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.

Looking back into the past can help you understand what's happening today and why.

"Creator economy" conjures up images of originality, sincerity, and passion. Where do Michelangelos and da Vincis push advancement with their gifts without battling for bread and proving themselves posthumously? 

Creativity has been as long as humanity, but it's just recently become a new economic paradigm. We even talk about Web3 now.

Let's examine the creative economy's history to better comprehend it. What brought us here? Looking back can help you understand what's happening now.

No yawning, I promise 😉.

Creator Economy's history

Long, uneven transition to creator economy. Let's examine the economic and societal changes that led us there.

1. Agriculture to industry

Mid-18th-century Industrial Revolution led to shift from agriculture to manufacturing. The industrial economy lasted until World War II.

The industrial economy's principal goal was to provide more affordable, accessible commodities.

Unlike today, products were scarce and inaccessible.

To fulfill its goals, industrialization triggered enormous economic changes, moving power from agrarians to manufacturers. Industrialization brought hard work, rivalry, and new ideas connected to production and automation. Creative thinkers focused on that then.

It doesn't mean music, poetry, or painting had no place back then. They weren't top priority. Artists were independent. The creative field wasn't considered a different economic subdivision.

2. The consumer economy

Manufacturers produced more things than consumers desired after World War II. Stuff was no longer scarce.

The economy must make customers want to buy what the market offers.

The consumer economic paradigm supplanted the industrial one. Customers (or consumers) replaced producers as the new economic center.

Salesmen, marketing, and journalists also played key roles (TV, radio, newspapers, etc.). Mass media greatly boosted demand for goods, defined trends, and changed views regarding nearly everything.

Mass media also gave rise to pop culture, which focuses on mass-market creative products. Design, printing, publishing, multi-media, audio-visual, cinematographic productions, etc. supported pop culture.

The consumer paradigm generated creative occupations and activities, unlike the industrial economy. Creativity was limited by the need for wide appeal.

Most creators were corporate employees.

Creating a following and making a living from it were difficult.

Paul Saffo said that only journalists and TV workers were known. Creators who wished to be known relied on producers, publishers, and other gatekeepers. To win their favor was crucial. Luck was the best tactic.

3. The creative economy

Consumer economy was digitized in the 1990s. IT solutions transformed several economic segments. This new digital economy demanded innovative, digital creativity.

Later, states declared innovation a "valuable asset that creates money and jobs." They also introduced the "creative industries" and the "creative economy" (not creator!) and tasked themselves with supporting them. Australia and the UK were early adopters.

Individual skill, innovation, and intellectual property fueled the creative economy. Its span covered design, writing, audio, video material, etc. The creative economy required IT-powered activity.

The new challenge was to introduce innovations to most economic segments and meet demand for digital products and services.

Despite what the title "creative economy" may imply, it was primarily oriented at meeting consumer needs. It didn't provide inventors any new options to become entrepreneurs. Instead of encouraging innovators to flourish on their own, the creative economy emphasized "employment-based creativity."

4. The creator economy

Next, huge IT platforms like Google, Facebook, YouTube, and others competed with traditional mainstream media.

During the 2008 global financial crisis, these mediums surpassed traditional media. People relied on them for information, knowledge, and networking. That was a digital media revolution. The creator economy started there.

The new economic paradigm aimed to engage and convert clients. The creator economy allowed customers to engage, interact, and provide value, unlike the consumer economy. It gave them instruments to promote themselves as "products" and make money.

Writers, singers, painters, and other creators have a great way to reach fans. Instead of appeasing old-fashioned gatekeepers (producers, casting managers, publishers, etc.), they can use the platforms to express their talent and gain admirers. Barriers fell.

It's not only for pros. Everyone with a laptop and internet can now create.

2022 creator economy:

Since there is no academic description for the current creator economy, we can freestyle.

The current (or Web2) creator economy is fueled by interactive digital platforms, marketplaces, and tools that allow users to access, produce, and monetize content.

No entry hurdles or casting in the creative economy. Sign up and follow platforms' rules. Trick: A platform's algorithm aggregates your data and tracks you. This is the payment for participation.

The platforms offer content creation, design, and ad distribution options. This is platforms' main revenue source.

