Alex K's Profile
This is really thought-provoking – I remember taking the moral machine test a while back and being surprised to learn some of the biases that I have in terms of who to save and who not to save. The paradox that you mention about having different standards for yourself and others applies in other places where individual good vs. societal good are in conflict. For instance, when splitting 8 pieces of pizza among 4 people, I’d rather be able to eat three slices but live in a society where we split the pizza evenly. Social norms of fairness (my fellow pizza eaters would judge me) and laws are guard-rails to optimize societal good and I think autonomous cars are an area where government regulation would be beneficial.
I would rather have top-down rules around car decision-making than car companies competing on passenger vs. driver vs. pedestrian safety. It looks like the government is starting to think about that – http://www.theverge.com/2016/9/19/12981448/self-driving-car-guidelines-obama-foxx-dot-nhtsa mentions that the federal government is mandating data reporting around several topics, including “how vehicles are programmed to address conflict dilemmas on the road” – wonder how much of this will be decided by the federal government and when.
This sounds like a truly amazing service – filling a huge unmet need in a way that is accessible and can scale well. As you point out in your suggestions, there’s a huge potential for an app like this to expand beyond just obstetrics and gynecology into other areas of healthcare – whether chronic disease management (AIDS or diabetes) or general health literacy (nutrition, education). It could also be used as a social platform to empower women – currently it offers legal advice and interventions for domestic violence. That service could be expanded to potentially offer other services to women such as small loans, family planning education (both medical and non-medical), and even helping foster a local community of women in a given area. There’s tremendous potential here and I hope this takes off.
Also, 600K women dying from pregnancy/childbirth complications seems really high – WHO has a smaller number for the world (http://www.who.int/features/qa/12/en/)
I’m not sure I agree that Airbnb and Starwood are direct competitors. I agree that both offer lodging away from home, but the experiences and value propositions are very different. Starwood has leisure and business customers. The business travelers who are looking for consistency, standardization, and easy booking – not really what Airbnb is offering. Likewise, a portion of Starwood leisure customers are “locked” into Starwood due to the rewards program from business travel (looking at you, former/current/future consultants). So, Airbnb competes with a subset of Starwood leisure guests and of those, I’m not sure how many people staying at the W Maldives are truly looking to “live like a local”. I wonder if Airbnb is actually a bigger threat to hostels (which offer cheaper rooms and a “local” community) and lower-budget hotels (which can compete with Airbnb on price). Finally, at least for now, Airbnb is <0.5% of the global 550B hotel industry (see: http://www.hospitalitynet.org/news/4073336.html), so it hasn't quite taken over just yet.
I share Cara’s concern about information security – it is a tremendous issue and hospitals are overall not great places when it comes to secure IT systems.
One tremendous benefit of Epic to the healthcare system as a whole (not just to an individual hospital/patient) is the data that these program generate. Researchers in healthcare have used insurance claims data to answer some questions, but also want more detailed clinical data that hospitals have. Historically, getting this data was manual and very institution-specific or required a parallel data collection process (as in clinical trials).
Epic is collecting tremendous amounts of data from hospitals which could be de-identified, aggregated, and used to meaningfully improve care quality and conduct retrospective studies. There are some early initiatives to do so – http://healthitanalytics.com/news/qpid-epic-ehr-combine-for-big-data-analytics-at-partners-health is an example. However, for the most part Epic is quite protective of that data and unwilling to share it with outside researchers…which is a shame.
I never knew how much Google/Alphabet is investing in sustainability. One really interesting point to me is that they go beyond making “themselves” sustainable – most companies we talk about focus on sustainability within their company (e.g., reducing their own energy use, making their supply chain sustainable, reducing their carbon footprint). Google has done that but also has the capital to go beyond that and try to create projects that would actually help sustainability globally. In some ways they are coming from a position of privilege – large amounts of capital, stead cash inflow, and a dominant market position that is unlikely to be disrupted anytime soon.
One question to think about is whether public-private partnerships between organizations such as Google and governments (however bureaucracy-laden they might be) are. For instance, carbon emissions are rapidly growing in developing countries yet much of Google’s research (self-driving cars, energy storage, electric planes) are likely to have the greatest impact in developed countries. What would it take for Google (or other organizations) to partner with smaller countries (or cities or regions) on local climate change initiatives while also developing “moonshot” technologies which might be used globally? Sort of like Google Fiber in Kansas city or Google’s partnerships with public schools in India but focusing on climate change.
One other piece to consider is the impact of international oil prices on ROI of shale extraction- shale has tremendous potential but investing in shale extraction when oil/gas prices are low is much more difficult. Oil prices can change rapidly, suddenly making shale oil extraction a lot less profitable as happened in the US in North Dakota a few years ago. Thus, if shale is to be developed further in Argentina, there would also need to be a longer-term perspective and potential long-term investor or government support to reduce the impact of monthly/yearly oil price variation.
When it comes to GMO seeds and products in general, it’s very interesting to me how “pro-GMO” is often portrayed in popular culture and media as “anti-environment”, despite very limited evidence to support that. I’m curious how much of Hershey’s decision not to go into GMO is driven by their own corporate mission and policy vs. (1) not feeling enough supply pressure yet to warrant the investment and (2) fear of a negative perception of GMO further down in the supply chain (among retailers, consumers, etc) especially in more upscale markets and in Europe. To your other solution – shrinking portions of chocolate would be unacceptable to me.
“Second, Partners should develop a forum for best practices sharing among US hospitals to reduce energy use” – Partners has followed your advice!
They are a founding member of the Healthier Hospitals Initiative (HHI) which is a collaboration of big healthcare systems focused on improving sustainability – “reducing energy consumption, chemical use, and increasing environmentally preferable purchasing” (see: http://www.partners.org/Innovation-And-Leadership/Sustainability/Healthier-Hospitals-Initiative.aspx)
Also 100% with your point about being ready for disasters – given what happened in NYC with Hurricane Sandy and New Orleans with Memorial Hospital, it’s crucial that there are clear plans and backup plans and back up to backup plans in case something happens so as to not put the most vulnerable patients at great risk.
*we care less about the seventh flood of the year
I agree with the risk of short-term benefits of climate change (more disasters = more $) and long-term risks from disaster fatigue (we care more about the seventh flood of the year). Cynically, I wonder about marketing disaster relief – how do some of the principles we learn in marketing apply to Red Cross campaigns and is it OK to advertise disasters for a “good cause”? Another long-term play by the Red Cross might be to separate funding from individual disasters – solicit donations consistently throughout the year while minimizing ties to individual disasters (a harder sell but maybe possible?), invest them in a portfolio, and draw from the long-term portfolio when disaster strike.