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.

How a misplaced item may change your outlook

Losing your wallet means life stops. Money vanishes. No credit. Your identity is unverifiable. As you check your pockets for the missing object, you can't drive. You can't borrow a library book.

Last seen? intuitively. Every kid asks this, including yours. However, you know where you lost it: On the Providence River cycling trail. While pedaling vigorously, the wallet dropped out of your back pocket and onto the pavement.

A woman you know—your son's art teacher—says it will be returned. Faith.

You want that faith. Losing a wallet is all-consuming. You must presume it has been stolen and is being used to buy every diamond and non-fungible token on the market. Your identity may have been used to open bank accounts and fake passports. Because he used your license address, a ski mask-wearing man may be driving slowly past your house.

As you delete yourself by canceling cards, these images run through your head. You wait in limbo for replacements. Digital text on the DMV website promises your new license will come within 60 days and be approved by local and state law enforcement. In the following two months, your only defense is a screenshot.

Your wallet was ordinary. A worn, overstuffed leather rectangle. You understand how tenuous your existence has always been since you've never lost a wallet. You barely breathe without your documents.

Ironically, you wore a wallet-belt chain. You adored being a 1993 slacker for 15 years. Your wife just convinced you last year that your office job wasn't professional. You nodded and hid the chain.

Never lost your wallet. Until now.

Angry. Feeling stupid. How could you drop something vital? Why? Is the world cruel? No more dumb luck. You're always one pedal-stroke from death.

Then you get a call: We have your wallet.

Local post office, not cops.

The clerk said someone returned it. Due to trying to identify you, it's a chaos. It has your cards but no cash.

Your automobile screeches down the highway. You yell at the windshield, amazed. Submitted. Art teacher was right. Have some trust.

You thank the postmaster. You ramble through the story. The clerk doesn't know the customer, simply a neighborhood Good Samaritan. You wish you could thank that person for lifting your spirits.

You get home, beaming with gratitude. You thumb through your wallet, amazed that it’s all intact. Then you dig out your chain and reattach it.

Because even faith could use a little help.

It's kids' digital crack

TikTok is a destructive social media platform.

• The interface shortens attention spans and dopamine receptors.

• TikTok shares more data than other apps.

• Seeing an endless stream of dancing teens on my glowing box makes me feel like a Blade Runner extra.

TikTok did in one year what MTV, Hollywood, and Warner Music tried to do in 20 years. TikTok has psychotized the two-thirds of society Aldous Huxley said were hypnotizable.

Millions of people, mostly kids, are addicted to learning a new dance, lip-sync, or prank, and those who best dramatize this collective improvisation get likes, comments, and shares.

TikTok is a great app. So what?

The Commercial Magnifying Glass TikTok made me realize my generation's time was up and the teenage Zoomers were the target.

I told my 14-year-old sister, "Enjoy your time under the commercial magnifying glass."

TikTok sells your every move, gesture, and thought. Data is the new oil. If you tell someone, they'll say, "Yeah, they collect data, but who cares? I have nothing to hide."

It's a George Orwell novel's beginning. Look up Big Brother Award winners to see if TikTok won.

TikTok shares your data more than any other social media app, and where it goes is unclear. TikTok uses third-party trackers to monitor your activity after you leave the app.

Consumers can't see what data is shared or how it will be used. — Genius URL

32.5 percent of Tiktok's users are 10 to 19 and 29.5% are 20 to 29.

TikTok is the greatest digital marketing opportunity in history, and they'll use it to sell you things, track you, and control your thoughts. Any of its users will tell you, "I don't care, I just want to be famous."

TikTok manufactures mental illness

TikTok's effect on dopamine and the brain is absurd. Dopamine controls the brain's pleasure and reward centers. It's like a switch that tells your brain "this feels good, repeat."

Dr. Julie Albright, a digital culture and communication sociologist, said TikTok users are "carried away by dopamine." It's hypnotic, you'll keep watching."

