Philippa Kaur

AS BIG tech companies face a brutal slow-down the hunt is on for new areas of expansion. Amazon, which is now America’s second-biggest business by revenue, is a case in point. In the final quarter of 2022 its sales are expected to expand by just 6.7% year on year. Last week, on November 17th, Andy Jassy, the firm’s chief executive, confirmed that it had begun laying off employees and would continue to do so next year. Mr Jassy said it was the most difficult decision he had made since becoming boss. But he also noted that “big opportunities” lay ahead. One that he highlighted is the largest, most lucrative and hellishly difficult businesses in America: health care.Many tech firms have health care ambitions. Apple tracks wellbeing through the iPhone; Microsoft offers cloud-computing services to health firms and Alphabet sells wearable devices and is pumping money into biotech research. But Amazon is now busy creating the most ambitious offering of them all. Two days before Mr Jassy’s statement, on November 15th, it launched “Amazon Clinic”, an online service operating in 32 states that offers virtual health care for over 20 conditions from acne to allergies. Amazon describes the new service as a virtual storefront that connects users with third-party health providers.The Amazon Clinic launch follows the $3.9bn takeover, announced in July, of One Medical, a primary care provider that offers telehealth services online and runs bricks-and-mortar clinics (the deal has yet to close). It has 790,000 members. The deal was led by Neil Linsday, formerly responsible for Prime, Amazon’s subscription service, who has said health care “is high on the list of experiences that need reinvention”.These latest moves complement existing assets that Amazon has. Its Halo band is a wearable device that monitors the user’s health status, and which went on sale in 2020. In 2018 it bought PillPack, a digital pharmacy that is now part of Amazon Pharmacy, for $753m. Amazon Web Services launched specific cloud services for health care and life science companies in 2021.The move into primary care, jargon for the role of the traditional family doctor, is a big step but has an obvious logic. Walgreens, a pharmacy chain, reckons the industry is worth $1trn a year. Around half of Generation Z and millennial Americans do not have a primary-care doctor and One Medical’s membership has almost doubled since 2019. Amazon Clinic will accept cash for its services, rather than relying on America’s nightmare insurance system to recoup costs.The company is betting that primary care will become more digital. And it is likely that it will seek to integrate these services with other parts of Amazon’s health care offering. Amazon Clinic’s new users can buy drugs from Amazon Pharmacy. Over time the firm could add features to the Halo band that give people reminders to take medicine or set up clinics in branches of Whole Foods, the supermarket chain it acquired in 2017. And it may wrap health care into Prime which now has some 200m members worldwide. “The low-hanging fruit is offering discounts on membership to Prime members”, says Daniel Grosslight of Citigroup, a bank.Amazon’s health push comes with several risks. One is that its own record is far from flawless. It is closing Amazon Care, which it launched to provide health services for its own employees and which expanded to offer some services to outside customers. Haven, a collaboration with Berkshire Hathaway, Warren Buffet’s investment firm, and JPMorgan Chase, a bank, to procure lower cost health care for employees was set up in 2018 but died less than three years later.Another danger is competition. cvs, an American retail pharmacy, reportedly outbid Amazon for Signify Health, a large primary-care provider in September. In October, Walgreens increased its stake in Villagemd with a $5.2bn investment. JPMorgan recently opened primary-care centres of its own. Amazon’s new venture will also be competing with the likes of Ro and Hims & Hers, both tech startups that are dedicated to providing virtual health care.Finally Amazon will have to grapple with regulators. The Federal Trade Commission, a trust-busting agency, is examining the One Medical deal. The takeover and the launch of Amazon clinic will raise questions about who should be allowed to hold sensitive health care data. Amazon has said “we remain focused on the important mission of protecting customers’ health information”. The firm may need to set up hefty firewalls to separate customer information held by clinics from that gathered through other products and services. But satisfying data-privacy concerns could wipe out many of the data-sharing opportunities that Amazon deftly deploys across the rest of its business.Amazon’s attempts at disrupting health care will be subject to intense scrutiny. Nonetheless it should have a positive effect on health care in America. Its experience at keeping customers happy while generating razor-thin margins could improve primary care and force other providers to up their game. It may also prompt other tech giants to do more to disrupt health care themselves. All this may be just the medicine that America’s heath-care system—and Mr Jassy’s tenure as Amazon’s boss—badly need.■ More

On December 18th the winners of the football World Cup in Qatar will lift the famous golden trophy. Several rituals will then unfold. The final entry will be made on fans’ wall charts. Pundits will share their lists of players of the tournament. In the victors’ home country, cars will clog the streets and drivers will lean on their horns. And in the days that follow, leadership coaches will post drivel about the secrets to be learned from the successful manager. Listen to this story. Enjoy more audio and podcasts on More

As is the fate of anyone running a hotel in Kerala these days, Bijoy George is a man with too much to do. Before pandemic-induced lockdowns began in 2020, he managed 40 employees at the Eighth Bastion Hotel near the old Dutch cemetery in the charming historic quarter of Kochi, a bustling coastal city. Now that business is back to pre-covid levels he needs the same number of staff again. But he has only 20 workers. His plight is shared with every other hotel, café and bar. It is a result of the state’s hospitality employees moving en masse to Qatar, not to watch football but to take up employment tied to the World Cup.Listen to this story. Enjoy more audio and podcasts on More

“Twitter is the worst! But also the best,” Elon Musk tweeted recently. Not everyone agrees with the second sentiment. Soon after he purchased the social network for $44bn on October 27th, the hashtag #TwitterMigration started trending. Concerned with what Mr Musk has planned for the social-media platform, some are searching for alternative spaces to swap news, views and pictures of pets. Along with renewed interest in established platforms such as Tumblr, Discord and Reddit, newcomers are under consideration. What chance do they have of pecking away at Twitter’s 240m users?Listen to this story. Enjoy more audio and podcasts on More