The creator economy opens many avenues for creators to monetize their work. Artists can now earn money through advertising, tipping, brand sponsorship, affiliate links, streaming, and other digital marketing activities.

Even if your content isn't digital, you can utilize platforms to promote it, interact and convert your audience, and more. No limits. However, some of your income always goes to a platform (well, a huge one).

The creator economy aims to empower online entrepreneurship by offering digital marketing tools and reducing impediments.

Barriers remain. They are just different. Next articles will examine these.

Why update the creator economy for Web3?

I could address this question by listing the present creator economy's difficulties that led us to contemplate a Web3 upgrade.

I don't think these difficulties are the main cause. The mentality shift made us see these challenges and understand there was a better reality without them.

Crypto drove this thinking shift. It promoted disintermediation, independence from third-party service providers, 100% data ownership, and self-sovereignty. Crypto has changed the way we view everyday things.

Crypto's disruptive mission has migrated to other economic segments. It's now called Web3. Web3's creator economy is unique.

Here's the essence of the Web3 economy:

• Eliminating middlemen between creators and fans.

• 100% of creators' data, brand, and effort.

• Business and money-making transparency.

• Authentic originality above ad-driven content.

In the next several articles, I'll explain. We'll also discuss the creator economy and Web3's remedies.

Final thoughts

The creator economy is the organic developmental stage we've reached after all these social and economic transformations.

The Web3 paradigm of the creator economy intends to allow creators to construct their own independent "open economy" and directly monetize it without a third party.

If this approach succeeds, we may enter a new era of wealth creation where producers aren't only the products. New economies will emerge.

This article is a summary. To read the full post, click here.

A J.Crew collaboration for fashion label Eveliina Vintage is not a paradox; it is a solution.

Eveliina Vintage's capsule collection debuted yesterday at J.Crew. This J.Crew partnership stopped me in my tracks.

Eveliina Vintage sells vintage goods. Eeva Musacchia founded the shop in Finland in the 1970s. It's recognized for its one-of-a-kind slip dresses from the 1930s and 1940s.

I wondered why a vintage brand would partner with a mass shop. Fast fashion against vintage shopping? Will Eveliina Vintages customers be turned off?

But Eveliina Vintages customers don't care about sustainability. They want Eveliina's Instagram look. Eveliina Vintage collaborated with J.Crew to give customers what they wanted: more Eveliina at a lower price.

Vintage: A Fashion Option That Is Eco-Conscious

Secondhand shopping is a trendy response to quick fashion. J.Crew releases hundreds of styles annually. Waste and environmental damage have been criticized. A pair of jeans requires 1,800 gallons of water. J.Crew's limited-time deals promote more purchases. J.Crew items are likely among those Americans wear 7 times before discarding.

Consumers and designers have emphasized sustainability in recent years. Stella McCartney and Eileen Fisher are popular eco-friendly brands. They've also flocked to ThredUp and similar sites.

Gap, Levis, and Allbirds have listened to consumer requests. They promote recycling, ethical sourcing, and secondhand shopping.

Secondhand shoppers feel good about reusing and recycling clothing that might have ended up in a landfill.

Eco-conscious fashionistas shop vintage. These shoppers enjoy the thrill of the hunt (that limited-edition Chanel bag!) and showing off a unique piece (nobody will have my look!). They also reduce their environmental impact.

Is Eveliina Vintage capitalizing on an aesthetic or is it a sustainable brand?

Eveliina Vintage emphasizes environmental responsibility. Vogue's Amanda Musacchia emphasized sustainability. Amanda, founder Eeva's daughter, is a company leader.

But Eveliina's press message doesn't address sustainability, unlike Instagram. Scarcity and fame rule.

Eveliina Vintages Instagram has see-through dresses and lace-trimmed slip dresses. Celebrities and influencers are often photographed in Eveliina's apparel, which has 53,000+ followers. Vogue appreciates Eveliina's style. Multiple publications discuss Alexa Chung's Eveliina dress.

Eveliina Vintage markets its one-of-a-kind goods. It teases future content, encouraging visitors to return. Scarcity drives demand and raises clothing prices. One dress is $1,600+, but most are $500-$1,000.

The catch: Eveliina can't monetize its expanding popularity due to exorbitant prices and limited quantity. Why?

