After a decade in large tech, I know how software engineers were interviewed. I've seen outstanding engineers fail interviews because their responses were too vague.

So I wrote Nail A Coding Interview: Six-Step Mental Framework. Give candidates a mental framework for coding questions; help organizations better prepare candidates so they can calibrate traits.

Recently, I sold more than 100 books, something I never expected.

In this essay, I'll describe my publication journey, which included self-doubt and little triumphs. I hope this helps if you want to publish.

It was originally a Medium post.

How did I know to develop a coding interview book? Years ago, I posted on Medium.

Six steps to ace a coding interview Inhale. blog.devgenius.io

This story got a lot of attention and still gets a lot of daily traffic. It indicates this domain's value.

Converted the Medium article into an ebook

The Medium post contains strong bullet points, but it is missing the “flesh”. How to use these strategies in coding interviews, for example. I filled in the blanks and made a book.

I made the book cover for free. It's tidy.

Shared the article with my close friends on my social network WeChat.

I shared the book on Wechat's Friend Circle (朋友圈) after publishing it on Gumroad. Many friends enjoyed my post. It definitely triggered endorphins.

In Friend Circle, I presented a 100% off voucher. No one downloaded the book. Endorphins made my heart sink.

Several days later, my Apple Watch received a Gumroad notification. A friend downloaded it. I majored in finance, he subsequently said. My brother-in-law can get it? He downloaded it to cheer me up.

I liked him, but was disappointed that he didn't read it.

The Tipping Point: Reddit's Free Giving

I trusted the book. It's based on years of interviewing. I felt it might help job-hunting college students. If nobody wants it, it can still have value.

I posted the book's link on /r/leetcode. I told them to DM me for a free promo code.

Momentum shifted everything. Gumroad notifications kept coming when I was out with family. Following orders.

As promised, I sent DMs a promo code. Some consumers ordered without asking for a promo code. Some readers finished the book and posted reviews.

My book was finally on track.

A 5-Star Review, plus More

A reader afterwards DMed me and inquired if I had another book on system design interviewing. I said that was a good idea, but I didn't have one. If you write one, I'll be your first reader.

Later, I asked for a book review. Yes, but how? That's when I learned readers' reviews weren't easy. I built up an email pipeline to solicit customer reviews. Since then, I've gained credibility through ratings.

Learnings

I wouldn't have gotten 100 if I gave up when none of my pals downloaded. Here are some lessons.

• Your friends are your allies, but they are not your clients.

• Be present where your clients are

• Request ratings and testimonials

• gain credibility gradually

I did it, so can you. Follow me on Twitter @imgracehuang for my publishing and entrepreneurship adventure.

Discover How We Used Facebook Ads to Grow a New Mobile App from $0 to $15K MRR in Just 6 Months and Our Strategy to Hit $100K a Month.

Our client introduced a mobile app for Poshmark resellers in December and wanted as many to experience it and subscribe to the monthly plan.

An Error We Committed

We initiated a Facebook ad campaign with a "awareness" goal, not "installs." This sent them to a landing page that linked to the iPhone App Store and Android Play Store. Smart, right?

We got some installs, but we couldn't tell how many came from the ad versus organic/other channels because the objective we chose only reported landing page clicks, not app installs.

We didn't know which interest groups/audiences had the best cost per install (CPI) to optimize and scale our budget.

After spending $700 without adequate data (installs and trials report), we stopped the campaign and worked with our client's app developer to set up app events tracking.

This allowed us to create an installs campaign and track installs, trials, and purchases (in some cases).

Finding a Successful Audience

Once we knew what ad sets brought in what installs at what cost, we began optimizing and testing other interest groups and audiences, growing the profitable low CPI ones and eliminating the high CPI ones.

We did all our audience testing using an ABO campaign (Ad Set Budget Optimization), spending $10 to $30 on each ad set for three days and optimizing afterward. All ad sets under $30 were moved to a CBO campaign (Campaign Budget Optimization).

We let Facebook's AI decide how much to spend on each ad set, usually the one most likely to convert at the lowest cost.

If the CBO campaign maintains a nice CPI, we keep increasing the budget by $50 every few days or duplicating it sometimes in order to double the budget. This is how we've scaled to $400/day profitably.

Finding Successful Creatives

Per campaign, we tested 2-6 images/videos. Same ad copy and CTA. There was no clear winner because some images did better with some interest groups.

