The REAL Reason Putin is Invading Ukraine [video with transcript]
Transcript:
[Reporter] The Russian invasion of Ukraine.
Momentum is building for a war between Ukraine and Russia.
[Reporter] Tensions between Russia and the West
are growing rapidly.
[Reporter] President Biden considering deploying
thousands of troops to Eastern Europe.
There are now 100,000 troops
on the Eastern border of Ukraine.
Russia is setting up field hospitals on this border.
Like this is what preparation for war looks like.
A legitimate war.
Ukrainian troops are watching and waiting,
saying they are preparing for a fight.
The U.S. has ordered the families of embassy staff
to leave Ukraine.
Britain has sent all of their nonessential staff home.
And now the U.S. is sending tons of weapons and munitions
to Ukraine's army.
And we're even considering deploying
our own troops to the region.
I mean, this thing is heating up.
Meanwhile, Russia and the West have been in Geneva
and Brussels trying to talk it out,
and sort of getting nowhere.
The message is very clear.
Should Russia take further aggressive actions
against Ukraine the costs will be severe
and the consequences serious.
It's a scary, grim momentum that is unpredictable.
And the chances of miscalculation
and escalation are growing.
I want to explain what's going on here,
but I want to show you that this isn't just
typical geopolitical behavior.
Stuff that can just be explained on the map.
Instead, to understand why 100,000 troops are camped out
on Ukraine's Eastern border, ready for war,
you have to understand Russia
and how it's been cut down over the ages
from the Slavic empire that dominated this whole region
to then the Soviet Union,
which was defeated in the nineties.
And what you really have to understand here
is how that history is transposed
onto the brain of one man.
This guy, Vladimir Putin.
This is a story about regional domination
and struggles between big powers,
but really it's the story about
what Vladimir Putin really wants.
[Reporter] Russian troops moving swiftly
to take control of military bases in Crimea.
[Reporter] Russia has amassed more than 100,000 troops
and a lot of military hardware
at the border with Ukraine.
Let's dive back in.
Okay. Let's get up to speed on what's happening here.
And I'm just going to quickly give you the highlight version
of like the news that's happening,
because I want to get into the juicy part,
which is like why, the roots of all of this.
So let's go.
A few months ago, Russia started sending
more and more troops to this border.
It's this massive border between Ukraine and Russia.
They said they were doing a military exercise,
but the rest of the world was like,
"Yeah, we totally believe you Russia. Pshaw."
This was right before this big meeting
where North American and European countries
were coming together to talk about a lot
of different things, like these countries often do
in these diplomatic summits.
But soon, because of Russia's aggressive behavior
coming in and setting up 100,000 troops
on the border with Ukraine,
the entire summit turned into a whole, "WTF Russia,
what are you doing on the border of Ukraine," meeting.
Before the meeting Putin comes out and says,
"Listen, I have some demands for the West."
And everyone's like, "Okay, Russia, what are your demands?
You know, we have like, COVID19 right now.
And like, that's like surging.
So like, we don't need your like,
bluster about what your demands are."
And Putin's like, "No, here's my list of demands."
Putin's demands for the summit were this:
number one, that NATO, which is this big military alliance
between U.S., Canada, and Europe stop expanding,
meaning they don't let any new members in, okay.
So, Russia is like, "No more new members to your, like,
cool military club that I don't like.
You can't have any more members."
Number two, that NATO withdraw all of their troops
from anywhere in Eastern Europe.
Basically Putin is saying,
"I can veto any military cooperation
or troops going between countries
that have to do with Eastern Europe,
the place that used to be the Soviet Union."
Okay, and number three, Putin demands that America vow
not to protect its allies in Eastern Europe
with nuclear weapons.
"LOL," said all of the other countries,
"You're literally nuts, Vladimir Putin.
Like these are the most ridiculous demands, ever."
But there he is, Putin, with these demands.
These very, very aggressive demands.
And he sort of is implying that if his demands aren't met,
he's going to invade Ukraine.
I mean, it doesn't work like this.
This is not how international relations work.
You don't just show up and say like,
"I'm not gonna allow other countries to join your alliance
because it makes me feel uncomfortable."
