In the early 2000s, I began developing SaaS. I helped launch an internet fax service that delivered faxes to email inboxes. Back then, it saved consumers money and made the procedure easier.

Google AdWords was young then. Anyone might establish a new website, spend a few hundred dollars on keywords, and see dozens of new paying clients every day. That's how we launched our new SaaS, and these clients stayed for years. Our early ROI was sky-high.

Changing times

The situation changed dramatically after 15 years. Our paid advertising cost $200-$300 for every new customer. Paid advertising takes three to four years to repay.

Fortunately, we still had tens of thousands of loyal clients. Good organic rankings gave us new business. We needed less sponsored traffic to run a profitable SaaS firm.

Is it still possible?

Since selling our internet fax firm, I've dreamed about starting a SaaS company. One I could construct as a lone developer and progressively grow a dedicated customer base, as I did before in a small team.

It seemed impossible to me. Solo startups couldn't afford paid advertising. SEO was tough. Even the worst SaaS startup ideas attracted VC funding. How could I compete with startups that could hire great talent and didn't need to make money for years (or ever)?

The One and Only Way to Learn

After years of talking myself out of SaaS startup ideas, I decided to develop and launch one. I needed to know if a solitary developer may create a SaaS app in 2022.

Thus, I did. I invented webwriter.ai, an AI-powered writing tool for website content, from hero section headlines to blog posts, this year. I soft-launched an MVP in July.

Considering the Issue

Now that I've developed my own fully capable SaaS app for site builders and developers, I wonder if it's still possible. Can webwriter.ai be successful?

I know webwriter.ai's proposal is viable because Jasper.ai and Grammarly are also AI-powered writing tools. With competition comes validation.

To Win, Differentiate

To compete with well-funded established brands, distinguish to stand out to a portion of the market. So I can speak directly to a target user, unlike larger competition.

I created webwriter.ai to help web builders and designers produce web content rapidly. This may be enough differentiation for now.

Budget-Friendly Promotion

When paid search isn't an option, we get inventive. There are more tools than ever to promote a new website.

• Organic Results

• on social media (Twitter, Instagram, TikTok, LinkedIn)

• Marketing with content that is compelling

• Link Creation

• Listings in directories

• references made in blog articles and on other websites

• Forum entries

The Beginning of the Journey

As I've labored to construct my software, I've pondered a new mantra. Not sure where that originated from, but I like it. I'll live by it and teach my kids:

“Do the work.”

Here is the ugly stuff, read this if you have a founder in your life or are trying to become one. Your call.

#1 You'll try to talk yourself to sleep, but it won't always work.

As founders, we're all driven. Good and bad, you're restless. Success requires resistance and discipline. Your startup will be on your mind 24/7, and not everyone will have the patience to listen to your worries, ideas, and coffee runs. You become more self-sufficient than ever before.

#2 No one will understand what you're going through unless they've been a founder.

Some of my closest friends don't understand the work that goes into starting a business, and we can't blame them.

#3 You'll feel alienated.

Your problems aren't common; calling your bestie won't help. You must search hard for the right resources. It alienates you from conversations you no longer relate to. (No 4th of July, no long weekends!)

#4 Since you're your "own boss," people assume you have lots of free time.

Do you agree? I was on a webinar with lots of new entrepreneurs, and one woman said, "I started my own business so I could have more time for myself." This may be true for some lucky people, and you can be flexible with your schedule. If you want your business to succeed, you'll probably be its slave for a while.

#5 No time for illness or family emergencies.

Both last month. Oh, no! Physically and emotionally withdrawing at the worst times will give you perspective. I learned this the hard way because I was too stubborn to postpone an important interview. I thought if I rested all day and only took one call, I'd be fine. Nope. I had a fever and my mind wasn't as sharp, so my performance and audience interaction suffered. Nope. Better to delay than miss out.

Oh, and setting a "OoO" makes you cringe.

#6 Good luck with your mental health, perfectionists.

When building a startup, it's difficult to accept that there won't be enough time to do everything. You can't make them all, not perfectly. You must learn to accept things that are done but not perfect.

#7 As a founder, you'll make mistakes, but you'll want to make them quickly so you can learn.

Hard lessons are learned quicker. You'll need to pivot and try new things often; some won't work, and it's best to discover them sooner rather than later.

#8 Pyramid schemes abound.

