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.

Trigger warning — Andrew Tate is running a genius marketing campaign

Andrew Tate is a 2022 internet celebrity.

Kickboxing world champion became rich playboy with controversial views on gender roles.

Andrew's get-rich-quick scheme isn't new. His social media popularity is impressive.

He’s currently running one of the most genius marketing campaigns in history.

He pulls society's pendulum away from diversity and inclusion and toward diversion and exclusion. He's unstoppable.

Here’s everything you need to know about Andrew Tate. And how he’s playing chess while the world plays checkers.

Cobra Tate is the name he goes by.

American-born, English-raised entrepreneur Andrew Tate lives in Romania.

Romania? Says Andrew,

“I prefer a country in which corruption is available to everyone.”

Andrew was a professional kickboxer with the ring moniker Cobra before starting Hustlers University.

Before that, he liked chess and worshipped his father.

Emory Andrew Tate III is named after his grandmaster chess player father.

Emory was the first black-American chess champion. He was military, martial arts-trained, and multilingual. A superhuman.

He lived in his car to make ends meet.

Andrew and Tristan relocated to England with their mother when their parents split.

It was there that Andrew began his climb toward becoming one of the internet’s greatest villains.

Andrew fell in love with kickboxing.

Andrew spent his 20s as a professional kickboxer and reality TV star, featuring on Big Brother UK and The Ultimate Traveller.

These 3 incidents, along with a chip on his shoulder, foreshadowed Andrews' social media breakthrough.

• Chess

• Combat sports

• Reality television

A dangerous trio.

Andrew started making money online after quitting kickboxing in 2017 due to an eye issue.

Andrew didn't suddenly become popular.

Andrew's web work started going viral in 2022.

Due to his contentious views on patriarchy and gender norms, he's labeled the King of Toxic Masculinity. His most contentious views (trigger warning):

• “Women are intrinsically lazy.”

• “Female promiscuity is disgusting.”

• “Women shouldn’t drive cars or fly planes.”

• “A lot of the world’s problems would be solved if women had their body count tattooed on their foreheads.”

Andrew's two main beliefs are:

1. “These are my personal opinions based on my experiences.”

2. “I believe men are better at some things and women are better at some things. We are not equal.”

Andrew intentionally offends.

Andrew's thoughts began circulating online in 2022.

In July 2022, he was one of the most Googled humans, surpassing:

• Joe Biden

• Donald Trump

• Kim Kardashian

Andrews' rise is a mystery since no one can censure or suppress him. This is largely because Andrew nor his team post his clips.

But more on that later.

Andrew's path to wealth.

Andrew Tate is a self-made millionaire. His morality is uncertain.

Andrew and Tristan needed money soon after retiring from kickboxing.

“I owed some money to some dangerous people. I had $70K and needed $100K to stay alive.”

Andrews lost $20K on roulette at a local casino.

Andrew had one week to make $50,000, so he started planning. Andrew locked himself in a chamber like Thomas Edison to solve an energy dilemma.

He listed his assets.

• Physical strength (but couldn’t fight)

• a BMW (worth around $20K)

• Intelligence (but no outlet)

A lightbulb.

He had an epiphany after viewing a webcam ad. He sought aid from women, ironically. His 5 international girlfriends are assets.

Then, a lightbulb.

Andrew and Tristan messaged and flew 7 women to a posh restaurant. Selling desperation masked as opportunity, Andrew pitched his master plan:

A webcam business — with a 50/50 revenue split.

5 women left.

2 stayed.

Andrew Tate, a broke kickboxer, became Top G, Cobra Tate.

The business model was simple — yet sad.

Andrew's girlfriends moved in with him and spoke online for 15+ hours a day. Andrew handled ads and equipment as the women posed.

Andrew eventually took over their keyboards, believing he knew what men wanted more than women.

Andrew detailed on the Full Send Podcast how he emotionally manipulated men for millions. They sold houses, automobiles, and life savings to fuel their companionship addiction.

When asked if he felt bad, Andrew said,

“F*ck no.“

Andrew and Tristan wiped off debts, hired workers, and diversified.

Tristan supervised OnlyFans models.

Andrew bought Romanian casinos and MMA league RXF (Real Xtreme Fighting).

Pandemic struck suddenly.

Andrew couldn't run his 2 businesses without a plan. Another easy moneymaker.

He banked on Hustlers University.

The actual cause of Andrew's ubiquity.

On a Your Mom’s House episode Andrew's 4 main revenue sources:

1. Hustler’s University

2. Owning casinos in Romania

3. Owning 10% of the Romanian MMA league “RXF”

4. “The War Room” — a society of rich and powerful men

When the pandemic hit, 3/4 became inoperable.