But what I love about this list of demands
from Vladimir Putin for this summit
is that it gives us a clue
on what Vladimir Putin really wants.
What he's after here.
You read them closely and you can grasp his intentions.
But to grasp those intentions
you have to understand what NATO is.
and what Russia and Ukraine used to be.
(dramatic music)
Okay, so a while back I made this video
about why Russia is so damn big,
where I explain how modern day Russia started here in Kiev,
which is actually modern day Ukraine.
In other words, modern day Russia, as we know it,
has its original roots in Ukraine.
These places grew up together
and they eventually became a part
of the same mega empire called the Soviet Union.
They were deeply intertwined,
not just in their history and their culture,
but also in their economy and their politics.
So it's after World War II,
it's like the '50s, '60s, '70s, and NATO was formed,
the North Atlantic Treaty Organization.
This was a military alliance between all of these countries,
that was meant to sort of deter the Soviet Union
from expanding and taking over the world.
But as we all know, the Soviet Union,
which was Russia and all of these other countries,
collapsed in 1991.
And all of these Soviet republics,
including Ukraine, became independent,
meaning they were not now a part
of one big block of countries anymore.
But just because the border's all split up,
it doesn't mean that these cultural ties actually broke.
Like for example, the Soviet leader at the time
of the collapse of the Soviet Union, this guy, Gorbachev,
he was the son of a Ukrainian mother and a Russian father.
Like he grew up with his mother singing him
Ukrainian folk songs.
In his mind, Ukraine and Russia were like one thing.
So there was a major reluctance to accept Ukraine
as a separate thing from Russia.
In so many ways, they are one.
There was another Russian at the time
who did not accept this new division.
This young intelligence officer, Vladimir Putin,
who was starting to rise up in the ranks
of postSoviet Russia.
There's this amazing quote from 2005
where Putin is giving this stateoftheunionlike address,
where Putin declares the collapse of the Soviet Union,
quote, "The greatest catastrophe of the 20th century.
And as for the Russian people, it became a genuine tragedy.
Tens of millions of fellow citizens and countrymen
found themselves beyond the fringes of Russian territory."
Do you see how he frames this?
The Soviet Union were all one people in his mind.
And after it collapsed, all of these people
who are a part of the motherland were now outside
of the fringes or the boundaries of Russian territory.
First off, fact check.
Greatest catastrophe of the 20th century?
Like, do you remember what else happened
in the 20th century, Vladimir?
(ominous music)
Putin's worry about the collapse of this one people
starts to get way worse when the West, his enemy,
starts showing up to his neighborhood
to all these exSoviet countries that are now independent.
The West starts selling their ideology
of democracy and capitalism and inviting them
to join their military alliance called NATO.
And guess what?
These countries are totally buying it.
All these exSoviet countries are now joining NATO.
And some of them, the EU.
And Putin is hating this.
He's like not only did the Soviet Union divide
and all of these people are now outside
of the Russia motherland,
but now they're being persuaded by the West
to join their military alliance.
This is terrible news.
Over the years, this continues to happen,
while Putin himself starts to chip away
at Russian institutions, making them weaker and weaker.
He's silencing his rivals
and he's consolidating power in himself.
(triumphant music)
And in the past few years,
he's effectively silenced anyone who can challenge him;
any institution, any court,
or any political rival have all been silenced.
It's been decades since the Soviet Union fell,
but as Putin gains more power,
he still sees the region through the lens
of the old Cold War, Soviet, Slavic empire view.
He sees this region as one big block
that has been torn apart by outside forces.
"The greatest catastrophe of the 20th century."
And the worst situation of all of these,
according to Putin, is Ukraine,
which was like the gem of the Soviet Union.
There was tons of cultural heritage.
Again, Russia sort of started in Ukraine,
not to mention it was a very populous
and industrious, resourcerich place.
And over the years Ukraine has been drifting west.
It hasn't joined NATO yet, but more and more,
it's been electing proWestern presidents.
It's been flirting with membership in NATO.
It's becoming less and less attached
to the Russian heritage that Putin so adores.
