kilogram costs a million dollars and we must aggressively descope our objective.

An overengineer at work

Space agencies can deliver 100x more payload to space for the same budget with 100x lower costs and 100x higher transportation volumes. How can space economy saturate this new supply?

Before Starship, NASA supplied heavy equipment for Moon base construction. After Starship, Caterpillar and Deere may space-qualify their products with little alterations. Instead than waiting decades for NASA engineers to catch up, we could send people to build a space outpost with John Deere equipment in a few years.

History is littered with the wreckage of former industrial titans that underestimated the impact of new technology and overestimated their ability to adapt: Blockbuster, Motorola, Kodak, Nokia, RIM, Xerox, Yahoo, IBM, Atari, Sears, Hitachi, Polaroid, Toshiba, HP, Palm, Sony, PanAm, Sega, Netscape, Compaq, GM… — Casey Handmer, Starship is still not understood

Everyone saw it coming, but senior management failed to realize that adaption would involve moving beyond their established business practice. Others will if they don't.

4. The Starship Possibilities

It's Starlink.

SpaceX invented affordable cargo space and grasped its implications first. How can we use all this inexpensive cargo nobody knows how to use?

Satellite communications seemed like the best way to capitalize on it. They tried. Starlink, designed by SpaceX, provides fast, dependable Internet worldwide. Beaming information down is often cheaper than cable. Already profitable.

Starlink is one use for all this cheap cargo space. Many more. The longer firms ignore the opportunity, the more SpaceX will acquire.

What are these chances?

Satellite imagery is outdated and lacks detail. We can improve greatly. Synthetic aperture radar can take beautiful shots like this:

This radar image acquired by the SIR-C/X-SAR radar on board the Space Shuttle Endeavour shows the Teide volcano. The city of Santa Cruz de Tenerife is visible as the purple and white area on the lower right edge of the island. Lava flows at the summit crater appear in shades of green and brown, while vegetation zones appear as areas of purple, green and yellow on the volcano’s flanks. Source.

Have you ever used Google Maps and thought, "I want to see this in more detail"? What if I could view Earth live? What if we could livestream an infrared image of Earth?

The fall of Kabul. Source: Maxar

We could launch hundreds of satellites with such mind-blowing visual precision of the Earth that we would dramatically improve the accuracy of our meteorological models; our agriculture; where crime is happening; where poachers are operating in the savannah; climate change; and who is moving military personnel where. Is that useful?

What if we could see Earth in real time? That affects businesses? That changes society?

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Tim Denning

Tim Denning

3 years ago

In this recession, according to Mark Cuban, you need to outwork everyone

Here’s why that’s baloney

Image Credit-MarkCuban

Mark Cuban popularized entrepreneurship.

Shark Tank (which made Mark famous) made starting a business glamorous to attract more entrepreneurs. First off

This isn't an anti-billionaire rant.

Mark Cuban has done excellent. He's a smart, principled businessman. I enjoy his Web3 work. But Mark's work and productivity theories are absurd.

You don't need to outwork everyone in this recession to live well.

You won't be able to outwork me.

Yuck! Mark's words made me gag.

Why do boys think working is a football game where the winner wins a Super Bowl trophy? To outwork you.

Hard work doesn't equal intelligence.

Highly clever professionals spend 4 hours a day in a flow state, then go home to relax with family.

If you don't put forth the effort, someone else will.

- Mark.

He'll burn out. He's delusional and doesn't understand productivity. Boredom or disconnection spark our best thoughts.

TikTok outlaws boredom.

In a spare minute, we check our phones because we can't stand stillness.

All this work p*rn makes things worse. When is it okay to feel again? Because I can’t feel anything when I’m drowning in work and haven’t had a holiday in 2 years.

Your rivals are actively attempting to undermine you.

Ohhh please Mark…seriously.

This isn't a Tom Hanks war film. Relax. Not everyone is a rival. Only yourself is your competitor. To survive the recession, be better than a year ago.

If you get rich, great. If not, there's more to life than Lambos and angel investments.

Some want to relax and enjoy life. No competition. We witness people with lives trying to endure the recession and record-high prices.

This fictitious rival worsens life and work.

Image Credit-MarkCuban

If you are truly talented, you will motivate others to work more diligently and effectively.

No Mark. Soz.

If you're a good leader, you won't brag about working hard and treating others like cogs. Treat them like humans. You'll have EQ.

Silly statements like this are caused by an out-of-control ego. No longer watch Shark Tank.

Ego over humanity.

