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.

Are you one of these Zoom dogs?

The Person Who Is Apparently Always on Mute

Waffles thinks he can overpower the mute button by shouting loudly.

The person who believed their camera to be off

Barkley's used to remote work, but he hasn't mastered the "Stop Video" button. Everyone is affected.

Who is driving for some reason, exactly?

Why is Pumpkin always late? Who knows? Shouldn't she be driving? If you could hear her over the freeway, she'd answer these questions.

The Person With the Amazing Bookcase

Cicero likes to use SAT-words like "leverage" and "robust" in Zoom sessions, presumably from all the books he wants you to see behind him.

The Individual Who Is Unnecessarily Dressed

We hope Bandit is going somewhere beautiful after this meeting, or else he neglected the quarterly earnings report and is overcompensating to distract us.

The person who works through lunch in between zoom calls

Barksworth has back-to-back meetings all day, so you can watch her eat while she talks.

The Person Who Is A Little Too Comfy

Hercules thinks Zoom meetings happen between sleeps. He'd appreciate everyone speaking more quietly.

The Person Who Answered the Phone Outside

Frisbee has a gorgeous backyard and lives in a place with great weather year-round, and she wants you to think about that during the daily team huddle.

Who Wants You to Pay Attention to Their Pet

Snickers hasn't listened to you in 20 minutes unless you tell her how cute her kitten is.

One who is, for some reason, positioned incorrectly on the screen

Nelson's meetings consist primarily of attempting to figure out how he positioned his laptop so absurdly.

The person who says too many goodbyes

Zeus waves farewell like it's your first day of school while everyone else searches for the "Leave Meeting" button. It's nice.

He who has a poor internet connection

Ziggy's connectivity problems continue... She gives a long speech as everyone waits awkwardly to inform her they missed it.

The Clearly Multitasking Person

Tinkerbell can play fetch during the monthly staff meeting if she works from home, but that's not a good idea.

The Person Using Zoom as a Makeup and Hair Mirror

If Gail and Bob knew Zoom had a "hide self view" option, they'd be distraught.

The person who feels at ease with simply leaving

Rusty bails when a Zoom conference is over. Rusty's concept is decent.

WTF is wrong with you people?

When I was laid off as editor of my town's daily newspaper, I went silent on social media. I knew it was coming and had been quietly removing personal items each day, but the pain was intense.

I posted a day later. I didn't bad-mouth GateHouse Media but expressed my sadness at leaving the newspaper industry, pride in my accomplishments, and hope for success in another industry.

Normal job-loss response.

What do you recognize as abnormal?

The bullshit I’ve been reading from laid-off folks on LinkedIn.

If you're there, you know. Many Twitter or Facebook/Meta employees recently lost their jobs.

Well, many of them did not “lose their job,” actually. They were “impacted by the layoffs” at their former employer. I keep seeing that phrase.

Why don’t they want to actually say it? Why the euphemism?

Many are excited about the opportunities ahead. The jobless deny being sad.

They're ecstatic! They have big plans.

Hope so. Sincerely! Being laid off stinks, especially if, like me, your skills are obsolete. It's worse if, like me, you're too old to start a new career. Ageism exists despite denials.

Nowadays, professionalism seems to demand psychotic levels of fake optimism.

Why? Life is unpredictable. That's indisputable. You shouldn't constantly complain or cry in public, but you also shouldn't pretend everything's great.

It makes you look psychotic, not positive. It's like saying at work:

“I was impacted by the death of my spouse of 20 years this week, and many of you have reached out to me, expressing your sympathy. However, I’m choosing to remember the amazing things we shared. I feel confident that there is another marriage out there for me, and after taking a quiet weekend trip to reset myself, I’ll be out there looking for the next great marital adventure! #staypositive #available #opentolove

Also:

“Now looking for our next #dreamhome after our entire neighborhood was demolished by a wildfire last night. We feel so lucky to have lived near so many amazing and inspirational neighbors, all of whom we will miss as we go on our next housing adventure. The best house for us is yet to come! If you have a great neighborhood you’d recommend, please feel free to reach out and touch base with us! #newhouse #newneighborhood #newlife

Admit it. That’s creepy.

The constant optimism makes me feel sick to my stomach.

Viscerally.