And more than half of Ukrainians say
that they'd be down to join the EU.
64% of them say that it would be cool joining NATO.
But Putin can't handle this. He is in total denial.
Like an exboyfriend who handle his exgirlfriend
starting to date someone else,
Putin can't let Ukraine go.
He won't let go.
So for the past decade,
he's been trying to keep the West out
and bring Ukraine back into the motherland of Russia.
This usually takes the form of Putin sending
secret soldiers from Russia into Ukraine
to help the people in Ukraine who want to like separate
from Ukraine and join Russia.
It also takes the form of, oh yeah,
stealing entire parts of Ukraine for Russia.
Russian troops moving swiftly to take control
of military bases in Crimea.
Like in 2014, Putin just did this.
To what America is officially calling
a Russian invasion of Ukraine.
He went down and just snatched this bit of Ukraine
and folded it into Russia.
So you're starting to see what's going on here.
Putin's life's work is to salvage what he calls
the greatest catastrophe of the 20th century,
the division and the separation
of the Soviet republics from Russia.
So let's get to present day. It's 2022.
Putin is at it again.
And honestly, if you really want to understand
the mind of Vladimir Putin and his whole view on this,
you have to read this.
"On the History of Unity of Russians and Ukrainians,"
by Vladimir Putin.
A blog post that kind of sounds
like a ninth grade history essay.
In this essay, Vladimir Putin argues
that Russia and Ukraine are one people.
He calls them essentially the same historical
and spiritual space.
Kind of beautiful writing, honestly.
Anyway, he argues that the division
between the two countries is due to quote,
"a deliberate effort by those forces
that have always sought to undermine our unity."
And that the formula they use, these outside forces,
is a classic one: divide and rule.
And then he launches into this super indepth,
like 10page argument, as to every single historical beat
of Ukraine and Russia's history
to make this argument that like,
this is one people and the division is totally because
of outside powers, i.e. the West.
Okay, but listen, there's this moment
at the end of the post,
that actually kind of hit me in a big way.
He says this, "Just have a look at Austria and Germany,
or the U.S. and Canada, how they live next to each other.
Close in ethnic composition, culture,
and in fact, sharing one language,
they remain sovereign states with their own interests,
with their own foreign policy.
But this does not prevent them
from the closest integration or allied relations.
They have very conditional, transparent borders.
And when crossing them citizens feel at home.
They create families, study, work, do business.
Incidentally, so do millions of those born in Ukraine
who now live in Russia.
We see them as our own close people."
I mean, listen, like,
I'm not in support of what Putin is doing,
but like that, it's like a pretty solid like analogy.
If China suddenly showed up and started like
coaxing Canada into being a part of its alliance,
I would be a little bit like, "What's going on here?"
That's what Putin feels.
And so I kind of get what he means there.
There's a deep heritage and connection between these people.
And he's seen that falter and dissolve
and he doesn't like it.
He clearly genuinely feels a brotherhood
and this deep heritage connection
with the people of Ukraine.
Okay, okay, okay, okay. Putin, I get it.
Your essay is compelling there at the end.
You're clearly very smart and wellread.
But this does not justify what you've been up to. Okay?
It doesn't justify sending 100,000 troops to the border
or sending cyber soldiers to sabotage
the Ukrainian government, or annexing territory,
fueling a conflict that has killed
tens of thousands of people in Eastern Ukraine.
No. Okay.
No matter how much affection you feel for Ukrainian heritage
and its connection to Russia, this is not okay.
Again, it's like the boyfriend
who genuinely loves his girlfriend.
They had a great relationship,
but they broke up and she's free to see whomever she wants.
But Putin is not ready to let go.
[Man In Blue Shirt] What the hell's wrong with you?
I love you, Jessica.
What the hell is wrong with you?
Dude, don't fucking touch me.
I love you. Worldstar!
What is wrong with you? Just stop!
Putin has constructed his own reality here.
One in which Ukraine is actually being controlled
by shadowy Western forces
who are holding the people of Ukraine hostage.
And if that he invades, it will be a swift victory
because Ukrainians will accept him with open arms.
The great liberator.
(triumphant music)
Like, this guy's a total romantic.