The image above with mail packages, for example, got us a cheap CPI of $9.71 from our Goodwill Stores interest group but, a high $48 CPI from our lookalike audience. Once we had statistically significant data, we turned off the high-cost ad.

New marketers who are just discovering A/B testing may assume it's black and white — winner and loser. However, Facebook ads' machine learning and reporting has gotten so sophisticated that it's hard to call a creative a flat-out loser, but rather a 'bad fit' for some audiences, and perfect for others.

You can see how each creative performs across age groups and optimize.

How Many Installs Did It Take Us to Earn $15K Per Month?

Six months after paying $25K, we got 1,940 app installs, 681 free trials, and 522 $30 monthly subscriptions. 522 * $30 gives us $15,660 in monthly recurring revenue (MRR).

Next, what? $100K per month

The conversation above is with the app's owner. We got on a 30-minute call where I shared how I plan to get the app to be making $100K a month like I’ve done for other businesses.

Reverse Engineering $100K

Formula:

For $100K/month, we need 3,334 people to pay $30/month. 522 people pay that. We need 2,812 more paid users.

522 paid users from 1,940 installs is a 27% conversion rate. To hit $100K/month, we need 10,415 more installs. Assuming...

With a $400 daily ad spend, we average 40 installs per day. This means that if everything stays the same, it would take us 260 days (around 9 months) to get to $100K a month (MRR).

Conclusion

You must market your goods to reach your income objective (without waiting forever). Paid ads is the way to go if you hate knocking on doors or irritating friends and family (who aren’t scalable anyways).

You must also test and optimize different angles, audiences, interest groups, and creatives.

Everyone wants a scalable startup.

Innovation helps launch a startup. The secret to a scalable business is growth trials (from 1 to 100).

Growth marketing combines marketing and product development for long-term growth.

Today, I'll explain growth hacking strategies popular startups used to scale.

1/ A Facebook user's social value is proportional to their friends.

Facebook built its user base using content marketing and paid ads. Mark and his investors feared in 2007 when Facebook's growth stalled at 90 million users.

Chamath Palihapitiya was brought in by Mark.

The team tested SEO keywords and MAU chasing. The growth team introduced “people you may know”

This feature reunited long-lost friends and family. Casual users became power users as the retention curve flattened.

Growth Hack Insights: With social network effect the value of your product or platform increases exponentially if you have users you know or can relate with.

2/ Airbnb - Focus on your value propositions

Airbnb nearly failed in 2009. The company's weekly revenue was $200 and they had less than 2 months of runway.

Enter Paul Graham. The team noticed a pattern in 40 listings. Their website's property photos sucked.

Why?

Because these photos were taken with regular smartphones. Users didn't like the first impression.

Graham suggested traveling to New York to rent a camera, meet with property owners, and replace amateur photos with high-resolution ones.

A week later, the team's weekly revenue doubled to $400, indicating they were on track.

Growth Hack Insights: When selling an “online experience” ensure that your value proposition is aesthetic enough for users to enjoy being associated with them.

3/ Zomato - A company's smartphone push ensured growth.

Zomato delivers food. User retention was a challenge for the founders. Indian food customers are notorious for switching brands at the drop of a hat.

Zomato wanted users to order food online and repeat orders throughout the week.

Zomato created an attractive website with “near me” keywords for SEO indexing.

Zomato gambled to increase repeat orders. They only allowed mobile app food orders.

Zomato thought mobile apps were stickier. Product innovations in search/discovery/ordering or marketing campaigns like discounts/in-app notifications/nudges can improve user experience.

Zomato went public in 2021 after users kept ordering food online.

Growth Hack Insights: To improve user retention try to build platforms that build user stickiness. Your product and marketing team will do the rest for them.

4/ Hotmail - Signaling helps build premium users.

Ever sent or received an email or tweet with a sign — sent from iPhone?

Hotmail did it first! One investor suggested Hotmail add a signature to every email.

Overnight, thousands joined the company. Six months later, the company had 1 million users.

When serving an existing customer, improve their social standing. Signaling keeps the top 1%.

5/ Dropbox - Respect loyal customers

Dropbox is a company that puts people over profits. The company prioritized existing users.

Dropbox rewarded loyal users by offering 250 MB of free storage to anyone who referred a friend. The referral hack helped Dropbox get millions of downloads in its first few months.

Growth Hack Insights: Think of ways to improve the social positioning of your end-user when you are serving an existing customer. Signaling goes a long way in attracting the top 1% to stay.