Good leaders will urge people to keep together during the recession. Good leaders support those who are laid off and need a reference.

Not harder, quicker, better. That created my mental health problems 10 years ago.

Truth: we want to work less.

The promotion of entrepreneurship is ludicrous.

Marvel superheroes. Seriously, relax Max.

I used to write about entrepreneurship, then I quit. Many WeWork Adam Neumanns. Carelessness.

I now utilize the side hustle title when writing about online company or entrepreneurship. Humanizes.

Stop glorifying. Thinking we'll all be Elon Musks who send rockets to Mars is delusional. Most of us won't create companies employing hundreds.

OK.

The true epidemic is glorification. fewer selfies Little birdy needs less bank account screenshots. Less Uber talk.

We're exhausted.

Fun, ego-free business can transform the world. Take a relax pill.

Work as if someone were attempting to take everything from you.

I've seen people lose everything.

Myself included. My 20s startup failed. I was almost bankrupt. I thought I'd never recover. Nope.

Best thing ever.

Losing everything reveals your true self. Unintelligent entrepreneur egos perish instantly. Regaining humility revitalizes relationships.

Money's significance shifts. Stop chasing it like a puppy with a bone.

Fearing loss is unfounded.

Here is a more effective approach than outworking nobody.

(You'll thrive in the recession and become wealthy.)

Smarter work

Overworking is donkey work.

You don't want to be a career-long overworker. Instead than wasting time, write down what you do. List tasks and processes.

Keep doing/outsource the list. Step-by-step each task. Continuously systematize.

Then recruit a digital employee like Zapier or a virtual assistant in the same country.

Intelligent, not difficult.

If your big break could burn in hell, diversify like it will.

People err by focusing on one chance.

Chances can vanish. All-in risky. Instead of working like a Mark Cuban groupie, diversify your income.

If you're employed, your customer is your employer.

Sell the same abilities twice and add 2-3 contract clients. Reduce your hours at your main job and take on more clients.

Leave brand loyalty behind

Mark desires his employees' worship.

That's stupid. When times are bad, layoffs multiply. The problem is the false belief that companies care. No. A business maximizes profit and pays you the least.

To care or overpay is anti-capitalist (that run the world). Be honest.

I was a banker. Then the bat virus hit and jobs disappeared faster than I urinate after a night of drinking.

Start being disloyal now since your company will cheerfully replace you with a better applicant. Meet recruiters and hiring managers on LinkedIn. Whenever something goes wrong at work, act.

Loyalty to self and family. Nobody.

Outwork this instead

Mark doesn't suggest outworking inflation instead of people.

Inflation erodes your time on earth. If you ignore inflation, you'll work harder for less pay every minute.

Financial literacy beats inflation.

Get a side job and earn money online

So you can stop outworking everyone.

Internet leverages time. Same effort today yields exponential results later. There are still whole places not online.

Instead of working forever, generate money online.

Final Words

Overworking is stupid. Don't listen to wealthy football jocks.

Work isn't everything. Prioritize diversification, internet income streams, boredom, and financial knowledge throughout the recession.

That’s how to get wealthy rather than burnout-rich.

Chris

Chris

2 years ago

What the World's Most Intelligent Investor Recently Said About Crypto

Cryptoshit. This thing is crazy to buy.

Sloww

Charlie Munger is revered and powerful in finance.

Munger, vice chairman of Berkshire Hathaway, is noted for his wit, no-nonsense attitude to investment, and ability to spot promising firms and markets.

Munger's crypto views have upset some despite his reputation as a straight shooter.

“There’s only one correct answer for intelligent people, just totally avoid all the people that are promoting it.” — Charlie Munger

The Munger Interview on CNBC (4:48 secs)

This Monday, CNBC co-anchor Rebecca Quick interviewed Munger and brought up his 2007 statement, "I'm not allowed to have an opinion on this subject until I can present the arguments against my viewpoint better than the folks who are supporting it."

Great investing and life advice!

If you can't explain the opposing reasons, you're not informed enough to have an opinion.

In today's world, it's important to grasp both sides of a debate before supporting one.

Rebecca inquired:

Does your Wall Street Journal article on banning cryptocurrency apply? If so, would you like to present the counterarguments?

Mungers reply:

I don't see any viable counterarguments. I think my opponents are idiots, hence there is no sensible argument against my position.

Consider his words.

Do you believe Munger has studied both sides?

He said, "I assume my opponents are idiots, thus there is no sensible argument against my position."

This is worrisome, especially from a guy who once encouraged studying both sides before forming an opinion.