TikTok constantly releases dopamine. A guy on TikTok recently said he didn't like books because they were slow and boring.

The US didn't ban Tiktok.

Biden and Trump agree on bad things. Both agree that TikTok threatens national security and children's mental health.

The Chinese Communist Party owns and operates TikTok, but that's not its only problem.

• There’s borderline child porn on TikTok

• It's unsafe for children and violated COPPA.

• It's also Chinese spyware. I'm not a Trump supporter, but I was glad he wanted TikTok regulated and disappointed when he failed.

Full-on internet censorship is rare outside of China, so banning it may be excessive. US should regulate TikTok more.

We must reject a low-quality present for a high-quality future.

TikTok vs YouTube

People got mad when I wrote about YouTube's death.

They didn't like when I said TikTok was YouTube's first real challenger.

Indeed. TikTok is the fastest-growing social network. In three years, the Chinese social media app TikTok has gained over 1 billion active users. In the first quarter of 2020, it had the most downloads of any app in a single quarter.

TikTok is the perfect social media app in many ways. It's brief and direct.

Can you believe they had a YouTube vs TikTok boxing match? We are doomed as a species.

YouTube hosts my favorite videos. That’s why I use it. That’s why you use it. New users expect more. They want something quicker, more addictive.

TikTok's impact on other social media platforms frustrates me. YouTube copied TikTok to compete.

It's all about short, addictive content.

I'll admit I'm probably wrong about TikTok. My friend says his feed is full of videos about food, cute animals, book recommendations, and hot lesbians.

Whatever.

TikTok makes us bad

TikTok is the opposite of what the Ancient Greeks believed about wisdom.

It encourages people to be fake. It's like a never-ending costume party where everyone competes.

It does not mean that Gen Z is doomed.

They could be the saviors of the world for all I know.

TikTok feels like a step towards Mike Judge's "Idiocracy," where the average person is a pleasure-seeking moron.

Technical books aren't like novels. We need a new approach to technical texts. I've spent years looking for a decent reading method. I tried numerous ways before finding one that worked. This post explains how I read technical books efficiently.

What Do I Mean When I Say Effective?

Effectiveness depends on the book. Effective implies I know where to find answers after reading a reference book. Effective implies I learned the book's knowledge after reading it.

I use reference books as tools in my toolkit. I won't carry all my tools; I'll merely need them. Non-reference books teach me techniques. I never have to make an effort to use them since I always have them.

Reference books I like:

• Design Patterns: Elements of Reusable Object-Oriented Software

• Refactoring: Improving the Design of Existing Code 
  You can also check My Top Takeaways from Refactoring here.

• Practical Object-Oriented Design in Ruby: An Agile Primer

Non-reference books I like:

• The Pragmatic Programmer: your journey to mastery

• Clean Code: A Handbook of Agile Software Craftsmans

The Approach

Technical books might be overwhelming to read in one sitting. Especially when you have no idea what is coming next as you read. When you don't know how deep the rabbit hole goes, you feel lost as you read. This is my years-long method for overcoming this difficulty.

Whether you follow the step-by-step guide or not, remember these:

• Understand the terminology. Make sure you get the meaning of any terms you come across more than once. The likelihood that a term will be significant increases as you encounter it more frequently.

• Know when to stop. I've always believed that in order to truly comprehend something, I must delve as deeply as possible into it. That, however, is not usually very effective. There are moments when you have to draw the line and start putting theory into practice (if applicable).

• Look over your notes. When reading technical books or documents, taking notes is a crucial habit to develop. Additionally, you must regularly examine your notes if you want to get the most out of them. This will assist you in internalizing the lessons you acquired from the book. And you'll see that the urge to review reduces with time.

Let's talk about how I read a technical book step by step.

0. Read the Foreword/Preface

These sections are crucial in technical books. They answer Who should read it, What each chapter discusses, and sometimes How to Read? This is helpful before reading the book. Who could know the ideal way to read the book better than the author, right?

1. Scanning

I scan the chapter. Fast scanning is needed.

