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In Praise of the Six Page Narrative

Jeff Bezos is famous for being customer-centric, so much so that Amazon's annual letters proudly say, "We seek to be Earth’s most customer-centric company." Shipping, easy returns, streaming, and Kindle are proof. "Free" 2-day shipping for Prime membership is a big part for me. So far this year I've ordered 54 packages, 1.4 per week. Another cultural strength is its lack of flashy presentations. Amazon doesn't do PowerPoint or other slide shows. They prefer memos of up to six pages, reviewed in ...

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Passive vs. Active in Investing and in Health

It has taken over 40 years for index investing to reach 20% market share. That's longer and less heft than most people would guess. But it's also a reminder of how a good idea can take generations of incremental awareness and results to move beyond shallow roots. Index investing is a form of passive investing, a low fee autopilot strategy. The reasoning behind it is that most individuals and funds can't beat the S&P 500. So why try? Just match it by relying on the collective wisdom of the a ...

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How Outlier Stories Stain Healthcare

Price opacity is one of the grievances people have with healthcare in the US. Hip replacement price variation is an oft-cited procedure, yet another example where hoarding information and obfuscation is the norm. In one city, prices can vary by a factor of 3x or more. Price transparency is a laudable goal and progress is being made, but its impact is modest. And how common are hip replacements? For the commercially insured under age 65, there are 1-2 per 1,000 lives per year. That amounts to $2. ...