Munger said:

National currencies have benefitted humanity more than almost anything else.

Hang on, I think we located the perpetrator.

Munger thinks crypto will replace currencies.

False.

I doubt he studied cryptocurrencies because the name is deceptive.

He misread a headline as a Dollar destroyer.

Cryptocurrencies are speculations.

Like Tesla, Amazon, Apple, Google, Microsoft, etc.

Crypto won't replace dollars.

In the interview with CNBC, Munger continued:

“I’m not proud of my country for allowing this crap, what I call the cryptoshit. It’s worthless, it’s no good, it’s crazy, it’ll do nothing but harm, it’s anti-social to allow it.” — Charlie Munger

Not entirely inaccurate.

Daily cryptos are established solely to pump and dump regular investors.

Let's get into Munger's crypto aversion.

Rat poison is bitcoin.

Munger famously dubbed Bitcoin rat poison and a speculative bubble that would implode.

Partially.

But the bubble broke. Since 2021, the market has fallen.

Scam currencies and NFTs are being eliminated, which I like.

Whoa.

Why does Munger doubt crypto?

Mungers thinks cryptocurrencies has no intrinsic value.

He worries about crypto fraud and money laundering.

Both are valid issues.

Yet grouping crypto is intellectually dishonest.

Ethereum, Bitcoin, Solana, Chainlink, Flow, and Dogecoin have different purposes and values (not saying they’re all good investments).

Fraudsters who hurt innocents will be punished.

Therefore, complaining is useless.

Why not stop it? Repair rather than complain.

Regrettably, individuals today don't offer solutions.

Blind Areas for Mungers

As with everyone, Mungers' bitcoin views may be impacted by his biases and experiences.

OK.

But Munger has always advocated classic value investing and may be wary of investing in an asset outside his expertise.

Mungers' banking and insurance investments may influence his bitcoin views.

Could a coworker or acquaintance have told him crypto is bad and goes against traditional finance?

Right?

Takeaways

Do you respect Charlie Mungers?

Yes and no, like any investor or individual.

To understand Mungers' bitcoin beliefs, you must be critical.

Mungers is a successful investor, but his views about bitcoin should be considered alongside other viewpoints.

Munger’s success as an investor has made him an influencer in the space.

Influence gives power.

He controls people's thoughts.

Munger's ok. He will always be heard.

I'll do so cautiously.

Scott Galloway

Scott Galloway

3 years ago

First Health

ZERO GRACE/ZERO MALICE

Amazon's purchase of One Medical could speed up American healthcare

The U.S. healthcare industry is a 7-ton seal bleeding at sea. Predators are circling. Unearned margin: price increases relative to inflation without quality improvements. Amazon is the 11-foot megalodon with 7-inch teeth. Amazon is no longer circling... but attacking.

In 2020 dollars, per capita U.S. healthcare spending increased from $2,968 in 1980 to $12,531. The result is a massive industry with 13% of the nation's workers and a fifth of GDP.

Doctor No

In 40 years, healthcare has made progress. From 73.7 in 1980 to 78.8 in 2019, life expectancy rose (before Covid knocked it back down a bit). Pharmacological therapies have revolutionized, and genetic research is paying off. The financial return, improvement split by cost increases, is terrible. No country has expense rises like the U.S., and no one spends as much per capita as we do. Developed countries have longer life expectancies, healthier populations, and less economic hardship.

Two-thirds of U.S. personal bankruptcies are due to medical expenses and/or missed work. Mom or Dad getting cancer could bankrupt many middle-class American families. 40% of American adults delayed or skipped needed care due to cost. Every healthcare improvement seems to have a downside. Same pharmacological revolution that helped millions caused opioid epidemic. Our results are poor in many areas: The U.S. has a high infant mortality rate.

Healthcare is the second-worst retail industry in the country. Gas stations are #1. Imagine walking into a Best Buy to buy a TV and a Blue Shirt associate requests you fill out the same 14 pages of paperwork you filled out yesterday. Then you wait in a crowded room until they call you, 20 minutes after the scheduled appointment you were asked to arrive early for, to see the one person in the store who can talk to you about TVs, who has 10 minutes for you. The average emergency room wait time in New York is 6 hours and 10 minutes.

If it's bad for the customer, it's worse for the business. Physicians spend 27% of their time helping patients; 49% on EHRs. Documentation, order entry, billing, and inbox management. Spend a decade getting an M.D., then become a bureaucrat.

No industry better illustrates scale diseconomies. If we got the same return on healthcare spending as other countries, we'd all live to 100. We could spend less, live longer and healthier, and pay off the national debt in 15 years. U.S. healthcare is the worst ever.