• I review the headings.

• I scan the pictures quickly.

• I assess the chapter's length to determine whether I might divide it into more manageable sections.

2. Skimming

Skimming is faster than reading but slower than scanning.

• I focus more on the captions and subtitles for the photographs.

• I read each paragraph's opening and closing sentences.

• I examined the code samples.

• I attempt to grasp each section's basic points without getting bogged down in the specifics.

• Throughout the entire reading period, I make an effort to make mental notes of what may require additional attention and what may not. Because I don't want to spend time taking physical notes, kindly notice that I am using the term "mental" here. It is much simpler to recall. You may think that this is more significant than typing or writing “Pay attention to X.”

• I move on quickly. This is something I considered crucial because, when trying to skim, it is simple to start reading the entire thing.

3. Complete reading

Previous steps pay off.

• I finished reading the chapter.

• I concentrate on the passages that I mentally underlined when skimming.

• I put the book away and make my own notes. It is typically more difficult than it seems for me. But it's important to speak in your own words. You must choose the right words to adequately summarize what you have read. How do those words make you feel? Additionally, you must be able to summarize your notes while you are taking them. Sometimes as I'm writing my notes, I realize I have no words to convey what I'm thinking or, even worse, I start to doubt what I'm writing down. This is a good indication that I haven't internalized that idea thoroughly enough.

• I jot my inquiries down. Normally, I read on while compiling my questions in the hopes that I will learn the answers as I read. I'll explore those issues more if I wasn't able to find the answers to my inquiries while reading the book.

Bonus!

Best part: If you take lovely notes like I do, you can publish them as a blog post with a few tweaks.

Conclusion

This is my learning journey. I wanted to show you. This post may help someone with a similar learning style. You can alter the principles above for any technical material.

The company's epidemic gains are gone.

Mark Zuckerberg was in line behind Jeff Bezos and Bill Gates less than two years ago. His wealth soared to $142 billion. Facebook's shares reached $382 in September 2021.

What comes next is either the start of something truly innovative or the beginning of an epic rise and fall story.

In order to start over (and avoid Facebook's PR issues), he renamed the firm Meta. Along with the new logo, he announced a turn into unexplored territory, the Metaverse, as the next chapter for the internet after mobile. Or, Zuckerberg believed Facebook's death was near, so he decided to build a bigger, better, cooler ship. Then we saw his vision (read: dystopian nightmare) in a polished demo that showed Zuckerberg in a luxury home and on a spaceship with aliens. Initially, it looked entertaining. A problem was obvious, though. He might claim this was the future and show us using the Metaverse for business, play, and more, but when I took off my headset, I'd realize none of it was genuine.

The stock price is almost as low as January 2019, when Facebook was dealing with the aftermath of the Cambridge Analytica crisis.

Irony surrounded the technology's aim. Zuckerberg says the Metaverse connects people. Despite some potential uses, this is another step away from physical touch with people. Metaverse worlds can cause melancholy, addiction, and mental illness. But forget all the cool stuff you can't afford. (It may be too expensive online, too.)

Metaverse activity slowed for a while. In early February 2022, we got an earnings call update. Not good. Reality Labs lost $10 billion on Oculus and Zuckerberg's Metaverse. Zuckerberg expects losses to rise. Meta's value dropped 20% in 11 minutes after markets closed.

It was a sign of things to come.

The corporation has failed to create interest in Metaverse, and there is evidence the public has lost interest. Meta still relies on Facebook's ad revenue machine, which is also struggling. In July, the company announced a decrease in revenue and missed practically all its forecasts, ending a decade of exceptional growth and relentless revenue. They blamed a dismal advertising demand climate, and Apple's monitoring changes smashed Meta's ad model. Throw in whistleblowers, leaked data revealing the firm knows Instagram negatively affects teens' mental health, the current Capital Hill probe, and the fact TikTok is eating its breakfast, lunch, and dinner, and 2022 might be the corporation's worst year ever.