I didn't realize how bad it was until I started a company. You must spy and constantly research. As a founder, you'll receive many emails from people claiming to "support" you. Be wary and keep your eyes open. When it's too good to be true. Some "companies" will try to get you to pay for "competitions" to "pitch at events." Don't do it.

#9 Keep your competitor research to a minimum.

Actually, competition is good. It means there's a market for those solutions. However, this can be mentally exhausting too. Learn about their geography and updates, but that's it.

#10 You'll feel guilty taking vacation.

I don't know what to say, but I no longer enjoy watching TV, and that's okay. Pay attention to things that enrich you, bring you joy, and have fun. It boosts creativity.

Being a startup founder may be one of the hardest professional challenges you face, but it's also a great learning experience. Your passion will take you places you never imagined and open doors to opportunities you wouldn't have otherwise. You'll meet amazing people. No regrets, no complaints. It's a roller coaster, but the good days are great.

Miss anything? Comment below

Ali's $1,054,053.74 YouTube Adsense haul.

YouTuber, entrepreneur, and former doctor Ali Abdaal. He began filming productivity and financial videos in 2017. Ali Abdaal has 3 million YouTube subscribers and has crossed $1 million in AdSense revenue. Crazy, no?

Ali will share the revenue of his top 5 youtube videos, things he's learned that you can apply to your side hustle, and how many views it takes to make a livelihood off youtube.

First, "The Long Game."

All good things take time to bear fruit. Compounding improves everything. Long-term work yields better returns. Ali made his first dollar after nine months and 85 videos.

Second, "One piece of content can transform your life, but you never know which one."

Had he abandoned YouTube at 84 videos without making any money, he wouldn't have filmed the 85th video that altered everything.

Third Lesson: Your Industry Choice Can Multiply.

The industry or niche you target as a business owner or side hustler can have a major impact on how much money you make.

Here are the top 5 videos.

1) 9.8m views: $191,258.16 for 9 passive income ideas

Ali made 2 points.

We should consider YouTube videos digital assets. They're investments, which make us money. His investments are yielding passive income.

Investing extra time and effort in your films can pay off.

2) How to Invest for Beginners — 5.2m Views: $87,200.08.

This video did poorly in the first several weeks after it was published; it was his tenth poorest performer. Don't worry about things you can't control. This applies to life, not just YouTube videos.

He stated we constantly have anxieties, fears, and concerns about things outside our control, but if we can find that line, life is easier and more pleasurable.

3) How to Build a Website in 2022— 866.3k views: $42,132.72.

The RPM was $48.86 per thousand views, making it his highest-earning video. Squarespace, Wix, and other website builders are trying to put ads on it and competing against one other, so ad rates go up.

Because it was beyond his niche, Ali almost didn't make the video. He made the video because he wanted to help at least one person.

4) How I take notes on my iPad in medical school — 5.9m views: $24,479.80

85th video. It's the video that affected Ali's YouTube channel and his life the most. The video's success wasn't certain.

5) How I Type Fast 156 Words Per Minute — 8.2M views: $25,143.17

Ali didn't know this video would perform well; he made it because he can type fast and has been practicing for 10 years. So he made a video with his best advice.

How many views to different wealth levels?

It depends on geography, niche, and other monetization sources. To keep things simple, he would solely utilize AdSense.

How many views to generate money?

To generate money on Youtube, you need 1,000 subscribers and 4,000 hours of view time. How much work do you need to make pocket money?

Ali's first 1,000 subscribers took 52 videos and 6 months. The typical channel with 1,000 subscribers contains 152 videos, according to Tubebuddy. It's time-consuming.

After monetizing, you'll need 15,000 views/month to make $5-$10/day.

How many views to go part-time?

Say you make $35,000/year at your day job. If you work 5 days/week, you make $7,000/year each day. If you want to drop down from 5 days to 4 days/week, you need to make an extra $7,000/year from YouTube, or $600/month.

What's the quit-your-job budget?

Silicon Valley Girl is in a highly successful niche targeting tech-focused folks in the west. When her channel had 500k views/month, she made roughly $3,000/month or $47,000/year, enough to quit your work.

Marina has another 1.5m subscriber channel in Russia, which has a lower rpm because fewer corporations advertise there than in the west. 2.3 million views/month is $4,000/month or $50,000/year, enough to quit your employment.

