Michael Callaghan

Let me start by saying: I’m not a billionaire. Clearly @mcuban knows how to allocate capital. I’ve long been a fan because he’s not just a disrupter, he’s a transformer. That’s one of the hallmarks if you’ve followed his work at all. I agree with a lot of what he’s uncovered in healthcare and support anyone serious about - even just - nudging the system in a better direction. Our current setup is no longer sustainable. This isn’t a political problem. This is a math problem. It will implode under its own weight. Entropy is real. Cycles are real. However, “universal anything” tends to produce universal nothing. I won’t wax too philosophical here, but this is a first-principles issue. Universality sounds romantic, even just. Counterintuitively, it almost always devolves into lower quality, higher costs, and artificial scarcity…along with the waste, fraud, and abuse we pretend won’t happen. Let’s talk mechanics (not mystical philosophy). Government is an idea, not a business. Whatever it wants administered is almost always contracted out to corporations. Most people live in an alternate reality about how government and bureaucracy actually function. Viewing this through politics or ideology will get your feelings hurt. Universal healthcare, for example, won’t be checks mailed from an office in DC. It would almost certainly be run by the handful of large payers that already specialize as government fiscal intermediaries - UnitedHealthcare, Aetna, Centene, and the like. These companies answer to shareholders. And by “shareholders,” I largely mean boomers’ retirement accounts. The same cohort that are the biggest beneficiaries and highest utilizers of healthcare services. The universe (no pun intended) does have a sense of humor. I wrote about this here if you’re bored enough to continue reading: x.com/heathveuleman/…