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.

His story will inspire you.

“Google search went down for a few hours in 2002; Jeff Dean handled all the queries by hand and checked quality doubled.”- Jeff Dean Facts.

One of many Jeff Dean jokes, but you get the idea.

Google's top six engineers met in a war room in mid-2000. Google's crawling system, which indexed the Web, stopped working. Users could still enter queries, but results were five months old.

Google just signed a deal with Yahoo to power a ten-times-larger search engine. Tension rose. It was crucial. If they failed, the Yahoo agreement would likely fall through, risking bankruptcy for the firm. Their efforts could be lost.

A rangy, tall, energetic thirty-one-year-old man named Jeff dean was among those six brilliant engineers in the makeshift room. He had just left D. E. C. a couple of months ago and started his career in a relatively new firm Google, which was about to change the world. He rolled his chair over his colleague Sanjay and sat right next to him, cajoling his code like a movie director. The history started from there.

When you think of people who shaped the World Wide Web, you probably picture founders and CEOs like Larry Page and Sergey Brin, Marc Andreesen, Tim Berners-Lee, Bill Gates, and Mark Zuckerberg. They’re undoubtedly the brightest people on earth.

Under these giants, legions of anonymous coders work at keyboards to create the systems and products we use. These computer workers are irreplaceable.

Let's get to know him better.

It's possible you've never heard of Jeff Dean. He's American. Dean created many behind-the-scenes Google products. Jeff, co-founder and head of Google's deep learning research engineering team, is a popular technology, innovation, and AI keynote speaker.

While earning an MS and Ph.D. in computer science at the University of Washington, he was a teaching assistant, instructor, and research assistant. Dean joined the Compaq Computer Corporation Western Research Laboratory research team after graduating.

Jeff co-created ProfileMe and the Continuous Profiling Infrastructure for Digital at Compaq. He co-designed and implemented Swift, one of the fastest Java implementations. He was a senior technical staff member at mySimon Inc., retrieving and caching electronic commerce content.

Dean, a top young computer scientist, joined Google in mid-1999. He was always trying to maximize a computer's potential as a child.

An expert

His high school program for processing massive epidemiological data was 26 times faster than professionals'. Epi Info, in 13 languages, is used by the CDC. He worked on compilers as a computer science Ph.D. These apps make source code computer-readable.

Dean never wanted to work on compilers forever. He left Academia for Google, which had less than 20 employees. Dean helped found Google News and AdSense, which transformed the internet economy. He then addressed Google's biggest issue, scaling.

Growing Google faced a huge computing challenge. They developed PageRank in the late 1990s to return the most relevant search results. Google's popularity slowed machine deployment.

Dean solved problems, his specialty. He and fellow great programmer Sanjay Ghemawat created the Google File System, which distributed large data over thousands of cheap machines.

These two also created MapReduce, which let programmers handle massive data quantities on parallel machines. They could also add calculations to the search algorithm. A 2004 research article explained MapReduce, which became an industry sensation.

Several revolutionary inventions

Dean's other initiatives were also game-changers. BigTable, a petabyte-capable distributed data storage system, was based on Google File. The first global database, Spanner, stores data on millions of servers in dozens of data centers worldwide.

It underpins Gmail and AdWords. Google Translate co-founder Jeff Dean is surprising. He contributes heavily to Google News. Dean is Senior Fellow of Google Research and Health and leads Google AI.

Recognitions

The National Academy of Engineering elected Dean in 2009. He received the 2009 Association for Computing Machinery fellowship and the 2016 American Academy of Arts and Science fellowship. He received the 2007 ACM-SIGOPS Mark Weiser Award and the 2012 ACM-Infosys Foundation Award. Lists could continue.

A sneaky question may arrive in your mind: How much does this big brain earn? Well, most believe he is one of the highest-paid employees at Google. According to a survey, he is paid $3 million a year.

He makes espresso and chats with a small group of Googlers most mornings. Dean steams milk, another grinds, and another brews espresso. They discuss families and technology while making coffee. He thinks this little collaboration and idea-sharing keeps Google going.

“Some of us have been working together for more than 15 years,” Dean said. “We estimate that we’ve collectively made more than 20,000 cappuccinos together.”

We all know great developers and software engineers. It may inspire many.

He’s not the President. Stop treating him like one.

Elon Musk tweeted from Qatar, where he was watching the World Cup Final with Jared Kushner.

Musk's subsequent Tweets were as normal, basic, and bland as anyone's from a World Cup Final: It's depressing to see the world's richest man looking at his phone during a grand ceremony. Rich guy goes to rich guy event didn't seem important.

Before Musk posted his should-I-step-down-at-Twitter poll, CNN ran a long segment asking if it was hypocritical for him to reveal his real-time location after defending his (very dumb) suspension of several journalists for (supposedly) revealing his assassination coordinates by linking to a site that tracks Musks private jet. It was hard to ignore CNN's hypocrisy: It covered Musk as Twitter CEO like President Trump. EVERY TRUMP STORY WAS BASED ON HIM SAYING X, THEN DOING Y. Trump would do something horrific, lie about it, then pretend it was fine, then condemn a political rival who did the same thing, be called hypocritical, and so on. It lasted four years. Exhausting.

