Why I quit a $500K job at Amazon to work for myself
I quit my 8-year Amazon job last week. I wasn't motivated to do another year despite promotions, pay, recognition, and praise.
In AWS, I built developer tools. I could have worked in that field forever.
I became an Amazon developer. Within 3.5 years, I was promoted twice to senior engineer and would have been promoted to principal engineer if I stayed. The company said I had great potential.
Over time, I became a reputed expert and leader within the company. I was respected.
First year I made $75K, last year $511K. If I stayed another two years, I could have made $1M.
Despite Amazon's reputation, my work–life balance was good. I no longer needed to prove myself and could do everything in 40 hours a week. My team worked from home once a week, and I rarely opened my laptop nights or weekends.
My coworkers were great. I had three generous, empathetic managers. I’m very grateful to everyone I worked with.
Everything was going well and getting better. My motivation to go to work each morning was declining despite my career and income growth.
Another promotion, pay raise, or big project wouldn't have boosted my motivation. Motivation was also waning. It was my freedom.
Demotivation
My motivation was high in the beginning. I worked with someone on an internal tool with little scrutiny. I had more freedom to choose how and what to work on than in recent years. Me and another person improved it, talked to users, released updates, and tested it. Whatever we wanted, we did. We did our best and were mostly self-directed.
In recent years, things have changed. My department's most important project had many stakeholders and complex goals. What I could do depended on my ability to convince others it was the best way to achieve our goals.
Amazon was always someone else's terms. The terms started out simple (keep fixing it), but became more complex over time (maximize all goals; satisfy all stakeholders). Working in a large organization imposed restrictions on how to do the work, what to do, what goals to set, and what business to pursue. This situation forced me to do things I didn't want to do.
Finding New Motivation
What would I do forever? Not something I did until I reached a milestone (an exit), but something I'd do until I'm 80. What could I do for the next 45 years that would make me excited to wake up and pay my bills? Is that too unambitious? Nope. Because I'm motivated by two things.
One is an external carrot or stick. I'm not forced to file my taxes every April, but I do because I don't want to go to jail. Or I may not like something but do it anyway because I need to pay the bills or want a nice car. Extrinsic motivation
One is internal. When there's no carrot or stick, this motivates me. This fuels hobbies. I wanted a job that was intrinsically motivated.
Is this too low-key? Extrinsic motivation isn't sustainable. Getting promoted felt good for a week, then it was over. When I hit $100K, I admired my W2 for a few days, but then it wore off. Same thing happened at $200K, $300K, $400K, and $500K. Earning $1M or $10M wouldn't change anything. I feel the same about every material reward or possession. Getting them feels good at first, but quickly fades.
Things I've done since I was a kid, when no one forced me to, don't wear off. Coding, selling my creations, charting my own path, and being honest. Why not always use my strengths and motivation? I'm lucky to live in a time when I can work independently in my field without large investments. So that’s what I’m doing.
What’s Next?
I'm going all-in on independence and will make a living from scratch. I won't do only what I like, but on my terms. My goal is to cover my family's expenses before my savings run out while doing something I enjoy. What more could I want from my work?
You can now follow me on Twitter as I continue to document my journey.
This post is a summary. Read full article here
More on Personal Growth
Jari Roomer
3 years ago
Successful people have this one skill.
Without self-control, you'll waste time chasing dopamine fixes.
I found a powerful quote in Tony Robbins' Awaken The Giant Within:
“Most of the challenges that we have in our personal lives come from a short-term focus” — Tony Robbins
Most people are short-term oriented, but highly successful people are long-term oriented.
Successful people act in line with their long-term goals and values, while the rest are distracted by short-term pleasures and dopamine fixes.
Instant gratification wrecks lives
Instant pleasure is fleeting. Quickly fading effects leave you craving more stimulation.
Before you know it, you're in a cycle of quick fixes. This explains binging on food, social media, and Netflix.
These things cause a dopamine spike, which is entertaining. This dopamine spike crashes quickly, leaving you craving more stimulation.