These experiments weren’t hacks. Hundreds of failed experiments and user research drove these experiments. Scaling up experiments is difficult.

Contact me if you want to grow your startup's user base.

Combining AIs creates realistic AI News Videos.

Powerful AI tools like Chat GPT-3 are trending. Have you combined AIs?

The 1-minute fake news video below is startlingly realistic. Artificial Intelligence developed NASA's Mars exploration breakthrough video (AI). However, integrating the aforementioned AIs generated it.

• AI-generated text for the Chat GPT-3 based on a succinct tagline

• DALL-E-2 AI generates an image from a brief slogan.

• Artificial intelligence-generated avatar and speech

This article shows how to use and mix the three AIs to make a realistic news video. First, watch the video (1 minute).

Talk GPT-3

Chat GPT-3 is an OpenAI NLP model. It can auto-complete text and produce conversational responses.

Try it at the playground. The AI will write a comprehensive text from a brief tagline. Let's see what the AI generates with "Breakthrough in Mars Project" as the headline.

Amazing. Our tagline matches our complete and realistic text. Fake news can start here.

DALL-E-2

OpenAI's huge transformer-based language model DALL-E-2. Its GPT-3 basis is geared for image generation. It can generate high-quality photos from a brief phrase and create artwork and images of non-existent objects.

DALL-E-2 can create a news video background. We'll use "Breakthrough in Mars project" again. Our AI creates four striking visuals. Last.

Synthesia

Synthesia lets you quickly produce videos with AI avatars and synthetic vocals.

Avatars are first. Rosie it is.

Upload and select DALL-backdrop. E-2's

Copy the Chat GPT-3 content and choose a synthetic voice.

Voice: English (US) Professional.

Finally, we generate and watch or download our video.

Synthesia AI completes the AI video.

Overview & Resources

We used three AIs to make surprisingly realistic NASA Mars breakthrough fake news in this post. Synthesia generates an avatar and a synthetic voice, therefore it may be four AIs.

These AIs created our fake news.

• AI-generated text for the Chat GPT-3 based on a succinct tagline

• DALL-E-2 AI generates an image from a brief slogan.

• Artificial intelligence-generated avatar and speech

Our RISE community is stoked on ChatGPT. ChatGPT has countless uses.

Early on. Companies are figuring out the legal and ethical implications of AI's content revolution. Using AI for everyday tasks is cool.

So I challenged RISE friends... Let's have fun and share non-obvious uses.

Onward!

1. Tweet

Jim MacLeod requested a design-themed Twitter thread from ChatGPT.

2. Novelize

Giuseppe Fratoni writes novels.

"This is amazing!" Impotent. I asked about writing, mystery novels, and jazz.

"Develop a mystery novel plot in which a disillusioned homicide detective hunts a serial killer who targets jazz musicians who play Autumn Leaves."

"I have:

Detective James Thompson is a seasoned veteran of the Homicide department, but lately he’s been feeling burnt out and disillusioned. His latest case, the murder of a young jazz pianist who was found brutally killed in his home, only serves to deepen his sense of despair … (much more provided)

3. Question-and-answer sessions

Bliss recommends:

You have a guest speaker and want to ask audience questions.

Pre-generate questions with ChatGPT. "And here's a question from our AI?"

The conference is about Western water scarcity. Water management expert. My AI question was...

Which desalination-related questions should I ask an expert?

ChatGPT said...

• How is desalination currently being used around the world, and in what types of locations is it most effective?

• What are the potential advantages and disadvantages of using desalination to provide fresh water?

• What are some of the key challenges and limitations of desalination technology, and how are they being addressed?

4. Game-making

Richard's a board game expert. He suggests using ChatGPT to plan games. Note: Some people have started getting help solving crossword puzzle clues.

5. Matchmaking

Tanya Thompson thinks it helps dating. ChatGPT:

Here are some flirty first-message ideas for dating apps:

I noticed you from afar. I had to say hi and see if we clicked.

Your profile picture is gorgeous. I'm obsessed with your [Feature] and want to know you better.

I don't usually message first, but I had to. You're [Attractive Quality] and I can't wait to talk.”

Hello. Your profile intimidates me. I'm starstruck by your [Attractiveness]. (Many instances)

5. Solitude/anxiety

ChatGPT excels at one-on-one conversations.

PepperBrooks: "I'm sad and lonely."

