Most crypto is probably too.

The goals of Web 3 and the metaverse are admirable and attractive. Who doesn't want an internet owned by users? Who wouldn't want a digital realm where anything is possible? A better way to collaborate and visit pals.

Companies pursue profits endlessly. Infinite growth and revenue are expected, and if a corporation needs to sacrifice profits to safeguard users, the CEO, board of directors, and any executives will lose to the system of incentives that (1) retains workers with shares and (2) makes a company answerable to all of its shareholders. Only the government can guarantee user protections, but we know how successful that is. This is nothing new, just a problem with modern capitalism and tech platforms that a user-owned internet might remedy. Moxie, the founder of Signal, has a good articulation of some of these current Web 2 tech platform problems (but I forget the timestamp); thoughts on JRE aside, this episode is worth listening to (it’s about a bunch of other stuff too).

Moxie Marlinspike, founder of Signal, on the Joe Rogan Experience podcast.

Source: https://open.spotify.com/episode/2uVHiMqqJxy8iR2YB63aeP?si=4962b5ecb1854288

Web 3 champions are premature. There was so much spectacular growth during Web 2 that the next wave of founders want to make an even bigger impact, while investors old and new want a chance to get a piece of the moonshot action. Worse, crypto enthusiasts believe — and financially need — the fact of its success to be true, whether or not it is.

I’m doubtful that it will play out like current proponents say. Crypto has been the white-hot focus of SV’s best and brightest for a long time yet still struggles to come up any mainstream use case other than ‘buy, HODL, and believe’: a store of value for your financial goals and wishes. Some kind of the metaverse is likely, but will it be decentralized, mostly in VR, or will Meta (previously FB) play a big role? Unlikely.

METAVERSE

The metaverse exists already. Our digital lives span apps, platforms, and games. I can design a 3D house, invite people, use Discord, and hang around in an artificial environment. Millions of gamers do this in Rust, Minecraft, Valheim, and Animal Crossing, among other games. Discord's voice chat and Slack-like servers/channels are the present social anchor, but the interface, integrations, and data portability will improve. Soon you can stream YouTube videos on digital house walls. You can doodle, create art, play Jackbox, and walk through a door to play Apex Legends, Fortnite, etc. Not just gaming. Digital whiteboards and screen sharing enable real-time collaboration. They’ll review code and operate enterprises. Music is played and made. In digital living rooms, they'll watch movies, sports, comedy, and Twitch. They'll tweet, laugh, learn, and shittalk.

The metaverse is the evolution of our digital life at home, the third place. The closest analog would be Discord and the integration of Facebook, Slack, YouTube, etc. into a single, 3D, customizable hangout space.

I'm not certain this experience can be hugely decentralized and smoothly choreographed, managed, and run, or that VR — a luxury, cumbersome, and questionably relevant technology — must be part of it. Eventually, VR will be pragmatic, achievable, and superior to real life in many ways. A total sensory experience like the Matrix or Sword Art Online, where we're physically hooked into the Internet yet in our imaginations we're jumping, flying, and achieving athletic feats we never could in reality; exploring realms far grander than our own (as grand as it is). That VR is different from today's.

https://podcasts.google.com/feed/aHR0cHM6Ly9leHBvbmVudC5mbS9mZWVkLw/episode/aHR0cHM6Ly9leHBvbmVudC5mbS8_cD00MzM?hl=en&ved=2ahUKEwjH5u6r4rv2AhUjc98KHeybAP8QjrkEegQIChAF&ep=6

Ben Thompson released an episode of Exponent after Facebook changed its name to Meta. Ben was suspicious about many metaverse champion claims, but he made a good analogy between Oculus and the PC. The PC was initially far too pricey for the ordinary family to afford. It began as a business tool. It got so powerful and pervasive that it affected our personal life. Price continues to plummet and so much consumer software was produced that it's impossible to envision life without a home computer (or in our pockets). If Facebook shows product market fit with VR in business, through use cases like remote work and collaboration, maybe VR will become practical in our personal lives at home.

