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Fascinating read, thanks Graham! While I agree with Eerik and E-nonymous that automation will likely result in a net positive for the economy as new industries are created, this is no consolation for the individuals losing their jobs. In practice, those who lose their trucking jobs will generally not be able to take advantage of new industries because those jobs are in a different location or they don’t have the required skills, particularly if no programs are put in place to help them manage the transition. We should remember the lesson we’ve learned in class, which is that people generally want to do the jobs they have been hired to do. It is very difficult for someone mid-career or later to suddenly do a completely different job out of necessity. I do believe society will be better off in the long run, I also believe we as a society have a responsibility to mitigate the pain that these economic transitions will inevitably cause.

I also wonder if the ATA is the right organization to address the challenges of job displacement. I would think that if trucking jobs disappear, then the ATA will as well. I’m inclined to think that it is instead the job of policymakers and employers to develop programs that mitigate the pain of job displacement from technology.

This is fascinating! I thought your analysis of the problem and proposed solutions were excellent. To your last question, I think that Southwest will likely take climate change challenges more seriously if they view it as a customer service problem. Southwest prides itself on its customer service, presenting itself as a friendly, down to earth airline that goes out of its way to delight customers and doesn’t nickel and dime them by charging baggage or change fees. Management should realize that being more proactive about climate change could be another way to differentiate the airline from its competition in terms of customer service. It can enhance its reputation for reliability if it manages inevitable weather events to be less disruptive for customers compared to competition. On the flip side, if it lags its competitors in addressing climate change challenges, it could irreparably damage its reputation in the market.

On November 30, 2017, KTR commented on Hanging Gardens of Healthcare or Tower of Babel? :

I think that there is certainly potential for telemedicine providers like Babylon to improve access to healthcare for certain populations, particularly in low-resource setting like Rwanda where there is a significant shortage of physicians and many patients may have no other options. These models also generally work best for one-off, high urgency but low acuity issues like sinus / ear / urinary tract infections or prescription refills, with more complex issues requiring an in-person visit.

We actually looked at a similar company when I worked in healthcare VC, and we ultimately decided not to invest. One of the primary reasons was that the utilization/adoption data for companies like this has actually been pretty poor. This was very surprising to me because I thought that these solutions offer a significant convenience advantage for the reasons you outlined above. But it seems that for the most part, patients are unwilling to forego traditional face-to-face visits with a healthcare provider, even when inconvenient. Perhaps this will change over time, but it has taken much longer to see adoption than many in the industry expected. Another reason we were bearish is that these models don’t work in favor of entrenched healthcare players that are reimbursed per visit, as you mentioned above.

That said, in the long run I am very optimistic about the ability for AI and other emerging technologies like Babylon to improve care and increase capacity. Theoretically as the healthcare system moves toward more value-based arrangements the economic barriers should fall away. I would also assume that people will become more comfortable with receiving care via call, text, or video as time goes on. I just hope we can get there sooner rather than later!

On November 29, 2017, KTR commented on Would your favorite wine still be around in 2050? :

It actually strikes me that since Jackson Family already sources grapes from regions around the world, it is much better positioned than wineries that rely on a single vineyard or even a single region for its grapes. I would imagine that this kind of diversify would mitigate the impacts of extreme weather, as a single weather event cannot impact all of their growing regions at once.

While I applaud Jackson Family for all of the efforts they are undergoing to reduce their own environmental impact, as noted above these efforts will likely not move the needle when it comes to global climate change. While I believe they should continue doing their part and be as sustainable as possible, I think they should take additional efforts to prepare for the impact of climate change. For example, they should focus on expanding or launching their presence in Europe, which is expected to be better suited to weather the impacts of climate change [1].

[1] https://www.npr.org/sections/thesalt/2016/03/21/470872883/an-upside-to-climate-change-better-french-wine

**E-nonymous, not Kevin – got my articles mixed up and won’t let me edit!

Very interesting, Kevin! I actually think that CVS Health is in a very favorable position compared to Amazon. Most notably, the physical presence of stores and clinics remains critical for healthcare delivery, so CVS’s retail presence and convenience for many consumers gives it a significant advantage over Amazon. We can only hope that Amazon’s expected entrance into this market continues to nudge companies to raise the standard for customer service and transparency in this industry, which as you note is sorely needed.

It will be fascinating to see what happens with the proposed Aetna merger. I agree that there is certainly potential for efficiencies and benefits for patients with a vertically integrated system. But because prescription drugs represent only about 10% of healthcare costs, I wonder how much value can really be derived from this type of vertical integration. Putting a significant dent in healthcare costs will require preventing chronic disease and improving care for patients with multiple chronic diseases, as this represents the bulk of healthcare spending [1]. I don’t believe that CVS has a competitive advantage in achieving this, as Minute Clinics are currently designed to primarily address one-off, low acuity problems rather than preventative primary care. I therefore tend to be more optimistic about vertical integration between payers and providers (though admittedly, these arrangements have produced mixed results to date). So if it is serious about vertical integration, CVS Health should consider opening full-service primary care clinics and more directly address the management of patient care. This move would make it an even more formidable player in the healthcare ecosystem.

[1] https://www.rand.org/blog/rand-review/2017/07/chronic-conditions-in-america-price-and-prevalence.html

On November 29, 2017, KTR commented on Will Cash Always Be King? What Does It Mean for ATMs? :

Very interesting! I agree with you and with many of the other comments that the ATM industry is facing an existential threat and NCR needs to focus on growth in other segments to counteract the inevitable decline in the ATM business. It actually seems that NCR already has a very strong foothold in the POS market – they are apparently the market leader in retail and hospitality POS [1], and are the major provider of retail self-checkouts. As self-service kiosks and terminals become more ubiquitous, I would imagine that this represents a growth opportunity for them. However, it is worth mentioning that one of their primary POS customer segments is gas stations, which could well be another victim of disruptive technologies if and when electric vehicles become dominant.

Similar to others, I would recommend that NCR continue focus on its POS software and services segments. NCR should expand into other industry verticals that have been slower adopters of this technology, such as healthcare. I would also recommend that NCR take advantage of its existing customer relationships in the retail segment and jointly work towards payment innovation to stay ahead of future disruption. Because if Amazon realizes its vision of a grocery store without any cashiers, NCR may have much bigger problems ahead [2].

[1] http://www.nasdaq.com/article/ncr-leads-the-pos-market-according-to-research-firm-rbr-cm732729
[2] http://www.businessinsider.com/amazon-go-grocery-store-future-photos-video-2017-6