My ego is so huge it won't fit through the door.

I don't know how I feel about it. I should be excited. Many of you have this exact dream to publish a book with a well-known book publisher and get a juicy advance.

Let me dissect how I'm thinking about it to help you.

How it happened

An email comes in. A generic "can we put a backlink on your website and get a freebie" email.

Almost deleted it.

Then I noticed the logo. It seemed shady. I found the URL. Check. I searched the employee's LinkedIn. Legit. I avoided middlemen. Check.

Mixed feelings. LinkedIn hasn't valued my writing for years. I'm just a guy in an unironed t-shirt whose content they sell advertising against.

They get big dollars. I get $0 and a few likes, plus some email subscribers.

Still, I felt adrenaline for hours.

I texted a few friends to see how they felt. I wrapped them.

Messages like "No shocker. You're entertaining online." I didn't like praises, so I blushed.

The thrill faded after hours. Who knows?

Most authors desire this chance.

"You entitled piece of crap, Denning!"

You may think so. Okay. My job is to stand on the internet and get bananas thrown at me.

I approached writing backwards. More important than a book deal was a social media audience converted to an email list.

Romantic authors think backward. They hope a fantastic book will land them a deal and an audience.

Rarely occurs. So I never pursued it. It's like permission-seeking or the lottery.

Not being a professional writer, I've never written a good book. I post online for fun and to express my opinions.

Writing is therapeutic. I overcome mental illness and rebuilt my life this way. Without blogging, I'd be dead.

I've always dreamed of staying alive and doing something I love, not getting a book contract. Writing is my passion. I'm a winner without a book deal.

Why I was given a book deal

You may assume I received a book contract because of my views or follows. Nope.

They gave me a deal because they like my writing style. I've heard this for eight years.

Several authors agree. One asked me to improve their writer's voice.

Takeaway: highlight your writer's voice.

What if they discover I'm writing incompetently?

An edited book is published. It's edited.

I need to master writing mechanics, thus this concerns me. I need help with commas and sentence construction.

I must learn verb, noun, and adjective. Seriously.

Writing a book may reveal my imposter status to a famous publisher. Imagine the email

"It happened again. He doesn't even know how to spell. He thinks 'less' is the correct word, not 'fewer.' Are you sure we should publish his book?"

Fears stink.

I'm capable of blogging. Even listicles. So what?

Writing for a major publisher feels advanced.

I only blog. I'm good at listicles. Digital media executives have criticized me for this.

• It is allegedly clickbait.

• Or it is following trends.

• Alternately, growth hacking.

Never. I learned copywriting to improve my writing.

Apple, Amazon, and Tesla utilize copywriting to woo customers. Whoever thinks otherwise is the wisest person in the room.

Old-schoolers loathe copywriters.

Their novels sell nothing.

They assume their elitist version of writing is better and that the TikTok generation will invest time in random writing with no subheadings and massive walls of text they can't read on their phones.

I'm terrified of book proposals.

My friend's book proposal suggestion was contradictory and made no sense.

They told him to compose another genre. This book got three Amazon reviews. Is that a good model?

The process disappointed him. I've heard other book proposal horror stories. Tim Ferriss' book "The 4-Hour Workweek" was criticized.

Because he has thick skin, his book came out. He wouldn't be known without that.

I hate book proposals.

An ongoing commitment

Writing a book is time-consuming.

I appreciate time most. I want to focus on my daughter for the next few years. I can't recreate her childhood because of a book.

No idea how parents balance kids' goals.

My silly face in a bookstore. Really?

Genuine thought.

I don't want my face in bookstores. I fear fame. I prefer anonymity.

I want to purchase a property in a bad Australian area, then piss off and play drums. Is bookselling worth it?

Are there even bookstores anymore?

(Except for Ryan Holiday's legendary Painted Porch Bookshop in Texas.)

What's most important about books

Many were duped.

Tweets and TikTok hopscotch vids are their future. Short-form content creates devoted audiences that buy newsletter subscriptions.