It's fine to watch TV or play video games occasionally. Problems arise when brain impulses aren't controlled. You waste hours chasing dopamine fixes.
Instant gratification becomes problematic when it interferes with long-term goals, happiness, and life fulfillment.
Most rewarding things require delay
Life's greatest rewards require patience and delayed gratification. They must be earned through patience, consistency, and effort.
Ex:
A fit, healthy body
A deep connection with your spouse
A thriving career/business
A healthy financial situation
These are some of life's most rewarding things, but they take work and patience. They all require the ability to delay gratification.
To have a healthy bank account, you must save (and invest) a large portion of your monthly income. This means no new tech or clothes.
If you want a fit, healthy body, you must eat better and exercise three times a week. So no fast food and Netflix.
It's a battle between what you want now and what you want most.
Successful people choose what they want most over what they want now. It's a major difference.
Instant vs. delayed gratification
Most people subconsciously prefer instant rewards over future rewards, even if the future rewards are more significant.
We humans aren't logical. Emotions and instincts drive us. So we act against our goals and values.
Fortunately, instant gratification bias can be overridden. This is a modern superpower. Effective methods include:
#1: Train your brain to handle overstimulation
Training your brain to function without constant stimulation is a powerful change. Boredom can lead to long-term rewards.
Unlike impulsive shopping, saving money is boring. Having lots of cash is amazing.
Compared to video games, deep work is boring. A successful online business is rewarding.
Reading books is boring compared to scrolling through funny videos on social media. Knowledge is invaluable.
You can't do these things if your brain is overstimulated. Your impulses will control you. To reduce overstimulation addiction, try:
Daily meditation (10 minutes is enough)
Daily study/work for 90 minutes (no distractions allowed)
First hour of the day without phone, social media, and Netflix
Nature walks, journaling, reading, sports, etc.
#2: Make Important Activities Less Intimidating
Instant gratification helps us cope with stress. Starting a book or business can be intimidating. Video games and social media offer a quick escape in such situations.
Make intimidating tasks less so. Break them down into small tasks. Start a new business/side-hustle by:
Get domain name
Design website
Write out a business plan
Research competition/peers
Approach first potential client
Instead of one big mountain, divide it into smaller sub-tasks. This makes a task easier and less intimidating.
#3: Plan ahead for important activities
Distractions will invade unplanned time. Your time is dictated by your impulses, which are usually Netflix, social media, fast food, and video games. It wants quick rewards and dopamine fixes.
Plan your days and be proactive with your time. Studies show that scheduling activities makes you 3x more likely to do them.
To achieve big goals, you must plan. Don't gamble.
Want to get fit? Schedule next week's workouts. Want a side-job? Schedule your work time.
Darius Foroux
2 years ago
My financial life was changed by a single, straightforward mental model.
Prioritize big-ticket purchases
I've made several spending blunders. I get sick thinking about how much money I spent.
My financial mental model was poor back then.
Stoicism and mindfulness keep me from attaching to those feelings. It still hurts.
Until four or five years ago, I bought a new winter jacket every year.
Ten years ago, I spent twice as much. Now that I have a fantastic, warm winter parka, I don't even consider acquiring another one. No more spending. I'm not looking for jackets either.
Saving time and money by spending well is my thinking paradigm.
The philosophy is expressed in most languages. Cheap is expensive in the Netherlands. This applies beyond shopping.
In this essay, I will offer three examples of how this mental paradigm transformed my financial life.
Publishing books
In 2015, I presented and positioned my first book poorly.
I called the book Huge Life Success and made a funny Canva cover in 30 minutes. This:
That looks nothing like my present books. No logo or style. The book felt amateurish.
The book started bothering me a few weeks after publication. The advice was good, but it didn't appear professional. I studied the book business extensively.
I created a style for all my designs. Branding. Win Your Inner Wars was reissued a year later.
Title, cover, and description changed. Rearranging the chapters improved readability.