Before PCs, we relied on Blockbuster, the Yellow Pages, cabs to get to the airport, handwritten taxes, landline phones to schedule social events, and other archaic methods. It is impossible for me to conceive what VR, in the form of headsets and hand controllers, stands to give both professional and especially personal digital experiences that is an order of magnitude better than what we have today. Is looking around better than using a mouse to examine a 3D landscape? Do the hand controls make x10 or x100 work or gaming more fun or efficient? Will VR replace scalable Web 2 methods and applications like Web 1 and Web 2 did for analog? I don't know.

My guess is that the metaverse will arrive slowly, initially on displays we presently use, with more app interoperability. I doubt that it will be controlled by the people or by Facebook, a corporation that struggles to properly innovate internally, as practically every large digital company does. Large tech organizations are lousy at hiring product-savvy employees, and if they do, they rarely let them explore new things.

These companies act like business schools when they seek founders' results, with bureaucracy and dependency. Which company launched the last popular consumer software product that wasn't a clone or acquisition? Recent examples are scarce.

Web 3

Investors and entrepreneurs of Web 3 firms are declaring victory: 'Web 3 is here!' Web 3 is the future! Many profitable Web 2 enterprises existed when Web 2 was defined. The word was created to explain user behavior shifts, not a personal pipe dream.

Origins of Web 2: http://www.oreilly.com/pub/a/web2/archive/what-is-web-20.html

One of these Web 3 startups may provide the connecting tissue to link all these experiences or become one of the major new digital locations. Even so, successful players will likely use centralized power arrangements, as Web 2 businesses do now. Some Web 2 startups integrated our digital lives. Rockmelt (2010–2013) was a customizable browser with bespoke connectors to every program a user wanted; imagine seeing Facebook, Twitter, Discord, Netflix, YouTube, etc. all in one location. Failure. Who knows what Opera's doing?

Silicon Valley and tech Twitter in general have a history of jumping on dumb bandwagons that go nowhere. Dot-com crash in 2000? The huge deployment of capital into bad ideas and businesses is well-documented. And live video. It was the future until it became a niche sector for gamers. Live audio will play out a similar reality as CEOs with little comprehension of audio and no awareness of lasting new user behavior deceive each other into making more and bigger investments on fool's gold. Twitter trying to buy Clubhouse for $4B, Spotify buying Greenroom, Facebook exploring live audio and 'Tiktok for audio,' and now Amazon developing a live audio platform. This live audio frenzy won't be worth their time or energy. Blind guides blind. Instead of learning from prior failures like Twitter buying Periscope for $100M pre-launch and pre-product market fit, they're betting on unproven and uncompelling experiences.

NFTs

NFTs are also nonsense. Take Loot, a time-limited bag drop of "things" (text on the blockchain) for a game that didn't exist, bought by rich techies too busy to play video games and foolish enough to think they're getting in early on something with a big reward. What gaming studio is incentivized to use these items? Who's encouraged to join? No one cares besides Loot owners who don't have NFTs. Skill, merit, and effort should be rewarded with rare things for gamers. Even if a small minority of gamers can make a living playing, the average game's major appeal has never been to make actual money - that's a profession.

No game stays popular forever, so how is this objective sustainable? Once popularity and usage drop, exclusive crypto or NFTs will fall. And if NFTs are designed to have cross-game appeal, incentives apart, 30 years from now any new game will need millions of pre-existing objects to build around before they start. It doesn’t work.

Many games already feature item economies based on real in-game scarcity, generally for cosmetic things to avoid pay-to-win, which undermines scaled gaming incentives for huge player bases. Counter-Strike, Rust, etc. may be bought and sold on Steam with real money. Since the 1990s, unofficial cross-game marketplaces have sold in-game objects and currencies. NFTs aren't needed. Making a popular, enjoyable, durable game is already difficult.

With NFTs, certain JPEGs on the internet went from useless to selling for $69 million. Why? Crypto, Web 3, early Internet collectibles. NFTs are digital Beanie Babies (unlike NFTs, Beanie Babies were a popular children's toy; their destinies are the same). NFTs are worthless and scarce. They appeal to crypto enthusiasts seeking for a practical use case to support their theory and boost their own fortune. They also attract to SV insiders desperate not to miss the next big thing, not knowing what it will be. NFTs aren't about paying artists and creators who don't get credit for their work.