Books=depth.

Depth wins (if you can get people to buy your book). Creating a book will strengthen my reader relationships.

It's cheaper than my classes, so more people can benefit from my life lessons.

A deeper justification for writing a book

Mind wandered.

If I write this book, my daughter will follow it. "Look what you can do, love, when you ignore critics."

That's my favorite.

I'll be her best leader and teacher. If her dad can accomplish this, she can too.

My kid can read my book when I'm gone to remember her loving father.

Last paragraph made me cry.

The positive

This book thing might make me sound like Karen.

The upside is... Building in public, like I have with online writing, attracts the right people.

Proof-of-work over proposals, beautiful words, or huge aspirations. If you want a book deal, try writing online instead of the old manner.

Next steps

No idea.

I'm a rural Aussie. Writing a book in the big city is intimidating. Will I do it? Lots to think about. Right now, some level of reflection and gratitude feels most appropriate.

Sometimes when you don't feel worthy, it gives you the greatest lessons. That's how I feel about getting offered this book deal.

Perhaps you can relate.

Christopher Janz of Point Nine Capital created the SaaS napkin in 2016. This post shows how founders have raised cash in the last 6 years. View raw data.

Round size

Unsurprisingly, round sizes have expanded and will taper down in 2022. In 2016, pre-seed rounds were $200k to $500k; currently, they're $1-$2m. Despite the macroeconomic scenario, Series A have expanded from $3m to $12m in 2016 to $6m and $18m in 2022.

Valuation

There are hints that valuations are rebounding this year. Pre-seed valuations in 2022 are $12m from $3m in 2016, and Series B prices are $270m from $100m in 2016.

Compared to public SaaS multiples, Series B valuations more closely reflect the market, but Seed and Series A prices seem to be inflated regardless of the market.

I'd like to know how each annual cohort performed for investors, based on the year they invested and the valuations. I can't access this information.

ARR

Seed firms' ARR forecasts have risen from $0 to $0.6m to $0 to $1m. 2016 expected $1.2m to $3m, 2021 $0.5m to $4m, and this year $0.5m to $2.5m, suggesting that Series A firms may raise with less ARR today. Series B minutes fell from $4.2m to $3m.

Capitalization Rate

2022 is the year that VCs start discussing capital efficiency in portfolio meetings. Given the economic shift in the markets and the stealthy VC meltdown, it's not surprising. Christopher Janz added capital efficiency to the SaaS Napkin as a new statistic for Series A (3.5x) and Series B. (2.5x). Your investors must live under a rock if they haven't asked about capital efficiency. If you're unsure:

The Capital Efficiency Ratio is the ratio of how much a company has spent growing revenue and how much they’re receiving in return. It is the broadest measure of company effectiveness in generating ARR

What next?

No one knows what's next, including me. All startup and growing enterprises around me are tightening their belts and extending their runways in anticipation of a difficult fundraising ride. If you're wanting to raise money but can wait, wait till the market is more stable and access to money is easier.

There’s a funny part of ‘Steve Jobs’ by Walter Isaacson where Jobs says that Bill Gates was more a copier than an innovator:

“Bill is basically unimaginative and has never invented anything, which is why I think he’s more comfortable now in philanthropy than technology. He just shamelessly ripped off other people’s ideas….He’d be a broader guy if he had dropped acid once or gone off to an ashram when he was younger.”

Gates lacked flavor. Nobody ever got excited about a Microsoft launch, despite their good products. Jobs had the world's best product taste. Apple vs. Microsoft.

A CEO's core job functions are all driven by taste: recruiting, vision, and company culture all require good taste. Depending on the type of company you want to build, know where you stand between Microsoft and Apple.

How can you improve your product judgment? How to acquire taste?

Test and refine

Product development follows two parallel paths: the ‘customer obsession’ path and the ‘taste and iterate’ path.

The customer obsession path involves solving customer problems. Lean Startup frameworks show you what to build at each step.

Taste-and-iterate doesn't involve the customer. You iterate internally and rely on product leaders' taste and judgment.