It is hard to think of two more different firms than GE, a once-exalted symbol of American inventiveness, and FTX, a Bahamas-based fly-by-night crypto exchange. Besides high-pitched voices, it is hard to think of two people with less in common than the late Jack Welch, GE’s legendary former CEO, and Sam Bankman-Fried, FTX’s disgraced founder. The former, son of working-class parents, was fiendishly competitive about profits, had a frat-boy approach to life, and was as much at home on a golf course as he was on the factory floor. The latter, son of Stanford law professors, is scruffy, nerdy, a player of “League of Legends”, and claims to be motivated to make money only so that he can give it away. Listen to this story. Enjoy more audio and podcasts on More

The meeting is a dream come true for the screenwriters who are already said to be at work on the film version of events. In 2021 Sequoia Capital, a large venture-capital (vc) firm, made its first investment in FTX, a now-bankrupt cryptocurrency exchange. To publicise the deal Sequoia published part of the transcript from the virtual pitch meeting on its website. Sam Bankman-Fried, the founder of FTX, explained how he wanted the firm to be a “superapp” where “you can do anything you want with your money from inside FTX”. Sequoia’s investors swooned. “I love this founder,” said one in a chat function; “Yes!!!!” declared another. An FTX executive who sat close to Mr Bankman-Fried during the pitch noticed another detail: “It turns out that that fucker was playing ‘League of Legends’ throughout the entire meeting.”It also turns out that ftx was doing more with customers’ money than it had promised. Its demise has forced Sequoia to write down its $210m investment. It will also hurt another embattled backer. On November 11th More

After a day’s work, you are not quite ready to go home. Perhaps you fancy catching a film. You could head to the cinema. Instead, you retreat into your car. A few taps on the touchscreen dashboard and the vehicle turns into a multimedia cocoon. Light trickles down the interior surfaces like a waterfall. Speakers ooze surround sound. Augmented-reality glasses make a screen appear in front of your eyes.This immersive experience is at the core of what Nio, a Chinese electric-vehicle (EV) company, laid out as the future of the car at its European coming-out party last month in Berlin. The firm wants its high-end evs to be a “second living room”. Forget horsepower, acceleration and design—Nio talks up the two dozen high-resolution cameras and transistors (of which there are 68bn, about four times as many as in the latest iPhone) in their vehicles. “We have a supercomputer in our cars,” boasts Nio’s boss, William Li. Nio is at the forefront of a revolution in the car industry: what was once the archetypal hardware business is becoming ever more about software. Immutable objects that do not change after they leave the factory are turning into dynamic platforms for applications and features which can be updated “over the air”. Rather than deteriorate with age, such “software-defined vehicles” can improve over the years. Brands will become defined less by handling or mechanical excellence, and more by the services they offer, from safety features and infotainment to artificially intelligent driving aids. Nio’s cars come equipped with an ai assistant called Nomi, whose circular interface sits on top of the dashboard and smiles when you ask it questions.Like all revolutions, this one promises to usher in a new world. It will certainly benefit motorists and digitally native carmakers such as Nio or Tesla, America’s EV champion. It will also claim victims, mostly among incumbent carmakers steeped in the culture of mechanical engineering. The boss of Volkswagen, Herbert Diess, recently lost his job after botching the German giant’s software plans. For many of vw’s rivals, too, going “soft” is proving thornier than managing the other big transition, from the internal-combustion engine to electric power. It may also prove more consequential. Luca de Meo, boss of Renault, a French carmaker, likens the situation to the upheaval wrought on telecommunications by the smartphone. The shift will define the fate of a global industry with revenues of nearly $3trn. Cars have been accumulating software for decades. For the most part, however, code was deeply embedded in a car’s parts, powering the “electronic control units” of such things as the ignition, brakes and steering. Most of these programs were developed by the carmakers’ suppliers and came in completed units that were then assembled into a vehicle. Car firms “were mostly integrators”, explains Klaus Schmitz of Arthur D. Little, a consultancy.In recent years this setup has started to collapse under its own complexity. As more software was added, it became harder to make all the pieces work together, explains Andreas Boes of isf Munich, a think-tank. In June 2020 vw postponed for months the launch of the ID.3, a new ev, because of software troubles. Software engineers’ go-to approach to untangle such messes is to create a “platform”—to equip cars with a central computer powered by an operating system (os) that comes with standardised digital plugs for additional components (application programming interfaces, or APIs, in the jargon) and a connection to the computing clouds. This technical transformation, in turn, has triggered a knotty cultural one. In the old hardware world, car companies were hierarchical, process-oriented organisations often run by big egos. Launching a new model took around four years and the focus fell on meeting the deadline for the all important start of production. A new model was much the same as the old one, with precious little innovation, says Henrik Fisker, who once designed Aston Martin and BMW sports cars and now runs an EV startup bearing his name. In the new software world, by contrast, decentralised teams of developers focus more on problem-solving than on execution. Cars are updated in rhythms counted not in years but in days and sometimes hours. Products are never really finished. This is second nature to newcomers such as Tesla—which was conceived as a software company that happened to make cars and is now the world’s most valuable carmaker—as well as Nio More

On November 9th Meta said it would fire 11,000 people, or 13% of its workforce. It is not the only tech firm to give its workers the boot, as the sector goes through a harsh downturn. A week earlier Stripe, a fintech firm, announced it would cut 14% of its staff; Twitter’s new owner, Elon Musk, fired half its personnel. According to Crunchbase, a data provider, more than 60,000 American techies have been shown the door this year.To stay on top of the biggest stories in business and technology, sign up to the Bottom Line, our weekly subscriber-only newsletter. More