> Say Hello To The Lean-Hedge Model

People think starting a business requires significant debt and investment. Like Shark Tank, you need a world-changing idea. I'm not saying to avoid investors or brilliant ideas.

Investing is essential to build a genuinely profitable company. Think Apple or Starbucks.

Entrepreneurship is risky because many people go bankrupt from debt. As starters, we shouldn't do it. Instead, use lean-hedge.

Simply defined, you construct a cash-flow business to hedge against long-term investment-heavy business expenses.

What the “fx!$rench-toast” is the lean-hedge model?

When you start a business, your money should move down, down, down, then up when it becomes profitable.

Many people don't survive the business's initial losses and debt. What if, we created a cash-flow business BEFORE we started our Starbucks to hedge against its initial expenses?

Lean-hedge has two sections. Start a cash-flow business. A cash-flow business takes minimal investment and usually involves sweat and time.

Let’s take a look at some examples:

A Translation company

Personal portfolio website (you make a site then you do cold e-mail marketing)

FREELANCE (UpWork, Fiverr).

Educational business.

Infomarketing. (You design a knowledge-based product. You sell the info).

Online fitness/diet/health coaching ($50-$300/month, calls, training plan)

Amazon e-book publishing. (Medium writers do this)

YouTube, cash-flow channel

A web development agency (I'm a dev, but if you're not, a graphic design agency, etc.) (Sell your time.)

Digital Marketing

Online paralegal (A million lawyers work in the U.S).

Some dropshipping (Organic Tik Tok dropshipping, where you create content to drive traffic to your shopify store instead of spend money on ads).

(Disclaimer: My first two cash-flow enterprises, which were language teaching, failed terribly. My translation firm is now booming because B2B e-mail marketing is easy.)

Crossover occurs. Your long-term business starts earning more money than your cash flow business.

My cash-flow business (freelancing, translation) makes $7k+/month.

I’ve decided to start a slightly more investment-heavy digital marketing agency

Here are the anticipated business's time- and money-intensive investments:

1. ($$$) Top Front-End designer's Figma/UI-UX design (in negotiation)

2. (Time): A little copywriting (I will do this myself)

3. ($$) Creating an animated webpage with HTML (in negotiation)

4. Backend Development (Duration) (I'll carry out this myself using Laravel.)

5. Logo Design ($$)

6. Logo Intro Video for $

7. Video Intro (I’ll edit this myself with Premiere Pro)

etc.

Then evaluate product, place, price, and promotion. Consider promotion and pricing.

The lean-hedge model's point is:

Don't gamble. Avoid debt. First create a cash-flow project, then grow it steadily.

Check read my previous posts on “Nightmare Mode” (which teaches you how to make work as interesting as video games) and Why most people can't escape a 9-5 to learn how to develop a cash-flow business.

How did his money blind me?

Like most fledgling entrepreneurs, I wanted a mentor. I met as many nearby folks with "entrepreneur" in their LinkedIn biographies for coffee.

These meetings taught me a lot, and I'd suggest them to any new creator. Attention! Meeting with many experienced entrepreneurs means getting contradictory advice. One entrepreneur will tell you to do X, then the next one you talk to may tell you to do Y, which are sometimes opposites. You'll have to chose which suggestion to take after the chats.

I experienced this. Same afternoon, I had two coffee meetings with experienced entrepreneurs. The first meeting was with a billionaire entrepreneur who took his company public.

I met him in a swanky hotel lobby and ordered a drink I didn't pay for. As a fledgling entrepreneur, money was scarce.

During the meeting, I demoed the software I'd built, he liked it, and we spent the hour discussing what features would make it a success. By the end of the meeting, he requested I include a killer feature we both agreed would attract buyers. The feature was complex and would require some time. The billionaire I was sipping coffee with in a beautiful hotel lobby insisted people would love it, and that got me enthusiastic.

The second meeting was with a young entrepreneur who had recently raised a small amount of investment and looked as eager to pitch me as I was to pitch him. I forgot his name. I mostly recall meeting him in a filthy coffee shop in a bad section of town and buying his pricey cappuccino. Water for me.

