After our Christmas break THCB Gang is back! Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be THCB regular writer Kim Bellard (@kimbbellard); fierce patient activist Casey Quinlan (@MightyCasey); futurist Ian Morrison (@seccurve) & patient safety expert and all around wit Michael Millenson (@MLMillenson)
This is the last THCB Gang of what has been a long, grueling, but enthralling year. And every week (well almost every week) we have had a group from across the health care luminescence to discuss it.
Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be THCB regular writer Kim Bellard (@kimbbellard); delivery & tech expert Vince Kuraitis (@VinceKuraitis); privacy expert and entrepreneur Deven McGraw (@HealthPrivacy); WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa); and three occasional gang members making very welcome appearances–venture investor & soccer mogul Marcus Whitney (@marcuswhitney); surgeon & startup guy Raj Aggarwal (@docaggarwal); and health economist Jane Sarasohn-Kahn (@healthythinker).
And towards the end of the show we should have our now traditional (or 2nd time) visit from as many other gang members who can make it!
By KIM BELLARD
I recently watched some of the recent Congressional hearings on cryptocurrency, and, boy, if there’s anything funnier than watching experts try to educate most members of Congress on anything crypto-related, it’s probably me trying to explain it. I don’t own any digital assets, still don’t see the point of NFTs, and am not going to buy any real estate in the metaverse.
All that being said, there’s something about Web3 that fascinates me. Knowledgeable people are talking about Web3 “reinventing the internet,” “democratizing” it, giving people more ownership of/control over what they do on it. It’s a counterbalance to how the internet – both the traffic and the infrastructure — has grown increasingly dominated by a few very large firms, such as Google, Facebook, or Amazon.
As the Web3 Foundation declares, Web3 is an internet where:
- Users own their own data, not corporations
- Global digital transactions are secure
- Online exchanges of information and value are decentralized
All that sounds very intriguing to me, especially as someone who has dim views of how healthcare likes to silo information, has placed too little value on patient ownership of their own data, and is rushing to centralize.Continue reading…
By KIM BELLARD
I’ve finally come to understand why the U.S. healthcare system continues to be such a mess, and I have President Dwight Eisenhower to thank.
I’ve been paying close attention to our healthcare system for, I hate to admit, over forty years now. It has been a source of constant frustration and amazement that – year after year, crisis after crisis – our healthcare system doesn’t get “fixed.” Yes, we make some improvements, like ACA, but mostly it continues to muddle along.
Then I learned about President Eisenhower’s approach to problems:
That’s it! All these smart people, all these years; they didn’t know how to solve the problem that is our healthcare system, so they all took the Eisenhower approach: enlarge the problem. Let our healthcare system get so bad that not addressing it no longer is possible.
If, indeed, there is such a point.
The actual Eisenhower quote is more nuanced than the above version. It was:
Whenever I run into a problem I can’t solve, I always make it bigger. I can never solve it by trying to make it smaller, but if I make it big enough, I can begin to see the outlines of a solution.
I guess we’re not yet at the point when the outlines of a solution are clear (Bernie Sanders notwithstanding).
Instead, we’ve been chipping away at the problem, trying to make it smaller. For example:
- Employer-sponsored health insurance tax preference (WWII)
- Hill-Burton Act (1946)
- Medicare/Medicaid (1965)
- Federal HMO Act (1973)
- Stark Physician Self-Referral Law (1989)
- DGRs (1983) & RBRVS (1992)
- CHIP (1997)
- Medicare Modernization Act (2003)
- Affordable Care Act (2010)
Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond were Queen of all employer benefits Jennifer Benz (@Jenbenz); THCB regular writer Kim Bellard (@kimbbellard); futurist Ian Morrison (@seccurve) and two investor guests — Super smart AI doc from GSR Ventures (@GSRVentures) Sunny Kumar; and the “I make unicorns” King Bill Taranto from Merck GHIF (@BillTaranto).
We got some forecasts and some reviews of the money and the movers in health care this past year, and looked at the world of employment inside and outside of healthcare, RPM and the public vs private financial markets.
By KIM BELLARD
Did you know we are living in the Zettabyte Era? Honestly, did you even know what a zettabyte is? Kilobytes, gigabytes, maybe even terabytes, sure, but zettabytes? Well, if you ran data centers you’d know, and you’d care because demand for data storage is skyrocketing (all those TikTok videos and Netflix shows add up). Believe it or not, pretty much all of that data is still stored on magnetic tapes, which have served us well for the past sixty some years but at some point, there won’t be enough tapes or enough places to store them to keep up with the data storage needs.
That’s why people are so keen on DNA storage – including me.
