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Trump: How bad for tech? The a16z podcast recently tackled the question of whether or not a President Trump is good or bad for technology. The balanced panel of commentators seem to generally agree that Trump would have little effect on technology since most support for innovation happens at the state and local level. The Republican panelist argued that deregulation and lower taxes would actually benefit tech. The counter-arguments from the Democratic side talked about immigration and net neutrality. Fintech would seem to benefit from looser regulations. But healthcare technology, specifically diagnostic technology may be damaged when the ACA disappears and pre-existing conditions become a reason for denying coverage. Why does this matter? I think the panelists are confusing two distinct issues. There are technology companies which, by and large, will benefit by paying fewer taxes and not having to follow regulations. Then there is the culture of innovation which was turbo-charged under Obama, an intellectually curious president. Trump’s focus on pipelines, industrial factories and coal-fired electrical plants seem a better match for the economy of the previous century. Does it matter if the president doesn’t understand or respect your industry? I suspect we are about to find out. In a nutshell: Bad. Read More Energy innovation Brian Lakamp in a recent article in Techcrunch suggests that innovation in the energy grid is about to lead to a wave of new companies and disintermediation of old companies. He suggests that the revolution will be akin to the development of internet-based businesses starting in the early 90’s. Specifically, he points to advances in solar cell technology, nanogrids, intelligent building materials and smart lighting as technologies that have come of age. While he suggests that certain forward-thinking electricity giants will be able to participate in this energy transformation, he believes that a lot of the innovation will come from new companies like Tesla, SolarCity, and Sunrun. Why does this matter? There are multiple, competing narratives for what will drive the next generation of advancement the way the internet has driven innovation for the last twenty years. Knowledgeable people have suggested machine learning, quantum computing, the blockchain and now, energy. In all of these cases, I have reservations. Even though it is very recent history, we don’t have a very clear sense of why the internet took off when it did. Maybe it was cheaper servers, improved routers, better graphics capabilities or the coming-of age of a massive generational cohort (millennials.) Innovation is rarely a simple narrative. New technologies are typically worse than old technologies in the short term. There needs to be massive discontentment to overcome the inertia of the local maximum. Our energy grid is antiquated and at risk of failure, but is the average consumer discontented? In a nutshell: Energy technologies have matured to a point where they may fundamentally change our electric grid. Read More Amazon’s patent follies Like many successful technology companies, Amazon’s ability to grow is impeded by existing infrastructure. In Amazon’s case, it is the infrastructure that allows packages to be delivered to residences. Amazon has aggressively promoted their efforts to overcome these obstacles, specifically through drones. Recode recently reviewed all of their recent patent applications (link below), including their idea to create floating warehouses that would move at 45,000 feet and be restocked by drones. At first blush, these patent applications seem like fantastical science fiction. But in aggregate they hold together rather nicely, representing an alternative approach to delivery from factory to residence. (Except for the tunnels, which are just strange.) Why does this matter? It’s a mistake to underestimate Amazon. Because they are willing to forego profits, they have been able to change consumer behavior in fundamental ways. They have also revolutionized warehouses and reformed delivery structures. If Amazon is determined to see a world in which packages are delivered by drone armies, recharging on lampposts and fetching items from floating warehouses, then who am I to judge? This raises an interesting question, if self-driving vehicles and drones are the future of American transportation is it a good idea to reinvest in the last century’s infrastructure. In a nutshell: Amazon has given a great deal of thought to the realities of drone delivery. This is starting to look like something more than just a PR stunt. Read More What drives healthcare? Fred Wilson’s latest post on consumer centric healthcare (link below) raises some interesting questions. Wilson believes that the root of the rot in our healthcare system is that employers and insurers control the system. His overall solution is that healthcare should reorient itself around consumers. Specifically, he suggests that patients should be free to order their own tests and that companies that control large amount of healthcare data should be forced to release it in the form of an API so digital health initiatives can move forward. But I have to wonder. First, the centralization of healthcare is due, in large part to the large physical plants necessary to provide healthcare services (hospitals and clinics). Also, I’m not convinced that healthcare is one of those industries where the market should be free to decide what is right. Vaccination rates in San Francisco are shockingly low for children because parents decide that their judgement is equal to that of medical professionals. Why does this matter? There is technology and then there is the culture of technology. The culture of technology is informed by technology, but it is also informed by a libertarian ethos of heroic individualism in the pursuit of maximum profit. Unfortunately, healthcare actually requires a certain amount of expertise and training. It doesn’t lend itself to crowdsourcing. Yes, the system is broken. Yes, insurance companies (and pharmaceutical companies) have been allowed to profit inordinately. But further atomization of the consumer-base does not level the playing field. Most healthcare professionals I know, yearn to be empowered to push back against the bottom line for the good of their patients. And they actually possess the knowledge to push back effectively. Technology can certainly improve the dismal experience of getting and paying for healthcare in the United States, but I don’t see tests-on-demand or sacrificing patient privacy as the low-hanging fruit. In a nutshell: The power in the healthcare market is on the side of insurers and pharmaceutical companies. Consumers lack power because there is a knowledge disequilibrium. Technology solutions that empower patients must begin by addressing this information gap. Read More

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