It made sense because Trump was the President of the United States. The press's main purpose is to relentlessly cover and question the president.

It's strange to say this out. Twitter isn't America. Elon Musk isn't a president. He maintains a money-losing social media service to harass and mock people he doesn't like. Treating Musk like Trump, as if he should be held accountable like Trump, shows a startling lack of perspective. Some journalists treat Twitter like a country.

The compulsive, desperate way many journalists utilize the site suggests as much. Twitter isn't the town square, despite popular belief. It's a place for obsessives to meet and converse. Journalists say they're breaking news. Their careers depend on it. They can argue it's a public service. Nope. It's a place lonely people go to speak all day. Twitter. So do journalists, Trump, and Musk. Acting as if it has a greater purpose, as if it's impossible to break news without it, or as if the republic is in peril is ludicrous. Only 23% of Americans are on Twitter, while 25% account for 97% of Tweets. I'd think a large portion of that 25% are journalists (or attention addicts) chatting to other journalists. Their loudness makes Twitter seem more important than it is. Nope. It's another stupid website. They were there before Twitter; they will be there after Twitter. It’s just a website. We can all get off it if we want. Most of us aren’t even on it in the first place.

Musk is a website-owner. No world leader. He's not as accountable as Trump was. Musk is cable news's primary character now that Trump isn't (at least for now). Becoming a TV news anchor isn't as significant as being president. Elon Musk isn't as important as we all pretend, and Twitter isn't even close. Twitter is a dumb website, Elon Musk is a rich guy going through a midlife crisis, and cable news is lazy because its leaders thought the entire world was on Twitter and are now freaking out that their playground is being disturbed.

I’ve said before that you need to leave Twitter, now. But even if you’re still on it, we need to stop pretending it matters more than it does. It’s a site for lonely attention addicts, from the man who runs it to the journalists who can’t let go of it. It’s not a town square. It’s not a country. It’s not even a successful website. Let’s stop pretending any of it’s real. It’s not.

Las Vegas hosted CES 2023. This third and last look at CES 2023 previews upcoming consumer electronics trends that will be crucial for market share.

Definitely start with ICT. Qualcomm CEO Cristiano Amon spoke to CNBC from Las Vegas on China's crackdown and the company's automated driving systems for electric vehicles (EV). The business showed a concept car and its latest Snapdragon processor designs, which offer expanded digital interactions through SalesForce-partnered CRM platforms.

Qualcomm CEO Meets SK Hynix Vice Chairman at CES 2023 On Jan. 6, SK hynix Inc.'s vice chairman and co-CEO Park Jung-ho discussed strengthening www.businesskorea.co.kr.

Electrification is reviving Michigan's automobile industry. Michigan Local News reports that $14 billion in EV and battery manufacturing investments will benefit the state. The report also revealed that the Strategic Outreach and Attraction Reserve (SOAR) fund had generated roughly $1 billion for the state's automotive sector.

Michigan to "dominate" EV battery manufacturing after $2B investment. Michigan spent $2 billion to safeguard www.mlive.com.

Ars Technica is great for technology, society, and the future. After CES 2023, Jonathan M. Gitlin published How many electric car chargers are enough? Read about EV charging network issues and infrastructure spending. Politics aside, rapid technological advances enable EV charging network expansion in American cities and abroad.

New research says US needs 8x more EV chargers by 2030. Electric vehicle skepticism—which is widespread—is fundamentally about infrastructure. arstechnica.com

Finally, the UNEP's The Future of Electric Vehicles and Material Resources: A Foresight Brief. Understanding how lithium-ion batteries will affect EV sales is crucial. Climate change affects EVs in various ways, but electrification and mining trends stand out because more EVs demand more energy-intensive metals and rare earths. Areas & Producers has been publishing my electrification and mining trends articles. Follow me if you wish to write for the publication.

Producers This magazine analyzes medium.com-related corporate, legal, and international news to examine a paradigm shift.

The Weekend Brief (TWB) will routinely cover tech, industrials, and global commodities in global markets, including stock markets. Read more about the future of key areas and critical producers of the global economy in Areas & Producers.

TotalEnergies, Stellantis Form Automotive Cells Company (ACC) A joint-venture to design and build electric vehicles (EVs) was formed in 2020.

People-first update.

Every Google upgrade causes website owners to panic.

Some have just recovered from previous algorithm tweaks and resumed content development.

If you follow Google's Webmaster rules, you shouldn't fear its adjustments.

Everyone has a view of them. Miscommunication and confusion result.

Now, for some (hopefully) exciting news.

Google tweeted on August 18, 2022 about a fresh content update.

This change is another Google effort to remove low-quality, repetitive, and AI-generated content.

The algorithm generates and analyzes search results, not humans.

Google spends a lot to teach its algorithm what searchers want. Intent isn't always clear.

Google's content update aims to:

“… ensure people see more original, helpful content written by people, for people, in search results.”

Isn't it a noble goal?

However, what does it mean for content creators and website owners?