South Park's Underpants Gnomes

NFTs are a benign, foolish plan to earn money on par with South Park's underpants gnomes. At worst, they're the world of hucksterism and poor performers. Or those with money and enormous followings who, like everyone, don't completely grasp cryptocurrencies but are motivated by greed and status and believe Gary Vee's claim that CryptoPunks are the next Facebook. Gary's watertight logic: if NFT prices dip, they're on the same path as the most successful corporation in human history; buy the dip! NFTs aren't businesses or museum-worthy art. They're bs.

Gary Vee compares NFTs to Amazon.com. vm.tiktok.com/TTPdA9TyH2

We grew up collecting: Magic: The Gathering (MTG) cards printed in the 90s are now worth over $30,000. Imagine buying a digital Magic card with no underlying foundation. No one plays the game because it doesn't exist. An NFT is a contextless image someone conned you into buying a certificate for, but anyone may copy, paste, and use. Replace MTG with Pokemon for younger readers.

When Gary Vee strongarms 30 tech billionaires and YouTube influencers into buying CryptoPunks, they'll talk about it on Twitch, YouTube, podcasts, Twitter, etc. That will convince average folks that the product has value. These guys are smart and/or rich, so I'll get in early like them. Cryptography is similar. No solid, scaled, mainstream use case exists, and no one knows where it's headed, but since the global crypto financial bubble hasn't burst and many people have made insane fortunes, regular people are putting real money into something that is highly speculative and could be nothing because they want a piece of the action. Who doesn’t want free money? Rich techies and influencers won't be affected; normal folks will.

Imagine removing every $1 invested in Bitcoin instantly. What would happen? How far would Bitcoin fall? Over 90%, maybe even 95%, and Bitcoin would be dead. Bitcoin as an investment is the only scalable widespread use case: it's confidence that a better use case will arise and that being early pays handsomely. It's like pouring a trillion dollars into a company with no business strategy or users and a CEO who makes vague future references.

New tech and efforts may provoke a 'get off my lawn' mentality as you approach 40, but I've always prided myself on having a decent bullshit detector, and it's flying off the handle at this foolishness. If we can accomplish a functional, responsible, equitable, and ethical user-owned internet, I'm for it.

Postscript:

I wanted to summarize my opinions because I've been angry about this for a while but just sporadically tweeted about it. A friend handed me a Dan Olson YouTube video just before publication. He's more knowledgeable, articulate, and convincing about crypto. It's worth seeing:

This post is a summary. See the original one here.

In this essay, I studied REAL NFT use examples and their potential uses.

Knowledge of the Hype Cycle

Gartner's Hype Cycle.

It proposes 5 phases for disruptive technology.

1. Technology Trigger: the emergence of potentially disruptive technology.

2. Peak of Inflated Expectations: Early publicity creates hype. (Ex: 2021 Bubble)

3. Trough of Disillusionment: Early projects fail to deliver on promises and the public loses interest. I suspect NFTs are somewhere around this trough of disillusionment now.

4. Enlightenment slope: The tech shows successful use cases.

5. Plateau of Productivity: Mainstream adoption has arrived and broader market applications have proven themselves. Here’s a more detailed visual of the Gartner Hype Cycle from Wikipedia.

In the speculative NFT bubble of 2021, @beeple sold Everydays: the First 5000 Days for $69 MILLION in 2021's NFT bubble.

@nbatopshot sold millions in video collectibles.

This is when expectations peaked.

Let's examine NFTs' real-world applications.

Watch this video if you're unfamiliar with NFTs.

Online Art

Most people think NFTs are rich people buying worthless JPEGs and MP4s.

Digital artwork and collectibles are revolutionary for creators and enthusiasts.

NFT Profile Pictures

You might also have seen NFT profile pictures on Twitter.

My profile picture is an NFT I coined with @skogards factoria app, which helps me avoid bogus accounts.

Profile pictures are a good beginning point because they're unique and clearly yours.

NFTs are a way to represent proof-of-ownership. It’s easier to prove ownership of digital assets than physical assets, which is why artwork and pfps are the first use cases.

