Author: Art Diamond

Steve Case’s “Heroic Push” to Encourage Entrepreneurship Outside Silicon Valley, in “Surprising Places”

(p. C12) This is why one of the most energizing books I read this year was Steve Case’s “The Rise of the Rest.” It chronicles Steve’s journey to nurture tech startups in what some might consider “surprising” places. Think: Milwaukee vs. Silicon Valley.

. . .

Steve’s book is a heroic push encouraging us to widen the aperture. With the right investments and visibility, we can change the American landscape for the better, leveling the playing field and creating a more inclusive economy for years to come.

For the full review, see:

Asutosh Padhi. “12 Months of Reading; Asutosh Padhi.” The Wall Street Journal (Saturday, Dec. 10, 2021): C12.

(Note: ellipses added.)

(Note: the online version of the review has the date December 8, 2022, and has the title “Who Read What in 2022: Political and Business Leaders.”)

The book praised by Asutosh Padhi is:

Case, Steve. The Rise of the Rest: How Entrepreneurs in Surprising Places Are Building the New American Dream. New York: Avid Reader Press, 2022.

So-Called “Inflation Reduction Act” Reduces Incentive for Pharma Firms to Seek Approval for New Uses of Drugs


(p. A17) It may take years before we can fully appreciate the impact of the Inflation Reduction Act on the pharmaceutical industry, but we’re already getting signs of the damage. While Democrats boast that they’ve given Medicare the power to “negotiate” drug prices, the effect has been to saddle manufacturers with a complex and ill-conceived price-setting scheme. In response, many have canceled drug-development programs, resulting in an unfortunate but predictable loss for patients nationwide.

One poorly crafted provision is driving companies away from research into treating rare diseases. In its Oct. 27 earnings statement, Alnylam announced it is suspending development of a treatment for Stargardt disease, a rare eye disorder, because of the company’s need “to evaluate impact of the Inflation Reduction Act.” Alnylam’s decision turns on a provision in the Democrats’ bill that exempts from price-setting negotiations drugs that treat only one rare disease. The company’s drug is currently marketed as treating only amyloidosis, and thus is exempt from Medicare’s price setting. If Alnylam proceeded with research into treating Stargardt, it would lose its exemption.

That disincentive might be most pronounced in cancer treatments. On Tuesday [Nov. 1, 2022], Eli Lilly announced it is canceling work on a drug that had been undergoing studies for certain blood cancers. “In light of the Inflation Reduction Act,” the company wrote to Endpoints News, “this program no longer met our threshold for continued investment.”

. . .

Nearly 60% of oncology medications approved a decade ago received additional approvals in later years. The new law eliminates the incentive to conduct additional research, because its price-setting mechanisms kick in after nine years for small-molecule drugs and 13 years for biologics, regardless of how much research companies conduct after the drug’s initial approval.

For the full commentary, see:

Joe Grogan. “The Inflation Reduction Act Is Already Killing Potential Cures.” The Wall Street Journal (Saturday, Nov. 4, 2022): A17.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the commentary has the date November 3, 2022, and has the same title as the print version.)

Auto Experts Are Skeptical of EVs, but Are Afraid “So They Can’t Speak Out Loudly”

(p. A1) “People involved in the auto industry are largely a silent majority,” Mr. Toyoda said to reporters during a visit to Thailand. “That silent majority is wondering whether EVs are really OK to have as a single option. But they think it’s the trend so they can’t speak out loudly.”

. . .

(p. A6) The world’s biggest auto maker has said it sees hybrids, a technology it invented with the debut of the Toyota Prius in the 1990s, as an important option when EVs remain expensive and charging infrastructure is still being built out in many parts of the world. It is also developing zero-emission vehicles powered by hydrogen.

“Because the right answer is still unclear, we shouldn’t limit ourselves to just one option,” Mr. Toyoda said. Over the past few years, Mr. Toyoda said, he has tried to convey this point to industry stakeholders, including government officials—an effort he described as tiring at times.

Global car companies have made a sharp pivot to electric vehicles within the last few years, driven in part by the success of EV-only maker Tesla Inc.

. . .

At the same time, the legacy auto makers have a much broader base of customers, including many living in rural areas and developing economies with unreliable electricity supplies.

And their gas-engine businesses are still driving the bulk of profits needed to fund the costly shift to electric vehicles, which not only requires the development of new models but also construction of new facilities and battery plants.