How can you ensure you’re creating content that will be successful after the updates roll out?

Let's first define people-first content.

What does "people-first-content" mean?

If asked, I'd say information written to answer queries and solve problems.

Like others, I read it from the term.

Content creators and marketers disagree. They need more information to follow recommendations.

Google gives explicit instructions for creating people-first content.

According to Google, if you answer yes to the following questions, you have a people-first attitude.

1. Do you have customers who might find your content useful if they contacted you directly?

2. Does your content show the breadth of your knowledge?

3. Do you have a niche or a focus for your website?

4. After reading your content, will readers learn something new to aid them in achieving their goals?

5. Are readers happy after reading your content?

6. Have you been adhering to Google's fundamental updates and product reviews?

As an SEO writer, I'm not scared.

I’ve been following these rules consciously while creating content for my website. That’s why it’s been steadily growing despite me publishing just one or two stories a month.

If you avoid AI-generated text and redundant, shallow material, your website won't suffer.

If you use unscrupulous methods to boost your website's traffic, including link buying or keyword stuffing, stop. Google is getting smarter and will find and punish your site eventually.

For those who say, “SEO is no longer working,” I dedicated the whole paragraph below.

This does not imply that SEO is obsolete.

Google:

“People-first content creators focus on creating satisfying content, while also utilizing SEO best practices to bring searchers additional value.”

The official helpful content update page lists two people-first content components:

• meeting user needs

• best practices for SEO

Always read official guidelines, not unsolicited suggestions.

SEO will work till search engines die.

How to use the update

Google said the changes will arrive in August 2022.

They pledged to post updates on Google's search ranking updates page.

Google also tweets this info. If you haven't followed it already, I recommend it.

Ranking adjustments could take two weeks and will affect English searches internationally initially.

Google affirmed plans to extend to other languages.

If you own a website, monitor your rankings and traffic to see if it's affected.

10 biases in 10 visuals

Cognitive biases are crucial for UX research, design, and daily life. Our biases distort reality.

After learning about biases at my UX Research bootcamp, I studied Erika Hall's Just Enough Research and used the Nielsen Norman Group's wealth of information. 10 images show my findings.

1. Bias in sampling

Misselection of target population members causes sampling bias. For example, you are building an app to help people with food intolerances log their meals and are targeting adult males (years 20-30), adult females (ages 20-30), and teenage males and females (ages 15-19) with food intolerances. However, a sample of only adult males and teenage females is biased and unrepresentative.

2. Sponsor Disparity

Sponsor bias occurs when a study's findings favor an organization's goals. Beware if X organization promises to drive you to their HQ, compensate you for your time, provide food, beverages, discounts, and warmth. Participants may endeavor to be neutral, but incentives and prizes may bias their evaluations and responses in favor of X organization.

In Just Enough Research, Erika Hall suggests describing the company's aims without naming it.

Third, False-Consensus Bias

False-consensus bias is when a person thinks others think and act the same way. For instance, if a start-up designs an app without researching end users' needs, it could fail since end users may have different wants. https://www.nngroup.com/videos/false-consensus-effect/

Working directly with the end user and employing many research methodologies to improve validity helps lessen this prejudice. When analyzing data, triangulation can boost believability.

Bias of the interviewer

I struggled with this bias during my UX research bootcamp interviews. Interviewing neutrally takes practice and patience. Avoid leading questions that structure the story since the interviewee must interpret them. Nodding or smiling throughout the interview may subconsciously influence the interviewee's responses.

The Curse of Knowledge

The curse of knowledge occurs when someone expects others understand a subject as well as they do. UX research interviews and surveys should reduce this bias because technical language might confuse participants and harm the research. Interviewing participants as though you are new to the topic may help them expand on their replies without being influenced by the researcher's knowledge.

Confirmation Bias

Most prevalent bias. People highlight evidence that supports their ideas and ignore data that doesn't. The echo chamber of social media creates polarization by promoting similar perspectives.

A researcher with confirmation bias may dismiss data that contradicts their research goals. Thus, the research or product may not serve end users.

Design biases

UX Research design bias pertains to study construction and execution. Design bias occurs when data is excluded or magnified based on human aims, assumptions, and preferences.

The Hawthorne Impact

Remember when you behaved differently while the teacher wasn't looking? When you behaved differently without your parents watching? A UX research study's Hawthorne Effect occurs when people modify their behavior because you're watching. To escape judgment, participants may act and speak differently.

To avoid this, researchers should blend into the background and urge subjects to act alone.

The bias against social desire

People want to belong to escape rejection and hatred. Research interviewees may mislead or slant their answers to avoid embarrassment. Researchers should encourage honesty and confidentiality in studies to address this. Observational research may reduce bias better than interviews because participants behave more organically.

Relative Time Bias

Humans tend to appreciate recent experiences more. Consider school. Say you failed a recent exam but did well in the previous 7 exams. Instead, you may vividly recall the last terrible exam outcome.

If a UX researcher relies their conclusions on the most recent findings instead of all the data and results, recency bias might occur.

I hope you liked learning about UX design, research, and real-world biases.