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.

WTF is wrong with you people?

When I was laid off as editor of my town's daily newspaper, I went silent on social media. I knew it was coming and had been quietly removing personal items each day, but the pain was intense.

I posted a day later. I didn't bad-mouth GateHouse Media but expressed my sadness at leaving the newspaper industry, pride in my accomplishments, and hope for success in another industry.

Normal job-loss response.

What do you recognize as abnormal?

The bullshit I’ve been reading from laid-off folks on LinkedIn.

If you're there, you know. Many Twitter or Facebook/Meta employees recently lost their jobs.

Well, many of them did not “lose their job,” actually. They were “impacted by the layoffs” at their former employer. I keep seeing that phrase.

Why don’t they want to actually say it? Why the euphemism?

Many are excited about the opportunities ahead. The jobless deny being sad.

They're ecstatic! They have big plans.

Hope so. Sincerely! Being laid off stinks, especially if, like me, your skills are obsolete. It's worse if, like me, you're too old to start a new career. Ageism exists despite denials.

Nowadays, professionalism seems to demand psychotic levels of fake optimism.

Why? Life is unpredictable. That's indisputable. You shouldn't constantly complain or cry in public, but you also shouldn't pretend everything's great.

It makes you look psychotic, not positive. It's like saying at work:

“I was impacted by the death of my spouse of 20 years this week, and many of you have reached out to me, expressing your sympathy. However, I’m choosing to remember the amazing things we shared. I feel confident that there is another marriage out there for me, and after taking a quiet weekend trip to reset myself, I’ll be out there looking for the next great marital adventure! #staypositive #available #opentolove

Also:

“Now looking for our next #dreamhome after our entire neighborhood was demolished by a wildfire last night. We feel so lucky to have lived near so many amazing and inspirational neighbors, all of whom we will miss as we go on our next housing adventure. The best house for us is yet to come! If you have a great neighborhood you’d recommend, please feel free to reach out and touch base with us! #newhouse #newneighborhood #newlife

Admit it. That’s creepy.

The constant optimism makes me feel sick to my stomach.

Viscerally.

I hate fakes.

Imagine a fake wood grain desk. Wouldn't it be better if the designer accepted that it's plastic and went with that?

Real is better but not always nice. When something isn't nice, you don't have to go into detail, but you also shouldn't pretend it's great.

How to announce your job loss to the world.

Do not pretend to be happy, but don't cry and drink vodka all afternoon.

Say you loved your job, and that you're looking for new opportunities.

Yes, if you'll miss your coworkers. Otherwise, don't badmouth. No bridge-burning!

Please specify the job you want. You may want to pivot.

Alternatively, try this.

You could always flame out.

If you've pushed yourself too far into toxic positivity, you may be ready to burn it all down. If so, make it worthwhile by writing something like this:

Well, I was shitcanned by the losers at #Acme today. That bitch Linda in HR threw me under the bus just because she saw that one of my “friends” tagged me in some beach pics on social media after I called in sick with Covid. The good thing is I will no longer have to watch my ass around that #asspincher Ron in accounting, but I’m sad that I will no longer have a cushy job with high pay or access to the primo office supplies I’ve been sneaking home for the last five years. (Those gel pens were the best!) I am going to be taking some time off to enjoy my unemployment and hammer down shots of Jägermeister but in about five months I’ll be looking for anything easy with high pay and great benefits. Reach out if you can help! #officesupplies #unemploymentrocks #drinkinglikeagirlboss #acmesucks

It beats the fake positivity.

You have to use it.

Chat-GPT is a revolution.

All social media outlets are discussing it. How it will impact the future and different things.

True.

I've been using Chat-GPT for a few days, and it's a rare revolution. It's amazing and will only improve.

I asked Chat-GPT about the best non-fiction books. It advised this, albeit results rely on interests.

The Immortal Life of Henrietta Lacks

by Rebecca Skloot

Science, Biography

A impoverished tobacco farmer dies of cervical cancer in The Immortal Life of Henrietta Lacks. Her cell strand helped scientists treat polio and other ailments.

Rebecca Skloot discovers about Henrietta, her family, how the medical business exploited black Americans, and how her cells can live forever in a fascinating and surprising research.