I hate fakes.

Imagine a fake wood grain desk. Wouldn't it be better if the designer accepted that it's plastic and went with that?

Real is better but not always nice. When something isn't nice, you don't have to go into detail, but you also shouldn't pretend it's great.

How to announce your job loss to the world.

Do not pretend to be happy, but don't cry and drink vodka all afternoon.

Say you loved your job, and that you're looking for new opportunities.

Yes, if you'll miss your coworkers. Otherwise, don't badmouth. No bridge-burning!

Please specify the job you want. You may want to pivot.

Alternatively, try this.

You could always flame out.

If you've pushed yourself too far into toxic positivity, you may be ready to burn it all down. If so, make it worthwhile by writing something like this:

Well, I was shitcanned by the losers at #Acme today. That bitch Linda in HR threw me under the bus just because she saw that one of my “friends” tagged me in some beach pics on social media after I called in sick with Covid. The good thing is I will no longer have to watch my ass around that #asspincher Ron in accounting, but I’m sad that I will no longer have a cushy job with high pay or access to the primo office supplies I’ve been sneaking home for the last five years. (Those gel pens were the best!) I am going to be taking some time off to enjoy my unemployment and hammer down shots of Jägermeister but in about five months I’ll be looking for anything easy with high pay and great benefits. Reach out if you can help! #officesupplies #unemploymentrocks #drinkinglikeagirlboss #acmesucks

It beats the fake positivity.

After a crazy second half of 2021 and significant trade volumes into 2022, the market for NFT artworks like Bored Ape Yacht Club, CryptoPunks, and Pudgy Penguins has begun a sharp collapse as market downturns hit token values.

DappRadar data shows NFT monthly sales have fallen below $1 billion since June 2021. OpenSea, the world's largest NFT exchange, has seen sales volume decline 75% since May and is trading like July 2021.

Prices of popular non-fungible tokens have also decreased. Bored Ape Yacht Club (BAYC) has witnessed volume and sales drop 63% and 15%, respectively, in the past month.

BeInCrypto analysis shows market decline. May 2022 cryptocurrency marketplace volume was $4 billion, according to a news platform. This is a sharp drop from April's $7.18 billion.

OpenSea, a big marketplace, contributed $2.6 billion, while LooksRare, Magic Eden, and Solanart also contributed.

NFT markets are digital platforms for buying and selling tokens, similar stock trading platforms. Although some of the world's largest exchanges offer NFT wallets, most users store their NFTs on their favorite marketplaces.

In January 2022, overall NFT sales volume was $16.57 billion, with LooksRare contributing $11.1 billion. May 2022's volume was $12.57 less than January, a 75% drop, and June's is expected to be considerably smaller.

A World Based on Utility

Despite declines in NFT trading volumes, not all investors are negative on NFTs. Although there are uncertainties about the sustainability of NFT-based art collections, there are fewer reservations about utility-based tokens and their significance in technology's future.

In June, business CEO Christof Straub said NFTs may help artists monetize unreleased content, resuscitate catalogs, establish deeper fan connections, and make processes more efficient through technology.

We all know NFTs can't be JPEGs. Straub noted that NFT music rights can offer more equitable rewards to musicians.

Music NFTs are here to stay if they have real value, solve real problems, are trusted and lawful, and have fair and sustainable business models.

NFTs can transform numerous industries, including music. Market opinion is shifting towards tokens with more utility than the social media artworks we're used to seeing.

While the major NFT names remain dominant in terms of volume, new utility-based initiatives are emerging as top 20 collections.

Otherdeed, Sorare, and NBA Top Shot are NFT-based games that rank above Bored Ape Yacht Club and Cryptopunks.

Users can switch video NFTs of basketball players in NBA Top Shot. Similar efforts are emerging in the non-fungible landscape.

Sorare shows how NFTs can support a new way of playing fantasy football, where participants buy and swap trading cards to create a 5-player team that wins rewards based on real-life performances.

Sorare raised 579.7 million in one of Europe's largest Series B financing deals in September 2021. Recently, the platform revealed plans to expand into Major League Baseball.

Strong growth indications suggest a promising future for NFTs. The value of art-based collections like BAYC and CryptoPunks may be questioned as markets become diluted by new limited collections, but the potential for NFTs to become intrinsically linked to tangible utility like online gaming, music and art, and even corporate reward schemes shows the industry has a bright future.

