Author Archives: auren

Davosman for Dummies (for 2019 season)

Thought conferences (like Davos) are super expensive and take a lot of time. To save you the price of going, below is the content for 100% of all thought conferences.

All you need to do is read this and you can skip all the conferences for the last decade.

If you do go, feel free to use this handy guide to play BINGO.

UNIVERSAL THOUGHT-CONFERENCE AGENDA:

Universal Basic Income (UBI)

another agenda item on UBI

Trump

Self driving cars

Income inequality

UBI again. did we mention how much we love UBI?

M-Pesa

USMCA

Tarriffs

Artificial Intelligence

Marsh Mellow test

UBI for those who failed the Marsh Mellow test

Bitcoin

UBI for those who failed to buy crypto before 2017

UBI for those who bought crypto in December 2017

Who will be the Democratic Party nominee in 2020?

UBI for those who fail to be the Democratic nominee

“Modafinil is much more effective than Adderall”

Solar energy

Putin

Metformin

yet another one on AI

UBI because AI will take all the jobs

“The Turkish Air lounge in Ataturk Airport is THE BEST!”

MBS

Meditation

Self driving ELECTRIC cars

Self driving ELECTRIC drones

“Where do you summer: The Hamptons, Saint-Tropez, Aspen, or Martha’s Vineyard?”

China

China and self-driving cars

Singapore and self-driving cars

“I pay my three nannies under-the-table to avoid taxes”

Turkish Lira

Brexit

Opioid crisis

GDPR

Micro-dosing

“I’ll have the gluten-free wine”

Synthetic meat

Crypto

Growth mindset

“We are living in a simulation”

Two and twenty

Grit

Charter schools

“See you in Dubai”

Trump

note: this was originally published in Medium in 2018

Five Links for reading (Dec 2018 edition) – subscribe now

About ten times a year, I send an email to 35k+ people on five things to read. Below is the email from December 2018 (the Jan 2019 will come shortly). If you like these, subscribe to Five Links.

here are five links worth reading/viewing (this month we are focused on health care) … 

A Billionaire Pledges to Fight High Drug Prices, and the Industry Is Rattled by Peter Loftus
Five Links reader John Arnold has put $100 million behind efforts to curb drug prices.

Health care prices do not play the role most people believe by Random Critical Analysis
Interesting paper that suggests the problem in U.S. healthcare is the demand for services, not the expensive prices. (HT Alex Danco)

Melatonin: Much More than You Wanted to Know by Scott Alexander
As you know, an article from Slate Star Codex is almost mandatory in Five Links. 

Why Doctors Hate Their Computers by Atul Gawande
Like all Atul Gawande writings, this is incredibly insightful.  But like all Atul Gawande writings, this is also 3 times as long as it needs to be (so caution). 

Decline of cancer and heart disease (tweetstorm) by Aaron Mitchell
More and more, the most interesting “articles” are being published as tweetstorms. This is one of them.  (HT Matt Clifford)

Note: after reading 50+ articles (+1 book) on healthcare In November… my take-aways:
+ there is no 80/20 rule to fix U.S. healthcare.
+ there are a series of fixes that each improve the healthcare system by 2-5%.
+ so fixing U.S. healthcare is going to be really hard because no one thing will have a big effect.

In addition — Some books I read since the last Five Links:

Health Care Handbook by Elisabeth Askin and Nathan Moore
(HT Travis May)

How to Raise an Adult by Julie Lythcott-Haims  
(HT Brian Davis)

God is in the Crowd by Tal Keinan
(Tal is a Five Links reader)

Inspired: How to Create Tech Products Customers Love by Marty Cagan
(HT Lauren Spiegel)

the U.S. Healthcare system: it is complicated, nothing is as it seems, and there are no silver bullets

I spent the moth of November (2018) diving into the U.S. healthcare system. I read over 50 long-form articles, played with a bunch of Medicare datasets, and read one book. Below are a few random thoughts from my learnings.

There is no 80/20 rule
We all know U.S. healthcare is messed up. Compared to other countries … the outcomes are not superior and the costs are higher. And no one thinks the experience is a lot of fun.

Going into my deep dive, I thought I would come away with one big thing we could do to fix healthcare. To my surprise and disappointment, I did not see any silver bullets (even ones that could never pass Congress).

Instead healthcare needs hundreds of very small improvements
There are hundreds of important things we can do to improve U.S. healthcare … but no one thing will likely have more than 5% improvement. Which means this is going to be a really hard problem to solve. Really hard.