They can do much more.

NFTs can represent anything with a unique owner and digital ownership certificate. Domains and usernames.

Usernames & Domains

@unstoppableweb, @ensdomains, @rarible sell NFT domains.

NFT domains are transferable, which is a benefit.

Godaddy and other web2 providers have difficult-to-transfer domains. Domains are often leased instead of purchased.

Tickets

NFTs can also represent concert tickets and event passes.

There's a limited number, and entry requires proof.

NFTs can eliminate the problem of forgery and make it easy to verify authenticity and ownership.

NFT tickets can be traded on the secondary market, which allows for:

1. marketplaces that are uniform and offer the seller and buyer security (currently, tickets are traded on inefficient markets like FB & craigslist)

2. unbiased pricing

3. Payment of royalties to the creator

4. Historical ticket ownership data implies performers can airdrop future passes, discounts, etc.

5. NFT passes can be a fandom badge.

The $30B+ online tickets business is increasing fast.

NFT-based ticketing projects:

• @GetProtocol

• @SeatlabNFT

• @YellowHeartNFT

• @GUTStickets

• @WicketEvents

Gaming Assets

NFTs also help in-game assets.

Imagine someone spending five years collecting a rare in-game blade, then outgrowing or quitting the game. Gamers value that collectible.

The gaming industry is expected to make $200 BILLION in revenue this year, a significant portion of which comes from in-game purchases.

Royalties on secondary market trading of gaming assets encourage gaming businesses to develop NFT-based ecosystems.

Digital assets are the start. On-chain NFTs can represent real-world assets effectively.

Real estate has a unique owner and requires ownership confirmation.

Real Estate

Tokenizing property has many benefits.

1. Can be fractionalized to increase access, liquidity

2. Can be collateralized to increase capital efficiency and access to loans backed by an on-chain asset

3. Allows investors to diversify or make bets on specific neighborhoods, towns or cities +++

I've written about this thought exercise before.

I made an animated video explaining this.

We've just explored NFTs for transferable assets. But what about non-transferrable NFTs?

SBTs are Soul-Bound Tokens. Vitalik Buterin (Ethereum co-founder) blogged about this.

NFTs are basically verifiable digital certificates.

Diplomas & Degrees

That fits Degrees & Diplomas. These shouldn't be marketable, thus they can be non-transferable SBTs.

Anyone can verify the legitimacy of on-chain credentials, degrees, abilities, and achievements.

The same goes for other awards.

For example, LinkedIn could give you a verified checkmark for your degree or skills.

Authenticity Protection

NFTs can also safeguard against counterfeiting.

Counterfeiting is the largest criminal enterprise in the world, estimated to be $2 TRILLION a year and growing.

Anti-counterfeit tech is valuable.

This is one of @ORIGYNTech's projects.

Identity

Identity theft/verification is another real-world problem NFTs can handle.

In the US, 15 million+ citizens face identity theft every year, suffering damages of over $50 billion a year.

This isn't surprising considering all you need for US identity theft is a 9-digit number handed around in emails, documents, on the phone, etc.

Identity NFTs can fix this.

• NFTs are one-of-a-kind and unforgeable.

• NFTs offer a universal standard.

• NFTs are simple to verify.

• SBTs, or non-transferrable NFTs, are tied to a particular wallet.

• In the event of wallet loss or theft, NFTs may be revoked.

This could be one of the biggest use cases for NFTs.

Imagine a global identity standard that is standardized across countries, cannot be forged or stolen, is digital, easy to verify, and protects your private details.

Since your identity is more than your government ID, you may have many NFTs.

@0xPolygon and @civickey are developing on-chain identity.

Memberships

NFTs can authenticate digital and physical memberships.

Voting

NFT IDs can verify votes.

If you remember 2020, you'll know why this is an issue.

Online voting's ease can boost turnout.

Informational property

NFTs can protect IP.

This can earn creators royalties.

NFTs have 2 important properties:

• Verifiability IP ownership is unambiguously stated and publicly verified.

• Platforms that enable authors to receive royalties on their IP can enter the market thanks to standardization.

Content Rights

Monetization without copyrighting = more opportunities for everyone.