1. Most people struggle to pay for their clothing. But Eveliina Vintage lacks those more affordable entry-level products, in contrast to other luxury labels that sell accessories or perfume.

2. Many people have trouble fitting into their clothing. The bodies of most women in the past were different from those for which vintage clothing was designed. Each Eveliina dress's specific measurements are mentioned alongside it. Be careful, you can fall in love with an ill-fitting dress.

3. No matter how many people can afford it and fit into it, there is only one item to sell. To get the item before someone else does, those people must be on the Eveliina Vintage website as soon as it becomes available.

A Way for Eveliina Vintage to Make Money (and Expand) with J.Crew Its following

Eveliina Vintages' cooperation with J.Crew makes commercial sense.

This partnership spreads Eveliina's style. Slightly better pricing The $390 outfits have multicolored slips and gauzy cotton gowns. Sizes range from 00 to 24, which is wider than vintage racks.

Eveliina Vintage customers like the combination. Excited comments flood the brand's Instagram launch post. Nobody is mocking the 50-year-old vintage brand's fast-fashion partnership.

Vintage may be a sustainable fashion trend, but that's not why Eveliina's clients love the brand. They only care about the old look.

And that is a tale as old as fashion.

OpenAI's ChatGPT is an amazing AI-powered chatbot. It can write poetry, stories, and marketing campaigns, and it's also adept at coding. ChatGPT's coding is so amazing that it replicated itself. What happened:

Me: Hi

Hello! Can I help? I'll answer any inquiries you have.

Me: Build a python and flask AI chatbot that responds to user messages on the frontend.

CGPT:

from flask import Flask, request, jsonify

import openai
openai.api_key = "YOUR_API_KEY"

@app.route('/chatbot', methods=['POST'])
def chatbot():
    user_message = request.get_json()['message']
    response = chatbot_response(user_message)
    return jsonify({'response': response})


def chatbot_response(user_message):
    response = openai.Completion.create(
        engine="text-davinci-002",
        prompt=user_message,
        max_tokens=1024,
        n = 1,
        temperature=0.5
    )
    return response['choices'][0]['text']

if __name__ == '__main__':
    app.run()

To integrate a chatbot with a frontend, use Flask to serve an HTML page with a form for user messages and the chatbot's answer. AJAX can submit the form to the /chatbot route, and JavaScript can show the chatbot's response.

I imported code snippets at the top of the file.

Let's add a frontend interface, I said.

CGPT:

<!DOCTYPE html>
<html>
<head>
    <title>AI Chatbot</title>
</head>
<body>
    <h1>AI Chatbot</h1>
    <form id="chatbot-form">
        <label for="message">Message:</label><br>
        <input type="text" id="message" name="message"><br>
        <input type="submit" value="Submit">
    </form> 
    <div id="chatbot-response"></div>

    <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script>
    <script>
        $(document).ready(function() {
            $("#chatbot-form").submit(function(e) {
                e.preventDefault();
                var userMessage = $("#message").val();
                $.ajax({
                    type: "POST",
                    url: "/chatbot",
                    data: JSON.stringify({message: userMessage}),
                    contentType: "application/json; charset=utf-8",
                    dataType: "json",
                    success: function(response) {
                        $("#chatbot-response").text(response.response);
                    }
                });
            });
        });
    </script>
</body>
</html>

To serve this HTML page using Flask, build a new route that returns the page as a GET response.

So far, so good.

Looked quite basic so I got chatGPT to add some tailwind to the project.

Me: Tailwind the chatbot.html page, please. Give it a futuristic style with purple and neon

After a few more prompts, Talk GPT aligned the form to the center, changed some colors, and added padding.

CGPT:

<!DOCTYPE html>
<html>
<head>
    <title>AI Chatbot</title>
    <link href="https://unpkg.com/tailwindcss@^1.0/dist/tailwind.min.css" rel="stylesheet">
</head>
<body class="bg-black flex flex-col justify-center items-center">
    <h1 class="sm:text-center text-purple-500">AI Chatbot</h1>
    <form id="chatbot-form" class="border-purple-500 bg-purple-800 rounded">
        <label for="message">Message:</label><br>
        <input type="text" id="message" name="message" class="min-w-30 rounded"><br>
        <input type="submit" value="Submit" class="bg-purple-500 border-red-500 transform hover:scale-110 rounded">
    </form> 
    <div class="flex justify-center">
        <div id="chatbot-response" class="text-white rounded"></div>
    </div>