So he expanded Hustlers University.

But what is Hustler’s University?

Andrew says Hustlers University teaches 18 wealth-building tactics online. Examples:

• Real estate

• Copywriting

• Amazon FBA

• Dropshipping

• Flipping Cryptos

How to swiftly become wealthy.

Lessons are imprecise, rudimentary, and macro-focused, say reviews. Invest wisely, etc. Everything is free online.

You pay for community. One unique income stream.

The only money-making mechanism that keeps the course from being a scam.

The truth is, many of Andrew’s students are actually making money. Maybe not from the free YouTube knowledge Andrew and his professors teach in the course, but through Hustler’s University’s affiliate program.

Affiliates earn 10% commission for each new student = $5.

Students can earn $10 for each new referral in the first two months.

Andrew earns $50 per membership per month.

This affiliate program isn’t anything special — in fact, it’s on the lower end of affiliate payouts. Normally, it wouldn’t be very lucrative.

But it has one secret weapon— Andrew and his viral opinions.

Andrew is viral. Andrew went on a media tour in January 2022 after appearing on Your Mom's House.

• The Full Send Podcast

• The Fresh & Fit Podcast

• “BFFs” by Barstool Sports

And many, many more…

He chatted with Twitch streamers. Hustlers University wanted more controversy (and clips).

Here’s the strategy behind Hustler’s University that has (allegedly) earned students upwards of $10K per month:

1. Make a social media profile with Andrew Tates' name and photo.

2. Post any of the online videos of Andrews that have gone viral.

3. Include a referral link in your bio.

Effectively simple.

Andrew's controversy attracts additional students. More student clips circulate as more join. Andrew's students earn more and promote the product as he goes viral.

A brilliant plan that's functioning.

At the beginning of his media tour, Hustler’s University had 5,000 students. 6 months in, and he now has over 100,000.

One income stream generates $5 million every month.

Andrew's approach is not new.

But it is different.

In the early 2010s, Tai Lopez dominated the internet.

His viral video showed his house.

“Here in my garage. Just bought this new Lamborghini.”

Tais' marketing focused on intellect, not strength, power, and wealth to attract women.

How reading quicker leads to financial freedom in 67 steps.

Years later, it was revealed that Tai Lopez rented the mansion and Lamborghini as a marketing ploy to build social proof. Meanwhile, he was living in his friend’s trailer.

Faked success is an old tactic.

Andrew is doing something similar. But with one major distinction.

Andrew outsources his virality — making him nearly impossible to cancel.

In 2022, authorities searched Andrews' estate over human trafficking suspicions. Investigation continues despite withdrawn charges.

Andrew's divisive nature would normally get him fired. Andrew's enterprises and celebrity don't rely on social media.

He doesn't promote or pay for ads. Instead, he encourages his students and anyone wishing to get rich quick to advertise his work.

Because everything goes through his affiliate program. Old saying:

“All publicity is good publicity.”

Final thoughts: it’s ok to feel triggered.

Tate is divisive.

His emotionally charged words are human nature. Andrews created the controversy.

It's non-personal.

His opinions are those of one person. Not world nor generational opinion.

Briefly:

• It's easy to understand why Andrews' face is ubiquitous. Money.

• The world wide web is a chessboard. Misdirection is part of it.

• It’s not personal, it’s business.

• Controversy sells

Sometimes understanding the ‘why’, can help you deal with the ‘what.’

A worldwide energy crisis might have hampered renewable energy and clean tech investment. Nope.

BNEF's 2023 Energy Transition Investment Trends study surprised and encouraged. Global energy transition investment reached $1 trillion for the first time ($1.11t), up 31% from 2021. From 2013, the clean energy transition has come and cannot be reversed.

BNEF Head of Global Analysis Albert Cheung said our findings ended the energy crisis's influence on renewable energy deployment. Energy transition investment has reached a record as countries and corporations implement transition strategies. Clean energy investments will soon surpass fossil fuel investments.

The table below indicates the tripping point, which means the energy shift is occuring today.

BNEF calls money invested on clean technology including electric vehicles, heat pumps, hydrogen, and carbon capture energy transition investment. In 2022, electrified heat received $64b and energy storage $15.7b.

Nonetheless, $495b in renewables (up 17%) and $466b in electrified transport (up 54%) account for most of the investment. Hydrogen and carbon capture are tiny despite the fanfare. Hydrogen received the least funding in 2022 at $1.1 billion (0.1%).

