Thoughts on Burning Man

Upon returning from the desert in '17 after my first burn, a blunt contrarian friend of mine offered a few words on the festival which I dubbed worth sharing -- 

So if I ask you to help me push my car out of a ditch, you may well agree. But if I offer you $10 to help me push my car out of a ditch, you’ll likely think: Are you kidding? My time is worth much more than that. In other words, the mere act of putting a price tag on a good or a service bumps people from the social to the economic mode, and reduces their natural inclinations towards altruism (which doesn’t truly exist, BTW) and generosity. So it seems that Burning Man has managed to create an entire city operating in the social framework rather than the economic one.

The tricky question is what, if anything, one should take away from it. Unfortunately, the results are not extrapolatable. That’s because, although it’s true that the people who give you food and massages and rides all week were technically strangers, they weren’t just any strangers. They are your fellow tribe members (“burners”), i.e., your ‘in-group”.  As I mentioned to you, from Robert Sapolsky’s ”Behave”, homo sapiens brains are hard-wired to respond favorably to “in-groups” and negatively to “out groups” (although who falls into each category is dynamic and can change rapidly).  The real, harder question has always been: How do we foster cooperation between different in-groups, or otherwise stated, with an “out-group"?  Here, Burning man has little to offer….

Based on Sapolosky’s work, I would love to do an experiment with testosterone and oxytocin with those 70, 000 participants in the dessert:

Testosterone has gotten an awful reputation, whereas oxytocin has gotten a Teflon presidency that is not deserved. 

Testosterone does not invent new pathways of aggression; it increases the volume of the pathways that are already there.  But, what testosterone is mostly good for is that it makes you do what ever behavior is needed to hold on to status when it is being challenged.  So, if you are a baboon it's obvious what you do--that is aggression. In humans, if you set up a situation in which you gain status by for example being generous, then, testosterone makes you more generous.  if you took a thousand Buddhist monks and shot them up with testosterone, they would just run through the streets doing random act of kindness to see who would do the most of them the fastest! 

Oxytocin is involved in oceanic feelings of cooperation, mother-infant bonding, monogamous pair Bonding, etc, i.e., an amazing, wondrous prosocial hormone. But when you look more closely, Oxytocin makes you much nicer, more empathic to people who you feel are just like you-to "in group" members. When it comes to "out group" members, it makes you more crappy to them, more preemptively aggressive, less cooperative.  In other words, more xenophobic.

On the level of philosophy:

"Life is,” as Dostoyevsky wrote, "and it is our job to figure out what the 'is' is". That’s one of the core responsibilities of being human, and this perhaps serves as at least one unconscious drive for the yearly mass exodus to the desert...

A Note to Investors: Here's what to look for in 2018

Preventative health is hard.

It’s hard for medical students because their education has a strong focus on reactive care (e.g. pharmacology, surgery) vs. proactive care (e.g. nutrition, mindfulness, fitness). It’s hard for practicing physicians because they’re incentivized by pharmaceutical companies to promote reactive medicine and treatments. It’s hard for pharma companies because they make money from developing and selling drugs that fix problems vs. prevent problems. It’s hard for private health companies because consumers don’t prioritize health spending until they’re sick.

So here we stand today, with this hard problem that’s pervaded us since the dawn of medicine and with its progress moving forward at a pace decades behind the speed at which technology has managed to positively disrupt other industries. Over 70% of the US is overweight or obese and 45% suffer from at least one chronic illness, yet the top 3 causes are preventable (poor nutrition, inactivity, and tobacco use). Tech is improving nearly every aspect of our lives, while America's obesity count has been increasing every year since 1995. I'd say this should be a priority over flying cars and food delivery apps.

So, what's the solution?

It begins with rallying consumer interest. With consumer demand comes money, with money comes research, with research comes useful products and progress. Consumers will be the ones to change the future of health. It won’t be the sluggish government, not the regulated insurance companies, not the archaic medical school programs, and not the backward pharmaceutical industry. Consumers have the autonomy and power to quickly drive change, and rallying consumer interest is done by appealing to innate desires in an immediate way.

Investors sense the opportunity

According to Rock Health’s 2017 Funding Report, companies delivering consumer health information as a primary value proposition dominated 2017 funding, reaching $1.6 billion with 41 deals. This means that technology dedicated to empowering users to better understand and improve their own health surpassed technologies for clinical decision support, disease monitoring, disease diagnosing, and EMR. Consumers are the gas (or charge) for the vehicles that the big players drive in the health space. Health companies and investors accelerate towards what consumers care about. And, thankfully, this is shifting. 

Consumers are catching on

Consumers are starting to take health into their own hands. We're seeking out more transparency and control. We're ordering 23andMe and EverlyWell testing kits to learn about our genetic health risks and traits. We're subscribing to Care/Of to receive personalized supplement packs. We're using ShareCare and Apple HealthKit to manage all of our health information in one place (and Apple's working on taking that even further). We're visiting Forward to receive technology-driven concierge healthcare. We're using MyFitnessPal to track caloric intake and nutrient deficiencies. Consumers are taking initiative. Perhaps this is due to the increasing costs of healthcare. Or maybe it’s the growing trends of lifestyle brands and health influencers spanning the media (think SoulCycle, Urban Remedy juice cleanses, and Bulletproof coffee). It could also be a result of this increased funding going into consumer health companies causing improved options–a chicken or the egg question. Or maybe, and this is my favorite guess, consumers are recognizing the importance of preventative health and are seeking their own methods of addressing it. Regardless of the triggers, this is a good thing. 

What's next?

Consumer interest and investment funding are both important catalysts in the adoption and growth of preventative health. 2017 was a big year for both. I strongly believe that this will further increase in 2018–consumers will embrace their newfound control over their health, and investors will help fuel their options.

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