You ought to read it.

1. if you want to discover more about the past of medicine.

2. if you want to discover more about American history.

Bad Blood: Secrets and Lies in a Silicon Valley Startup

by John Carreyrou

Tech, Bio

Bad Blood tells the terrifying story of how a Silicon Valley tech startup's blood-testing device placed millions of lives at risk.

John Carreyrou, a Pulitzer Prize-winning journalist, wrote this book.

Theranos and its wunderkind CEO, Elizabeth Holmes, climbed to popularity swiftly and then plummeted.

You ought to read it.

1. if you are a start-up employee.

2. specialists in medicine.

The Power of Now: A Guide to Spiritual Enlightenment

by Eckhart Tolle

Self-improvement, Spirituality

The Power of Now shows how to stop suffering and attain inner peace by focusing on the now and ignoring your mind.

The book also helps you get rid of your ego, which tries to control your ideas and actions.

If you do this, you may embrace the present, reduce discomfort, strengthen relationships, and live a better life.

You ought to read it.

1. if you're looking for serenity and illumination.

2. If you believe that you are ruining your life, stop.

3. if you're not happy.

The 7 Habits of Highly Effective People

by Stephen R. Covey

Profession, Success

The 7 Habits of Highly Effective People is an iconic self-help book.

This vital book offers practical guidance for personal and professional success.

This non-fiction book is one of the most popular ever.

You ought to read it.

1. if you want to reach your full potential.

2. if you want to discover how to achieve all your objectives.

3. if you are just beginning your journey toward personal improvement.

Sapiens: A Brief History of Humankind

by Yuval Noah Harari

Science, History

Sapiens explains how our species has evolved from our earliest ancestors to the technology age.

How did we, a species of hairless apes without tails, come to control the whole planet?

It describes the shifts that propelled Homo sapiens to the top.

You ought to read it.

1. if you're interested in discovering our species' past.

2. if you want to discover more about the origins of human society and culture.

Crypto people have witnessed things. They've seen big hacks, mind-boggling swindles, and amazing successes. They've never seen a day like Tuesday, when the world's largest crypto exchange murdered its closest competition.

Here's a primer on Binance and FTX's lunacy and why it matters if you're new to crypto.

What happened?

CZ, a shrewd Chinese-Canadian billionaire, runs Binance. FTX, a newcomer, has challenged Binance in recent years. SBF (Sam Bankman-Fried)—a young American with wild hair—founded FTX (initials are a thing in crypto).

Last weekend, CZ complained about SBF's lobbying and then exploited Binance's market power to attack his competition.

How did CZ do that?

CZ invested in SBF's new cryptocurrency exchange when they were friends. CZ sold his investment in FTX for FTT when he no longer wanted it. FTX clients utilize those tokens to get trade discounts, although they are less liquid than Bitcoin.

SBF made a mistake by providing CZ just too many FTT tokens, giving him control over FTX. It's like Pepsi handing Coca-Cola a lot of stock it could sell at any time. CZ got upset with SBF and flooded the market with FTT tokens.

SBF owns a trading fund with many FTT tokens, therefore this was catastrophic. SBF sought to defend FTT's worth by selling other assets to buy up the FTT tokens flooding the market, but it didn't succeed, and as FTT's value plummeted, his liabilities exceeded his assets. By Tuesday, his companies were insolvent, so he sold them to his competition.

Crazy. How could CZ do that?

CZ likely did this to crush a rising competition. It was also personal. In recent months, regulators have been tough toward the crypto business, and Binance and FTX have been trying to stay on their good side. CZ believed SBF was poisoning U.S. authorities by saying CZ was linked to China, so CZ took retribution.

“We supported previously, but we won't pretend to make love after divorce. We're neutral. But we won't assist people that push against other industry players behind their backs," CZ stated in a tragic tweet on Sunday. He crushed his rival's company two days later.

So does Binance now own FTX?

No. Not yet. CZ has only stated that Binance signed a "letter of intent" to acquire FTX. CZ and SBF say Binance will protect FTX consumers' funds.

Who’s to blame?