Seven years later, the book sells hundreds of copies a month. That taught me a lot.
Rushing to finish a project is enticing. Send it and move forward.
Avoid rushing everything. Relax. Develop your projects. Perform well. Perform the job well.
My first novel was underfunded and underworked. A bad book arrived. I then invested time and money in writing the greatest book I could.
That book still sells.
Traveling
I hate travel. Airports, flights, trains, and lines irritate me.
But, I enjoy traveling to beautiful areas.
I do it strangely. I make up travel rules. I never go to airports in summer. I hate being near airports on holidays. Unworthy.
No vacation packages for me. Those airline packages with a flight, shuttle, and hotel. I've had enough.
I try to avoid crowds and popular spots. July Paris? Nuts and bolts, please. Christmas in NYC? No, please keep me sane.
I fly business class behind. I accept upgrades upon check-in. I prefer driving. I drove from the Netherlands to southern Spain.
Thankfully, no lines. What if travel costs more? Thus? I enjoy it from the start. I start traveling then.
I rarely travel since I'm so difficult. One great excursion beats several average ones.
Personal effectiveness
New apps, tools, and strategies intrigue most productivity professionals.
No.
I researched years ago. I spent years investigating productivity in university.
I bought books, courses, applications, and tools. It was expensive and time-consuming.
Im finished. Productivity no longer costs me time or money. OK. I worked on it once and now follow my strategy.
I avoid new programs and systems. My stuff works. Why change winners?
Spending wisely saves time and money.
Spending wisely means spending once. Many people ignore productivity. It's understudied. No classes.
Some assume reading a few articles or a book is enough. Productivity is personal. You need a personal system.
Time invested is one-time. You can trust your system for life once you find it.
Concentrate on the expensive choices.
Life's short. Saving money quickly is enticing.
Spend less on groceries today. True. That won't fix your finances.
Adopt a lifestyle that makes you affluent over time. Consider major choices.
Are they causing long-term poverty? Are you richer?
Leasing cars comes to mind. The automobile costs a fortune today. The premium could accomplish a million nice things.
Focusing on important decisions makes life easier. Consider your future. You want to improve next year.
Theo Seeds
3 years ago
The nine novels that have fundamentally altered the way I view the world
I read 53 novels last year and hope to do so again.
Books are best if you love learning. You get a range of perspectives, unlike podcasts and YouTube channels where you get the same ones.
Book quality varies. I've read useless books. Most books teach me something.
These 9 novels have changed my outlook in recent years. They've made me rethink what I believed or introduced me to a fresh perspective that changed my worldview.
You can order these books yourself. Or, read my summaries to learn what I've synthesized.
Enjoy!
Fooled By Randomness
Nassim Taleb worked as a Wall Street analyst. He used options trading to bet on unlikely events like stock market crashes.
Using financial models, investors predict stock prices. The models assume constant, predictable company growth.
These models base their assumptions on historical data, so they assume the future will be like the past.
Fooled By Randomness argues that the future won't be like the past. We often see impossible market crashes like 2008's housing market collapse. The world changes too quickly to use historical data: by the time we understand how it works, it's changed.
Most people don't live to see history unfold. We think our childhood world will last forever. That goes double for stable societies like the U.S., which hasn't seen major turbulence in anyone's lifetime.
Fooled By Randomness taught me to expect the unexpected. The world is deceptive and rarely works as we expect. You can't always trust your past successes or what you've learned.
Antifragile
More Taleb. Some things, like the restaurant industry and the human body, improve under conditions of volatility and turbulence.
We didn't have a word for this counterintuitive concept until Taleb wrote Antifragile. The human body (which responds to some stressors, like exercise, by getting stronger) and the restaurant industry both benefit long-term from disorder (when economic turbulence happens, bad restaurants go out of business, improving the industry as a whole).
Many human systems are designed to minimize short-term variance because humans don't understand it. By eliminating short-term variation, we increase the likelihood of a major disaster.
