And why we must keep arming Ukraine

Russian expatriates write about horrific news from home.

Read this from Nadin Brzezinski. She's not a native English speaker, so there are grammar errors, but her tale smells true.

Terrible truth.

There's much more that reveals Russia's grim reality.

Non-leadership. Millions of missing supplies are presumably sold for profit, leaving untrained troops without food or gear. Missile attacks pause because they run out. Fake schemes to hold talks as a way of stalling while they scramble for solutions.

Street men were mobilized. Millions will be ground up to please a crazed despot. Fear, wrath, and hunger pull apart civilization.

It's the most dystopian story, but Ukraine is worse. Destruction of a society, country, and civilization. Only the invaders' corruption and incompetence save the Ukrainians.

Rochester, NY. My suburb had many Soviet-era Ukrainian refugees. Their kids were my classmates. Fifty years later, many are still my friends. I loved their food and culture. My town has 20,000 Ukrainians.

Grieving but determined. They don't quit. They won't quit. Russians are eternal enemies.

It's the Russian people's willingness to tolerate corruption, abuse, and stupidity by their leaders. They are paying. 65000 dead. Ruined economy. No freedom to speak. Americans do not appreciate that freedom as we should.

It lets me write/publish.

Russian friends are shocked. Many are here because their parents escaped Russian anti-semitism and authoritarian oppression. A Russian cultural legacy says a strongman's methods are admirable.

A legacy of a slavery history disguised as serfdom. Peasants and Princes.

Read Tolstoy. Then Anna Karenina. The main characters are princes and counts, whose leaders are incompetent idiots with wealth and power.

Peasants who die in their wars due to incompetence are nameless ciphers.

Sound familiar?

If you're not genuine, you'll be revealed.

Sam Bankman-Fried (SBF) was called the Cryptocurrency Warren Buffet.

No wonder.

SBF's trading expertise, Blockchain knowledge, and ability to construct FTX attracted mainstream investors.

He had a fantastic worldview, donating much of his riches to charity.

As the onion layers peel back, it's clear he wasn't the altruistic media figure he portrayed.

SBF's mistakes were disastrous.

• Customer deposits were traded and borrowed by him.

• With ten other employees, he shared a $40 million mansion where they all had polyamorous relationships.

• Tone-deaf and wasteful marketing expenditures, such as the $200 million spent to change the name of the Miami Heat stadium to the FTX Arena

• Democrats received a $40 million campaign gift.

• And now there seems to be no regret.

FTX was a 32-billion-dollar cryptocurrency exchange.

It went bankrupt practically overnight.

SBF, FTX's creator, exploited client funds to leverage trade.

FTX had $1 billion in customer withdrawal reserves against $9 billion in liabilities in sister business Alameda Research.

Bloomberg Billionaire Index says it's the largest and fastest net worth loss in history.

It gets worse.

SBF's net worth is $900 Million, however he must still finalize FTX's bankruptcy.

SBF's arrest in the Bahamas and SEC inquiry followed news that his cryptocurrency exchange had crashed, losing billions in customer deposits.

A journalist contacted him on Twitter D.M., and their exchange is telling.

His ideas are revealed.

Kelsey Piper says they didn't expect him to answer because people under investigation don't comment.

Bankman-Fried wanted to communicate, and the interaction shows he has little remorse.

SBF talks honestly about FTX gaming customers' money and insults his competition.

Reporter Kelsey Piper was outraged by what he said and felt the mistakes SBF says plague him didn't evident in the messages.

Before FTX's crash, SBF was a poster child for Cryptocurrency regulation and avoided criticizing U.S. regulators.

He tells Piper that his lobbying is just excellent PR.

It shows his genuine views and supports cynics' opinions that his attempts to win over U.S. authorities were good for his image rather than Crypto.

SBF’s responses are in Grey, and Pipers are in Blue.

It's unclear if SBF cut corners for his gain. In their Twitter exchange, Piper revisits an interview question about ethics.

SBF says, "All the foolish sh*t I said"

SBF claims FTX has never invested customer monies.

Piper challenged him on Twitter.

While he insisted FTX didn't use customer deposits, he said sibling business Alameda borrowed too much from FTX's balance sheet.

He did, basically.

When consumers tried to withdraw money, FTX was short.

SBF thought Alameda had enough money to cover FTX customers' withdrawals, but life sneaks up on you.

SBF believes most exchanges have done something similar to FTX, but they haven't had a bank run (a bunch of people all wanting to get their deposits out at the same time).

SBF believes he shouldn't have consented to the bankruptcy and kept attempting to raise more money because withdrawals would be open in a month with clients whole.

If additional money came in, he needed $8 billion to bridge the creditors' deficit, and there aren't many corporations with $8 billion to spare.

Once clients feel protected, they will continue to leave their assets on the exchange, according to one idea.

Kevin OLeary, a world-renowned hedge fund manager, says not all investors will walk through the open gate once the company is safe, therefore the $8 Billion wasn't needed immediately.

SBF claims the bankruptcy was his biggest error because he could have accumulated more capital.