You could blame CZ for using his control over FTX to destroy it. SBF is also being criticized for not disclosing the full overlap between FTX and his trading company, which controlled plenty of FTT. If he had been upfront, someone might have warned FTX about this vulnerability earlier, preventing this mess.

Others have alleged that SBF utilized customer monies to patch flaws in his enterprises' balance accounts. That happened to multiple crypto startups that collapsed this spring, which is unfortunate. These are allegations, not proof.

Why does this matter? Isn't this common in crypto?

Crypto is notorious for shady executives and pranks. FTX is the second-largest crypto business, and SBF was largely considered as the industry's golden boy who would help it get on authorities' good side. Thus far.

Does this affect cryptocurrency prices?

Short-term, it's bad. Prices fell on suspicions that FTX was in peril, then rallied when Binance rescued it, only to fall again later on Tuesday.

These occurrences have hurt FTT and SBF's Solana token. It appears like a huge token selloff is affecting the rest of the market. Bitcoin fell 10% and Ethereum 15%, which is bad but not catastrophic for the two largest coins by market cap.

America should avoid BRICS

Vladimir Putin has watched videos of Muammar Gaddafi's CIA-backed demise.

Gaddafi...

Thief.

Did you know Gaddafi wanted a gold-backed dinar for Africa? Because he considered our global financial system was a Ponzi scheme, he wanted to discontinue trading oil in US dollars.

Or, Gaddafi's Libya enjoyed Africa's highest quality of living before becoming freed. Pictured:

Vladimir Putin is a nasty guy, but he had his reasons for not mentioning NATO assisting Ukraine in resisting US imperialism. Nobody tells you. Sure.

The US dollar's corruption post-2008, debasement by quantitative easing, and lack of value are key factors. BRICS will replace the dollar.

BRICS aren't bricks.

Economy-related.

Brazil, Russia, India, China, and South Africa have cooperated for 14 years to fight U.S. hegemony with a new international currency: BRICS.

BRICS is mostly comical. Now. Saudi Arabia, the second-largest oil hegemon, wants to join.

So what?

The New World Currency is BRICS

Russia was kicked out of G8 for its aggressiveness in Crimea in 2014.

It's now G7.

No biggie, said Putin, he said, and I quote, “Bon appetite.”

He was prepared. China, India, and Brazil lead the New World Order.

Together, they constitute 40% of the world's population and, according to the IMF, 50% of the world's GDP by 2030.

Here’s what the BRICS president Marcos Prado Troyjo had to say earlier this year about no longer needing the US dollar: “We have implemented the mechanism of mutual settlements in rubles and rupees, and there is no need for our countries to use the dollar in mutual settlements. And today a similar mechanism of mutual settlements in rubles and yuan is being developed by China.”

Ick. That's D.C. and NYC warmongers licking their chops for WW3 nasty.

Here's a lovely picture of BRICS to relax you:

If Saudi Arabia joins BRICS, as President Mohammed Bin Salman has expressed interest, a majority of the Middle East will have joined forces to construct a new world order not based on the US currency.

I'm not sure of the new acronym.

SBRICSS? CIRBSS? CRIBSS?

The Reason America Is Harvesting What It Sowed

BRICS began 14 years ago.

14 years ago, what occurred? Concentrate. It involved CDOs, bad subprime mortgages, and Wall Street quants crunching numbers.

2008 recession

When two nations trade, they do so in US dollars, not Euros or gold.

What happened when 2008, an avoidable crisis caused by US banks' cupidity and ignorance, what happened?

Everyone WORLDWIDE felt the pain.

Mostly due to corporate America's avarice.

This should have been a warning that China and Russia had enough of our bs. Like when France sent a battleship to America after Nixon scrapped the gold standard. The US was warned to shape up or be dethroned (or at least try).

Nixon improved in 1971. Kinda. Invented PetroDollar.

Another BS system that unfairly favors America and possibly pushed Russia, China, and Saudi Arabia into BRICS.

The PetroDollar forces oil-exporting nations to trade in US dollars and invest in US Treasury bonds. Brilliant. Genius evil.

Our misdeeds are:

• In conflicts that are not its concern, the USA uses the global reserve currency as a weapon.