China dominates investment. China spends $546 billion on energy transition, half the global amount. Second, the US total of $141 billion in 2022 was up 11% from 2021. With $180 billion, the EU is unofficially second. China invested 91% in battery technologies.

The 2022 transition tipping point is encouraging, but the BNEF research shows how far we must go to get Net Zero. Energy transition investment must average $4.55 trillion between 2023 and 2030—three times the amount spent in 2022—to reach global Net Zero. Investment must be seven times today's record to reach Net Zero by 2050.

BNEF 2023 Energy Transition Investment Trends.

As shown in the graph above, BNEF experts have been using their crystal balls to determine where that investment should go. CCS and hydrogen are still modest components of the picture. Interestingly, they see nuclear almost fading. Active transport advocates like me may have something to say about the massive $4b in electrified transport. If we focus on walkable 15-minute cities, we may need fewer electric automobiles. Though we need more electric trains and buses.

Albert Cheung of BNEF emphasizes the challenge. This week's figures promise short-term job creation and medium-term energy security, but more investment is needed to reach net zero in the long run.

I expect the BNEF Energy Transition Investment Trends report to show clean tech investment outpacing fossil fuels investment every year. Finally saying that is amazing. It's insufficient. The planet must maintain its electric (not gas) pedal. In response to the research, Christina Karapataki, VC at Breakthrough Energy Ventures, a clean tech investment firm, tweeted: Clean energy investment needs to average more than 3x this level, for the remainder of this decade, to get on track for BNEFs Net Zero Scenario. Go!

I'm trying to understand why Bitcoin NFTs aren't ready.

Ordinals, a new Bitcoin protocol, has been controversial. NFTs can be added to Bitcoin transactions using the protocol. They are not tokens or fungible. Bitcoin NFTs are transaction metadata. Yes. They're not owned.

In January, the Ordinals protocol allowed data like photos to be directly encoded onto sats, the smallest units of Bitcoin worth 0.00000001 BTC, on the Bitcoin blockchain. Ordinals does not need a sidechain or token like other techniques. The Ordinals protocol has encoded JPEG photos, digital art, new profile picture (PFP) projects, and even 1993 DOOM onto the Bitcoin network.

Ordinals inscriptions are permanent digital artifacts preserved on the Bitcoin blockchain. It differs from Ethereum, Solana, and Stacks NFT technologies that allow smart contract creators to change information. Ordinals store the whole image or content on the blockchain, not just a link to an external server, unlike centralized databases, which can change the linked image, description, category, or contract identifier.

So far, more than 50,000 ordinals have been produced on the Bitcoin blockchain, and some of them have already been sold for astronomical amounts. The Ethereum-based CryptoPunks NFT collection spawned Ordinal Punk. Inscription 620 sold for 9.5 BTC, or $218,000, the most.

Segwit and Taproot, two important Bitcoin blockchain updates, enabled this. These protocols store transaction metadata, unlike Ethereum, where the NFT is the token. Bitcoin's NFT is a sat's transaction details.

What effects do ordinary values and NFTs have on the Bitcoin blockchain?

Ordinals will likely have long-term effects on the Bitcoin Ecosystem since they store, transact, and compute more data.

Charges Ordinals introduce scalability challenges. The Bitcoin network has limited transaction throughput and increased fees during peak demand. NFTs could make network transactions harder and more expensive. Ordinals currently occupy over 50% of block space, according to Glassnode.

One of the protocols that supported Ordinals Taproot has also seen a huge uptick:

Taproot use increases block size and transaction costs.

This could cause network congestion but also support more L2s with Ordinals-specific use cases. Dune info here.

Storage Needs The Bitcoin blockchain would need to store more data to store NFT data directly. Since ordinals were introduced, blocksize has tripled from 0.7mb to over 2.2mb, which could increase storage costs and make it harder for nodes to join the network.

Use Case Diversity On the other hand, NFTs on the Bitcoin blockchain could broaden Bitcoin's use cases beyond storage and payment. This could expand Bitcoin's user base. This is two-sided. Bitcoin was designed to be trustless, decentralized, peer-to-peer money.

Chain to permanently store NFTs as ordinals will change everything.

Popularity rise This new use case will boost Bitcoin appeal, according to some. This argument fails since Bitcoin is the most popular cryptocurrency. Popularity doesn't require a new use case. Cryptocurrency adoption boosts Bitcoin. It need not compete with Ethereum or provide extra benefits to crypto investors. If there was a need for another chain that supports NFTs (there isn't), why would anyone choose the slowest and most expensive network? It appears contradictory and unproductive.