A zettabyte, for the record, is one sextillion bytes. A kilobyte is 1000 bytes; a zettabyte is 10007. Between gigabytes and zettabytes, by powers of 1000, come terabytes, petabytes, and exabytes; after zettabyte comes yottabytes. Back in 2016, Cisco announced we were in the Zettabyte Era, with global internet traffic reaching 1.2 zettabytes. We’ll be in the Yottabyte Era before the decade is out.Continue reading…
By KIM BELLARD
America, like most cultures, claims to love and value children, but, gosh, the reality sure seems very different. Three recent reports help illustrate this: The Pew Research Center’s report on the expectation of having children, Claire Suddath’s searing look at the childcare industry on Bloomberg, and a UNICEF survey about how young people, and their elders, view the future.
It’s hard to say which is more depressing.
Pew found that the percentage of non-parents under 50 who expect to have children jumped from 37% in 2018 to 44% in 2021. Current parents who don’t expect to have more children edged up slightly (71% to 74%). The main reason given by childless adults for not wanting children was simply not wanting children, cited by 56% of those not wanting children. Among those who gave a reason, medical and financial reasons were cited most often. Current parents were even more likely – 63% – to simply say they just didn’t want more.
This shouldn’t come as a huge surprise. Earlier this year the Census Bureau reported that the birthrate in America dropped for the sixth consecutive year, the largest percentage one year drop since 1965 and the lowest absolute number of babies since 1979. It’d be easy to blame this on the pandemic, but, as sociologist Phillip N. Cohen told The Washington Post: “It’s a shock but not a change in direction.”
In many ways, having children seems like ignoring everything that’s going on. We have a climate change/global warming crisis that threatens to wreak havoc on human societies, we’re still in the middle of a global pandemic, and our political/cultural climate seems even more volatile than the actual climate. One Gen Xer told The New York Times: “As I think of it, having a child is like rolling dice with the child’s life in an increasingly uncertain world.”
By KIM BELLARD
Last week General Electric announced it was breaking itself up. GE is an American icon, part of America’s industrial landscape for the last 129 years, but the 21st century has not been kind to it. The breakup didn’t come as a complete surprise. Then later in the week Johnson and Johnson, another longtime American icon, also announced it would split itself up, and I thought, well, that’s interesting. When on the same day Toshiba said it was splitting itself up, I thought, hmm, I may have to write about this.
Healthcare is still in the consolidation phase, but there may be some lessons here for it.
For most of its existence, GE was an acquirer, gobbling up companies with the belief that its vaunted management structure could provide value no matter what the industry. This was most famously true in the Jack Welch days, but since those days it has been gradually shrinking itself, spinning off some of its more problematic divisions, like appliances, locomotives, and much of its once-huge financial services business. It will spin off its healthcare business in early 2023 and its renewable energy and power business in early 2024; its aviation business will keep the GE name.
“A healthcare investor wants to invest in healthcare,” CEO Larry Culp explained. “We know we are under-owned in each of those three sectors, in part because of our structure.”Continue reading…
By KIM BELLARD
Shira Ovide, who writes the On Tech newsletter for The New York Times, had a thoughtful column last week: Tech Can’t Fix the Problem of Cars. It was, she said, inspired by Peter Norton’s Autonorama: The Illusionary Promise of High Tech Driving. The premise of both, in case the titles didn’t already give it away, is that throwing more tech into our cars is not going to address the underlying issues that cars pose.
It made me think of healthcare.
What’s been going on in the automotive world in the past decade has truly been amazing. Our cars have become mobile screens, with big dashboard touchscreen displays, Bluetooth, and streaming. Electric cars have gone from an expensive pipedream to an agreed-upon future, with Tesla valued at over a trillion dollars, despite never having sold a half-million cars annually before 2021.
If we don’t feel like driving, we can use our smartphones to call an Uber or Lyft. Or we can use the various autonomous features already available on many cars, with an expectation that fully self-driving vehicles are right around the corner. Soon, it seems, we’ll have non-polluting, self-driving vehicles on call: fewer deaths/injuries, less pollution, not as many vehicles sitting around idly most of the day. Utopia, right?Continue reading…
By KIM BELLARD
General Mark A. Milley, chairman of the Joint Chiefs of Staff, recently expressed grave concern about China’s reported test of a hypersonic missile: “I don’t know if it’s quite a Sputnik moment, but I think it’s very close to that. It has all of our attention.” Maybe it should be, but General Milley may have missed the real 21st-century version of a Sputnik moment: China has claimed huge breakthroughs in quantum computing.
It’s inside baseball to those of us who are neither computer experts nor quantum physicists, but let’s put it this way: the countries/companies that dominate quantum computing will dominate, full stop. Healthcare included.
I won’t pretend to understand quantum computers or try to explain how they work, but they’re to “traditional” computers as those computers are to, say, a calculator, or to an abacus. They’re much faster – like a quantum leap faster – and can quickly do computations that would take even traditional supercomputers centuries to complete, if ever. For example, think you’ve got an unbreakable code? Unless you’ve got the fastest quantum computer, think again.Continue reading…