Once, we put out every forest fire we found. Then, dead wood piled up in forests, causing catastrophic fires.
We don't like price changes, so politicians prop up markets with stimulus packages and printing money. This leads to a bigger crash later. Two years ago, we printed a ton of money for stimulus checks, and now we have double-digit inflation.
Antifragile taught me how important Plan B is. A system with one or two major weaknesses will fail. Make large systems redundant, foolproof, and change-responsive.
Reality is broken
We dread work. Work is tedious. Right?
Wrong. Work gives many people purpose. People are happiest when working. (That's why some are workaholics.)
Factory work saps your soul, office work is boring, and working for a large company you don't believe in and that operates unethically isn't satisfying.
Jane McGonigal says in Reality Is Broken that meaningful work makes us happy. People love games because they simulate good work. McGonigal says work should be more fun.
Some think they'd be happy on a private island sipping cocktails all day. That's not true. Without anything to do, most people would be bored. Unemployed people are miserable. Many retirees die within 2 years, much more than expected.
Instead of complaining, find meaningful work. If you don't like your job, it's because you're in the wrong environment. Find the right setting.
The Lean Startup
Before the airplane was invented, Harvard scientists researched flying machines. Who knew two North Carolina weirdos would beat them?
The Wright Brothers' plane design was key. Harvard researchers were mostly theoretical, designing an airplane on paper and trying to make it fly in theory. They'd build it, test it, and it wouldn't fly.
The Wright Brothers were different. They'd build a cheap plane, test it, and it'd crash. Then they'd learn from their mistakes, build another plane, and it'd crash.
They repeated this until they fixed all the problems and one of their planes stayed aloft.
Mistakes are considered bad. On the African savannah, one mistake meant death. Even today, if you make a costly mistake at work, you'll be fired as a scapegoat. Most people avoid failing.
In reality, making mistakes is the best way to learn.
Eric Reis offers an unintuitive recipe in The Lean Startup: come up with a hypothesis, test it, and fail. Then, try again with a new hypothesis. Keep trying, learning from each failure.
This is a great startup strategy. Startups are new businesses. Startups face uncertainty. Run lots of low-cost experiments to fail, learn, and succeed.
Don't fear failing. Low-cost failure is good because you learn more from it than you lose. As long as your worst-case scenario is acceptable, risk-taking is good.
The Sovereign Individual
Today, nation-states rule the world. The UN recognizes 195 countries, and they claim almost all land outside of Antarctica.
We agree. For the past 2,000 years, much of the world's territory was ungoverned.
Why today? Because technology has created incentives for nation-states for most of the past 500 years. The logic of violence favors nation-states, according to James Dale Davidson, author of the Sovereign Individual. Governments have a lot to gain by conquering as much territory as possible, so they do.
Not always. During the Dark Ages, Europe was fragmented and had few central governments. Partly because of armor. With armor, a sword, and a horse, you couldn't be stopped. Large states were hard to form because they rely on the threat of violence.
When gunpowder became popular in Europe, violence changed. In a world with guns, assembling large armies and conquest are cheaper.
James Dale Davidson says the internet will make nation-states obsolete. Most of the world's wealth will be online and in people's heads, making capital mobile.
Nation-states rely on predatory taxation of the rich to fund large militaries and welfare programs.
When capital is mobile, people can live anywhere in the world, Davidson says, making predatory taxation impossible. They're not bound by their job, land, or factory location. Wherever they're treated best.
Davidson says that over the next century, nation-states will collapse because they won't have enough money to operate as they do now. He imagines a world of small city-states, like Italy before 1900. (or Singapore today).
We've already seen some movement toward a more Sovereign Individual-like world. The pandemic proved large-scale remote work is possible, freeing workers from their location. Many cities and countries offer remote workers incentives to relocate.
Many Western businesspeople live in tax havens, and more people are renouncing their US citizenship due to high taxes. Increasing globalization has led to poor economic conditions and resentment among average people in the West, which is why politicians like Trump and Sanders rose to popularity with angry rhetoric, even though Obama rose to popularity with a more hopeful message.
