Tag: Drones

Health Care in Abundance

Mar 11, 2025

By KIM BELLARD

A recent report from Moody’s Analytics, by chief economist Mark Zandi, had an eye-opening fact: the top 10% of earners in the U.S. – those who make $250,000 or more – now account for just shy (49.7%) of half of consumer spending. If that strikes you as unusual, you’re right. It is a record since at least 1989. Thirty years ago the comparable percentage was 36%.

“The finances of the well-to-do have never been better, their spending never stronger and the economy never more dependent on that group,” wrote Dr. Zandi. He added: “Wealthier households are financially more secure and thus more able and willing to spend their income. That is, they save less than they would otherwise.”

The rest of us are struggling to hold our own against inflation, not always successfully. It’s why companies like Costco and Walmart are trying to target upscale shoppers, while “value” oriented firms like Big Lots, Family Dollar, or Kohl’s are closing stores or even declaring bankruptcy.

This extreme bifurcation, of course, made me think of healthcare, where – as is famously known – half of all spending is attributable to only 5% of patients. In case you’d forgotten, in healthcare, half the population accounts for 97% of all spending, so the other half accounts for a measly 3%.

Now, you might say, neither of those is surprising: rich people spend more, and sicker people cost more. But somehow neither of those seems right to me.

I started thinking more about this after reading a recent New York Times op-ed from Ezra Klein. In it he makes the following assertion:

The answer to a politics ofscarcity is a politics of abundance, a politics that asks what it is that people really need and then organizes government to make sure there is enough of it.

Mr. Klein didn’t coin the phrase “politics of abundance,” but he and Derek Thompson did just write a book on the topic (Abundance) that discusses their thoughts at more length. I have not read the book, but I saw a quote from it that I quite liked: “What is scarce that should be abundant? What is hard to build that should be easy?”

And so we’re back to healthcare.

We seem to live in a country where healthcare is too scarce. A new analysis suggests that we have a looming shortage of hospital beds, and if you live in a rural area, it’s already here. If you believe the Association of American Medical Colleges, we have a looming physician shortage, and if you’re looking for primary care, it’s already here. We’re facing nursing storages, pharmacist shortages, nursing home worker shortages, home health worker shortages, to name a few. We even have shortages of many critical prescriptions, including some needed for cancer treatments.

Despite all these shortages or would-be shortages, of course, we manage to spend way more than other countries on healthcare. One can only imagine how much we might be spending if there were no shortages. I take that back: I’m not sure I can imagine.

In the category of things that are scarce that should be abundant, and/or things that are hard to build that should be easy, I’d probably put housing at the top but healthcare as a close second. The trouble is, when we pour more money into healthcare, as we are wont to do, we don’t seem to fill any of our many shortages, much less improve the quality of care or outcomes.

War — and Health Care — on the Cheap

Sep 26, 2023

By KIM BELLARD

Like many of you, I’m watching the war in Ukraine with great interest and much support. For all the fuss about expensive weapons — like F-16 fighters, Abrams tanks, Stryker and Bradley armored fighting vehicles, Patriot missile defense systems, Javelin anti-tank missiles, Himars long range missiles, and various types of high tech drones — what I’m most fascinated with is how Ukraine is using inexpensive, practically homemade drones as a key weapon.

It’s a new way of waging war. And when I say “waging war,” I can’t help but also think “providing health care.” It’s not so much that I think drones are going to revamp health care, but if very expensive weapons may, in fact, not be the future of warfare, maybe very expensive treatments aren’t necessarily the future of healthcare either.

Just within the last two weeks, for example, The New York Times headlined Budget Drones Prove Their Value in a Billion-Dollar War, AP said Using duct tape and bombs, Ukraine’s drone pilots wage war with low-cost, improvised weapons, ABC News reports: Inside Ukraine’s efforts to bring an ‘army of drones’ to war against Russia, and Defense News describes how Cardboard drone vendor retools software based on Ukraine war hacks.

This is not the U.S. military-industrial complex’s “shock-and-awe” kind of warfare; this is the guy-in-his-garage-building-his-own-weapons kind of warfare.

Ukraine’s minister for digital transformation, Mykhailo Federov, says the government is committed to building a state-of-the-art “army of drones.” He promises: “A new stage of the war will soon begin.”

NYT detailed:

Drones made of plastic foam or plastic are harder to find on radar, reconnaissance teams said. Ukraine buys them from commercial suppliers who also sell to aerial photographers or hobbyists around the world, along with parts such as radios, cameras, antennas and motors. The drone units mix and match parts until they find combinations that can fly past sophisticated Russian air defenses.

“The doctrine of war is changing,” one Ukrainian commander said. “Drones that cost hundreds of dollars are destroying machines costing millions of dollars.” The AP discusses how an elite drone unit – “a ragtag group of engineers, corporate managers and filmmakers” — “assembled with just $700,000, has destroyed $80 million worth of enemy equipment.”

Amazon Shows the Way on Wellness — Treat People like Adults

Apr 16, 2014• 31

By VIK KHANNA and AL LEWIS

Since 2000, the government and healthcare industry have sold Americans a bill of goods called workplace wellness, which turns out to have been a colossal waste of billions of dollars.

Most of this money was spent bribing employees to do things that they don’t want to do, such as submit to biometrics, answer intrusive health risk appraisals, and get preventive medical care.

The marketing pitch that wellness makes people healthier and lowers medical care costs, and thus, produces a return on investment for the employer, isn’t true. Wellness also allowed companies to position themselves as employee-friendly, even while wages stagnated and employees morphed into fungible widgets, instead of vital assets in whom employers invested for years or decades.

However, it looks to us as though at least one major US company is treating economic reality seriously, and, consequently, asking its employees to act like adults.

Let’s look at wellness by Amazon.com, which has apparently avoided conventional wellness whole cloth. Despite our best research efforts, we find no evidence that the company makes conventional wellness programming a priority for employees.

It’s a bit ironic that they don’t given the recent spate of tough publicity about the company’s employment practices.

Amazon has been lambasted lately for the plight of the warehouse workers who animate its backroom operation, where constant video surveillance, productivity demands, and getting your bag searched before you go home are the norms. Message boards also detail the pressure-cooker atmosphere of the company’s white collar space, which raises, in our minds, the pointed question of why haven’t they done wellness?

We think it’s because Amazon’s philosophy about work is straightforward: if you work here, expectations are high and relentless. Amazon’s approach to employee well-being seems to be to not have one other than we invite you to grow with us. This is counter-cultural, and it has more to recommend it than first appears obvious.

When you are competing against Walmart and Target, remaining lean and low-cost is critical; wellness drives costs up, not down.

Expecting many staff to work 50, 60, or even 70 hours per week leaves little time for discretionary visits to the doctor that are pointless even before they happen because this superfluous care will save neither lives nor money. When you are not pouring money into coercing employees to join a wellness program, you preserve capital needed to optimize the technologies and product mix that help you grab market share and crush competitors like Best Buy.