Creative Selection by Ken Kocienda explains this method. In Creative Selection, demos are iterated and presented to product leaders. Your boss presents to their boss, and so on up to Steve Jobs. If you have good product taste, you can be a panelist.

The iPhone follows this path. Before seeing an iPhone, consumers couldn't want one. Customer obsession wouldn't have gotten you far because iPhone buyers didn't know they wanted one.

In The Hard Thing About Hard Things, Ben Horowitz writes:

“It turns out that is exactly what product strategy is all about — figuring out the right product is the innovator’s job, not the customer’s job. The customer only knows what she thinks she wants based on her experience with the current product. The innovator can take into account everything that’s possible, but often must go against what she knows to be true. As a result, innovation requires a combination of knowledge, skill, and courage.“

One path solves a problem the customer knows they have, and the other doesn't. Instead of asking a person what they want, observe them and give them something they didn't know they needed.

It's much harder. Apple is the world's most valuable company because it's more valuable. It changes industries permanently.

If you want to build superior products, use the iPhone of your industry.

How to Improve Your Taste

I. Work for a company that has taste.

People with the best taste in products, markets, and people are rewarded for building great companies. Tasteful people know quality even when they can't describe it. Taste isn't writable. It's feel-based.

Moving into a community that's already doing what you want to do may be the best way to develop entrepreneurial taste. Most company-building knowledge is tacit.

Joining a company you want to emulate allows you to learn its inner workings. It reveals internal patterns intuitively. Many successful founders come from successful companies.

Consumption determines taste. Excellence will refine you. This is why restauranteurs visit the world's best restaurants and serious painters visit Paris or New York. Joining a company with good taste is beneficial.

2. Possess a wide range of interests

“Edwin Land of Polaroid talked about the intersection of the humanities and science. I like that intersection. There’s something magical about that place… The reason Apple resonates with people is that there’s a deep current of humanity in our innovation. I think great artists and great engineers are similar, in that they both have a desire to express themselves.” — Steve Jobs

I recently discovered Edwin Land. Jobs modeled much of his career after Land's. It makes sense that Apple was inspired by Land.

A Triumph of Genius: Edwin Land, Polaroid, and the Kodak Patent War notes:

“Land was introverted in person, but supremely confident when he came to his ideas… Alongside his scientific passions, lay knowledge of art, music, and literature. He was a cultured person growing even more so as he got older, and his interests filtered into the ethos of Polaroid.”

Founders' philosophies shape companies. Jobs and Land were invested. It showed in the products their companies made. Different. His obsession was spreading Microsoft software worldwide. Microsoft's success is why their products are bland and boring.

Experience is important. It's probably why startups are built by generalists and scaled by specialists.

Jobs combined design, typography, storytelling, and product taste at Apple. Some of the best original Mac developers were poets and musicians. Edwin Land liked broad-minded people, according to his biography. Physicist-musicians or physicist-photographers.

Da Vinci was a master of art, engineering, architecture, anatomy, and more. He wrote and drew at the same desk. His genius is remembered centuries after his death. Da Vinci's statue would stand at the intersection of humanities and science.

We find incredibly creative people here. Superhumans. Designers, creators, and world-improvers. These are the people we need to navigate technology and lead world-changing companies. Generalists lead.

Canonicalization and canonical URLs are essential for SEO, and improper implementation can negatively impact your site's performance.

Canonical tags were introduced in 2009 to help webmasters with duplicate or similar content on multiple URLs.

To use canonical tags properly, you must understand their purpose, operation, and implementation.

Canonical URLs and Tags

Canonical tags tell search engines that a certain URL is a page's master copy. They specify a page's canonical URL. Webmasters can avoid duplicate content by linking to the "canonical" or "preferred" version of a page.

How are canonical tags and URLs different? Can these be specified differently?

Tags

Canonical tags are found in an HTML page's head></head> section.

<link rel="canonical" href="https://www.website.com/page/" />

These can be self-referencing or reference another page's URL to consolidate signals.

