Daniel Schwartz, MD

On the topic of billionaires and wealth taxes in California, I am opposed to wealth taxes because they effectively represent an expropriation of private property and have many unintended and negative consequences that have occurred in every country that has launched such a tax. I am however strongly in favor of a fairer tax system. To that end, it doesn’t seem fair that someone can build a valuable business, create a billion or more in wealth and pay no personal income taxes by living off loans secured by stock in the company, (and even if the loans are unsecured). Apparently, this approach is used by many super wealthy people. A small change in the tax code would address this unfairness. In short, personal loans taken in excess of one’s basis in the stock of a company should be taxable as if you sold the same dollar amount of stock as the loan amount. One shouldn’t be able to live and spend like a billionaire and pay no tax. I welcome arguments to the contrary as to why this is somehow unfair to the billionaire or even the hundred millionaire, but I don’t think there is a good one. The favorable current tax treatment of this approach also encourages the use of leverage which is not good for society. And with respect to California’s budget problem, the issue is not a lack of tax revenues. The problem is how the money is being spent. I have a bunch more ideas on other changes to the tax code that are hard to argue with if anyone cares.

I’ve been in Health Tech for 12+ years and I’ve realized 90% of success is rolling up your sleeves and doing the work 90% of vendors just won't do… which makes them differentiators if you do them. Here are 10 things Health Tech vendors can do to really stand out: 1. Actually CARE about the health system’s success with your product. Monitor their usage and engagement. Encourage them to measure the ROI. Measure your success as a vendor by how successful the health system truly is with your product. Why bother doing this just to collect a cheque? 2. Show up on-site and observe how clinicians engage with your product. What you see with your eyes tells you things dashboards can’t. What barriers are they facing? What friction can you remove? 3. Fill your team with people who are truly mission-driven and actually give a crap about the success of your health systems. That will lead to a better product, better service and better health system partnerships. Other companies can copy your product but they can’t copy your people. 4. Meet in-person and ask for truly candid feedback. You’ll learn stuff you’d never hear on a Zoom. Coming in person lets you earn that honesty. 5. Do the heavy lifting to adapt your Tech to their environment. Configure the workflows for them. Migrate off the old vendor for them. Make it as easy as possible to use your product. 6. Respond quickly to requests. This doesn’t mean you have to solve everything immediately - that’s not possible. But at least respond quickly to let them know you’re on the case. 7. Own the whole customer experience. Now sometimes things aren’t totally your fault. But own those anyways because your bar for excellence is higher than anyone else’s. 8. Be transparent about what you can and can’t do. If you truly can’t do it, they’re going to find out and you’ll burn that bridge. Why risk the relationship? 9. Do things with the health system’s best interest in mind. Put yourself in their shoes - what would you want to know? Sometimes it’s being brutally honest that they are making a decision that’s shooting themselves in the foot. If you’ve earned their Trust, you’ve also earned the right to be honest with them. 10. Apologize when you screw up and explain what you’ll do differently going forward. No one’s perfect and health systems realize that. What they don’t respect is you not taking accountability for your screwups. Do all of these things and I guarantee your health system partners will be more successful with your product, will stay with you longer and will rave about you. Does this sound like a LOT of work, discipline, humility and commitment? Yes, yes it is. Sorry - I didn’t say it would be easy. It’s really, really hard. But this is what it takes. How badly do you want your innovation to make a difference?

Waymo is so safe that if every car was driven like a Waymo, about 9% of America's life expectancy gap would disappear. 9 percent Americans die in car accidents *that often*.

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