He's a history buff and a romantic.
And he has a hill to die on here.
And it is liberating the people
who have been taken from the Russian motherland.
Kind of like the abusive boyfriend, who's like,
"She actually really loves me,
but it's her annoying friends
who were planting all these ideas in her head.
That's why she broke up with me."
And it's like, "No, dude, she's over you."
[Man In Blue Shirt] What the hell is wrong with you?
I love you, Jessica.
I mean, maybe this video should be called
Putin is just like your abusive exboyfriend.
[Man In Blue Shirt] What the hell is wrong with you?
I love you, Jessica!
Worldstar! What's wrong with you?
Okay. So where does this leave us?
It's 2022, Putin is showing up to these meetings in Europe
to tell them where he stands.
He says, "NATO, you cannot expand anymore. No new members.
And you need to withdraw all your troops
from Eastern Europe, my neighborhood."
He knows these demands will never be accepted
because they're ludicrous.
But what he's doing is showing a false effort to say,
"Well, we tried to negotiate with the West,
but they didn't want to."
Hence giving a little bit more justification
to a Russian invasion.
So will Russia invade? Is there war coming?
Maybe; it's impossible to know
because it's all inside of the head of this guy.
But, if I were to make the best argument
that war is not coming tomorrow,
I would look at a few things.
Number one, war in Ukraine would be incredibly costly
for Vladimir Putin.
Russia has a far superior army to Ukraine's,
but still, Ukraine has a very good army
that is supported by the West
and would give Putin a pretty bad bloody nose
in any invasion.
Controlling territory in Ukraine would be very hard.
Ukraine is a giant country.
They would fight back and it would be very hard
to actually conquer and take over territory.
Another major point here is that if Russia invades Ukraine,
this gives NATO new purpose.
If you remember, NATO was created because of the Cold War,
because the Soviet Union was big and nuclear powered.
Once the Soviet Union fell,
NATO sort of has been looking for a new purpose
over the past couple of decades.
If Russia invades Ukraine,
NATO suddenly has a brand new purpose to unite
and to invest in becoming more powerful than ever.
Putin knows that.
And it would be very bad news for him if that happened.
But most importantly, perhaps the easiest clue
for me to believe that war isn't coming tomorrow
is the Russian propaganda machine
is not preparing the Russian people for an invasion.
In 2014, when Russia was about to invade
and take over Crimea, this part of Ukraine,
there was a barrage of state propaganda
that prepared the Russian people
that this was a justified attack.
So when it happened, it wasn't a surprise
and it felt very normal.
That isn't happening right now in Russia.
At least for now. It may start happening tomorrow.
But for now, I think Putin is showing up to the border,
flexing his muscles and showing the West that he is earnest.
I'm not sure that he's going to invade tomorrow,
but he very well could.
I mean, read the guy's blog post
and you'll realize that he is a romantic about this.
He is incredibly idealistic about the glory days
of the Slavic empires, and he wants to get it back.
So there is dangerous momentum towards war.
And the way war works is even a small little, like, fight,
can turn into the other guy
doing something bigger and crazier.
And then the other person has to respond
with something a little bit bigger.
That's called escalation.
And there's not really a ceiling
to how much that momentum can spin out of control.
That is why it's so scary when two nuclear countries
go to war with each other,
because there's kind of no ceiling.
So yeah, it's dangerous. This is scary.
I'm not sure what happens next here,
but the best we can do is keep an eye on this.
At least for now, we better understand
what Putin really wants out of all of this.
Thanks for watching.
More on Current Events
Claire Berehova
4 years ago
There’s no manual for that
| Kyiv oblast in springtime. Photo by author. |
We’ve been receiving since the war began text messages from the State Emergency Service of Ukraine every few days. They’ve contained information on how to comfort a child and what to do in case of a water outage.
But a question that I struggle to suppress irks within me: How would we know if there really was a threat coming our away? So how can I happily disregard an air raid siren and continue singing to my three-month-old son when I feel like a World War II film became reality? There’s no manual for that.