• Targeted nations abandon the dollar, and rightfully so, as do nations that depend on them for trade in vital resources.

• The dollar's position as the world's reserve currency is in jeopardy, which could have disastrous economic effects.

• Although we have actually sown our own doom, we appear astonished. According to the Bible, whomever sows to appease his sinful nature will reap destruction from that nature whereas whoever sows to appease the Spirit will reap eternal life from the Spirit.

Americans, even our leaders, lack caution and delayed pleasure. When our unsustainable systems fail, we double down. Bailouts of the banks in 2008 were myopic, puerile, and another nail in America's hegemony.

America has screwed everyone.

We're unpopular.

The BRICS's future

It's happened before.

Saddam Hussein sold oil in Euros in 2000, and the US invaded Iraq a month later. The media has devalued the word conspiracy. The Iraq conspiracy.

There were no WMDs, but NYT journalists like Judy Miller drove Americans into a warmongering frenzy because Saddam would ruin the PetroDollar. Does anyone recall that this war spawned ISIS?

I think America has done good for the world. You can make a convincing case that we're many people's villain.

Learn more in Confessions of an Economic Hitman, The Devil's Chessboard, or Tyranny of the Federal Reserve. Or ignore it. That's easier.

We, America, should extend an olive branch, ask for forgiveness, and learn from our faults, as the Tao Te Ching advises. Unlikely. Our population is apathetic and stupid, and our government is corrupt.

Argentina, Iran, Egypt, and Turkey have also indicated interest in joining BRICS. They're also considering making it gold-backed, making it a new world reserve currency.

You should pay attention.

Thanks for reading!

One-hour ebook sales, affiliate relationships, and more.

If you follow me, you may know I started a new ebook in August 2022.

Despite publishing on this platform, my website, and Quora, I'm not a writer.

My writing speed is slow, 2,000 words a day, and I struggle to communicate cohesively.

In April 2022, I wrote a successful guide on How to Write Google-Friendly Blog Posts.

I had no email list or social media presence. I've made $1,600+ selling ebooks.

Evidence:

My first digital offering isn't a book.

It's an actionable guide with my tried-and-true process for writing Google-friendly content.

I'm not bragging.

Established authors like Tim Denning make more from my ebook sales with one newsletter.

This experience taught me writing isn't a privilege.

Writing a book and making money online doesn't require expertise.

Many don't consult experts. They want someone approachable.

Two years passed before I realized my own limits.

I have a brain, two hands, and Internet to spread my message.

I wrote and published a second ebook after the first's success.

On Gumroad, I released my second digital product.

Here's my complete Gumroad evaluation.

Gumroad is a marketplace for content providers to develop and sell sales pages.

Gumroad handles payments and client requests. It's helpful when someone sends a bogus payment receipt requesting an ebook (actual story!).

You'll forget administrative concerns after your first ebook sale.

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This thinking shift helps me become less busy while increasing my income and quality of life.

Besides helping others, folks sell evergreen digital things to earn passive money.

It's in my second ebook.

I explain how I built and sold 50+ copies of my SEO writing ebook without being an influencer.

I show how anyone can sell ebooks on Gumroad and automate their sales process.

This is my ebook.

After publicizing the ebook release, I sold three copies within an hour.

Wow, or meh?

I don’t know.

The answer is different for everyone.

These three sales came from a small email list of 40 motivated fans waiting for my ebook release.

I had bigger plans.

I'll market my ebook on Medium, my website, Quora, and email.

I'm testing affiliate partnerships this time.

One of my ebook buyers is now promoting it for 40% commission.

Become my affiliate if you think your readers would like my ebook.

My ebook is a few days old, but I'm interested to see where it goes.

My SEO writing book started without an email list, affiliates, or 4,000 website visitors. I've made four figures.

I'm slowly expanding my communication avenues to have more impact.

Even a small project can open doors you never knew existed.

So began my writing career.

In summary

If you dare, every concept can become a profitable trip.

Before, I couldn't conceive of creating an ebook.

How to Sell eBooks on Gumroad is my second digital product.

Marketing and writing taught me that anything can be sold online.