Final Reflections

Sam Bankman-Fried, 30, became the world's youngest billionaire in four years.

Never listen to what people say about investing; watch what they do.

SBF is a trader who gets wrecked occasionally.

Ten first-time entrepreneurs ran FTX, screwing each other with no risk management.

It prevents opposing or challenging perspectives and echo chamber highs.

Twitter D.M. conversation with a journalist is the final nail.

He lacks an experienced crew.

This event will surely speed up much-needed regulation.

It's also prompted cryptocurrency exchanges to offer proof of reserves to calm customers.

How to reframe irritation and go forward

“… before you can figure out where you are going, you need to know where you are, and once you know and accept where you are, you can design your way to where you want to be.” — Bill Burnett and Dave Evans

“You’ve been here before. But there are some new ingredients this time. What can tell yourself that will make you understand that now isn’t just like last year? That there’s something new in this August.”

My coach paused. I sighed, inhaled deeply, and considered her question.

What could I say? I simply needed a plan from her so everything would fall into place and I could be the happy, successful person I want to be.

Time passed. My mind was exhausted from running all morning, all summer, or the last five years, searching for what to do next and how to get there.

Calmer, I remembered that my coach's inquiry had benefited me throughout the summer. The month before our call, I read Designing Your Work Life — How to Thrive and Change and Find Happiness at Work from Standford University’s Bill Burnett and Dave Evans.

A passage in their book felt like a lifeline: “We have something important to say to you: Wherever you are in your work life, whatever job you are doing, it’s good enough. For now. Not forever. For now.”

As I remembered this book on the coaching call, I wondered if I could embrace where I am in August and say my job life is good enough for now. Only temporarily.

I've done that since. I'm getting unstuck.

Here's how you can take the first step in any area where you feel stuck.

How to acquire the perspective of "Good enough for now" for yourself

We’ve all heard the advice to just make the best of a bad situation. That´s not bad advice, but if you only make the best of a bad situation, you are still in a bad situation. It doesn’t get to the root of the problem or offer an opportunity to change the situation. You’re more cheerfully navigating lousiness, which is an improvement, but not much of one and rather hard to sustain over time.” — Bill Burnett and Dave Evans

Reframing Burnett at Evans says good enough for now is the key to being happier at work. Because, as they write, a designer always has options.

Choosing to believe things are good enough for now is liberating. It helps us feel less victimized and less judged. Accepting our situation helps us become unstuck.

Let's break down the process, which designers call constructing your way ahead, into steps you can take today.

Writing helps get started. First, write down your challenge and why it's essential to you. If pen and paper help, try this strategy:

• Make the decision to accept the circumstance as it is. Designers always begin by acknowledging the truth of the situation. You now refrain from passing judgment. Instead, you simply describe the situation as accurately as you can. This frees us from negative thought patterns that prevent us from seeing the big picture and instead keep us in a tunnel of negativity.

• Look for a reframing right now. Begin with good enough for the moment. Take note of how your body feels as a result. Tell yourself repeatedly that whatever is occurring is sufficient for the time being. Not always, but just now. If you want to, you can even put it in writing and repeatedly breathe it in, almost like a mantra.

• You can select a reframe that is more relevant to your situation once you've decided that you're good enough for now and have allowed yourself to believe it. Try to find another perspective that is possible, for instance, if you feel unappreciated at work and your perspective of I need to use and be recognized for all my new skills in my job is making you sad and making you want to resign. For instance, I can learn from others at work and occasionally put my new abilities to use.

• After that, leave your mind and act in accordance with your new perspective. Utilize the designer's bias for action to test something out and create a prototype that you can learn from. Your beginning point for creating experiences that will support the new viewpoint derived from the aforementioned point is the new perspective itself. By doing this, you recognize a circumstance at work where you can provide value to yourself or your workplace and then take appropriate action. Send two or three coworkers from whom you wish to learn anything an email, for instance, asking them to get together for coffee or a talk.

Choose tiny, doable actions. You prioritize them at work.

Let's assume you're feeling disconnected at work, so you make a list of folks you may visit each morning or invite to lunch. If you're feeling unmotivated and tired, take a daily walk and treat yourself to a decent coffee.

This may be plenty for now. If you want to take this procedure further, use Burnett and Evans' internet tools and frameworks.

Developing the daily practice of reframing

“We’re not discontented kids in the backseat of the family minivan, but how many of us live our lives, especially our work lives, as if we are?” — Bill Burnett and Dave Evans

I choose the good enough for me perspective every day, often. No quick fix. Am a failing? Maybe a little bit, but I like to think of it more as building muscle.

This way, every time I tell myself it's ok, I hear you. For now, that muscle gets stronger.

Hopefully, reframing will become so natural for us that it will become a habit, and not a technique anymore.

If you feel like you’re stuck in your career or at work, the reframe of Good enough, for now, might be valuable, so just go ahead and try it out right now.

And while you’re playing with this, why not think of other areas of your life too, like your relationships, where you live — even your writing, and see if you can feel a shift?

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.