Along with the anxiety, there’s the guilt that always seems to appear alongside dinner we’re fortunate to still have each evening while brave Ukrainian soldiers are facing serious food insecurity. There’s no manual for how to deal with this guilt.
When it comes to the enemy, there is no manual for how to react to the news of Russian casualties. Every dead Russian soldier weakens Putin, but I also know that many of these men had wives and girlfriends who are now living a nightmare.
So, I felt like I had to start writing my own manual.
The anxiety around the air raid siren? Only with time does it get easier to ignore it, but never completely.
The guilt? All we can do is pray.
That inner conflict? As Russia continues to stun the world with its war crimes, my emotions get less gray — I have to get used to accommodating absurd levels of hatred.
Sadness? It feels a bit more manageable when we laugh, and a little alcohol helps (as it usually does).
Cabin fever? Step outside in the yard when possible. At least the sunshine is becoming more fervent with spring approaching.
Slava Ukraini. Heroyam slava. (Glory to Ukraine. Glory to the heroes.)
MartinEdic
3 years ago
Russia Through the Windows: It's Very Bad
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?
Bloomberg
4 years ago
Expulsion of ten million Ukrainians
According to recent data from two UN agencies, ten million Ukrainians have been displaced.
The International Organization for Migration (IOM) estimates nearly 6.5 million Ukrainians have relocated. Most have fled the war zones around Kyiv and eastern Ukraine, including Dnipro, Zhaporizhzhia, and Kharkiv. Most IDPs have fled to western and central Ukraine.
Since Russia invaded on Feb. 24, 3.6 million people have crossed the border to seek refuge in neighboring countries, according to the latest UN data. While most refugees have fled to Poland and Romania, many have entered Russia.
Internally displaced figures are IOM estimates as of March 19, based on 2,000 telephone interviews with Ukrainians aged 18 and older conducted between March 9-16. The UNHCR compiled the figures for refugees to neighboring countries on March 21 based on official border crossing data and its own estimates. The UNHCR's top-line total is lower than the country totals because Romania and Moldova totals include people crossing between the two countries.
Sources: IOM, UNHCR
According to IOM estimates based on telephone interviews with a representative sample of internally displaced Ukrainians, over 53% of those displaced are women, and over 60% of displaced households have children.
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Micah Daigle
4 years ago
Facebook is going away. Here are two explanations for why it hasn't been replaced yet.
And tips for anyone trying.
We see the same story every few years.
BREAKING NEWS: [Platform X] launched a social network. With Facebook's reputation down, the new startup bets millions will switch.
Despite the excitement surrounding each new platform (Diaspora, Ello, Path, MeWe, Minds, Vero, etc.), no major exodus occurred.
Snapchat and TikTok attracted teens with fresh experiences (ephemeral messaging and rapid-fire videos). These features aren't Facebook, even if Facebook replicated them.
Facebook's core is simple: you publish items (typically text/images) and your friends (generally people you know IRL) can discuss them.
It's cool. Sometimes I don't want to, but sh*t. I like it.
Because, well, I like many folks I've met. I enjoy keeping in touch with them and their banter.
I dislike Facebook's corporation. I've been cautiously optimistic whenever a Facebook-killer surfaced.
None succeeded.
Why? Two causes, I think:
People couldn't switch quickly enough, which is reason #1
Your buddies make a social network social.
Facebook started in self-contained communities (college campuses) then grew outward. But a new platform can't.
If we're expected to leave Facebook, we want to know that most of our friends will too.
Most Facebook-killers had bottlenecks. You have to waitlist or jump through hoops (e.g. setting up a server).
Same outcome. Upload. Chirp.
After a week or two of silence, individuals returned to Facebook.
Reason #2: The fundamental experience was different.
Even when many of our friends joined in the first few weeks, it wasn't the same.
There were missing features or a different UX.
Want to reply with a meme? No photos in comments yet. (Trying!)
Want to tag a friend? Nope, sorry. 2019!
Want your friends to see your post? You must post to all your friends' servers. Good luck!
It's difficult to introduce a platform with 100% of the same features as one that's been there for 20 years, yet customers want a core experience.
If you can't, they'll depart.