The Sovereign Individual convinced me that the future will be different than Nassim Taleb's. Large countries like the U.S. will likely lose influence in the coming decades, while Portugal, Singapore, and Turkey will rise. If the trend toward less freedom continues, people may flee the West en masse.
So a traditional life of college, a big firm job, hard work, and corporate advancement may not be wise. Young people should learn as much as possible and develop flexible skills to adapt to the future.
Sapiens
Sapiens is a history of humanity, from proto-humans in Ethiopia to our internet society today, with some future speculation.
Sapiens views humans (and Homo sapiens) as a unique species on Earth. We were animals 100,000 years ago. We're slowly becoming gods, able to affect the climate, travel to every corner of the Earth (and the Moon), build weapons that can kill us all, and wipe out thousands of species.
Sapiens examines what makes Homo sapiens unique. Humans can believe in myths like religion, money, and human-made entities like countries and LLCs.
These myths facilitate large-scale cooperation. Ants from the same colony can cooperate. Any two humans can trade, though. Even if they're not genetically related, large groups can bond over religion and nationality.
Combine that with intelligence, and you have a species capable of amazing feats.
Sapiens may make your head explode because it looks at the world without presupposing values, unlike most books. It questions things that aren't usually questioned and says provocative things.
It also shows how human history works. It may help you understand and predict the world. Maybe.
The 4-hour Workweek
Things can be done better.
Tradition, laziness, bad bosses, or incentive structures cause complacency. If you're willing to make changes and not settle for the status quo, you can do whatever you do better and achieve more in less time.
The Four-Hour Work Week advocates this. Tim Ferriss explains how he made more sales in 2 hours than his 8-hour-a-day colleagues.
By firing 2 of his most annoying customers and empowering his customer service reps to make more decisions, he was able to leave his business and travel to Europe.
Ferriss shows how to escape your 9-to-5, outsource your life, develop a business that feeds you with little time, and go on mini-retirement adventures abroad.
Don't accept the status quo. Instead, level up. Find a way to improve your results. And try new things.
Why Nations Fail
Nogales, Arizona and Mexico were once one town. The US/Mexico border was arbitrarily drawn.
Both towns have similar cultures and populations. Nogales, Arizona is well-developed and has a high standard of living. Nogales, Mexico is underdeveloped and has a low standard of living. Whoa!
Why Nations Fail explains how government-created institutions affect country development. Strong property rights, capitalism, and non-corrupt governments promote development. Countries without capitalism, strong property rights, or corrupt governments don't develop.
Successful countries must also embrace creative destruction. They must offer ordinary citizens a way to improve their lot by creating value for others, not reducing them to slaves, serfs, or peasants. Authors say that ordinary people could get rich on trading expeditions in 11th-century Venice.
East and West Germany and North and South Korea have different economies because their citizens are motivated differently. It explains why Chile, China, and Singapore grow so quickly after becoming market economies.
People have spent a lot of money on third-world poverty. According to Why Nations Fail, education and infrastructure aren't the answer. Developing nations must adopt free-market economic policies.
Elon Musk
Elon Musk is the world's richest man, but that’s not a good way to describe him. Elon Musk is the world's richest man, which is like calling Steve Jobs a turtleneck-wearer or Benjamin Franklin a printer.
Elon Musk does cool sci-fi stuff to help humanity avoid existential threats.
Oil will run out. We've delayed this by developing better extraction methods. We only have so much nonrenewable oil.
Our society is doomed if it depends on oil. Elon Musk invested heavily in Tesla and SolarCity to speed the shift to renewable energy.
Musk worries about AI: we'll build machines smarter than us. We won't be able to stop these machines if something goes wrong, just like cows can't fight humans. Neuralink: we need to be smarter to compete with AI when the time comes.