The infrastructure to charge electric vehicles is meanwhile still lacking in the U.S. and many other parts of the world, making owning an EV still a challenge for many types of consumers.

. . .

Ryan Gremore, an Illinois-based dealer, who owns several brand franchises, said he gets a lot of customers inquiring about EVs, in part because of limited supplies.

That might give the impression of robust demand, but it is unclear how it will materialize when inventory levels at dealerships normalize, he added. “Is there interest in electric vehicles? Yes. Is it more than 10% to 15% of our customer base? No way,” Mr. Gremore said.

Mr. Toyoda’s long-held skepticism about a fully electric future has been shared by others in the Japanese car industry, as well.

Mazda Motor Corp. executives once cautioned that whether EVs were cleaner depends largely on where the electricity is produced. They also worried that EV batteries were too big and expensive to replace gas-powered models and better suited to the types of smaller vehicles that Americans didn’t want.

For the full story, see:

River Davis and Sean McLain. “Toyota Skeptical of Going All-EV.” The Wall Street Journal (Monday, Dec. 19, 2022 ): A1 & A6.

(Note: ellipses added.)

(Note: the online version of the story was updated Dec. 18, 2022, and has the title “Toyota Chief Says ‘Silent Majority’ Has Doubts About Pursuing Only EVs.”)

Dogs Can Accurately Know by Smell When a Human Is Stressed


(p. C4) Dogs are champion sniffers, equipped with 100 to 300 million olfactory receptors in their noses—compared with a mere 6 million in our own—and an olfactory cortex 40 times as large as ours. They can be trained to detect disease in human beings, including cancer cells, a latent epileptic seizure, or a Covid infection, just by sniffing—no blood samples, biopsies, MRIs, antigen or PCR tests required.

. . .

In a study published in September in the journal PLoS One, Ms. Wilson and colleagues tested whether dogs can read and respond to our emotional states, without the benefit of facial expression, tone of voice, or social context. The researchers trained four dogs to detect and react to the smell of human stress, depending on their sense of smell alone to distinguish between a person’s baseline scent and the unique cocktail of volatile organic compounds (VOCs) in their sweat and breath when they’re feeling stressed out.

. . .

The results offered overwhelming confirmation that dogs can smell psychological states as well as physical ones. On average, the four dogs picked out the stress sample 94% of the time, with individual dogs ranging between 90% and 97% accuracy. “There’s a smell to stress,” Ms. Wilson concludes. “If we can add it to the dog’s repertoire, we can use it to identify anxiety and panic attacks before they occur.”

For the full commentary, see:

Susan Pinker. “MIND AND MATTER; Dogs Can Sniff Out When a Human Is Stressed.” The Wall Street Journal (Saturday, Oct. 22, 2022): C4.

(Note: ellipses added.)

(Note: the online version of the commentary has the date October 20, 2022, and has the title “MIND AND MATTER; Dogs Can Sniff Out Human Stress.”)

Smil Shows How Fossil Fuels “Are Indispensable to Feeding the World”

(p. C6) In “How the World Really Works” the distinguished Canadian environmental scientist Vaclav Smil distills a lifetime of erudition.

. . .

Mr. Smil describes the massive extent to which fossil fuels are required to extract and produce the core materials—ammonia-based fertilizers, steel, cement and plastics—that are indispensable to feeding the world and building the machines and infrastructure on which modern economies depend.

. . .

Within the realm of the possible, he writes, “one thing remains certain” about transitioning to renewable energy: “It will not be (it cannot be) a sudden abandonment of fossil carbon, nor even its rapid demise—but rather its gradual decline.”

For the full review, see:

William Barr. “12 Months of Reading; William Barr.” The Wall Street Journal (Saturday, Dec. 10, 2021): C6.

(Note: ellipses added.)

(Note: the online version of the review has the date December 8, 2022, and has the title “Who Read What in 2022: Political and Business Leaders.”)

The book praised by William Barr is:

Smil, Vaclav. How the World Really Works: The Science Behind How We Got Here and Where We’re Going. New York: Viking, 2022.

How to Resist the Heat Death Implied by the Second Law of Thermodynamics

When I was a young philosophy student I sometimes worried that the Second Law of Thermodynamics ultimately made meaningless all human perseverance toward progress. Physics Nobel laureate Frank Wilczek gives young philosophers reasons for hope.

