My personal little tech agenda
I'm rejoining policy world
In May, I shared that I was going independent. I’m excited to say that I will be spending a big chunk of that independent time working on policy again.
I recently (re)joined the American Economic Liberties Project as a senior fellow, where I’ll be focused on healthcare and access to markets. Original readers will recall that I started this newsletter while at AELP the first time, so this is nothing but good news for my writing.
We focus on concentrated power and how that affects the ability of independent entities — including physicians, pharmacists, dentists, startup founders, etc. — to operate in the market. This viewpoint has always suffused my newsletter writing, so nothing will change on that front. Dynamism! Small companies! Little tech!
Regulatory capture and how to fix it
Speaking of, if you’re interested in policy, you may have happened across a book this year titled Abundance, written by Ezra Klein and Derek Thompson. It was unusually popular for a policy book. My summary: America needs an abundance mindset, or more of the big things like healthcare, housing, and good jobs. The government could enable this, except it has become terribly inefficient and bogged down in requirements, each of which might be individually sensible but as a whole create a nonsense morass in which important programs (be it infrastructure or applying for Medicaid) get bogged down.
It makes sense, although it’s open for debate whether government inefficiency and red tape is actually the central problem facing America, or whether this is actually downstream of something more important (for example, regulatory capture by concentrated power).1
When it comes to healthcare, though, I think there’s an opportunity for everyone to work from the same policy playbook: healthcare “abundance” is limited because the government is inefficient because the big players benefit from the market being difficult to access for smaller players and startups.
I wrote a piece (before I rejoined AELP) on this topic for the Niskanen Center’s Hypertext, which you can read here. To pull an excerpt (although you should read the whole thing over at Hypertext):
Our container-ship fleet of health systems, insurers, and pharma certainly isn’t delivering the dramatic pivot America must make to keep pace with the rest of the developed world. An improved healthcare system would have more doctors and hospitals, with more readily available primary care appointments and rapid triage. It would also be more dynamic, with independent pharmacists able to stay open in suburban areas, physicians incentivized to set out a shingle in rural communities, and smaller biotech firms powering the engine of pharmaceutical innovation.
To achieve this vision, corporations must be held to account — and antitrust and abundance must find common ground.
All of this to say, much more to come from me, both here and elsewhere. And if you have ideas on markets that I should be focusing on, let me know by replying to this email. There’s a lot to cover.