The causes that led to the causes
Having worked on software teams for 14+ years, I'm not surprised by these challenges. They are a natural development of a few tech sector meta-problems:
Lean startup methodology
Silicon Valley worships lean startup. It's a way of developing software that involves testing a stripped-down version with a limited number of people before selecting what to build.
Billion people use Facebook's functions. They aren't tested. It must work right away*
*This may seem weird to software people, but it's how non-software works! You can't sell a car without wheels.
2. Creativity
Startup entrepreneurs build new things, not copies. I understand. Reinventing the wheel is boring.
We know what works. Different experiences raise adoption friction. Once millions have transferred, more features (and a friendlier UX) can be implemented.
3. Cost scaling
True. Building a product that can sustain hundreds of millions of users in weeks is expensive and complex.
Your lifeboats must have the same capacity as the ship you're evacuating. It's required.
4. Pure ideologies
People who work on Facebook-alternatives are (understandably) critical of Facebook.
They build an open-source, fully-distributed, data-portable, interface-customizable, offline-capable, censorship-proof platform.
Prioritizing these aims can prevent replicating the straightforward experience users expect. Github, not Facebook, is for techies only.
What about the business plan, though?
Facebook-killer attempts have followed three models.
Utilize VC funding to increase your user base, then monetize them later. (If you do this, you won't kill Facebook; instead, Facebook will become you.)
Users must pay to utilize it. (This causes a huge bottleneck and slows the required quick expansion, preventing it from seeming like a true social network.)
Make it a volunteer-run, open-source endeavor that is free. (This typically denotes that something is cumbersome, difficult to operate, and is only for techies.)
Wikipedia is a fourth way.
Wikipedia is one of the most popular websites and a charity. No ads. Donations support them.
A Facebook-killer managed by a good team may gather millions (from affluent contributors and the crowd) for their initial phase of development. Then it might sustain on regular donations, ethical transactions (e.g. fees on commerce, business sites, etc.), and government grants/subsidies (since it would essentially be a public utility).
When you're not aiming to make investors rich, it's remarkable how little money you need.
If you want to build a Facebook competitor, follow these tips:
Drop the lean startup philosophy. Wait until you have a finished product before launching. Build it, thoroughly test it for bugs, and then release it.
Delay innovating. Wait till millions of people have switched before introducing your great new features. Make it nearly identical for now.
Spend money climbing. Make sure that guests can arrive as soon as they are invited. Never keep them waiting. Make things easy for them.
Make it accessible to all. Even if doing so renders it less philosophically pure, it shouldn't require technical expertise to utilize.
Constitute a nonprofit. Additionally, develop community ownership structures. Profit maximization is not the only strategy for preserving valued assets.
Last thoughts
Nobody has killed Facebook, but Facebook is killing itself.
The startup is burying the newsfeed to become a TikTok clone. Meta itself seems to be ditching the platform for the metaverse.
I wish I was happy, but I'm not. I miss (understandably) removed friends' postings and remarks. It could be a ghost town in a few years. My dance moves aren't TikTok-worthy.
Who will lead? It's time to develop a social network for the people.
Greetings if you're working on it. I'm not a company founder, but I like to help hard-working folks.
Scott Galloway
4 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.
Mike Tarullo
4 years ago
Even In a Crazy Market, Hire the Best People: The "First Ten" Rules
Hiring is difficult, but you shouldn't compromise on team members. Or it may suggest you need to look beyond years in a similar role/function.
Every hire should be someone we'd want as one of our first ten employees.
If you hire such people, your team will adapt, initiate, and problem-solve, and your company will grow. You'll stay nimble even as you scale, and you'll learn from your colleagues.
If you only hire for a specific role or someone who can execute the job, you'll become a cluster of optimizers, and talent will depart for a more fascinating company. A startup is continually changing, therefore you want individuals that embrace it.
As a leader, establishing ideal conditions for talent and having a real ideology should be high on your agenda. You can't eliminate attrition, nor would you want to, but you can hire people who will become your company's leaders.
In my last four jobs I was employee 2, 5, 3, and 5. So while this is all a bit self serving, you’re the one reading my writing — and I have some experience with who works out in the first ten!