ChatGPT: I’m sorry to hear that you’re feeling sad and lonely. It’s natural to feel down sometimes, but it’s important to remember that you’re not alone. There are many people who care about you and want to help you. It can be helpful to talk to someone about your feelings, whether it’s a close friend, family member, or mental health professional.

Sometimes, just expressing your thoughts and emotions to someone else can help to alleviate your sadness and loneliness. It’s also important to take care of yourself and do things that make you happy, such as spending time with loved ones, pursuing a hobby, or exercising. These things can help to improve your mood and make you feel more connected to others. Remember that you are strong and capable, and that you can get through this difficult time.

Daniel Nestle asked ChatGPT to generate journal prompts to help him deal with anxiety.

1. Write down the things that are causing you anxiety at the moment.

2. Describe a situation in which you felt anxious and how you coped with it.

3. Reflect on how your thoughts and beliefs contribute to your anxiety.

4. Write a letter to your anxiety, expressing your feelings and concerns

5. Imagine yourself in a calm and peaceful place, and describe it in detail.

6. (many more items followed)

6. Names

Continued Daniel:

Also, naming ideas.

Me: Name this drink. Japanese gin, unsweetened tonic, lime, Szechuan pepper, grapefruit.

ChatGPT: How about “Sakura Sunrise?” The name incorporates the Japanese gin and the citrus flavors of grapefruit and lime, and the word “sunrise” suggests a fresh and invigorating start to the day. Alternatively, you could go with something like “Peppered Grapefruit Gin Fizz” to emphasize the unique flavor combination of Szechuan pepper and grapefruit.

7. Translation on the go

Monks recommends: ChatGPT is a perfect mobile translation tool. Say you need help in Italy.

ME: Translate to Italian

Where is the nearest gas station?

ChatGPT: “La mia auto sta per esaurire il carburante, mi puoi dire dove si trova la stazione di servizio più vicina?”

8. Fitness

Monks added:

ME: In 3 months, I want to run 5km. Plan out how I can do this.

ChatGPT: Here's a 3-month plan to run 5km.

• Start by walking for 15–20 minutes each day to build up your endurance and get your body used to regular exercise.

• After a week of walking, begin incorporating short jogs into your routine. Start by jogging for 1–2 minutes at a time, with walking breaks in between. Gradually increase the length of your jogs and reduce the amount of time you spend walking.

• Once you can jog for 10 minutes without stopping, start increasing the distance of your runs. Aim to run 1km without stopping and then gradually increase the distance over time.

• In addition to your regular runs, incorporate strength training and stretching into your routine to improve your overall fitness and reduce the risk of injury.

• (more details continued on)

9. Integrations and coding

10. Teacher lesson plans

Spencer Crandall saved time.

This morning, I wondered who has the hardest job. Teachers.

Many students, little time. ChatGPT could handle lesson planning. I tried it and got this.

Lesson Title: The History and Impact of Artificial Intelligence

Students will understand the history and development of AI and the potential positive and negative impacts on society.

AI timeline AI technologies and applications

Overview:

1. Introduce the topic of artificial intelligence, and explain that it refers to the development of computer systems and algorithms that can simulate human intelligence and behavior.

2. Show the timeline of significant events in the history of AI, and discuss the key milestones and developments in the field.

3. Show examples of AI technologies and applications, and explain how they are used in various industries and fields.

4. Discuss the potential positive and negative impacts of AI on society, including its potential to improve productivity, efficiency, and safety, as well as its potential to create new challenges and concerns, such as job displacement and ethical issues.

(many more details followed)

11. Find podcast guests.

Joeri Billast suggested:

Who should be on my Web3 podcast?

ChatGPT: Web3 marketing experts, influencers, and thought leaders make great podcast guests. These include Web3 marketers, content creators, business owners, entrepreneurs, and technologists. You could invite Web3 startups and organizations to your podcast.

Please give examples.

ChatGPT: Ideal Web3 marketing podcast guests include:

• Tim Berner-Lee, inventor of the World Wide Web

• Chris Dixon, general partner at Andreessen Horowitz

• Vitalik Buterin, founder of Ethereum

• Joe Lubin, founder of ConsenSys

• Susan Fowler, author of Whistleblower

• (many other suggestions)

12. Comments and reviews on social media

Lisa Monk thinks ChatGPT can help retail staff with social media.