If Earth becomes uninhabitable, we need a backup plan. Asteroid or nuclear war could strike Earth at any moment. We may not have much time to react if it happens in a few days. We must build a new civilization while times are good and resources are plentiful.
Short-term problems dominate our politics, but long-term issues are more important. Long-term problems can cause mass casualties and homelessness. Musk demonstrates how to think long-term.
The main reason people are impressed by Elon Musk, and why Ashlee Vances' biography influenced me so much, is that he does impossible things.
Electric cars were once considered unprofitable, but Tesla has made them mainstream. SpaceX is the world's largest private space company.
People lack imagination and dismiss ununderstood ideas as impossible. Humanity is about pushing limits. Don't worry if your dreams seem impossible. Try it.
Thanks for reading.
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Alex Mathers
2 years ago
400 articles later, nobody bothered to read them.
Writing for readers:
14 years of daily writing.
I post practically everything on social media. I authored hundreds of articles, thousands of tweets, and numerous volumes to almost no one.
Tens of thousands of readers regularly praise me.
I despised writing. I'm stuck now.
I've learned what readers like and what doesn't.
Here are some essential guidelines for writing with impact:
Readers won't understand your work if you can't.
Though obvious, this slipped me up. Share your truths.
Stories engage human brains.
Showing the journey of a person from worm to butterfly inspires the human spirit.
Overthinking hinders powerful writing.
The best ideas come from inner understanding in between thoughts.
Avoid writing to find it. Write.
Writing a masterpiece isn't motivating.
Write for five minutes to simplify. Step-by-step, entertaining, easy steps.
Good writing requires a willingness to make mistakes.
So write loads of garbage that you can edit into a good piece.
Courageous writing.
A courageous story will move readers. Personal experience is best.
Go where few dare.
Templates, outlines, and boundaries help.
Limitations enhance writing.
Excellent writing is straightforward and readable, removing all the unnecessary fat.
Use five words instead of nine.
Use ordinary words instead of uncommon ones.
Readers desire relatability.
Too much perfection will turn it off.
Write to solve an issue if you can't think of anything to write.
Instead, read to inspire. Best authors read.
Every tweet, thread, and novel must have a central idea.
What's its point?
This can make writing confusing.
️ Don't direct your reader.
Readers quit reading. Demonstrate, describe, and relate.
Even if no one responds, have fun. If you hate writing it, the reader will too.
Monroe Mayfield
2 years ago
CES 2023: A Third Look At Upcoming Trends
Las Vegas hosted CES 2023. This third and last look at CES 2023 previews upcoming consumer electronics trends that will be crucial for market share.
Definitely start with ICT. Qualcomm CEO Cristiano Amon spoke to CNBC from Las Vegas on China's crackdown and the company's automated driving systems for electric vehicles (EV). The business showed a concept car and its latest Snapdragon processor designs, which offer expanded digital interactions through SalesForce-partnered CRM platforms.
Electrification is reviving Michigan's automobile industry. Michigan Local News reports that $14 billion in EV and battery manufacturing investments will benefit the state. The report also revealed that the Strategic Outreach and Attraction Reserve (SOAR) fund had generated roughly $1 billion for the state's automotive sector.
Ars Technica is great for technology, society, and the future. After CES 2023, Jonathan M. Gitlin published How many electric car chargers are enough? Read about EV charging network issues and infrastructure spending. Politics aside, rapid technological advances enable EV charging network expansion in American cities and abroad.
Finally, the UNEP's The Future of Electric Vehicles and Material Resources: A Foresight Brief. Understanding how lithium-ion batteries will affect EV sales is crucial. Climate change affects EVs in various ways, but electrification and mining trends stand out because more EVs demand more energy-intensive metals and rare earths. Areas & Producers has been publishing my electrification and mining trends articles. Follow me if you wish to write for the publication.
The Weekend Brief (TWB) will routinely cover tech, industrials, and global commodities in global markets, including stock markets. Read more about the future of key areas and critical producers of the global economy in Areas & Producers.
Scott Galloway
3 years ago
First Health
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.