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.

It's kids' digital crack

TikTok is a destructive social media platform.

• The interface shortens attention spans and dopamine receptors.

• TikTok shares more data than other apps.

• Seeing an endless stream of dancing teens on my glowing box makes me feel like a Blade Runner extra.

TikTok did in one year what MTV, Hollywood, and Warner Music tried to do in 20 years. TikTok has psychotized the two-thirds of society Aldous Huxley said were hypnotizable.

Millions of people, mostly kids, are addicted to learning a new dance, lip-sync, or prank, and those who best dramatize this collective improvisation get likes, comments, and shares.

TikTok is a great app. So what?

The Commercial Magnifying Glass TikTok made me realize my generation's time was up and the teenage Zoomers were the target.

I told my 14-year-old sister, "Enjoy your time under the commercial magnifying glass."

TikTok sells your every move, gesture, and thought. Data is the new oil. If you tell someone, they'll say, "Yeah, they collect data, but who cares? I have nothing to hide."

It's a George Orwell novel's beginning. Look up Big Brother Award winners to see if TikTok won.

TikTok shares your data more than any other social media app, and where it goes is unclear. TikTok uses third-party trackers to monitor your activity after you leave the app.

Consumers can't see what data is shared or how it will be used. — Genius URL

32.5 percent of Tiktok's users are 10 to 19 and 29.5% are 20 to 29.

TikTok is the greatest digital marketing opportunity in history, and they'll use it to sell you things, track you, and control your thoughts. Any of its users will tell you, "I don't care, I just want to be famous."

TikTok manufactures mental illness

TikTok's effect on dopamine and the brain is absurd. Dopamine controls the brain's pleasure and reward centers. It's like a switch that tells your brain "this feels good, repeat."

Dr. Julie Albright, a digital culture and communication sociologist, said TikTok users are "carried away by dopamine." It's hypnotic, you'll keep watching."

TikTok constantly releases dopamine. A guy on TikTok recently said he didn't like books because they were slow and boring.

The US didn't ban Tiktok.

Biden and Trump agree on bad things. Both agree that TikTok threatens national security and children's mental health.

The Chinese Communist Party owns and operates TikTok, but that's not its only problem.

• There’s borderline child porn on TikTok

• It's unsafe for children and violated COPPA.

• It's also Chinese spyware. I'm not a Trump supporter, but I was glad he wanted TikTok regulated and disappointed when he failed.

Full-on internet censorship is rare outside of China, so banning it may be excessive. US should regulate TikTok more.

We must reject a low-quality present for a high-quality future.

TikTok vs YouTube

People got mad when I wrote about YouTube's death.

They didn't like when I said TikTok was YouTube's first real challenger.

Indeed. TikTok is the fastest-growing social network. In three years, the Chinese social media app TikTok has gained over 1 billion active users. In the first quarter of 2020, it had the most downloads of any app in a single quarter.

TikTok is the perfect social media app in many ways. It's brief and direct.

Can you believe they had a YouTube vs TikTok boxing match? We are doomed as a species.

YouTube hosts my favorite videos. That’s why I use it. That’s why you use it. New users expect more. They want something quicker, more addictive.

TikTok's impact on other social media platforms frustrates me. YouTube copied TikTok to compete.

It's all about short, addictive content.

I'll admit I'm probably wrong about TikTok. My friend says his feed is full of videos about food, cute animals, book recommendations, and hot lesbians.

Whatever.

TikTok makes us bad

TikTok is the opposite of what the Ancient Greeks believed about wisdom.

It encourages people to be fake. It's like a never-ending costume party where everyone competes.

It does not mean that Gen Z is doomed.

They could be the saviors of the world for all I know.

TikTok feels like a step towards Mike Judge's "Idiocracy," where the average person is a pleasure-seeking moron.

The Merge cut Ethereum's energy use by 99.5%.

The Crypto community celebrated on September 15, 2022. This day, Ethereum Merged. The entire blockchain successfully merged with the Beacon chain, and it was so smooth you barely noticed.

Many have waited, dreaded, and longed for this day.

Some investors feared the network would break down, while others envisioned a seamless merging.

Speculators predict a successful Merge will lead investors to Ethereum. This could boost Ethereum's popularity.

What Has Changed Since The Merge

The merging transitions Ethereum mainnet from PoW to PoS.

PoW sends a mathematical riddle to computers worldwide (miners). First miner to solve puzzle updates blockchain and is rewarded.