First, we'll examine what they do well (and why they're beneficial for startups), then what they don't, and how to hire them.
First 10 are:
Business partners: Because it's their company, they take care of whatever has to be done and have ideas about how to do it. You can rely on them to always put the success of the firm first because it is their top priority (company success is strongly connected with success for early workers). This approach will eventually take someone to leadership positions.
High Speed Learners: They process knowledge quickly and can reach 80%+ competency in a new subject matter rather quickly. A growing business that is successful tries new things frequently. We have all lost a lot of money and time on employees who follow the wrong playbook or who wait for someone else within the company to take care of them.
Autodidacts learn by trial and error, osmosis, networking with others, applying first principles, and reading voraciously (articles, newsletters, books, and even social media). Although teaching is wonderful, you won't have time.
Self-scaling: They figure out a means to deal with issues and avoid doing the grunt labor over the long haul, increasing their leverage. Great people don't keep doing the same thing forever; as they expand, they use automation and delegation to fill in their lower branches. This is a crucial one; even though you'll still adore them, you'll have to manage their scope or help them learn how to scale on their own.
Free Range: You can direct them toward objectives rather than specific chores. Check-ins can be used to keep them generally on course without stifling invention instead of giving them precise instructions because doing so will obscure their light.
When people are inspired, they bring their own ideas about what a firm can be and become animated during discussions about how to get there.
Novelty Seeking: They look for business and personal growth chances. Give them fresh assignments and new directions to follow around once every three months.
Here’s what the First Ten types may not be:
Domain specialists. When you look at their resumes, you'll almost certainly think they're unqualified. Fortunately, a few strategically positioned experts may empower a number of First Ten types by serving on a leadership team or in advising capacities.
Balanced. These people become very invested, and they may be vulnerable to many types of stress. You may need to assist them in managing their own stress and coaching them through obstacles. If you are reading this and work at Banza, I apologize for not doing a better job of supporting this. I need to be better at it.
Able to handle micromanagement with ease. People who like to be in charge will suppress these people. Good decision-making should be delegated to competent individuals. Generally speaking, if you wish to scale.
Great startup team members have versatility, learning, innovation, and energy. When we hire for the function, not the person, we become dull and staid. Could this person go to another department if needed? Could they expand two levels in a few years?
First Ten qualities and experience level may have a weak inverse association. People with 20+ years of experience who had worked at larger organizations wanted to try something new and had a growth mentality. College graduates may want to be told what to do and how to accomplish it so they can stay in their lane and do what their management asks.
Does the First Ten archetype sound right for your org? Cool, let’s go hiring. How will you know when you’ve found one?
They exhibit adaptive excellence, excelling at a variety of unrelated tasks. It could be hobbies or professional talents. This suggests that they will succeed in the next several endeavors they pursue.
Successful risk-taking is doing something that wasn't certain to succeed, sometimes more than once, and making it do so. It's an attitude.
Rapid Rise: They regularly change roles and get promoted. However, they don't leave companies when the going gets tough. Look for promotions at every stop and at least one position with three or more years of experience.
You can ask them:
Tell me about a time when you started from scratch or achieved success. What occurred en route? You might request a variety of tales from various occupations or even aspects of life. They ought to be energized by this.
What new skills have you just acquired? It is not required to be work-related. They must be able to describe it and unintentionally become enthusiastic about it.
Tell me about a moment when you encountered a challenge and had to alter your strategy. The core of a startup is reinventing itself when faced with obstacles.
Tell me about a moment when you eliminated yourself from a position at work. They've demonstrated they can permanently solve one issue and develop into a new one, as stated above.
Why do you want to leave X position or Y duty? These people ought to be moving forward, not backward, all the time. Instead, they will discuss what they are looking forward to visiting your location.
Any questions? Due to their inherent curiosity and desire to learn new things, they should practically never run out of questions. You can really tell if they are sufficiently curious at this point.
People who see their success as being the same as the success of the organization are the best-case team members, in any market. They’ll grow and change with the company, and always try to prioritize what matters. You’ll find yourself more energized by your work because you’re surrounded by others who are as well. Happy teambuilding!