Python Heatmap Technical Indicator

Heatmaps provide an instant overview. They can be used with correlations or to predict reactions or confirm the trend in trading. This article covers RSI heatmap creation.

The Market System

Market regime:

• Bullish trend: The market tends to make higher highs, which indicates that the overall trend is upward.

• Sideways: The market tends to fluctuate while staying within predetermined zones.

• Bearish trend: The market has the propensity to make lower lows, indicating that the overall trend is downward.

Most tools detect the trend, but we cannot predict the next state. The best way to solve this problem is to assume the current state will continue and trade any reactions, preferably in the trend.

If the EURUSD is above its moving average and making higher highs, a trend-following strategy would be to wait for dips before buying and assuming the bullish trend will continue.

Indicator of Relative Strength

J. Welles Wilder Jr. introduced the RSI, a popular and versatile technical indicator. Used as a contrarian indicator to exploit extreme reactions. Calculating the default RSI usually involves these steps:

• Determine the difference between the closing prices from the prior ones.

• Distinguish between the positive and negative net changes.

• Create a smoothed moving average for both the absolute values of the positive net changes and the negative net changes.

• Take the difference between the smoothed positive and negative changes. The Relative Strength RS will be the name we use to describe this calculation.

• To obtain the RSI, use the normalization formula shown below for each time step.

The 13-period RSI and black GBPUSD hourly values are shown above. RSI bounces near 25 and pauses around 75. Python requires a four-column OHLC array for RSI coding.

import numpy as np
def add_column(data, times):
    
    for i in range(1, times + 1):
    
        new = np.zeros((len(data), 1), dtype = float)
        
        data = np.append(data, new, axis = 1)
    return data
def delete_column(data, index, times):
    
    for i in range(1, times + 1):
    
        data = np.delete(data, index, axis = 1)
    return data
def delete_row(data, number):
    
    data = data[number:, ]
    
    return data
def ma(data, lookback, close, position): 
    
    data = add_column(data, 1)
    
    for i in range(len(data)):
           
            try:
                
                data[i, position] = (data[i - lookback + 1:i + 1, close].mean())
            
            except IndexError:
                
                pass
            
    data = delete_row(data, lookback)
    
    return data
def smoothed_ma(data, alpha, lookback, close, position):
    
    lookback = (2 * lookback) - 1
    
    alpha = alpha / (lookback + 1.0)
    
    beta  = 1 - alpha
    
    data = ma(data, lookback, close, position)
    data[lookback + 1, position] = (data[lookback + 1, close] * alpha) + (data[lookback, position] * beta)
    for i in range(lookback + 2, len(data)):
        
            try:
                
                data[i, position] = (data[i, close] * alpha) + (data[i - 1, position] * beta)
        
            except IndexError:
                
                pass
            
    return data
def rsi(data, lookback, close, position):
    
    data = add_column(data, 5)
    
    for i in range(len(data)):
        
        data[i, position] = data[i, close] - data[i - 1, close]
     
    for i in range(len(data)):
        
        if data[i, position] > 0:
            
            data[i, position + 1] = data[i, position]
            
        elif data[i, position] < 0:
            
            data[i, position + 2] = abs(data[i, position])
            
    data = smoothed_ma(data, 2, lookback, position + 1, position + 3)
    data = smoothed_ma(data, 2, lookback, position + 2, position + 4)
    data[:, position + 5] = data[:, position + 3] / data[:, position + 4]
    
    data[:, position + 6] = (100 - (100 / (1 + data[:, position + 5])))
    data = delete_column(data, position, 6)
    data = delete_row(data, lookback)
    return data

Make sure to focus on the concepts and not the code. You can find the codes of most of my strategies in my books. The most important thing is to comprehend the techniques and strategies.

My weekly market sentiment report uses complex and simple models to understand the current positioning and predict the future direction of several major markets. Check out the report here:

Using the Heatmap to Find the Trend

RSI trend detection is easy but useless. Bullish and bearish regimes are in effect when the RSI is above or below 50, respectively. Tracing a vertical colored line creates the conditions below. How:

• When the RSI is higher than 50, a green vertical line is drawn.