After his pitch, I demoed my app. When I was done, he barely noticed. He questioned my customer acquisition plan. Who was my client? What did they offer? What was my plan? Etc. No decent answers.

After our meeting, he insisted I spend more time learning my market and selling. He ignored my questions about features. Don't worry about features, he said. Customers will request features. First, find them.

Putting your faith in results over relevance

Problems plagued my afternoon. I met with two entrepreneurs who gave me differing advice about how to proceed, and I had to decide which to pursue. I couldn't decide.

Ultimately, I followed the advice of the billionaire.

Obviously.

Who wouldn’t? That was the guy who clearly knew more.

A few months later, I constructed the feature the billionaire said people would line up for.

The new feature was unpopular. I couldn't even get the billionaire to answer an email showing him what I'd done. He disappeared.

Within a few months, I shut down the company, wasting all the time and effort I'd invested into constructing the killer feature the billionaire said I required.

Would follow the struggling entrepreneur's advice have saved my company? It would have saved me time in retrospect. Potential consumers would have told me they didn't want what I was producing, and I could have shut down the company sooner or built something they did want. Both outcomes would have been better.

Now I know, but not then. I favored achievement above relevance.

Success vs. relevance

The millionaire gave me advice on building a large, successful public firm. A successful public firm is different from a startup. Priorities change in the last phase of business building, which few entrepreneurs reach. He gave wonderful advice to founders trying to double their stock values in two years, but it wasn't beneficial for me.

The other failing entrepreneur had relevant, recent experience. He'd recently been in my shoes. We still had lots of problems. He may not have achieved huge success, but he had valuable advice on how to pass the closest hurdle.

The money blinded me at the moment. Not alone So much of company success is defined by money valuations, fundraising, exits, etc., so entrepreneurs easily fall into this trap. Money chatter obscures the value of knowledge.

Don't base startup advice on a person's income. Focus on what and when the person has learned. Relevance to you and your goals is more important than a person's accomplishments when considering advice.

During the dot-com bust, I started my internet career. People used the internet intermittently to check email, plan travel, and do research. The average internet user spent 30 minutes online a day, compared to 7 today. To use the internet, you had to "log on" (most people still used dial-up), unlike today's always-on, high-speed mobile internet. In 2001, Amazon's market cap was $2.2B, 1/500th of what it is today. A study asked Americans if they'd adopt broadband, and most said no. They didn't see a need to speed up email, the most popular internet use. The National Academy of Sciences ranked the internet 13th among the 100 greatest inventions, below radio and phones. The internet was a cool invention, but it had limited uses and wasn't a good place to build a business. 

A small but growing movement of developers and founders believed the internet could be more than a read-only medium, allowing anyone to create and publish. This is web 2. The runner up name was read-write web. (These terms were used in prominent publications and conferences.) 

Web 2 concepts included letting users publish whatever they want ("user generated content" was a buzzword), social graphs, APIs and mashups (what we call composability today), and tagging over hierarchical navigation. Technical innovations occurred. A seemingly simple but important one was dynamically updating web pages without reloading. This is now how people expect web apps to work. Mobile devices that could access the web were niche (I was an avid Sidekick user). 

The contrast between what smart founders and engineers discussed over dinner and on weekends and what the mainstream tech world took seriously during the week was striking. Enterprise security appliances, essentially preloaded servers with security software, were a popular trend. Many of the same people would talk about "serious" products at work, then talk about consumer internet products and web 2. It was tech's biggest news. Web 2 products were seen as toys, not real businesses. They were hobbies, not work-related. 

There's a strong correlation between rich product design spaces and what smart people find interesting, which took me some time to learn and led to blog posts like "The next big thing will start out looking like a toy" Web 2's novel product design possibilities sparked dinner and weekend conversations. Imagine combining these features. What if you used this pattern elsewhere? What new product ideas are next? This excited people. "Serious stuff" like security appliances seemed more limited. 