Does the U.S. spend too much money?
On the one hand, of course it does. We spend roughly double per capita on healthcare than the next leading country (without better outcomes). On the other hand, we spend more per capita on almost everything. We live in way bigger houses, we have bigger yards, we drive bigger cars. We also spend WAY more than 2x per capita on higher education.

So if you look at the ration of healthcare/higher-education (I know this is a weird ratio, but stay with me), we are the lower spending G20 country (by a wide margin).

So do we spend too much on healthcare? The answer is still yes but it is not nearly as bad as people think.

U.S. consumers significantly subsidize European consumers
One of the most interesting things I learned about is the wealth transfer from the U.S. to other very wealthy countries. Many countries pay dramatically lower for the same drugs than the average U.S. price. That’s because these countries negotiate as one market … but also because the marginal price of a drug is essentially zero so the drug companies have a prisoner’s dilemma game to play with the countries and often make the calculation that some money is better than no money.

A simple solution to this (from the U.S. perspective) would be to create a law that drug prices to U.S. government buyers (like Medicare, Medicare, Veterans, Military, etc.) must not be higher than any price to any first world country (it would still be ok to sell drugs for low prices to poor countries in Africa … but not to rich countries in Western Europe). That means that the U.S. government would never pay a higher price for a drug than the market price. It would also mean that prices for drugs would be standardized since all other first world countries would follow suit and create the same rule. That shift would result in U.S. drug prices falling and European drug prices rising — ended the billions of dollars that the U.S. is currently transferring to Europe.

Summation: a month of deep dive, I know less than I did when I started the journey. Healthcare is complicated. Nothing is as it seems. People in it are really smart but also generally really conflicted.

Note: I had dozens of tutors but I want to especially thank Travis May (CEO of Datavant) and Joel Quadracci (CEO of Quad Graphics) for their guidance.

the experts are (usually) wrong – so dial down your trust meter

The experts are wrong a lot. If there is not a clear truth, the experts are usually wrong more than 50% of the time.

Experts (those who predict the future for a living) are, more often than not, dart-throwers. They usually perform no better than chance. And recently they have performed even worse than chance.

“Economists have predicted nine of the last five recessions.”

Most experts are biased by their experiences. In fact, the most dangerous person is one who says they are unbiased. “I am just using facts, not opinions, for this prediction” is almost always wrong.

We are ALL biased. We see the world through a very hazy prism of our experiences.

There is no unbiased news outlet. Even “real news” has lots of untruth to it. Almost every news story I had intimate knowledge of made a significant reporting mistake or factual error in the story.

We’re human and we make mistakes. We’re human and we see the world with our strong bias. We overweight certain sources and underweight others. We discount data that is very good and we rely on data that is wrong. We see patterns when there are none and see coincidences when there are conspiracies.

The “expert” can be dangerous.

We live in a world where people spend a lot of time building their bona fides so they can make their living off their “expertise.” Most of the top 1% of earners make their living predicting the future. But because people come with huge biases, their predictions can often be very, very wrong.

In even the most noble professions (like medicine), people have huge biases. Study after study finds top surgeons recommending treatments that they specialize in … even when the problem may be better served from another procedure. That’s because for most of us, every hammer is a nail.

Sacred cows tend to not be that sacred.

Experts tend to talk to other experts and can get sucked into a dangerous groupthink. Once all experts agree on something, even when it is highly speculative, it can become calcified.

Experts often say “that cannot be done” like it is a rule of the universe. But instead of a low of gravity, it is more akin to a custom (like setting fork on a left side of the plate).

We see groupthink happen most often is the softer sciences like political science, sociology, foreign policy, and economics. The more specialized the field, the more people find themselves talking to each other … and the more they will be prone to repeat one another.

While it is harder to happen in hard science, we see it happen there too. Wrong ideas are clung on to too long because it is hard to change one’s mind about the world. Max Planck famously said “Science advances one funeral at a time.”

None of this means experts are trying to be sinister. Yes, sometimes people are on the payroll of an interest (for instance, many people who campaign against oil pipelines are indirectly funded by the railroad companies or the Russian government), but that is not usually the case. Biases control people’s thoughts much more than money.

Protect yourself from experts through contrarian thinking

“Conventional Wisdom” is often very conventional thinking.

Before accepting opinions as truth, think through the issues yourself. Don’t just look for agendas but look for biases. If a surgeon recommends a specific procedure that only her hospital does, seek out other opinions.