What now? Competition is at the heart of capitalism, the worst system of its kind.

Priority Time

Amazon is buying One Medical for $3.9 billion. I think this deal will liberate society. Two years in, I think One Medical is great. When I got Covid, I pressed the One Medical symbol on my phone; a nurse practitioner prescribed Paxlovid and told me which pharmacies had it in stock.

Amazon enables the company's vision. One Medical's stock is down to $10 from $40 at the start of 2021. Last year, it lost $250 million and needs cash (Amazon has $60 billion). ONEM must grow. The service has 736,000 members. Half of U.S. households have Amazon Prime. Finally, delivery. One Medical is a digital health/physical office hybrid, but you must pick up medication at the pharmacy. Upgrade your Paxlovid delivery time after a remote consultation. Amazon's core competency means it'll happen. Healthcare speed and convenience will feel alien.

It's been a long, winding road to disruption. Amazon, JPMorgan, and Berkshire Hathaway formed Haven four years ago to provide better healthcare for their 1.5 million employees. It rocked healthcare stocks the morning of the press release, but folded in 2021.

Amazon Care is an employee-focused service. Home-delivered virtual health services and nurses. It's doing well, expanding nationwide, and providing healthcare for other companies. Hilton is Amazon Care's biggest customer. The acquisition of One Medical will bring 66 million Prime households capital, domain expertise, and billing infrastructure. Imagine:

"Alexa, I'm hot and my back hurts."

"Connecting you to a Prime doctor now."

Want to vs. Have to

I predicted Amazon entering healthcare years ago. Why? For the same reason Apple is getting into auto. Amazon's P/E is 56, double Walmart's. The corporation must add $250 billion in revenue over the next five years to retain its share price. White-label clothes or smart home products won't generate as much revenue. It must enter a huge market without scale, operational competence, and data skills.

Current Situation

Healthcare reform benefits both consumers and investors. In 2015, healthcare services had S&P 500-average multiples. The market is losing faith in public healthcare businesses' growth. Healthcare services have lower EV/EBITDA multiples than the S&P 500.

Amazon isn't the only prey-hunter. Walmart and Alibaba are starting pharmacies. Uber is developing medical transportation. Private markets invested $29 billion in telehealth last year, up 95% from 2020.

The pandemic accelerated telehealth, the immediate unlock. After the first positive Covid case in the U.S., services that had to be delivered in person shifted to Zoom... We lived. We grew. Video house calls continued after in-person visits were allowed. McKinsey estimates telehealth visits are 38 times pre-pandemic levels. Doctors adopted the technology, regulators loosened restrictions, and patients saved time. We're far from remote surgery, but many patient visits are unnecessary. A study of 40 million patients during lockdown found that for chronic disease patients, online visits didn't affect outcomes. This method of care will only improve.

Amazon's disruption will be significant and will inspire a flood of capital, startups, and consumer brands. Mark Cuban launched a pharmacy that eliminates middlemen in January. Outcome? A 90-day supply of acid-reflux medication costs $17. Medicare could have saved $3.6 billion by buying generic drugs from Cuban's pharmacy. Other apex predators will look at different limbs of the carcass for food. Nike could enter healthcare via orthopedics, acupuncture, and chiropractic. LVMH, L'Oréal, and Estée Lauder may launch global plastic surgery brands. Hilton and Four Seasons may open hospitals. Lennar and Pulte could build "Active Living" communities that Nana would leave feet first, avoiding the expense and tragedy of dying among strangers.

Risks

Privacy matters: HIV status is different from credit card and billing address. Most customers (60%) feel fine sharing personal health data via virtual technologies, though. Unavoidable. 85% of doctors believe data-sharing and interoperability will become the norm. Amazon is the most trusted tech company for handling personal data. Not Meta: Amazon.

What about antitrust, then?

Amazon should be required to spin off AWS and/or Amazon Fulfillment and banned from promoting its own products. It should be allowed to acquire hospitals. One Medical's $3.9 billion acquisition is a drop in the bucket compared to UnitedHealth's $498 billion market valuation.

Antitrust enforcement shouldn't assume some people/firms are good/bad. It should recognize that competition is good and focus on making markets more competitive in each deal. The FTC should force asset divestitures in e-commerce, digital marketing, and social media. These companies can also promote competition in a social ill.

U.S. healthcare makes us fat, depressed, and broke. Competition has produced massive value and prosperity across most of our economy.

Dear Amazon … bring it.