The small and passionate web 2 community also stood out. I attended the first New York Tech meetup in 2004. Everyone fit in Meetup's small conference room. Late at night, people demoed their software and chatted. I have old friends. Sometimes I get asked how I first met old friends like Fred Wilson and Alexis Ohanian. These topics didn't interest many people, especially on the east coast. We were friends. Real community. Alex Rampell, who now works with me at a16z, is someone I met in 2003 when a friend said, "Hey, I met someone else interested in consumer internet." Rare. People were focused and enthusiastic. Revolution seemed imminent. We knew a secret nobody else did. 

My web 2 startup was called SiteAdvisor. When my co-founders and I started developing the idea in 2003, web security was out of control. Phishing and spyware were common on Internet Explorer PCs. SiteAdvisor was designed to warn users about security threats like phishing and spyware, and then, using web 2 concepts like user-generated reviews, add more subjective judgments (similar to what TrustPilot seems to do today). This staged approach was common at the time; I called it "Come for the tool, stay for the network." We built APIs, encouraged mashups, and did SEO marketing. 

Yahoo's 2005 acquisitions of Flickr and Delicious boosted web 2 in 2005. By today's standards, the amounts were small, around $30M each, but it was a signal. Web 2 was assumed to be a fun hobby, a way to build cool stuff, but not a business. Yahoo was a savvy company that said it would make web 2 a priority. 

As I recall, that's when web 2 started becoming mainstream tech. Early web 2 founders transitioned successfully. Other entrepreneurs built on the early enthusiasts' work. Competition shifted from ideation to execution. You had to decide if you wanted to be an idealistic indie bar band or a pragmatic stadium band. 

Web 2 was booming in 2007 Facebook passed 10M users, Twitter grew and got VC funding, and Google bought YouTube. The 2008 financial crisis tested entrepreneurs' resolve. Smart people predicted another great depression as tech funding dried up. 

Many people struggled during the recession. 2008-2011 was a golden age for startups. By 2009, talented founders were flooding Apple's iPhone app store. Mobile apps were booming. Uber, Venmo, Snap, and Instagram were all founded between 2009 and 2011. Social media (which had replaced web 2), cloud computing (which enabled apps to scale server side), and smartphones converged. Even if social, cloud, and mobile improve linearly, the combination could improve exponentially. 

This chart shows how I view product and financial cycles. Product and financial cycles evolve separately. The Nasdaq index is a proxy for the financial sentiment. Financial sentiment wildly fluctuates. 

Next row shows iconic startup or product years. Bottom-row product cycles dictate timing. Product cycles are more predictable than financial cycles because they follow internal logic. In the incubation phase, enthusiasts build products for other enthusiasts on nights and weekends. When the right mix of technology, talent, and community knowledge arrives, products go mainstream. (I show the biggest tech cycles in the chart, but smaller ones happen, like web 2 in the 2000s and fintech and SaaS in the 2010s.) 

Tech has changed since the 2000s. Few tech giants dominate the internet, exerting economic and cultural influence. In the 2000s, web 2 was ignored or dismissed as trivial. Entrenched interests respond aggressively to new movements that could threaten them. Creative patterns from the 2000s continue today, driven by enthusiasts who see possibilities where others don't. Know where to look. Crypto and web 3 are where I'd start. 

Today's negative financial sentiment reminds me of 2008. If we face a prolonged downturn, we can learn from 2008 by preserving capital and focusing on the long term. Keep an eye on the product cycle. Smart people are interested in things with product potential. This becomes true. Toys become necessities. Hobbies become mainstream. Optimists build the future, not cynics.

Full article is available here

If you think NFTs are awful, check out the art market.

The fervor around NFTs has subsided in recent months due to the crypto market crash and the media's short attention span. They were all anyone could talk about earlier this spring. Last semester, when passions were high and field luminaries were discussing "slurp juices," I asked my students and students from over 20 other universities what they thought of NFTs.

According to many, NFTs were either tasteless pyramid schemes or a new way for artists to make money. NFTs contributed to the climate crisis and harmed the environment, but so did air travel, fast fashion, and smartphones. Some students complained that NFTs were cheap, tasteless, algorithmically generated schlock, but others asked how this was different from other art.