This works well with the music.

Spotify and Apple Music pay creators very little.

Crowdfunding

Creators can crowdfund with NFTs.

NFTs can represent future royalties for investors.

This is particularly useful for fields where people who are not in the top 1% can’t make money. (Example: Professional sports players)

Mirror.xyz allows blog-based crowdfunding.

Financial NFTs

This introduces Financial NFTs (fNFTs). Unique financial contracts abound.

Examples:

• a person's collection of assets (unique portfolio)

• A loan contract that has been partially repaid with a lender

• temporal tokens (ex: veCRV)

Legal Agreements

Not just financial contracts.

NFT can represent any legal contract or document.

Messages & Emails

What about other agreements? Verbal agreements through emails and messages are likewise unique, but they're easily lost and fabricated.

Health Records

Medical records or prescriptions are another types of documentation that has to be verified but isn't.

Medical NFT examples:

• Immunization records

• Covid test outcomes

• Prescriptions

• health issues that may affect one's identity

• Observations made via health sensors

Existing systems of proof by paper / PDF have photoshop-risk.

I tried to include most use scenarios, but this is just the beginning.

NFTs have many innovative uses.

For example: @ShaanVP minted an NFT called “5 Minutes of Fame” 👇

Here are 2 Twitter threads about NFTs:

1. This piece of gold by @chriscantino

2. This conversation between @punk6529 and @RaoulGMI on @RealVision“The World According to @punk6529”

If you're wondering why NFTs are better than web2 databases for these use scenarios, see this Twitter thread I wrote:

If you liked this, please share it.

Reddit's NFT market is alive and well.

NFT owners outnumber OpenSea on Reddit.

Reddit NFTs flip in OpenSea in days:

Fast-selling.

NFT sales will make Reddit's current communities more engaged.

I don't think NFTs will affect existing groups, but they will build hype for people to acquire them.

The first season of Collectibles is unique, but many missed the first season.

Second-season NFTs are less likely to be sold for a higher price than first-season ones.

If you use Reddit, it's fun to own NFTs.

Generative AI hype: some thoughts

The sudden surge in "generative AI" startups and projects feels like the inverse of the recent "web3" boom. Both came from hyped-up pots. But while web3 hyped idealistic tech and an easy way to make money, generative AI hypes unsettling tech and questions whether it can be used to make money.

Web3 is technology looking for problems to solve, while generative AI is technology creating almost too many solutions. Web3 has been evangelists trying to solve old problems with new technology. As Generative AI evolves, users are resolving old problems in stunning new ways.

It's a jab at web3, but it's true. Web3's hype, including crypto, was unhealthy. Always expected a tech crash and shakeout. Tech that won't look like "web3" but will enhance "web2"

But that doesn't mean AI hype is healthy. There'll be plenty of bullshit here, too. As moths to a flame, hype attracts charlatans. Again, the difference is the different starting point. People want to use it. Try it.

With the beta launch of Dall-E 2 earlier this year, a new class of consumer product took off. Midjourney followed suit (despite having to jump through the Discord server hoops). Twelve more generative art projects. Lensa, Prisma Labs' generative AI self-portrait project, may have topped the hype (a startup which has actually been going after this general space for quite a while). This week, ChatGPT went off-topic.

This has a "fake-it-till-you-make-it" vibe. We give these projects too much credit because they create easy illusions. This also unlocks new forms of creativity. And faith in new possibilities.

As a user, it's thrilling. We're just getting started. These projects are not only fun to play with, but each week brings a new breakthrough. As an investor, it's all happening so fast, with so much hype (and ethical and societal questions), that no one knows how it will turn out. Web3's demand won't be the issue. Too much demand may cause servers to melt down, sending costs soaring. Companies will try to mix rapidly evolving tech to meet user demand and create businesses. Frustratingly difficult.

Anyway, I wanted an excuse to post some Lensa selfies.

These are really weird. I recognize them as me or a version of me, but I have no memory of them being taken. It's surreal, out-of-body. Uncanny Valley.

Apple's latest revelation may shock iPod fans and former owners.

Apple discontinued the iPod touch on May 11, 2022. After 21 years, Apple killed the last surviving iPod, a device Steve Jobs believed would revolutionize the music industry.