Seek out outcasts. Seek out non-expert experts who often challenge the status quo. Some that I would recommend are: Peter Thiel, Naval Ravikant, Nassim Taleb, Paul Graham, Judith Rich Harris, John Hempton, Charlie Songhurst, Tyler Cowen, Sam Altman, Jonathan Haidt, and Slate Star Codex. I’d even throw in some more mainstream thinkers like Malcolm Gladwell, Susan Athey, Daniel Kahneman, Richard Feynman, Tim Ferriss, Daniel Yergin, Robert Cialdini, Oliver Sacks, Elie Wiesel, Robert Caro, and Charlie Munger because people like them will always make you think.

Of course, experts can be right. They often are.

You don’t have time to question everything in this world — you might turn into the Unabomber if you did.

For instance, even if you cannot prove the earth is round, it is not a good idea to think the world is flat. It is likely that the government did not fake the moon landing. And when you were born, you probably were not delivered by stork.

The 40-year life lesson: experts are (very often) wrong

Just because someone knows much more about you about a particular subject, do not assume there are correct. Do not bestow authority on them just because they are wearing a lab coat or possess a PhD.

Summation: just because someone has spent more time learning about something, it does not mean that they are a closer to the truth than you.

This is expanded from my 2017 post on Quora.

some totally random Rules for Life (2019)

ABC: Always Be Charging
Whenever you have a chance to charge your devices (phone, laptop, etc), always do it. You never know when you will lack access to reliable power.

Always Be Reading Long-form
Read at least 7 hours a week of long-form. Read books. But also read well-written articles longer than 3 pages. Save time to go down reading rabbit holes. Feel free to cut out short-form reading (like clickbait articles) to make time for long-form. The airplane is a fantastic place to read.

Always Go to the Bathroom
Whenever you have a chance to go to the bathroom, take it. Never “hold it in.” Just makes you very uncomfortable and unproductive.

Always Be Listening Long-Form
We are in a podcast revolution — take advantage of it. You also can get many books (but unfortunately only 20% of good books) on audio.

Always Love Email
Email is the best form of communication ever invented. All new communications methods in the last 20 years are inferior to email. Email is the greatest asynchronous communication tool. For synchronous communication: meet in-person, by live video, or talk on the phone. Slack and Facebook Messenger can be productivity killers.

Always be Writing
Try to write something over 500 words a few times per week … even if the only person who reads it is yourself. This will help you collect your thoughts.

Sometimes Change your Mind
At least once a year, challenge yourself to change your mind about a deeply held belief (business, family, political, societal, etc.).

self-driving cars will cause the Rich to Get Even RICHER

When self-driving cars come (and I’m skeptical they will come in mass in the next 20 years … but that is for another post), everyone’s commute will be much faster. That is because cars will be able to coordinate with each other and rarely need to go below 80 miles/hour on highways (even during the busiest of times).

But once self-driving cars happen, the next thing is to allow cars to pay up to go EVEN faster. There is no reason a car can’t go 160 miles per hour and get you there in half the time.

Cars that don’t pay up for the privilege will be forced to yield to cars that do. Essentially expect to see surge pricing to get to places faster.

Would you pay an extra $100 to get from San Francisco to Los Angeles in 100 minutes by car? An extra $300?

Note: I’ve been thinking a LOT about transportation recently because of all the transportation-related companies that use SafeGraph Places.

Summation: while self-driving cars will be good for everyone, they will be GREAT for people with lots of money (especially in capitalist societies like the U.S. and China).

Waymo self-driving car

Shorter deadlines for offers lead to better employees

Deadlines for offers should be extremely short. Ideally they are under 36 hours. There is even a good argument for deadlines to be under 20 minutes (as long as the employee knows it is coming).

Beside the obvious criteria for a great employee (smart, gets things done, etc), the number one (less obvious) criteria is that they REALLY want to work at your company. They will be so much more effective if they really want to work for you.

They need to have a REAL attraction to your company. Maybe is is because of the company’s mission. Maybe is is because of the culture. Maybe it is because of the people (or their direct supervisor). Maybe it is because of the technology. Maybe it is to get rich. … there could be MANY reasons … but that reason has to equal a genuine excitement to join your company that is beyond the rational pros and cons.

This is why you should give offers with a really short deadline. If someone needs a lot of time to make a decision whether to join your company or not, they probably are not super excited about your company. They still could pick your company and be a solid contributor … but my experience is that they rarely turn out to be amazing.

The a phrase in romance “he’s just not into you” applies in recruiting as well. You want people that want you. If a candidate, after the hours and hours of interviews, projects, reference checks, etc. still needs more time to decide to join your company or not, you should move on.

Summation: to most optimize for a 10Xer, keep deadlines for offers short.

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