Is there enough skin-in-the-game within healthcare?

Primary care gets a fresh set of eyes (Amazon's). Re-visit Taleb's take on why surgeons shouldn't look like surgeons. Meet a guy who so obsessed with anti-aging, he's spending $2 million a year on 30 doctors turning back the clock (or trying to).

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Welcome to the March 12 edition of The Digest.

Amazon buys One Medical; but can they really change things?

Is primary care solvable? With Amazon's budget and recent purchase of One Medical, Amazon is certainly attempting it.

They might care because it could lead to lower costs for employers in the future that self-fund insurance packages for employees. Can Amazon's purchase of One Medical make real changes to primary care for certain populations? Maybe?"

Reams of evidence show that good primary care is associated with improved health and lower costs" but primary care remains one of the lowest paying fields in medicine. Is the problem one based on supply or demand?

As the author ends, "Amazon might think it can fix anything with enough money, technology and logistics, but Amazon Care didn’t have a hope of untangling this mess. Against most companies that sell products in America, Amazon is a Goliath. Put it up against the problems of the American health care system, and it looks like David with a slingshot made of wet spaghetti." Link

Skin-in-the-Game: Perception trumps Reality (but should it?)

Is it one's ability to sell or one's existing results that matter? Most likely, you're inclined to say...selling? But why is that? And should we work harder to reward results instead of perception?

As Taleb wrote in Skin in the Game, "Simply the one who doesn’t look the part, conditional of having made a (sort of) successful career in his profesión, had to have much to overcome in terms of perception. And if we are lucky enough to have people who do not look the part, it is thanks to the presence of some skin in the game, the contact with reality that filters out incompetencia, as reality is blind to looks.When los resultados come from dealing directly with reality rather than through the agency of commentators, image matters less, even if it correlates to skills.

"We know that image matters. Everyone is constantly in a state of judgement, especially when making decisions. But does that mean we shouldn't strive for assessing results over the presentation? LInk

Extreme Anti-Aging

Ok, too much skin in the game? Seriously, this is wild for us.

This year, [Johnson is] on track to spend at least $2 million on his body. He wants to have the brain, heart, lungs, liver, kidneys, tendons, teeth, skin, hair, bladder, penis and rectum of an 18-year-old...“The body delivers a certain configuration at age 18,” he says. “This really is an impassioned approach to achieve age 18 everywhere.” Johnson is well aware that this can sound like derangement and that his methods might strike some as biotech-infused snake oil, but he doesn’t much care. “This is expected and fine,” he says of the criticism he’s received. Link