Jobs was used to making bold predictions, but few expected Apple's digital music player to change the music industry. It did.

This chaos created new business opportunities. Spotify, YouTube, and Amazon are products of that chaotic era.

As the digital landscape changes, so do consumers, and the iPod has lost favor. I'm sure Apple realizes the importance of removing an icon. The iPod was Apple like the Mac and iPhone. I think it's bold to retire such a key Apple cornerstone. What would Jobs do?

iPod evolution across the ages

Here's an iPod family tree for all you enthusiasts.

iPod vintage (Oct 2001 to Sep 2014, 6 generations)

The original iPod had six significant upgrades since 2001. Apple announced an 80 GB ($249) and 160 GB ($349) iPod classic in 2007.

Apple updated the 80 GB model with a 120 GB device in September 2008. Apple upgraded the 120 GB model with a 160 GB variant a year later (2009). This was the last iteration, and Apple discontinued the classic in September 2014.

iPod nano (Jan 2004 to Sep 2005, 2 generations)

Apple debuted a smaller, brightly-colored iPod in 2004. The first model featured 4 GB, enough for 1,000 songs.

Apple produced a new 4 GB or 6 GB iPod mini in February 2005 and discontinued it in September when they released a better-looking iPod nano.

iTouch nano (Sep 2005 to July 2017, 7 generations)

I loved the iPod nano. It was tiny and elegant with enough tech to please most music aficionados, unless you carry around your complete music collection.

Apple owed much of the iPod nano's small form and success to solid-state flash memory. Flash memory doesn't need power because it has no moving parts. This makes the iPod nano more durable than the iPod classic and mini, which employ hard drives.

Apple manufactured seven generations of the iPod nano, improving its design, display screen, memory, battery, and software, but abandoned it in July 2017 due to dwindling demand.

Shuffle iPod (Jan 2005 to Jul 2017, 4 generations)

The iPod shuffle was entry-level. It was a simple, lightweight, tiny music player. The iPod shuffle was perfect for lengthy bike trips, runs, and hikes.

Apple sold 10 million iPod shuffles in the first year and kept making them for 12 years, through four significant modifications.

iOS device (Sep 2007 to May 2022, 7 generations)

The iPod touch's bigger touchscreen interface made it a curious addition to the iPod family. The iPod touch resembled an iPhone more than the other iPods, making them hard to tell apart.

Many were dissatisfied that Apple removed functionality from the iPod touch to avoid making it too similar to the iPhone. Seven design improvements over 15 years brought the iPod touch closer to the iPhone, but not completely.

The iPod touch uses the same iOS operating system as the iPhone, giving it access to many apps, including handheld games.

The iPod touch's long production run is due to the next generation of music-loving gamers.

What made the iPod cool

iPod revolutionized music listening. It was the first device to store and play MP3 music, allowing you to carry over 1,000 songs anywhere.

The iPod changed consumer electronics with its scroll wheel and touchscreen. Jobs valued form and function equally. He showed people that a product must look good to inspire an emotional response and ignite passion.

The elegant, tiny iPod was a tremendous sensation when it arrived for $399 in October 2001. Even at this price, it became a must-have for teens to CEOs.

It's hard to identify any technology that changed how music was downloaded and played like the iPod. Apple iPod and iTunes had 63% of the paid music download market in the fourth quarter of 2012.

The demise of the iPod was inevitable

Apple discontinuing the iPod touch after 21 years is sad. This ends a 00s music icon.

Jobs was a genius at anticipating market needs and opportunities, and Apple launched the iPod at the correct time.

Few consumer electronics items have had such a lasting impact on music lovers and the music industry as the iPod.

Smartphones and social media have contributed to the iPod's decline. Instead of moving to the music, the new generation of consumers is focused on social media. They're no longer passive content consumers; they're active content creators seeking likes and followers. Here, the smartphone has replaced the iPod.

It's hard not to feel a feeling of loss, another part of my adolescence now forgotten by the following generation.

So, if you’re lucky enough to have a working iPod, hang on to that relic and enjoy the music and the nostalgia.

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.