I'm not sure what I expected, but the intensity of students' reactions surprised me. They had strong, emotional opinions about a technology I'd always considered administrative. NFTs address ownership and accounting, like most crypto/blockchain projects.

Art markets can be irrational, arbitrary, and subject to the same scams and schemes as any market. And maybe a few shenanigans that are unique to the art world.

The Fairness Question

Fairness, a deflating moral currency, was the general sentiment (the less of it in circulation, the more ardently we clamor for it.) These students, almost all of whom are artists, complained to the mismatch between the quality of the work in some notable NFT collections and the excessive amounts these items were fetching on the market. They can sketch a Bored Ape or Lazy Lion in their sleep. Why should they buy ramen with school loans while certain swindlers get rich?

I understand students. Art markets are unjust. They can be irrational, arbitrary, and governed by chance and circumstance, like any market. And art-world shenanigans.

Almost every mainstream critique leveled against NFTs applies just as easily to art markets

Over 50% of artworks in circulation are fake, say experts. Sincere art collectors and institutions are upset by the prevalence of fake goods on the market. Not everyone. Wealthy people and companies use art as investments. They can use cultural institutions like museums and galleries to increase the value of inherited art collections. People sometimes buy artworks and use family ties or connections to museums or other cultural taste-makers to hype the work in their collection, driving up the price and allowing them to sell for a profit. Money launderers can disguise capital flows by using market whims, hype, and fluctuating asset prices.

Almost every mainstream critique leveled against NFTs applies just as easily to art markets.

Art has always been this way. Edward Kienholz's 1989 print series satirized art markets. He stamped 395 identical pieces of paper from $1 to $395. Each piece was initially priced as indicated. Kienholz was joking about a strange feature of art markets: once the last print in a series sells for $395, all previous works are worth at least that much. The entire series is valued at its highest auction price. I don't know what a Kienholz print sells for today (inquire with the gallery), but it's more than $395.

I love Lee Lozano's 1969 "Real Money Piece." Lozano put cash in various denominations in a jar in her apartment and gave it to visitors. She wrote, "Offer guests coffee, diet pepsi, bourbon, half-and-half, ice water, grass, and money." "Offer real money as candy."

Lee Lozano kept track of who she gave money to, how much they took, if any, and how they reacted to the offer of free money without explanation. Diverse reactions. Some found it funny, others found it strange, and others didn't care. Lozano rarely says:

Apr 17 Keith Sonnier refused, later screws lid very tightly back on. Apr 27 Kaltenbach takes all the money out of the jar when I offer it, examines all the money & puts it all back in jar. Says he doesn’t need money now. Apr 28 David Parson refused, laughing. May 1 Warren C. Ingersoll refused. He got very upset about my “attitude towards money.” May 4 Keith Sonnier refused, but said he would take money if he needed it which he might in the near future. May 7 Dick Anderson barely glances at the money when I stick it under his nose and says “Oh no thanks, I intend to earn it on my own.” May 8 Billy Bryant Copley didn’t take any but then it was sort of spoiled because I had told him about this piece on the phone & he had time to think about it he said.

Smart Contracts (smart as in fair, not smart as in Blockchain)

Cornell University's Cheryl Finley has done a lot of research on secondary art markets. I first learned about her research when I met her at the University of Florida's Harn Museum, where she spoke about smart contracts (smart as in fair, not smart as in Blockchain) and new protocols that could help artists who are often left out of the economic benefits of their own work, including women and women of color.

Her talk included findings from her ArtNet op-ed with Lauren van Haaften-Schick, Christian Reeder, and Amy Whitaker.

NFTs allow us to think about and hack on formal contractual relationships outside a system of laws that is currently not set up to service our community.

The ArtNet article The Recent Sale of Amy Sherald's ‘Welfare Queen' Symbolizes the Urgent Need for Resale Royalties and Economic Equity for Artists discussed Sherald's 2012 portrait of a regal woman in a purple dress wearing a sparkling crown and elegant set of pearls against a vibrant red background.

