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.’

Homeownership isn't the only life pattern.

Want to irritate people?

My party trick is to say I used to own a house but no longer do.

I no longer wish to own a home, not because I lost it or because I'm moving.

It was a long-term plan. It was more deliberate than buying a home. Many people are committed for this reason.

Poppycock.

Anyone who told me that owning a house (or striving to do so) is a must is wrong.

Because, URGH.

One pattern for life is to own a home, but there are millions of others.

You can afford to buy a home? Go, buddy.

You think you need 1,000 square feet (or more)? You think it's non-negotiable in life?

Nope.

It's insane that society forces everyone to own real estate, regardless of income, wants, requirements, or situation. As if this trade brings happiness, stability, and contentment.

Take it from someone who thought this for years: drywall isn't happy. Living your way brings contentment.

That's in real estate. It may also be renting a small apartment in a city that makes your soul sing, but you can't afford the downpayment or mortgage payments.

Living or traveling abroad is difficult when your life savings are connected to something that eats your money the moment you sign.

#vanlife, which seems like torment to me, makes some people feel alive.

I've seen co-living, vacation rental after holiday rental, living with family, and more work.

Insisting that home ownership is the only path in life is foolish and reduces alternative options.

How little we question homeownership is a disgrace.

No one challenges a homebuyer's motives. We congratulate them, then that's it.

When you offload one, you must answer every question, even if you have a loose screw.

• Why do you want to sell?

• Do you have any concerns about leaving the market?

• Why would you want to renounce what everyone strives for?

• Why would you want to abandon a beautiful place like that?

• Why would you mismanage your cash in such a way?

• But surely it's only temporary? RIGHT??

Incorrect questions. Buying a property requires several inquiries.

• The typical American has $4500 saved up. When something goes wrong with the house (not if, it’s never if), can you actually afford the repairs?

• Are you certain that you can examine a home in less than 15 minutes before committing to buying it outright and promising to pay more than twice the asking price on a 30-year 7% mortgage?

• Are you certain you're ready to leave behind friends, family, and the services you depend on in order to acquire something?

• Have you thought about the connotation that moving to a suburb, which more than half of Americans do, means you will be dependent on a car for the rest of your life?

Plus:

Are you sure you want to prioritize home ownership over debt, employment, travel, raising kids, and daily routines?

Homeownership entails that. This ex-homeowner says it will rule your life from the time you put the key in the door.

This isn't questioned. We don't question enough. The holy home-ownership grail was set long ago, and we don't challenge it.

Many people question after signing the deeds. 70% of homeowners had at least one regret about buying a property, including the expense.

Exactly. Tragic.

Homes are different from houses

We've been fooled into thinking home ownership will make us happy.

Some may agree. No one.

Bricks and brick hindered me from living the version of my life that made me most comfortable, happy, and steady.

I'm spending the next month in a modest apartment in southern Spain. Even though it's late November, today will be 68 degrees. My spouse and I will soon meet his visiting parents. We'll visit a Sherry store. We'll eat, nap, walk, and drink Sherry. Writing. Jerez means flamenco.

That's my home. This is such a privilege. Living a fulfilling life brings me the contentment that buying a home never did.

I'm happy and comfortable knowing I can make almost all of my days good. Rejecting home ownership is partly to blame.

I'm broke like most folks. I had to choose between home ownership and comfort. I said, I didn't find them together.

Feeling at home trumps owning brick-and-mortar every day.

The following is the reality of what it's like to turn the American Dream around.

Leaving the housing market.

Sometimes I wish I owned a home.

I miss having my own yard and bed. My kitchen, cookbooks, and pizza oven are missed.

But I rarely do.

Someone else's life plan pushed home ownership on me. I'm grateful I figured it out at 35. Many take much longer, and some never understand homeownership stinks (for them).

It's confusing. People will think you're dumb or suicidal.

If you read what I write, you'll know. You'll realize that all you've done is choose to live intentionally. Find a home beyond four walls and a picket fence.

Miss? As I said, they're not home. If it were, a pizza oven, a good mattress, and a well-stocked kitchen would bring happiness.

No.

If you can afford a house and desire one, more power to you.

There are other ways to discover home. Find calm and happiness. For fun.

For it, look deeper than your home's foundation.

Better technology and lower launch costs revive science-fiction tech.

Airbus engineers showed off sustainable energy's future in Munich last month. They captured sunlight with solar panels, turned it into microwaves, and beamed it into an airplane hangar, where it lighted a city model. The test delivered 2 kW across 36 meters, but it posed a serious question: Should we send enormous satellites to capture solar energy in space? In orbit, free of clouds and nighttime, they could create power 24/7 and send it to Earth.

Airbus engineer Jean-Dominique Coste calls it an engineering problem. “But it’s never been done at [large] scale.”

Proponents of space solar power say the demand for green energy, cheaper space access, and improved technology might change that. Once someone invests commercially, it will grow. Former NASA researcher John Mankins says it might be a trillion-dollar industry.

Myriad uncertainties remain, including whether beaming gigawatts of power to Earth can be done efficiently and without burning birds or people. Concept papers are being replaced with ground and space testing. The European Space Agency (ESA), which supported the Munich demo, will propose ground tests to member nations next month. The U.K. government offered £6 million to evaluate innovations this year. Chinese, Japanese, South Korean, and U.S. agencies are working. NASA policy analyst Nikolai Joseph, author of an upcoming assessment, thinks the conversation's tone has altered. What formerly appeared unattainable may now be a matter of "bringing it all together"

NASA studied space solar power during the mid-1970s fuel crunch. A projected space demonstration trip using 1970s technology would have cost $1 trillion. According to Mankins, the idea is taboo in the agency.