Marina is an intriguing example because she has three YouTube channels with the same skills, but one is 16x more profitable due to the niche she chose.

In Ali's case, he made 100+ videos when his channel was producing enough money to quit his job, roughly $4,000/month.

How many views make you rich?

Depending on how you define rich. Ali felt prosperous with over $100,000/year and 3–5m views/month.

Conclusion

YouTubers and artists don't treat their work like a company, which is a mistake. Businesses have been attempting to figure this out for decades, if not centuries.

We can learn from the business world how to monetize YouTube, Instagram, and Tiktok and make them into sustainable enterprises where we can hire people and delegate tasks.

Bonus

Watch Ali's video explaining all this:

This post is a summary. Read the full article here

Its not a fuc*ing fad.

It's not about boring monkeys or photos as nfts; that's just what's been pushed up and made a lot of money. The technology underlying those ridiculous nft photos will one day prove your house and automobile ownership and tell you where your banana came from. Are you ready for web3? Soar!

People don't realize that absolutely anything can and will be part of the blockchain and smart contracts, making them even better. I'll tell you a secret: it will and is happening.

Why?

Why is something blockchain-based a good idea? So let’s speak about cars!

So a new Tesla car is manufactured, and when you buy it, it is bound to an NFT on the blockchain that proves current ownership. The NFT in the smart contract can contain some data about the current owner of the car and some data about the car's status, such as the number of miles driven, the car's overall quality, and so on, as well as a reference to a digital document bound to the NFT that has more information.

Now, 40 years from now, if you want to buy a used automobile, you can scan the car's serial number to view its NFT and see all of its history, each owner, how long they owned it, if it had damages, and more. Since it's on the blockchain, it can't be tampered with.

When you're ready to buy it, the owner posts it for sale, you buy it, and it's sent to your wallet. 5 seconds to change owner, 100% safe and verifiable.

Incorporate insurance logic into the car contract. If you crashed, your car's smart contract would take money from your insurance contract and deposit it in an insurance company wallet.

It's limitless. Your funds may be used by investors to provide insurance as they profit from everyone's investments.

Or suppose all car owners in a country deposit a fixed amount of money into an insurance smart contract that promises if something happens, we'll take care of it. It could be as little as $100-$500 per year, and in a country with 10 million people, maybe 3 million would do that, which would be $500 000 000 in that smart contract and it would be used by the insurance company to invest in assets or take a cut, literally endless possibilities.

Instead of $300 per month, you may pay $300 per year to be covered if something goes wrong, and that may include multiple insurances.

What about your grocery store banana, though?

Yes that too.

You can scan a banana to learn its complete history. You'll be able to see where it was cultivated, every middleman in the supply chain, and hopefully the banana's quality, farm, and ingredients used.

If you want locally decent bananas, you can only buy them, offering you transparency and options. I believe it will be an online marketplace where farmers publish their farms and products for trust and transparency. You might also buy bananas from the farmer.

And? Food security to finish the article. If an order of bananas included a toxin, you could easily track down every banana from the same origin and supply chain and uncover the root cause. This is a tremendous thing that will save lives and have a big impact; did you realize that 1 in 6 Americans gets poisoned by food every year? This could lower the number.

To summarize:

Smart contracts can issue nfts as proof of ownership and include functionality.

Sundar Pichai unveiled Simplicity Sprint at Google's latest all-hands conference.

To boost employee efficiency.

Not surprising. Few envisioned Google declaring a productivity drive.

Sunder Pichai's speech:

“There are real concerns that our productivity as a whole is not where it needs to be for the head count we have. Help me create a culture that is more mission-focused, more focused on our products, more customer focused. We should think about how we can minimize distractions and really raise the bar on both product excellence and productivity.”

The primary driver driving Google's efficiency push is:

Google's efficiency push follows 13% quarterly revenue increase. Last year in the same quarter, it was 62%.

Market newcomers may argue that the previous year's figure was fuelled by post-Covid reopening and growing consumer spending. Investors aren't convinced. A promising company like Google can't afford to drop so quickly.

Google’s quarterly revenue growth stood at 13%, against 62% in last year same quarter.

Google isn't alone. In my recent essay regarding 2025 programmers, I warned about the economic downturn's effects on FAAMG's workforce. Facebook had suspended hiring, and Microsoft had promised hefty bonuses for loyal staff.