Amy Sherald sold "Welfare Queen" to Princeton professor Imani Perry. Sherald agreed to a payment plan to accommodate Perry's budget.

Amy Sherald rose to fame for her 2016 portrait of Michelle Obama and her full-length portrait of Breonna Taylor, one of the most famous works of the past decade.

As is common, Sherald's rising star drove up the price of her earlier works. Perry's "Welfare Queen" sold for $3.9 million in 2021.

Imani Perry's early investment paid off big-time. Amy Sherald, whose work directly increased the painting's value and who was on an artist's shoestring budget when she agreed to sell "Welfare Queen" in 2012, did not see any of the 2021 auction money. Perry and the auction house got that money.

Sherald sold her Breonna Taylor portrait to the Smithsonian and Louisville's Speed Art Museum to fund a $1 million scholarship. This is a great example of what an artist can do for the community if they can amass wealth through their work.

NFTs haven't solved all of the art market's problems — fakes, money laundering, market manipulation — but they didn't create them. Blockchain and NFTs are credited with making these issues more transparent. More ideas emerge daily about what a smart contract should do for artists.

NFTs are a copyright solution. They allow us to hack formal contractual relationships outside a law system that doesn't serve our community.

Amy Sherald shows the good smart contracts can do (as in, well-considered, self-determined contracts, not necessarily blockchain contracts.) Giving back to our community, deciding where and how our work can be sold or displayed, and ensuring artists share in the equity of our work and the economy our labor creates.

Unleash the power of persuasion and captivate your audience with compelling headlines.

As the old adage goes, "You never get a second chance to make a first impression."

In the world of content creation and social ads, headlines and titles play a critical role in making that first impression.

A well-crafted headline can make the difference between an article being read or ignored, a video being clicked on or bypassed, or a product being purchased or passed over.

To make an impact with your headlines, mastering the art of rhetoric is essential. In this post, we'll explore various rhetorical devices and techniques that can help you create headlines that captivate your audience and drive engagement.

tl;dr : Headline Magician will help you craft the ultimate headline titles powered by rhetoric devices

Example with a high-end luxury organic zero-waste skincare brand

✍️ The Power of Alliteration

Alliteration is the repetition of the same consonant sound at the beginning of words in close proximity. This rhetorical device lends itself well to headlines, as it creates a memorable, rhythmic quality that can catch a reader's attention.

By using alliteration, you can make your headlines more engaging and easier to remember.

Examples:

"Crafting Compelling Content: A Comprehensive Course"

"Mastering the Art of Memorable Marketing"

🔁 The Appeal of Anaphora

Anaphora is the repetition of a word or phrase at the beginning of successive clauses. This rhetorical device emphasizes a particular idea or theme, making it more memorable and persuasive.

In headlines, anaphora can be used to create a sense of unity and coherence, which can draw readers in and pique their interest.

Examples:

"Create, Curate, Captivate: Your Guide to Social Media Success"

"Innovation, Inspiration, and Insight: The Future of AI"

🔄 The Intrigue of Inversion

Inversion is a rhetorical device where the normal order of words is reversed, often to create an emphasis or achieve a specific effect.

In headlines, inversion can generate curiosity and surprise, compelling readers to explore further.

Examples:

"Beneath the Surface: A Deep Dive into Ocean Conservation"

"Beyond the Stars: The Quest for Extraterrestrial Life"

⚖️ The Persuasive Power of Parallelism

Parallelism is a rhetorical device that involves using similar grammatical structures or patterns to create a sense of balance and symmetry.

In headlines, parallelism can make your message more memorable and impactful, as it creates a pleasing rhythm and flow that can resonate with readers.

Examples:

"Eat Well, Live Well, Be Well: The Ultimate Guide to Wellness"

"Learn, Lead, and Launch: A Blueprint for Entrepreneurial Success"

⏭️ The Emphasis of Ellipsis

Ellipsis is the omission of words, typically indicated by three periods (...), which suggests that there is more to the story.

In headlines, ellipses can create a sense of mystery and intrigue, enticing readers to click and discover what lies behind the headline.