Space and solar power technology have evolved. Photovoltaic (PV) solar cell efficiency has increased 25% over the past decade, Jones claims. Telecoms use microwave transmitters and receivers. Robots designed to repair and refuel spacecraft might create solar panels.

Falling launch costs have boosted the idea. A solar power satellite large enough to replace a nuclear or coal plant would require hundreds of launches. ESA scientist Sanjay Vijendran: "It would require a massive construction complex in orbit."

SpaceX has made the idea more plausible. A SpaceX Falcon 9 rocket costs $2600 per kilogram, less than 5% of what the Space Shuttle did, and the company promised $10 per kilogram for its giant Starship, slated to launch this year. Jones: "It changes the equation." "Economics rules"

Mass production reduces space hardware costs. Satellites are one-offs made with pricey space-rated parts. Mars rover Perseverance cost $2 million per kilogram. SpaceX's Starlink satellites cost less than $1000 per kilogram. This strategy may work for massive space buildings consisting of many identical low-cost components, Mankins has long contended. Low-cost launches and "hypermodularity" make space solar power economical, he claims.

Better engineering can improve economics. Coste says Airbus's Munich trial was 5% efficient, comparing solar input to electricity production. When the Sun shines, ground-based solar arrays perform better. Studies show space solar might compete with existing energy sources on price if it reaches 20% efficiency.

Lighter parts reduce costs. "Sandwich panels" with PV cells on one side, electronics in the middle, and a microwave transmitter on the other could help. Thousands of them build a solar satellite without heavy wiring to move power. In 2020, a team from the U.S. Naval Research Laboratory (NRL) flew on the Air Force's X-37B space plane.

NRL project head Paul Jaffe said the satellite is still providing data. The panel converts solar power into microwaves at 8% efficiency, but not to Earth. The Air Force expects to test a beaming sandwich panel next year. MIT will launch its prototype panel with SpaceX in December.

As a satellite orbits, the PV side of sandwich panels sometimes faces away from the Sun since the microwave side must always face Earth. To maintain 24-hour power, a satellite needs mirrors to keep that side illuminated and focus light on the PV. In a 2012 NASA study by Mankins, a bowl-shaped device with thousands of thin-film mirrors focuses light onto the PV array.

International Electric Company's Ian Cash has a new strategy. His proposed satellite uses enormous, fixed mirrors to redirect light onto a PV and microwave array while the structure spins (see graphic, above). 1 billion minuscule perpendicular antennas act as a "phased array" to electronically guide the beam toward Earth, regardless of the satellite's orientation. This design, argues Cash, is "the most competitive economically"

If a space-based power plant ever flies, its power must be delivered securely and efficiently. Jaffe's team at NRL just beamed 1.6 kW over 1 km, and teams in Japan, China, and South Korea have comparable attempts. Transmitters and receivers lose half their input power. Vijendran says space solar beaming needs 75% efficiency, "preferably 90%."

Beaming gigawatts through the atmosphere demands testing. Most designs aim to produce a beam kilometers wide so every ship, plane, human, or bird that strays into it only receives a tiny—hopefully harmless—portion of the 2-gigawatt transmission. Receiving antennas are cheap to build but require a lot of land, adds Jones. You could grow crops under them or place them offshore.

Europe's public agencies currently prioritize space solar power. Jones: "There's a devotion you don't see in the U.S." ESA commissioned two solar cost/benefit studies last year. Vijendran claims it might match ground-based renewables' cost. Even at a higher price, equivalent to nuclear, its 24/7 availability would make it competitive.

ESA will urge member states in November to fund a technical assessment. If the news is good, the agency will plan for 2025. With €15 billion to €20 billion, ESA may launch a megawatt-scale demonstration facility by 2030 and a gigawatt-scale facility by 2040. "Moonshot"

I pitched 10 brands per workday for a total of 200.

How did I do?

It was difficult.

I've never pitched so much.

What did this challenge teach me?

• the superiority of quality over quantity

• When you need help, outsource

• Don't disregard burnout in order to complete a challenge because it exists.

First, pitching brands for brand deals requires quality. Find firms that align with your brand to expose to your audience.

If you associate with any company, you'll lose audience loyalty. I didn't lose sight of that, but I couldn't resist finishing the task.

Outsourcing.

Delegating work to teammates is effective.

I wish I'd done it.

Three people can pitch 200 companies a month significantly faster than one.

One person does research, one to two do outreach, and one to two do follow-up and negotiating.

Simple.

In 2022, I'll outsource everything.

Burnout.

I felt this, so I slowed down at the end of the month.

Thanksgiving week in November was slow.

I was buying and decorating for Christmas. First time putting up outdoor holiday lights was fun.

Much was happening.

I'm not perfect.

I'm being honest.

The Outcomes

Less than 50 brands pitched.

Result: A deal with 3 brands.

I hoped for 4 brands with reaching out to 200 companies, so three with under 50 is wonderful.

That’s a 6% conversion rate!

Whoo-hoo!

I needed 2%.

Here's a screenshot from one of the deals I booked.

These companies fit my company well. Each campaign is different, but I've booked $2,450 in brand work with a couple of pending transactions for December and January.

$2,450 in brand work booked!

How did I do? You tell me.

Is this something you’d try yourself?