In the same article, I predicted Google's troubles. Online advertising, especially the way Google and Facebook sell it using user data, is over.

FAAMG and 2nd rung IT companies could be the first to fall without Post-COVID revival and uncertain global geopolitics.

Google has hardly ever discussed effectiveness:

Apparently openly.

Amazon treats its employees like robots, even in software positions. It has significant turnover and a terrible reputation as a result. Because of this, it rarely loses money due to staff productivity.

Amazon trumps Google. In reality, it treats its employees poorly.

Google was the founding father of the modern-day open culture.

Larry and Sergey Google founded the IT industry's Open Culture. Silicon Valley called Google's internal democracy and transparency near anarchy. Management rarely slammed decisions on employees. Surveys and internal polls ensured everyone knew the company's direction and had a vote.

20% project allotment (weekly free time to build own project) was Google's open-secret innovation component.

After Larry and Sergey's exit in 2019, this is Google's first profitability hurdle. Only Google insiders can answer these questions.

• Would Google's investors compel the company's management to adopt an Amazon-style culture where the developers are treated like circus performers?

• If so, would Google follow suit?

• If so, how does Google go about doing it?

Before discussing Google's likely plan, let's examine programming productivity.

What determines a programmer's productivity is simple:

How would we answer Google's questions?

As a programmer, I'm more concerned about Simplicity Sprint's aftermath than its economic catalysts.

Large organizations don't care much about quarterly and annual productivity metrics. They have 10-year product-launch plans. If something seems horrible today, it's likely due to someone's lousy judgment 5 years ago who is no longer in the blame game.

Deconstruct our main question.

• How exactly do you change the culture of the firm so that productivity increases?

• How can you accomplish that without affecting your capacity to profit? There are countless ways to increase output without decreasing profit.

• How can you accomplish this with little to no effect on employee motivation? (While not all employers care about it, in this case we are discussing the father of the open company culture.)

• How do you do it for a 10-developer IT firm that is losing money versus a 1,70,000-developer organization with a trillion-dollar valuation?

When implementing a large-scale organizational change, success must be carefully measured.

The fastest way to do something is to do it right, no matter how long it takes.

You require clearly-defined group/team/role segregation and solid pass/fail matrices to:

• You can give performers rewards.

• Ones that are average can be inspired to improve

• Underachievers may receive assistance or, in the worst-case scenario, rehabilitation

As a 20-year programmer, I associate productivity with greatness.

Doing something well, no matter how long it takes, is the fastest way to do it.

Let's discuss a programmer's productivity.

Why productivity is a strange term in programming:

Productivity is work per unit of time.

Money=time This is an economic proverb. More hours worked, more pay. Longer projects cost more.

As a buyer, you desire a quick supply. As a business owner, you want employees who perform at full capacity, creating more products to transport and boosting your profits.

All economic matrices encourage production because of our obsession with it. Productivity is the only organic way a nation may increase its GDP.

Time is money — is not just a proverb, but an economical fact.

Applying the same productivity theory to programming gets problematic. An automating computer. Its capacity depends on the software its master writes.

Today, a sophisticated program can process a billion records in a few hours. Creating one takes a competent coder and the necessary infrastructure. Learning, designing, coding, testing, and iterations take time.

Programming productivity isn't linear, unlike manufacturing and maintenance.

Average programmers produce code every day yet miss deadlines. Expert programmers go days without coding. End of sprint, they often surprise themselves by delivering fully working solutions.

Reversing the programming duties has no effect. Experts aren't needed for productivity.

These patterns remind me of an XKCD comic.

Programming productivity depends on two factors:

• The capacity of the programmer and his or her command of the principles of computer science

• His or her productive bursts, how often they occur, and how long they last as they engineer the answer

At some point, productivity measurement becomes Schrödinger’s cat.

Product companies measure productivity using use cases, classes, functions, or LOCs (lines of code). In days of data-rich source control systems, programmers' merge requests and/or commits are the most preferred yardstick. Companies assess productivity by tickets closed.

Every organization eventually has trouble measuring productivity. Finer measurements create more chaos. Every measure compares apples to oranges (or worse, apples with aircraft.) On top of the measuring overhead, the endeavor causes tremendous and unnecessary stress on teams, lowering their productivity and defeating its purpose.