(p. C4) The capstone of thermodynamics is its so-called Second Law, . . ., which states that entropy, a measure of disorder, increases over time—distinctive structure erodes. Featureless equilibrium is the state of maximum entropy, toward which the Second Law drives us.

The inexorable logic of the Second Law leads, in the long run, to a bland universe wherein nothing changes—that is, heat death.

. . .

There are several ways that our distant descendants, or other embodiments of mind in the universe, might resist heat death. Here are some ideas that occurred to me . . .:

First, it is probably possible to burn matter further than stars do. Stars rearrange protons and neutrons but do not change their overall number. Burning those particles would give access to hundreds of times more energy. Another (barely) conceivable form of fuel is “dark matter.” At present, nobody knows what it is, but there’s lots of it in the universe.

Second, future engineers also might be able to arrange controlled collisions of planets or dead stars, to tap into the energy the crashes liberate.

Third, future minds themselves might be able to run on very limited power. Recent theoretical work on reversible and quantum computers, and on time crystals, has shown that there’s no lower limit to how little energy they need to keep making progress, or at least to keep moving.

Fourth, since we don’t really understand what triggered the Big Bang, it’s conceivable that someday we’ll be able to engineer something similar, and thereby rejuvenate the universe.

For the full commentary, see:

Frank Wilczek. “WILCZEK’S UNIVERSE; Delaying the Heat Death of The Universe.” The Wall Street Journal (Saturday, Sept. 3, 2022): C4.

(Note: ellipses added.)

(Note: the online version of the commentary has the date September 1, 2022, and has the same title as the print version.)

New Technology Creates More Jobs Than It Destroys

(p. 3) The pessimist’s basic mistake is to focus too much on what is lost to competition and technology, and too little on what is gained. Over the past 25 years, as McKinsey & Company, the consulting firm, has pointed out, about a third of the new jobs created in the United States were types that did not exist or barely existed 25 years ago.

. . .

In New York City the car replaced the horse carriage within the first 15 years of the 20th century, killing off the carriage trade and giving birth to the taxi trade — as well as to highly paid auto mechanics. Uber threatens the taxi trade, and the self-driving car threatens the Uber driver. But it has also brought multimillion-dollar signing bonuses for self-driving-car engineers and created new opportunities for mechanics. People tend to find a way to work with and profit from new technology.

. . .

In most cases, an industry without enough workers to meet customer demand would simply hire more, or at least raise wages to attract them.

Yet, according to the Bureau of Labor Statistics, neither of those things happened last year. The number of pharmacists employed in the United States dropped about 1 percent from 2020 to 2021. On balance, employers did not raise wages — in fact, median pay fell slightly, even without adjusting for inflation.

. . .

. . . there is no evidence so far to support forecasts of a nearly jobless future. If robots threatened human labor, human joblessness would be growing. But it’s not. In fact, since 2008, job growth has been strongest in countries like Germany and Japan, which deploy the most robots.

For the full commentary, see:

Ruchir Sharma. “No, That Robot Will Not Steal Your Job.” The New York Times, SundayReview Section (Sunday, October 8, 2017): 3.

(Note: ellipses added.)

(Note: the online version of the commentary has the date Oct. 7, 2017, and has the same title as the print version.)

Across Communist China a Sheet of Blank White Paper “Is a Symbol of Tacit Defiance”

(p. A7) In Shanghai, a vigil grew into a street protest where many held blank sheets of white paper in a symbol of tacit defiance.

. . .

. . . in a country where the authorities have very little tolerance for open dissent, many communicated through subtler methods, and among the most prominent were the blank sheets of white paper used in Shanghai, Beijing and other cities.

. . .

Demonstrators used the white sheets to mourn those lost — white is a common funeral color in China — and to express an anger understood implicitly by millions who have suffered under pandemic restrictions.

The display of wordless papers “means ‘we are the voiceless, but we are also powerful,’” said Hazel Liu, a 29-year-old film producer who attended the vigil along the Liangma River in Beijing on Sunday [Nov. 27, 2022].

. . .

“People have a common message,” said Xiao Qiang, a researcher on internet freedom at the University of California, Berkeley. “They know what they want to express, and authorities know too, so people don’t need to say anything. If you hold a blank sheet, then everyone knows what you mean.”