Canonical tags and URLs are often used interchangeably, which is incorrect.

The rel="canonical" tag is the most common way to set canonical URLs, but it's not the only way.

Canonical URLs

What's a canonical link? Canonical link is the'master' URL for duplicate pages.

In Google's own words:

A canonical URL is the page Google thinks is most representative of duplicate pages on your site.

— Google Search Console Help

You can indicate your preferred canonical URL. For various reasons, Google may choose a different page than you.

When set correctly, the canonical URL is usually your specified URL.

Canonical URLs determine which page will be shown in search results (unless a duplicate is explicitly better for a user, like a mobile version).

Canonical URLs can be on different domains.

Other ways to specify canonical URLs

Canonical tags are the most common way to specify a canonical URL.

You can also set canonicals by:

• Setting the HTTP header rel=canonical.

• All pages listed in a sitemap are suggested as canonicals, but Google decides which pages are duplicates.

• Redirects 301.

Google recommends these methods, but they aren't all appropriate for every situation, as we'll see below. Each has its own recommended uses.

Setting canonical URLs isn't required; if you don't, Google will use other signals to determine the best page version.

To control how your site appears in search engines and to avoid duplicate content issues, you should use canonicalization effectively.

Why Duplicate Content Exists

Before we discuss why you should use canonical URLs and how to specify them in popular CMSs, we must first explain why duplicate content exists. Nobody intentionally duplicates website content.

Content management systems create multiple URLs when you launch a page, have indexable versions of your site, or use dynamic URLs.

Assume the following URLs display the same content to a user:

1. https://www.website.com/category/product-a/

2. https://www.website.com/product-a/

3. https://website.com/product-a/

4. http://www.website.com/product-a/

5. http://website.com/product-a/

6. https://m.website.com/product-a/

7. https://www.website.com/product-a

8. https://www.website.com/product-A/

A search engine sees eight duplicate pages, not one.

• URLs #1 and #2: the CMS saves product URLs with and without the category name.

• #3, #4, and #5 result from the site being accessible via HTTP, HTTPS, www, and non-www.

• #6 is a subdomain mobile-friendly URL.

• URL #7 lacks URL #2's trailing slash.

• URL #8 uses a capital "A" instead of a lowercase one.

Duplicate content may also exist in URLs like:

https://www.website.com
https://www.website.com/index.php

Duplicate content is easy to create.

Canonical URLs help search engines identify different page variations as a single URL on many sites.

SEO Canonical URLs

Canonical URLs help you manage duplicate content that could affect site performance.

Canonical URLs are a technical SEO focus area for many reasons.

Specify URL for search results

When you set a canonical URL, you tell Google which page version to display.

Which would you click?

https://www.domain.com/page-1/

https://www.domain.com/index.php?id=2

First, probably.

Canonicals tell search engines which URL to rank.

Consolidate link signals on similar pages

When you have duplicate or nearly identical pages on your site, the URLs may get external links.

Canonical URLs consolidate multiple pages' link signals into a single URL.

This helps your site rank because signals from multiple URLs are consolidated into one.

Syndication management

Content is often syndicated to reach new audiences.

Canonical URLs consolidate ranking signals to prevent duplicate pages from ranking and ensure the original content ranks.

Avoid Googlebot duplicate page crawling

Canonical URLs ensure that Googlebot crawls your new pages rather than duplicated versions of the same one across mobile and desktop versions, for example.

Crawl budgets aren't an issue for most sites unless they have 100,000+ pages.

How to Correctly Implement the rel=canonical Tag

Using the header tag rel="canonical" is the most common way to specify canonical URLs.

Adding tags and HTML code may seem daunting if you're not a developer, but most CMS platforms allow canonicals out-of-the-box.

These URLs each have one product.

How to Correctly Implement a rel="canonical" HTTP Header

A rel="canonical" HTTP header can replace canonical tags.

This is how to implement a canonical URL for PDFs or non-HTML documents.