Examples:

"The Secret to Success... Revealed"

"Unlocking the Power of Your Mind... A Step-by-Step Guide"

🎭 The Drama of Hyperbole

Hyperbole is a rhetorical device that involves exaggeration for emphasis or effect.

In headlines, hyperbole can grab the reader's attention by making bold, provocative claims that stand out from the competition. Be cautious with hyperbole, however, as overuse or excessive exaggeration can damage your credibility.

Examples:

"The Ultimate Guide to Mastering Any Skill in Record Time"

"Discover the Revolutionary Technique That Will Transform Your Life"

❓The Curiosity of Questions

Posing questions in your headlines can be an effective way to pique the reader's curiosity and encourage engagement.

Questions compel the reader to seek answers, making them more likely to click on your content. Additionally, questions can create a sense of connection between the content creator and the audience, fostering a sense of dialogue and discussion.

Examples:

"Are You Making These Common Mistakes in Your Marketing Strategy?"

"What's the Secret to Unlocking Your Creative Potential?"

💥 The Impact of Imperatives

Imperatives are commands or instructions that urge the reader to take action. By using imperatives in your headlines, you can create a sense of urgency and importance, making your content more compelling and actionable.

Examples:

"Master Your Time Management Skills Today"

"Transform Your Business with These Innovative Strategies"

💢 The Emotion of Exclamations

Exclamations are powerful rhetorical devices that can evoke strong emotions and convey a sense of excitement or urgency.

Including exclamations in your headlines can make them more attention-grabbing and shareable, increasing the chances of your content being read and circulated.

Examples:

"Unlock Your True Potential: Find Your Passion and Thrive!"

"Experience the Adventure of a Lifetime: Travel the World on a Budget!"

🎀 The Effectiveness of Euphemisms

Euphemisms are polite or indirect expressions used in place of harsher, more direct language.

In headlines, euphemisms can make your message more appealing and relatable, helping to soften potentially controversial or sensitive topics.

Examples:

"Navigating the Challenges of Modern Parenting"

"Redefining Success in a Fast-Paced World"

⚡Antithesis: The Power of Opposites

Antithesis involves placing two opposite words side-by-side, emphasizing their contrasts. This device can create a sense of tension and intrigue in headlines.

Examples:

"Once a day. Every day"

"Soft on skin. Kill germs"

"Mega power. Mini size."

To utilize antithesis, identify two opposing concepts related to your content and present them in a balanced manner.

🎨 Scesis Onomaton: The Art of Verbless Copy

Scesis onomaton is a rhetorical device that involves writing verbless copy, which quickens the pace and adds emphasis.

Example:

"7 days. 7 dollars. Full access."

To use scesis onomaton, remove verbs and focus on the essential elements of your headline.

🌟 Polyptoton: The Charm of Shared Roots

Polyptoton is the repeated use of words that share the same root, bewitching words into memorable phrases.

Examples:

"Real bread isn't made in factories. It's baked in bakeries"

"Lose your knack for losing things."

To employ polyptoton, identify words with shared roots that are relevant to your content.

✨ Asyndeton: The Elegance of Omission

Asyndeton involves the intentional omission of conjunctions, adding crispness, conviction, and elegance to your headlines.

Examples:

"You, Me, Sushi?"

"All the latte art, none of the environmental impact."

To use asyndeton, eliminate conjunctions and focus on the core message of your headline.

🔮 Tricolon: The Magic of Threes

Tricolon is a rhetorical device that uses the power of three, creating memorable and impactful headlines.

Examples:

"Show it, say it, send it"

"Eat Well, Live Well, Be Well."

To use tricolon, craft a headline with three key elements that emphasize your content's main message.

🔔 Epistrophe: The Chime of Repetition

Epistrophe involves the repetition of words or phrases at the end of successive clauses, adding a chime to your headlines.

Examples:

"Catch it. Bin it. Kill it."

"Joint friendly. Climate friendly. Family friendly."

To employ epistrophe, repeat a key phrase or word at the end of each clause.

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.