Some protesters told The New York Times that the white papers took inspiration from a Soviet-era joke, in which a dissident accosted by the police for distributing leaflets in a public square reveals the fliers to be blank. When asked, the dissident replies that there is no need for words because “everyone knows.”

. . .

Some have pushed the protests in other creative directions. A statement that appeared to have been sent by one of China’s largest stationery companies circulated online, saying that the company would suspend sales of A4 paper to “safeguard national security and stability.” The company was forced to announce on its social media account that the message was fabricated and that all operations remained normal.

The muted defiance of the protests — often innocuous on the surface — has handed the police the nebulous task of deciding what crosses the line.

For the full story, see:

Chang Che and Amy Chang Chien. “With Sly Memes and Wordless Protests, Fed-Up Chinese Test the Authorities.” The New York Times (Tuesday, November 29, 2022): A7.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the story has the date Nov. 28, 2022, and has the title “Memes, Puns and Blank Sheets of Paper: China’s Creative Acts of Protest.”)

Pharmacy Benefit Managers (PBMs) Create Incentives to Reduce Hiring and Pay of Pharmacists

(p. A1) If any group of workers might have expected their pay to rise last year, it would arguably have been pharmacists. With many drugstores dispensing coronavirus tests and vaccines while filling hundreds of prescriptions each day, working as a pharmacist became a sleep-deprived, lunch-skipping frenzy — one in which ornery customers did not hesitate to vent their frustrations over the inevitable backups and bottlenecks.

“I was stressed all day long about giving immunizations,” said Amanda Poole, who left her job as a pharmacist at a CVS in Tuscaloosa, Ala., in June. “I’d look at patients and say to them, ‘I’d love to fill your prescriptions today, but there’s no way I can.’”

Yet pay for pharmacists, who typically spend six or seven years after high school working toward their professional degree, fell nearly 5 percent last year after adjusting for inflation. Dr. Poole said her pay, about $65 per hour, did not increase in more than four years — first at an independent pharmacy, then at CVS.

For many Americans, one of the pandemic’s few bright spots has been wage growth, with pay rising rapidly for those near the bottom and those at the top. But a broad swath of workers in between has lagged behind.

. . .

(p. A16) Pharmacies also faced external challenges. To hold down the cost of prescription drugs, insurance companies and employers rely on so-called pharmacy benefit managers to negotiate discounts with drugmakers and pharmacies. Consolidation among benefit managers gave them more leverage over pharmacies to drive prices lower. (CVS merged with a large benefits manager in 2007.)

Big drugstore chains often responded by trying to rein in labor costs, according to William Doucette, a professor of pharmacy practice at the University of Iowa. Several pharmacists who worked at Walgreens and CVS said the formulas their companies used to allocate labor resulted in low levels of staffing that were extremely difficult to increase.

According to documents provided by a former CVS pharmacist, managers are motivated by bonuses to stay within these aggressive targets.

. . .

In most cases, an industry without enough workers to meet customer demand would simply hire more, or at least raise wages to attract them.

Yet, according to the Bureau of Labor Statistics, neither of those things happened last year. The number of pharmacists employed in the United States dropped about 1 percent from 2020 to 2021. On balance, employers did not raise wages — in fact, median pay fell slightly, even without adjusting for inflation.

. . .

Several pharmacists said they were especially concerned that understaffing had put patients at risk, given the potentially deadly consequences of mix-ups. “It was so mentally taxing,” said Dr. Poole, the Tuscaloosa pharmacist. “Every day, I was like: I hope I don’t kill anyone.”

. . .

Asked about safety and staffing, CVS and Walgreens said they had made changes, like automating routine tasks, to help pharmacists focus on the most important aspects of their jobs.

Many pharmacists contacted for this article quit rather than face this persistent dread, often taking lower-paying positions.

Still, none had regrets about the decision to leave. “I was 4,000 pounds lighter the moment I sent my resignation email in,” said Dr. Wommack, who left the company in May 2021 and now works at a small community hospital.

As for the medication she had taken for depression and anxiety while at Walgreens, she said, “Shortly after I stopped working there, I stopped taking those pills.”

For the full story, see:

Noam Scheiber. “Why Working At Pharmacies Lost Its Luster.” The New York Times (Tuesday, September 13, 2022): A1 & A16.

(Note: ellipses added.)

(Note: the online version of the story has the same date as the print version, and has the title “How Pharmacy Work Stopped Being So Great.”)