She asked ChatGPT to "review this restaurant"

POSITIVE CUSTOMER REVIEW: I absolutely love this place. We eat out a lot however this place has topped it all. Perfect meals, amazing staff and the timing for it all was great! Special thanks to Sophie B (you rock) From your guests all the way from the Gold Coast, THANK YOU

ChatGPT REPLY: Thank you so much for your kind words and for taking the time to write a review. We are delighted to hear that you had such a great experience at our restaurant. We are thrilled that you enjoyed your meal and the service provided by Sophie. It’s always a pleasure to serve guests visiting from the Gold Coast and we are grateful for your support. We look forward to welcoming you back again soon. Thank you again for your positive review.

CUSTOMER REVIEW: Most average food, there is a nice view, But that’s about it

ChatGPT: Thank you for your review. We apologize if your dining experience was not up to your expectations. We strive to provide top-quality food and service to all of our customers, and we will take your feedback into consideration as we continue to improve. Thank you for letting us know about your experience.

13. Crime-fighting

Zack Seipert said, "I researched some famous unsolved murders, and ChatGPT laid out the crime, suspects, clues, and more." I bet experienced detectives could solve some of these cold cases.

14. Reduce bias

Joanne Taylor struggles to remove biases from her writing. She asked ChatGPT for ideas.

I asked ChatGPT to check a text for racial bias, and it did well.

15. Furnishings

I designed a small, unique table using ChatGPT and MidJourney. I edited ChatGPT's idea for clarity and brevity before entering it in MidJourney.

Results:

16. Serialize a novel

Scott Scowcoft led ChatCPT through iterations of a story text to create serialized novel frames. You can view this here.

17. Interview preparation

I was on a sales podcast. Although this is marketing-related, it's not my forte. I asked ChatGPT for help with a sales interview. Response:

Here are some interview questions about the future of sales and how to answer them.

How will technology affect sales in the future?

Technology will impact sales in the coming years. Automation and AI could be used to handle routine tasks, and data analysis and CRM could become more important. E-commerce and online sales channels are also reshaping the sales landscape.

How will the salesperson's role change?

Future sales roles may change in response to changing customer needs and expectations. Salespeople must be knowledgeable and consultative to help customers navigate complex products and services. Increasing importance of data analysis and CRM tools will require salespeople to understand and use technology effectively.

Future sales professionals will need what skills?

Future salespeople will need many skills. Sales professionals must have strong communication and interpersonal skills, as well as product and service knowledge and the ability to use data analysis and CRM tools effectively. Adapting to changing customer needs and staying current on industry trends will also be important for sales success.

18. Gift ideas

I need Christmas gift ideas for my wife. I asked:

Suggest a gift idea under $200 for a middle-aged woman who loves The Eagles.

A middle-aged woman who loves The Eagles might like a vinyl record of "Hotel California" or "The Long Run." Many music fans enjoy the unique sound and experience of vinyl records.

Pair the record with a high-quality record player for a complete gift. The vinyl record and record player should fit within your $200 budget for an Eagles fan.

19. Explaining complex concepts

I entered: Explain quantum physics to me as if I were 10 years old.

Quantum physics is a branch of science that studies how tiny particles, like atoms and subatomic particles, behave. These particles are so small that they don’t always follow the same rules as the things we can see and touch every day.

For example, sometimes they can be in two places at the same time, or they can be friends with each other even if they are far apart. This might sound strange, but it’s what scientists have learned from studying these tiny particles. Quantum physics helps us understand how the world works at a very small scale, and it can also help us make new technologies, like computers that are much faster than the ones we have today.

20. AP-style editing

Blogs, journals, and books follow AP Style. I asked ChatGPT to "edit using AP Style" and it did a great job.

And then... "Write a catchy headline for a blog post about 16 ChatGPT uses"

Here are some possible blog post titles for 20 creative ChatGPT uses:

• “20 Fun and Creative Ways to Use ChatGPT: From Games to Quizzes and More”

• “The Ultimate Guide to Using ChatGPT for Entertainment and Creativity”

• “20 Reasons to Use ChatGPT: How it Can Enhance Your Gaming, Storytelling, and More”

• 20 Entertaining Uses for ChatGPT You Never Knew Were Possible”

• “Unleash Your Imagination with ChatGPT: 16 Creative and Fun Ways to Use it”

In a previous post, I said ChatGPT will change marketing careers forever. I have never made a statement like that in my life. Even in the early days of the internet, people were cautious.

This technology was just released two weeks ago, and over a million people are already using it. This is the fastest technology adoption in history.

Today's post offers inventive and entertaining ideas, but it's just the beginning. ChatGPT writes code, music, and papers.

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.