You can specify a canonical URL in your site's.htaccess file using the code below.

<Files "file-to-canonicalize.pdf"> Header add Link "< http://www.website.com/canonical-page/>; rel=\"canonical\"" </Files>

301 redirects for canonical URLs

Google says 301 redirects can specify canonical URLs.

Only the canonical URL will exist if you use 301 redirects. This will redirect duplicates.

This is the best way to fix duplicate content across:

• HTTPS and HTTP

• Non-WWW and WWW

• Trailing-Slash and Non-Trailing Slash URLs

On a single page, you should use canonical tags unless you can confidently delete and redirect the page.

Sitemaps' canonical URLs

Google assumes sitemap URLs are canonical, so don't include non-canonical URLs.

This does not guarantee canonical URLs, but is a best practice for sitemaps.

Best-practice Canonical Tag

Once you understand a few simple best practices for canonical tags, spotting and cleaning up duplicate content becomes much easier.

Always include:

One canonical URL per page

If you specify multiple canonical URLs per page, they will likely be ignored.

Correct Domain Protocol

If your site uses HTTPS, use this as the canonical URL. It's easy to reference the wrong protocol, so check for it to catch it early.

Trailing slash or non-trailing slash URLs

Be sure to include trailing slashes in your canonical URL if your site uses them.

Specify URLs other than WWW

Search engines see non-WWW and WWW URLs as duplicate pages, so use the correct one.

Absolute URLs

To ensure proper interpretation, canonical tags should use absolute URLs.

So use:

<link rel="canonical" href="https://www.website.com/page-a/" />

And not:

<link rel="canonical" href="/page-a/" />

If not canonicalizing, use self-referential canonical URLs.

When a page isn't canonicalizing to another URL, use self-referencing canonical URLs.

Canonical tags refer to themselves here.

Common Canonical Tags Mistakes

Here are some common canonical tag mistakes.

301 Canonicalization

Set the canonical URL as the redirect target, not a redirected URL.

Incorrect Domain Canonicalization

If your site uses HTTPS, don't set canonical URLs to HTTP.

Irrelevant Canonicalization

Canonicalize URLs to duplicate or near-identical content only.

SEOs sometimes try to pass link signals via canonical tags from unrelated content to increase rank. This isn't how canonicalization should be used and should be avoided.

Multiple Canonical URLs

Only use one canonical tag or URL per page; otherwise, they may all be ignored.

When overriding defaults in some CMSs, you may accidentally include two canonical tags in your page's <head>.

Pagination vs. Canonicalization

Incorrect pagination can cause duplicate content. Canonicalizing URLs to the first page isn't always the best solution.

Canonicalize to a 'view all' page.

How to Audit Canonical Tags (and Fix Issues)

Audit your site's canonical tags to find canonicalization issues.

SEMrush Site Audit can help. You'll find canonical tag checks in your website's site audit report.

Let's examine these issues and their solutions.

No Canonical Tag on AMP

Site Audit will flag AMP pages without canonical tags.

Canonicalization between AMP and non-AMP pages is important.

Add a rel="canonical" tag to each AMP page's head>.

No HTTPS redirect or canonical from HTTP homepage

Duplicate content issues will be flagged in the Site Audit if your site is accessible via HTTPS and HTTP.

You can fix this by 301 redirecting or adding a canonical tag to HTTP pages that references HTTPS.

Broken canonical links

Broken canonical links won't be considered canonical URLs.

This error could mean your canonical links point to non-existent pages, complicating crawling and indexing.

Update broken canonical links to the correct URLs.

Multiple canonical URLs

This error occurs when a page has multiple canonical URLs.

Remove duplicate tags and leave one.

Canonicalization is a key SEO concept, and using it incorrectly can hurt your site's performance.

Once you understand how it works, what it does, and how to find and fix issues, you can use it effectively to remove duplicate content from your site.

Canonicalization SEO Myths

I'd spend hours composing articles only to find out they were useless. Twitter solved the problem.