    <script src="https://ajax.googleapis.com/ajax/libs/jquery/3.5.1/jquery.min.js"></script>
    <script>
        var colors = ['red', 'orange', 'yellow', 'green', 'blue', 'indigo', 'violet'];
        var colorIndex = 0;
        
        $(document).ready(function() {
            setInterval(function() {
                $("#chatbot-form").css('border-color', colors[colorIndex]);
                colorIndex = (colorIndex + 1) % colors.length;
            }, 1000);

            $("#chatbot-form").submit(function(e) {
                e.preventDefault();
                var userMessage = $("#message").val();
                $.ajax({
                    type: "POST",
                    url: "/chatbot",
                    data: JSON.stringify({message: userMessage}),
                    contentType: "application/json; charset=utf-8",
                    dataType: "json",
                    success: function(response) {
                        $("#chatbot-response").text(response.response);
                    }
                });
            });
        });
    </script>
</body>
</html>

Improved:

A few more prompts like “Add more vertical and horizontal padding to the submit button and vertical margin, and vertically align this file's body.”

The result:

Is it effective? Now, I'll chat with ChatGPT's AI Chatbot. I intervened minimally throughout construction. Chat GPT created numerous files, connected and interacted with its own API, and presented the user request response on the front end by itself.

Me to AI Chatbot: Hey, can you give me 6 name suggestions for a black horse?

Me to AI Chatbot: Write a poem in the style of Jim Morrison. Make sure to mention cacti and black holes

ChatGPTs Chatbot:

In the desert night, I am confronted by cacti, 
Their arms reaching out, As if to grab me and take me away. 
The stars in the sky, Beckon me to come, 
To a world of black holes, Where I can be free. 
I am in a trance, My body and mind, 
In a state of limbo, As I wander the night. 
I hear a voice, Calling me to the unknown, 
I cannot resist, The lure of the black hole. 
The cacti watch, As I take my leave, 
To a place of mystery, Where I can find peace.

Of course, the next question I gave it was to build a chatbot!

Me: Build a python and flask AI chatbot that responds to user messages on the frontend.

ChatbotGPTs:

import os from flask 
import Flask, request, jsonify 
from chatterbot 
import ChatBot 
from chatterbot.trainers 
import ListTrainer 

# Create a new chatbot 
bot = ChatBot( 
  "My Bot", 
  storage_adapter="chatterbot.storage.SQLStorageAdapter", 
  logic_adapters=[ 
    "chatterbot.logic.BestMatch", 
    { "import_path": "chatterbot.logic.BestMatch", 
      "statement_comparison_function": "chatterbot.comparisons.levenshtein_distance", 
       "response_selection_method": "chatterbot.response_selection.get_first_response" } 
    ], 
    database_uri="sqlite:///database.sqlite3" ) 

# Train the chatbot with a few sample conversations 
conversation = [ "Hello", "Hi there!", "How are you doing?", "I'm doing great.", "That is good to hear", "Thank you.", "You're welcome." ] 
trainer = ListTrainer(bot) trainer.train(conversation) 

# Create a Flask app 
app = Flask(__name__) 

# Define a route for the default URL 
@app.route("/") def index(): return "<h1>Chatbot</h1>" 

# Define a route for the /get_response URL 
@app.route("/get_response", methods=["POST"]) 

def get_response(): 
# Get the user's message 
user_message = request.form["user_message"] 
# Get the bot's response 
bot_response = bot.get_response(user_message) 
# Return the bot's response 
return str(bot_response) 
# Run the Flask 
app if __name__ == "__main__": app.run()

No matter how many times I tried, the second generation always used chatterbot instead of the ChatGPT API. Even when I told it to use the ChatGPT API, it didn't.

ChatGTP's ability to reproduce or construct other machine learning algorithms is interesting and possibly terrifying. Nothing prevents ChatGPT from replicating itself ad infinitum throughout the Internet other than a lack of desire. This may be the first time a machine repeats itself, so I've preserved the project as a reference. Adding a requirements.txt file and python env for easier deployment is the only change to the code.

I hope you enjoyed this.