After a rocky start, tech saw unprecedented growth during the pandemic. It was a tech bubble and then some.

The gains reversed after the dust settled and stock markets adjusted. Meta's year-to-date decline is 60%. Apple Inc is down 14%, Amazon is down 26%, and Alphabet Inc is down 29%. At the time of writing, Facebook's stock price is almost as low as January 2019, when the Cambridge Analytica scandal broke. Zuckerberg owns 350 million Meta shares. This drop costs him $71 billion.

The company's problems are growing, and solutions won't be easy.

• Facebook's period of unabated expansion and exorbitant ad revenue is ended, and the company's impact is dwindling as it continues to be the program that only your parents use. Because of the decreased ad spending and stagnant user growth, Zuckerberg will have less time to create his vision for the Metaverse because of the declining stock value and decreasing ad spending.

• Instagram is progressively dying in its attempt to resemble TikTok, alienating its user base and further driving users away from Meta-products.

• And now that the corporation has shifted its focus to the Metaverse, it is clear that, in its eagerness to improve its image, it fired the launch gun too early. You're fighting a lost battle when you announce an idea and then claim it won't happen for 10-15 years. When the idea is still years away from becoming a reality, the public is already starting to lose interest.

So, as I questioned earlier, is it the beginning of a technological revolution that will take this firm to stratospheric growth and success, or are we witnessing the end of Meta and Zuckerberg himself?

I'm gadget-obsessed. So I shared my top 6 desk gadgets.

These gadgets improve my workflow and are handy for working from home.

Without further ado...

Computer light bar Xiaomi Mi

I've previously recommended the Xiaomi Mi Light Bar, and I still do. It's stylish and convenient.

The Mi bar is a monitor-mounted desk lamp. The lamp's hue and brightness can be changed with a stylish wireless remote.

Changeable hue and brightness make it ideal for late-night work.

Desk Mat 2.

I wasn't planning to include a desk surface in this article, but I find it improves computer use.

The mouse feels smoother and is a better palm rest than wood or glass.

I'm currently using the overkill Razer Goliathus Extended Chroma RGB Gaming Surface, but I like RGB.

Using a desk surface or mat makes computer use more comfortable, and it's not expensive.

Third, the Logitech MX Master 3 Mouse

The Logitech MX Master 3 or any from the MX Master series is my favorite mouse.

The side scroll wheel on these mice is a feature I've never seen on another mouse.

Side scroll wheels are great for spreadsheets and video editing. It would be hard for me to switch from my Logitech MX Master 3 to another mouse. Only gaming is off-limits.

Google Nest 4.

Without a smart assistant, my desk is useless. I'm currently using the second-generation Google Nest Hub, but I've also used the Amazon Echo Dot, Echo Spot, and Apple HomePod Mini.

As a Pixel 6 Pro user, the Nest Hub works best with my phone.

My Nest Hub plays news, music, and calendar events. It also lets me control lights and switches with my smartphone. It plays YouTube videos.

Google Pixel Stand, No. 5

A wireless charger on my desk is convenient for charging my phone and other devices while I work. My desk has two wireless chargers. I have a Satechi aluminum fast charger and a second-generation Google Pixel Stand.

If I need to charge my phone and earbuds simultaneously, I use two wireless chargers. Satechi chargers are well-made and fast. Micro-USB is my only complaint.

The Pixel Stand converts compatible devices into a smart display for adjusting charging speeds and controlling other smart devices. My Pixel 6 Pro charges quickly. Here's my video review.

6. Anker Power Bank

Anker's 65W charger is my final recommendation. This online find was a must-have. This can charge my laptop and several non-wireless devices, perfect for any techie!

The charger has two USB-A ports and two USB-C ports, one with 45W and the other with 20W, so it can charge my iPad Pro and Pixel 6 Pro simultaneously.

Summary

These are some of my favorite office gadgets. My kit page has an updated list.

Links to the products mentioned in this article are in the appropriate sections. These are affiliate links.

You're up! Share the one desk gadget you can't live without and why.