Twitter is wrinkled, say critics.

Nope. Writing is different. It won't make sense until you write there.

Twitter is resurgent. People are reading again. 15-second TikToks overloaded our senses.

After nuking my 20,000-follower Twitter account and starting again, I wrote every day for 210 days.

I'll explain.

I came across the strange world of microblogging.

Traditional web writing is filler-heavy.

On Twitter, you must be brief. I played Wordle.

Twitter Threads are the most popular writing format. Like a blog post. It reminds me of the famous broetry posts on LinkedIn a few years ago.

Threads combine tweets into an article.

• Sharp, concise sentences

• No regard for grammar

• As important as the information is how the text looks.

Twitter Threads are like Michael Angelo's David monument. He chipped away at an enormous piece of marble until a man with a big willy appeared.

That's Twitter Threads.

I tried to remove unnecessary layers from several of my Wordpress blog posts. Then I realized something.

Tweeting from scratch is easier and more entertaining. It's quicker and makes you think more concisely.

Superpower: saying much with little words. My long-form writing has improved. My article sentences resemble tweets.

You never know what will happen.

Twitter's subcultures are odd. Best-performing tweets are strange.

Unusual trend: working alone and without telling anyone. It's a rebellion against Instagram influencers who share their every moment.

Early on, random thoughts worked:

My friend’s wife is Ukrainian. Her family are trapped in the warzone. He is devastated. And here I was complaining about my broken garage door. War puts everything in perspective. Today is a day to be grateful for peace.

Documenting what's happening triggers writing. It's not about viral tweets. Helping others matters.

There are numerous anonymous users.

Twitter uses pseudonyms.

You don't matter. On sites like LinkedIn, you must use your real name. Welcome to the Cyberpunk metaverse of Twitter :)

One daily piece of writing is a powerful habit.

Habits build creator careers. Read that again.

Twitter is an easy habit to pick up. If you can't tweet in one sentence, something's wrong. Easy-peasy-japanese.

Not what I tweeted, but my constancy, made the difference.

Daily writing is challenging, especially if your supervisor is on your back. Twitter encourages writing.

Tweets evolved as the foundation of all other material.

During my experiment, I enjoyed Twitter's speed.

Tweets get immediate responses, comments, and feedback. My popular tweets become newspaper headlines. I've also written essays from tweet discussions.

Sometimes the tweet and article were clear. Twitter sometimes helped me overcome writer's block.

I used to spend hours composing big things that had little real-world use.

Twitter helped me. No guessing. Data guides my coverage and validates concepts.

Test ideas on Twitter.

It took some time for my email list to grow.

Subscribers are a writer's lifeblood.

Without them, you're broke and homeless when Mark Zuckerberg tweaks the algorithms for ad dollars. Twitter has three ways to obtain email subscribers:

1. Add a link to your bio.

Twitter allows bio links (LinkedIn now does too). My eBook's landing page is linked. I collect emails there.

2. Start an online newsletter.

Twitter bought newsletter app Revue. They promote what they own.

I just established up a Revue email newsletter. I imported them weekly into my ConvertKit email list.

3. Create Twitter threads and include a link to your email list in the final tweet.

Write Twitter Threads and link the last tweet to your email list (example below).

Initial email subscribers were modest.

Numbers are growing. Twitter provides 25% of my new email subscribers. Some days, 50 people join.

Without them, my writing career is over. I'd be back at a 9-5 job begging for time off to spend with my newborn daughter. Nope.

Collect email addresses or die trying.

As insurance against unsubscribes and Zucks, use a second email list or Discord community.

What I still need to do

Twitter's fun. I'm wiser. I need to enable auto-replies and auto-DMs (direct messages).

This adds another way to attract subscribers. I schedule tweets with Tweet Hunter.

It’s best to go slow. People assume you're an internet marketer if you spam them with click requests.

A human internet marketer is preferable to a robot. My opinion.

210 days on Twitter taught me that. I plan to use the platform until I'm a grandfather unless Elon ruins it.

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.