• When the RSI is lower than 50, a red vertical line is drawn.

Zooming out yields a basic heatmap, as shown below.

Plot code:

def indicator_plot(data, second_panel, window = 250):
    fig, ax = plt.subplots(2, figsize = (10, 5))
    sample = data[-window:, ]
    for i in range(len(sample)):
        ax[0].vlines(x = i, ymin = sample[i, 2], ymax = sample[i, 1], color = 'black', linewidth = 1)  
        if sample[i, 3] > sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 0], ymax = sample[i, 3], color = 'black', linewidth = 1.5)  
        if sample[i, 3] < sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
        if sample[i, 3] == sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
    ax[0].grid() 
    for i in range(len(sample)):
        if sample[i, second_panel] > 50:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'green', linewidth = 1.5)  
        if sample[i, second_panel] < 50:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'red', linewidth = 1.5)  
    ax[1].grid()
indicator_plot(my_data, 4, window = 500)

Call RSI on your OHLC array's fifth column. 4. Adjusting lookback parameters reduces lag and false signals. Other indicators and conditions are possible.

Another suggestion is to develop an RSI Heatmap for Extreme Conditions.

Contrarian indicator RSI. The following rules apply:

• Whenever the RSI is approaching the upper values, the color approaches red.

• The color tends toward green whenever the RSI is getting close to the lower values.

Zooming out yields a basic heatmap, as shown below.

Plot code:

import matplotlib.pyplot as plt
def indicator_plot(data, second_panel, window = 250):
    fig, ax = plt.subplots(2, figsize = (10, 5))
    sample = data[-window:, ]
    for i in range(len(sample)):
        ax[0].vlines(x = i, ymin = sample[i, 2], ymax = sample[i, 1], color = 'black', linewidth = 1)  
        if sample[i, 3] > sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 0], ymax = sample[i, 3], color = 'black', linewidth = 1.5)  
        if sample[i, 3] < sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
        if sample[i, 3] == sample[i, 0]:
            ax[0].vlines(x = i, ymin = sample[i, 3], ymax = sample[i, 0], color = 'black', linewidth = 1.5)  
    ax[0].grid() 
    for i in range(len(sample)):
        if sample[i, second_panel] > 90:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'red', linewidth = 1.5)  
        if sample[i, second_panel] > 80 and sample[i, second_panel] < 90:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'darkred', linewidth = 1.5)  
        if sample[i, second_panel] > 70 and sample[i, second_panel] < 80:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'maroon', linewidth = 1.5)  
        if sample[i, second_panel] > 60 and sample[i, second_panel] < 70:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'firebrick', linewidth = 1.5) 
        if sample[i, second_panel] > 50 and sample[i, second_panel] < 60:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'grey', linewidth = 1.5) 
        if sample[i, second_panel] > 40 and sample[i, second_panel] < 50:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'grey', linewidth = 1.5) 
        if sample[i, second_panel] > 30 and sample[i, second_panel] < 40:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'lightgreen', linewidth = 1.5)
        if sample[i, second_panel] > 20 and sample[i, second_panel] < 30:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'limegreen', linewidth = 1.5) 
        if sample[i, second_panel] > 10 and sample[i, second_panel] < 20:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'seagreen', linewidth = 1.5)  
        if sample[i, second_panel] > 0 and sample[i, second_panel] < 10:
            ax[1].vlines(x = i, ymin = 0, ymax = 100, color = 'green', linewidth = 1.5)
    ax[1].grid()
indicator_plot(my_data, 4, window = 500)

Dark green and red areas indicate imminent bullish and bearish reactions, respectively. RSI around 50 is grey.

Summary

To conclude, my goal is to contribute to objective technical analysis, which promotes more transparent methods and strategies that must be back-tested before implementation.

Technical analysis will lose its reputation as subjective and unscientific.

When you find a trading strategy or technique, follow these steps:

• Put emotions aside and adopt a critical mindset.

• Test it in the past under conditions and simulations taken from real life.

• Try optimizing it and performing a forward test if you find any potential.

• Transaction costs and any slippage simulation should always be included in your tests.

• Risk management and position sizing should always be considered in your tests.

After checking the above, monitor the strategy because market dynamics may change and make it unprofitable.