The puzzles sent are power-intensive to solve, so mining requires a lot of electricity. It's sent to every miner competing to solve it, requiring duplicate computation.

PoS allows investors to stake their coins to validate a new transaction. Instead of validating a whole block, you validate a transaction and get the fees.

You can validate instead of mine. A validator stakes 32 Ethereum. After staking, the validator can validate future blocks.

Once a validator validates a block, it's sent to a randomly selected group of other validators. This group verifies that a validator is not malicious and doesn't validate fake blocks.

This way, only one computer needs to solve or validate the transaction, instead of all miners. The validated block must be approved by a small group of validators, causing duplicate computation.

PoS is more secure because validating fake blocks results in slashing. You lose your bet tokens. If a validator signs a bad block or double-signs conflicting blocks, their ETH is burned.

Theoretically, Ethereum has one block every 12 seconds, so a validator forging a block risks burning 1 Ethereum for 12 seconds of transactions. This makes mistakes expensive and risky.

What Impact Does This Have On Energy Use?

Cryptocurrency is a natural calamity, sucking electricity and eating away at the earth one transaction at a time.

Many don't know the environmental impact of cryptocurrencies, yet it's tremendous.

A single Ethereum transaction used to use 200 kWh and leave a large carbon imprint. This update reduces global energy use by 0.2%.

Ethereum will submit a challenge to one validator, and that validator will forward it to randomly selected other validators who accept it.

This reduces the needed computing power.

They expect a 99.5% reduction, therefore a single transaction should cost 1 kWh.

Carbon footprint is 0.58 kgCO2, or 1,235 VISA transactions.

This is a big Ethereum blockchain update.

I love cryptocurrency and Mother Earth.

Smarter work yields better results.

17-year-old me worked and studied 20 hours a day. During school breaks, I did coursework and ran a nonprofit at night. Long hours earned me national campaigns, A-list opportunities, and a great career. As I aged, my thoughts changed. Working harder isn't necessarily the key to success.

In some cases, doing less work might lead to better outcomes.

Consider a hard-working small business owner. He can't beat his corporate rivals by working hard. Time's limited. An entrepreneur can work 24 hours a day, 7 days a week, but a rival can invest more money, create a staff, and put in more man hours. Why have small startups done what larger companies couldn't? Facebook paid $1 billion for 13-person Instagram. Snapchat, a 30-person startup, rejected Facebook and Google bids. Luck and efficiency each contributed to their achievement.

The key to success is not working hard. It’s working smart.

Being busy and productive are different. Busy doesn't always equal productive. Productivity is less about time management and more about energy management. Life's work. It's using less energy to obtain more rewards. I cut my work week from 80 to 40 hours and got more done. I value simplicity.

Here are seven activities I gave up in order to be more productive.

1. Give up working extra hours and boost productivity instead.

When did the five-day, 40-hour work week start? Henry Ford, Ford Motor Company founder, experimented with his workers in 1926.

He decreased their daily hours from 10 to 8, and shortened the work week from 6 days to 5. As a result, he saw his workers’ productivity increase.

According to a 1980 Business Roundtable report, Scheduled Overtime Effect on Construction Projects, the more you work, the less effective and productive you become.

“Where a work schedule of 60 or more hours per week is continued longer than about two months, the cumulative effect of decreased productivity will cause a delay in the completion date beyond that which could have been realized with the same crew size on a 40-hour week.” Source: Calculating Loss of Productivity Due to Overtime Using Published Charts — Fact or Fiction

AlterNet editor Sara Robinson cited US military research showing that losing one hour of sleep per night for a week causes cognitive impairment equivalent to a.10 blood alcohol level. You can get fired for showing up drunk, but an all-nighter is fine.

Irrespective of how well you were able to get on with your day after that most recent night without sleep, it is unlikely that you felt especially upbeat and joyous about the world. Your more-negative-than-usual perspective will have resulted from a generalized low mood, which is a normal consequence of being overtired. More important than just the mood, this mind-set is often accompanied by decreases in willingness to think and act proactively, control impulses, feel positive about yourself, empathize with others, and generally use emotional intelligence. Source: The Secret World of Sleep: The Surprising Science of the Mind at Rest

To be productive, don't overwork and get enough sleep. If you're not productive, lack of sleep may be to blame. James Maas, a sleep researcher and expert, said 7/10 Americans don't get enough sleep.

Did you know?

• Leonardo da Vinci slept little at night and frequently took naps.

• Napoleon, the French emperor, had no qualms about napping. He splurged every day.