Nonetheless, holding an NFT on the Bitcoin blockchain is more secure than any other blockchain, but this has little utility.

Bitcoin NFTs are undoubtedly controversial. NFTs are strange and perhaps harmful to Bitcoin's mission. If Bitcoin NFTs are here to stay, I hope a sidechain or rollup solution will take over and leave the base chain alone.

Microsoft co-founder Bill Gates assesses digital assets while the bull is caged.

Bill Gates is well-respected.

Reasonably. He co-founded and led Microsoft during its 1980s and 1990s revolution.

After leaving Microsoft, Bill Gates pursued other interests. He and his wife founded one of the world's largest philanthropic organizations, Bill & Melinda Gates Foundation. He also supports immunizations, population control, and other global health programs.

When Gates criticized Bitcoin, cryptocurrencies, and NFTs, it made news.

Bill Gates said at the 58th Munich Security Conference...

“You have an asset class that’s 100% based on some sort of greater fool theory that somebody’s going to pay more for it than I do.”

Gates means digital assets. Like many bitcoin critics, he says digital coins and tokens are speculative.

And he's not alone. Financial experts have dubbed Bitcoin and other digital assets a "bubble" for a decade.

Gates also made fun of Bored Ape Yacht Club and NFTs, saying, "Obviously pricey digital photographs of monkeys will help the world."

Why does Bill Gates dislike digital assets?

According to Gates' latest comments, Bitcoin, cryptos, and NFTs aren't good ways to hold value.

Bill Gates is a better investor than Elon Musk.

“I’m used to asset classes, like a farm where they have output, or like a company where they make products,” Gates said.

The Guardian claimed in April 2021 that Bill and Melinda Gates owned the most U.S. farms. Over 242,000 acres of farmland.

The Gates couple has enough farmland to cover Hong Kong.

Bill Gates is a classic investor. He wants companies with an excellent track record, strong fundamentals, and good management. Or tangible assets like land and property.

Gates prefers the "old economy" over the "new economy"

Gates' criticism of Bitcoin and cryptocurrency ventures isn't surprising. These digital assets lack all of Gates's investing criteria.

Volatile digital assets include Bitcoin. Their costs might change dramatically in a day. Volatility scares risk-averse investors like Gates.

Gates has a stake in the old financial system. As Microsoft's co-founder, Gates helped develop a dominant tech company.

Because of his business, he's one of the world's richest men.

Bill Gates is invested in protecting the current paradigm.

He won't invest in anything that could destroy the global economy.

When Gates criticizes Bitcoin, cryptocurrencies, and NFTs, he's suggesting they're a hoax. These soapbox speeches are one way he protects his interests.

Digital assets aren't a bad investment, though. Many think they're the future.

Changpeng Zhao and Brian Armstrong are two digital asset billionaires. Two crypto exchange CEOs. Binance/Coinbase.

Digital asset revolution won't end soon.

If you disagree with Bill Gates and plan to invest in Bitcoin, cryptocurrencies, or NFTs, do your own research and understand the risks.

But don’t take Bill Gates’ word for it.

He’s just an old rich guy with a lot of farmland.

He has a lot to lose if Bitcoin and other digital assets gain global popularity.

This post is a summary. Read the full article here.

Yes, salary details ought to be mentioned in job postings. Recruiters and candidates both agree, so why doesn't it happen?

The short answer is “Unfortunately, it’s not the Recruiter’s decision”. The longer answer is well… A LOT.

Starting in November 2022, NYC employers must include salary ranges in job postings. It should have started in May, but companies balked.

I'm thrilled about salary transparency. This decision will promote fair, inclusive, and equitable hiring practices, and I'm sure other states will follow suit. Good news!

Candidates, recruiters, and ED&I practitioners have advocated for pay transparency for years. Why the opposition?

Let's quickly review why companies have trouble sharing salary bands.

💰 Pay Parity

Many companies and leaders still oppose pay parity. Yes, even in 2022.

💰 Pay Equity

Many companies believe in pay parity and have reviewed their internal processes and systems to ensure equality.

However, Pay Equity affects who gets roles/promotions/salary raises/bonuses and when. Enter the pay gap!

💰Pay Transparency and its impact on Talent Retention

Sharing salary bands with external candidates (and the world) means current employees will have access to that information, which is one of the main reasons companies don't share salary data.

If a company has Pay Parity and Pay Equity issues, they probably have a Pay Transparency policy as well.

Sharing salary information with external candidates without ensuring current employees understand their own salary bands and how promotions/raises are decided could impact talent retention strategies.

This information should help clarify recent conversations.