The “Longevity Under Adversity” of the Bristlecone Pine “Is a Metaphorical Dose of Qualified Hope in an Unstable World”

(p. C9) . . ., trees seem to grow on a timescale humans can comprehend. A seed planted by a child will be largely mature when she is—and will likewise get thicker and wrinklier as it ages. The tree, however, might long outlive her; there’s a reason we use the shape of a tree to chart the chain of human generations.

This intertwining of biology and chronology is the subject of Jared Farmer’s rich but overstuffed “Elderflora: A Modern History of Ancient Trees.”

. . .

Mr. Farmer, raised in Utah, is partial to the Great Basin of the American West, cradle of the oldest living things securely dated: gnarled specimens of bristlecone pine. The coronation of bristlecones in the 1950s followed a few decades of scientific progress. Counting rings had long been the main method of tree dating, one that held an intuitive power even beyond the laboratory. Slices of big trunks marked with purportedly significant dates had become popular exhibits, a way to make time tangible. Scientists at the University of Arizona perfected the trick of combining multiple samples and lining up shared clumps of thick and thin rings—caused by year-to-year variation in climate—to extend the chronology beyond the span of a single specimen.

Using this technique, the pioneering dendrochronologist Edmund Schulman pegged one bristlecone at more than 4,500 years old, announcing his discovery in a National Geographic article whose publication he didn’t live to see. Mr. Farmer chronicles Schulman’s career in novelistic close-third-person narration—one more idiosyncrasy in this fascinating farrago of a book—lingering on Schulman’s coinage “longevity under adversity.” For Schulman, the phrase was a tribute to the bristlecone’s ability to endure extreme conditions through partial death; for Mr. Farmer, it is a metaphorical dose of qualified hope in an unstable world.

For the full review, see:

Timothy Farrington. “Time Made Tangible.” The Wall Street Journal (Saturday, Dec. 3, 2022): C9.

(Note: ellipses added.)

(Note: the online version of the review has the date December 2, 2022, and has the title “‘Elderflora’ Review: Ancient Trees Grow Among Us.”)

The book under review is:

Farmer, Jared. Elderflora: A Modern History of Ancient Trees. New York: Basic Books, 2022.

Office Space Designers Finally Pull Back from Extreme “Open” Space that Forces Collaboration at the Price of Blocking Concentration

(p. 1) First there were individual offices. Then cubicles and open floor plans. Now, there is a “palette of places.”

. . .

. . . the move toward pure open floor plans that packed more workers into less and less space . . . was supposed to drive collaboration, but many experts agree it often went too far, with row upon row of desks and workbench-style seating more likely to generate ennui than efficiency.

. . .

The new model is largely open, but not entirely. Under the revised thinking, breaking down walls to bring people together is good, but so are “team spaces” and standing tables, comfortable couches and movable walls.

Privacy is also good, particularly for tasks that require intense concentration, the thinking goes. That doesn’t mean a return to the glory days of private offices, but it does mean workers have more space and more places to seek solitude than in the neo-Dickensian workbench settings. The new designs often include “isolation rooms,” soundproof phone booths, and even lounges where technology is forbidden.

. . .

(p. 4) But in 2010, Microsoft started testing open designs with a quarter of a floor, and then expanded. Since 2014, it has opened 10 renovated buildings without offices, including four this year.

Microsoft, Mr. Ford said, has taken a test-and-learn approach. It learned, for example, that its early designs were too open plan, with 16 to 24 engineers in team-based spaces. Engineers found those spaces noisy and distracting, and concentration suffered. Too much openness can cause workers to “do a turtle,” researchers say, and retrench and communicate less — colleagues who retreat into their headphones all day, for example.

Today, there are more private spaces, and the team areas hold only eight to 12 engineers. “That’s the sweet spot for Microsoft,” Mr. Ford said.

The company thinks it is working. Microsoft’s Azure cloud software business has surged in the last few years, as has the company’s stock price. Mr. Ford said about 20 percent of the workplaces have been redone on Microsoft’s campus in Redmond, Wash., and the surrounding area. Within five years, he said, he expects the renovated share to reach 80 percent.

For the full story, see:

Steve Lohr. “Don’t Get Too Comfortable at That Desk.” The New York Times, SundayBusiness Section (Sunday, October 8, 2017): 1 & 4.

(Note: ellipses added.)

(Note: the online version of the story has the date Oct. 6, 2017, and has the same title as the print version.)