• Even though Thomas Edison felt self-conscious about his napping behavior, he regularly engaged in this ritual.

• President Franklin D. Roosevelt's wife Eleanor used to take naps before speeches to increase her energy.

• The Singing Cowboy, Gene Autry, was known for taking regular naps in his dressing area in between shows.

• Every day, President John F. Kennedy took a siesta after eating his lunch in bed.

• Every afternoon, oil businessman and philanthropist John D. Rockefeller took a nap in his office.

• It was unavoidable for Winston Churchill to take an afternoon snooze. He thought it enabled him to accomplish twice as much each day.

• Every afternoon around 3:30, President Lyndon B. Johnson took a nap to divide his day into two segments.

• Ronald Reagan, the 40th president, was well known for taking naps as well.

Source: 5 Reasons Why You Should Take a Nap Every Day — Michael Hyatt

Since I started getting 7 to 8 hours of sleep a night, I've been more productive and completed more work than when I worked 16 hours a day. Who knew marketers could use sleep?

2. Refrain from accepting too frequently

Pareto's principle states that 20% of effort produces 80% of results, but 20% of results takes 80% of effort. Instead of working harder, we should prioritize the initiatives that produce the most outcomes. So we can focus on crucial tasks. Stop accepting unproductive tasks.

“The difference between successful people and very successful people is that very successful people say “no” to almost everything.” — Warren Buffett

What should you accept? Why say no? Consider doing a split test to determine if anything is worth your attention. Track what you do, how long it takes, and the consequences. Then, evaluate your list to discover what worked (or didn't) to optimize future chores.

Most of us say yes more often than we should, out of guilt, overextension, and because it's simpler than no. Nobody likes being awful.

Researchers separated 120 students into two groups for a 2012 Journal of Consumer Research study. One group was educated to say “I can't” while discussing choices, while the other used “I don't”.

The students who told themselves “I can’t eat X” chose to eat the chocolate candy bar 61% of the time. Meanwhile, the students who told themselves “I don’t eat X” chose to eat the chocolate candy bars only 36% of the time. This simple change in terminology significantly improved the odds that each person would make a more healthy food choice.

Next time you need to say no, utilize I don't to encourage saying no to unimportant things.

The 20-second rule is another wonderful way to avoid pursuits with little value. Add a 20-second roadblock to things you shouldn't do or bad habits you want to break. Delete social media apps from your phone so it takes you 20 seconds to find your laptop to access them. You'll be less likely to engage in a draining hobby or habit if you add an inconvenience.

Lower the activation energy for habits you want to adopt and raise it for habits you want to avoid. The more we can lower or even eliminate the activation energy for our desired actions, the more we enhance our ability to jump-start positive change. Source: The Happiness Advantage: The Seven Principles of Positive Psychology That Fuel Success and Performance at Work

3. Stop doing everything yourself and start letting people help you

I once managed a large community and couldn't do it alone. The community took over once I burned out. Members did better than I could have alone. I learned about community and user-generated content.

Consumers know what they want better than marketers. Octoly says user-generated videos on YouTube are viewed 10 times more than brand-generated videos. 51% of Americans trust user-generated material more than a brand's official website (16%) or media coverage (22%). (14 percent). Marketers should seek help from the brand community.

Being a successful content marketer isn't about generating the best content, but cultivating a wonderful community.

We should seek aid when needed. We can't do everything. It's best to delegate work so you may focus on the most critical things. Instead of overworking or doing things alone, let others help.

Having friends or coworkers around can boost your productivity even if they can't help.

Just having friends nearby can push you toward productivity. “There’s a concept in ADHD treatment called the ‘body double,’ ” says David Nowell, Ph.D., a clinical neuropsychologist from Worcester, Massachusetts. “Distractable people get more done when there is someone else there, even if he isn’t coaching or assisting them.” If you’re facing a task that is dull or difficult, such as cleaning out your closets or pulling together your receipts for tax time, get a friend to be your body double. Source: Friendfluence: The Surprising Ways Friends Make Us Who We Are

4. Give up striving for perfection

Perfectionism hinders professors' research output. Dr. Simon Sherry, a psychology professor at Dalhousie University, did a study on perfectionism and productivity. Dr. Sherry established a link between perfectionism and productivity.

Perfectionism has its drawbacks.

• They work on a task longer than necessary.

• They delay and wait for the ideal opportunity. If the time is right in business, you are already past the point.

• They pay too much attention to the details and miss the big picture.