Macro productivity measurements make sense. Amazon's factory-era management has done it, but at great cost.

Google can pull it off if it wants to.

What Google meant in reality when it said that employee productivity has decreased:

When Google considers its employees unproductive, it doesn't mean they don't complete enough work in the allotted period.

They can't multiply their work's influence over time.

• Programmers who produce excellent modules or products are unsure on how to use them.

• The best data scientists are unable to add the proper parameters in their models.

• Despite having a great product backlog, managers struggle to recruit resources with the necessary skills.

• Product designers who frequently develop and A/B test newer designs are unaware of why measures are inaccurate or whether they have already reached the saturation point.

• Most ignorant: All of the aforementioned positions are aware of what to do with their deliverables, but neither their supervisors nor Google itself have given them sufficient authority.

So, Google employees aren't productive.

How to fix it?

• Business analysis: White suits introducing novel items can interact with customers from all regions. Track analytics events proactively, especially the infrequent ones.

• SOLID, DRY, TEST, and AUTOMATION: Do less + reuse. Use boilerplate code creation. If something already exists, don't implement it yourself.

• Build features-building capabilities: N features are created by average programmers in N hours. An endless number of features can be built by average programmers thanks to the fact that expert programmers can produce 1 capability in N hours.

• Work on projects that will have a positive impact: Use the same algorithm to search for images on YouTube rather than the Mars surface.

• Avoid tasks that can only be measured in terms of time linearity at all costs (if a task can be completed in N minutes, then M copies of the same task would cost M*N minutes).

In conclusion:

Software development isn't linear. Why should the makers be measured?

Notation for The Big O

I'm discussing a new way to quantify programmer productivity. (It applies to other professions, but that's another subject)

The Big O notation expresses the paradigm (the algorithmic performance concept programmers rot to ace their Google interview)

Google (or any large corporation) can do this.

1. Sort organizational roles into categories and specify their impact vs. time objectives. A CXO role's time vs. effect function, for instance, has a complexity of O(log N), meaning that if a CEO raises his or her work time by 8x, the result only increases by 3x.

2. Plot the influence of each employee over time using the X and Y axes, respectively.

3. Add a multiplier for Y-axis values to the productivity equation to make business objectives matter. (Example values: Support = 5, Utility = 7, and Innovation = 10).

4. Compare employee scores in comparable categories (developers vs. devs, CXOs vs. CXOs, etc.) and reward or help employees based on whether they are ahead of or behind the pack.

After measuring every employee's inventiveness, it's straightforward to help underachievers and praise achievers.

Example of a Big(O) Category:

If I ran Google (God forbid, its worst days are far off), here's how I'd classify it. You can categorize Google employees whichever you choose.

The Google interview truth:

O(1) < O(log n) < O(n) < O(n log n) < O(n^x) where all logarithmic bases are < n.

O(1): Customer service workers' hours have no impact on firm profitability or customer pleasure.

CXOs Most of their time is spent on travel, strategic meetings, parties, and/or meetings with minimal floor-level influence. They're good at launching new products but bad at pivoting without disaster. Their directions are being followed.

Devops, UX designers, testers Agile projects revolve around deployment. DevOps controls the levers. Their automation secures results in subsequent cycles.

UX/UI Designers must still prototype UI elements despite improved design tools.

All test cases are proportional to use cases/functional units, hence testers' work is O(N).

Architects Their effort improves code quality. Their right/wrong interference affects product quality and rollout decisions even after the design is set.

Core Developers Only core developers can write code and own requirements. When people understand and own their labor, the output improves dramatically. A single character error can spread undetected throughout the SDLC and cost millions.

Core devs introduce/eliminate 1000x bugs, refactoring attempts, and regression. Following our earlier hypothesis.

The fastest way to do something is to do it right, no matter how long it takes.

Conclusion:

Google is at the liberal extreme of the employee-handling spectrum

Microsoft faced an existential crisis after 2000. It didn't choose Amazon's data-driven people management to revitalize itself.

Instead, it entrusted developers. It welcomed emerging technologies and opened up to open source, something it previously opposed.

Google is too lax in its employee-handling practices. With that foundation, it can only follow Amazon, no matter how carefully.

Any attempt to redefine people's measurements will affect the organization emotionally.

The more Google compares apples to apples, the higher its chances for future rebirth.

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.