Marketers await the right time. They miss out.

The perfect moment is NOW.

5. Automate monotonous chores instead of continuing to do them.

A team of five workers who spent 3%, 20%, 25%, 30%, and 70% of their time on repetitive tasks reduced their time spent to 3%, 10%, 15%, 15%, and 10% after two months of working to improve their productivity.

Last week, I wrote a 15-minute Python program. I wanted to generate content utilizing Twitter API data and Hootsuite to bulk schedule it. Automation has cut this task from a day to five minutes. Whenever I do something more than five times, I try to automate it.

Automate monotonous chores without coding. Skills and resources are nice, but not required.  If you cannot build it, buy it.

People forget time equals money. Manual work is easy and requires little investigation. You can moderate 30 Instagram photographs for your UGC campaign. You need digital asset management software to manage 30,000 photographs and movies from five platforms. Filemobile helps individuals develop more user-generated content. You may buy software to manage rich media and address most internet difficulties.

Hire an expert if you can't find a solution. Spend money to make money, and time is your most precious asset.

Visit GitHub or Google Apps Script library, marketers. You may often find free, easy-to-use open source code.

6. Stop relying on intuition and start supporting your choices with data.

You may optimize your life by optimizing webpages for search engines.

Numerous studies might help you boost your productivity. Did you know individuals are most distracted from midday to 4 p.m.? This is what a Penn State psychology professor found. Even if you can't find data on a particular question, it's easy to run a split test and review your own results.

7. Stop working and spend some time doing absolutely nothing.

Most people don't know that being too focused can be destructive to our work or achievements. The Boston Globe's The Power of Lonely says solo time is excellent for the brain and spirit.

One ongoing Harvard study indicates that people form more lasting and accurate memories if they believe they’re experiencing something alone. Another indicates that a certain amount of solitude can make a person more capable of empathy towards others. And while no one would dispute that too much isolation early in life can be unhealthy, a certain amount of solitude has been shown to help teenagers improve their moods and earn good grades in school. Source: The Power of Lonely

Reflection is vital. We find solutions when we're not looking.

We don't become more productive overnight. It demands effort and practice. Waiting for change doesn't work. Instead, learn about your body and identify ways to optimize your energy and time for a happy existence.

The same way Amazon killed bookstores. You just can’t see it yet.

Shultz globalized coffee. Before Starbucks, coffee sucked.

All accounts say 1970s coffee was awful.

Starbucks had three stores selling ground Indonesian coffee in the 1980s.

What a show!

A year after joining the company at 29, Shultz traveled to Italy for R&D.

He noticed the coffee shops' sense of theater and community and realized Starbucks was in the wrong business.

Integrating coffee and destination created a sense of community in the store.

Brilliant!

He told Starbucks' founders about his experience.

They disapproved.

For two years.

Shultz left and opened an Italian coffee shop chain like any good entrepreneur.

Starbucks ran into financial trouble, so the founders offered to sell to Shultz.

Shultz bought Starbucks in 1987 for $3.8 million, including six stores and a payment plan.

Starbucks is worth $100.79Billion, per Google Finance.

26,500 times Shultz's initial investment

Starbucks is releasing its own NFT Platform under Shultz and his early Vision.

This year, Starbucks Odyssey launches. The new digital experience combines a Loyalty Rewards program with NFT.

The side chain Polygon-based platform doesn't require a Crypto Wallet. Customers can earn and buy digital assets to unlock incentives and experiences.

They've removed all friction, making it more immersive and convenient than a coffee shop.

Brilliant!

NFTs are the access coupon to their digital community, but they don't highlight the technology.

They prioritize consumer experience by adding non-technical users to Web3. Their collectables are called journey stamps, not NFTs.

No mention of bundled gas fees.

Brady Brewer, Starbucks' CMO, said;

“It happens to be built on blockchain and web3 technologies, but the customer — to be honest — may very well not even know that what they’re doing is interacting with blockchain technology. It’s just the enabler,”

Rewards members will log into a web app using their loyalty program credentials to access Starbucks Odyssey. They won't know about blockchain transactions.

Join the waitlist here

Starbucks has just dealt its rivals a devastating blow.

It generates more than ten times the revenue of its closest competitor Costa Coffee.

The coffee giant is booming.

Starbucks is ahead of its competitors. No wonder.

They have an innovative, adaptable leadership team.

Starbucks' DNA challenges the narrative, especially when others reject their ideas.

I’m off for a cappuccino.