Nina

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On December 1, 2017, Nina commented on Lotte at the Whim and Mercy of Chinese Nationalism :

This article was very interesting. I was unsurprised to read that China has basically forced Lotte out, as there is a history of China supporting domestic companies. While I support keeping Lotte in China, I would only do so dependent on what expectations Lotte management has. If Lotte expects that they will manage the company or make major decisions, they should pull out, as I doubt the Chinese government or businesses would allow that. However, if Lotte is looking to make some money by investing or utilizing its supply chain, staying in China may be a possibility — Lotte just has to be comfortable with ceding the majority if not all decision making power.

In response to the questions posed, companies can mitigate political risk by diversifying its operations into different locations. By doing so, the company has minimized idiosyncratic risk of that specific location. Additionally, I do not think China’s actions is a representation of nationalism — it’s simply a way for one nation to pressure another into conforming to its demands. In this case, China was reacting to an event, rather than organically feeling nationalistic and kicking Lotte out of the country. These actions will most likely become more commonplace as China feels it has increased power to influence and make demands in the world.

On December 1, 2017, Nina commented on Nestle: Greening the Supply Chain :

This article and its questions were interesting. I doubt that consumers take sustainability into account on purchases — perhaps there are a few who do, but the overwhelming majority do not. If they did, meat consumption (a big causer of carbon emissions) would be drastically reduced, but that’s not the case. Nestle’s foray into sustainability, as mentioned in the article, may simply be for good PR and a marketing ploy. If this was the case, it makes sense why they have gone so far into “greenwashing” — after all, they can now use the idea of sustainability to drive sales even more. I would be curious to see if sales have increased due to consumer perception of sustainability with Nestle, and if so, what has the increased production volume done to the environment.

In regards to large companies convincing shareholders for sustainability — the solution is simple: show how investing in sustainability would result in greater returns. PR, lowered costs, and a sustainable supply for the future are all reasons.

This was an interesting article, especially as I did not know Colgate had participated in such a campaign to reduce water usage. However, their participation makes a lot of sense: making their products has costs and if their consumers are increasing their costs, they will eventually see the ramifications. Thus, this leads to my answer for the first question posed. While I do not think big companies have any obligation to control for sustainability in their suppliers, it is to their best interest that they do so. There are many upsides: good PR, controlled future costs, and potentially even lower future costs. The main downside is that costs may increase in the future or that government regulation would cause changes/disruptions to the supply chain. Thus, its in the best interest of large companies to get in front of externally instituted regulations and make those changes themselves in a less costly manner.

In regards to the second question, while not necessarily first movers, but companies that have a lot of purchasing/influencing power can work with suppliers to have sustainable practices to the point that it would be more costly to keep both operations open (sustainable/non-sustainable). In that way, they would force laggards to adopt sustainability, as the laggards would have no other interest. However, I recognize that such pressuring may be difficult from only one company, hence I believe that an agreement between different companies would oftentimes have to be formed in order to make widespread changes across an entire industry.

I would be curious to know, however, whether Colgate has received any upside yet from implementing their Smile campaign. Have their costs decreased or their revenue increased?

On December 1, 2017, Nina commented on Cuba Libre: Airbnb’s Approach to Diplomacy in Cuba :

This was an extremely interesting article. I agree that there is huge potential–simply economically–for AirBNB to expand in Cuba. While I question any humanitarian motives, I appreciate the outcome of encouraging interaction between people globally, which would hopefully improve relations between different cultures. I am happy to read that AirBNB has faced challenges, such as providing cash to its hosts, and found solutions.

I disagree with the comments above that suggests that AirBNB is not making too much of a difference as there is already a network of casa particulares. Even though an infrastructure for hosting is already available, I believe that by making such bookings available on AirBNB, people would be more encouraged to try to go to Cuba. Instead of having to perform research themselves on what casa particulares even are, AirBNB simplifies this process or at least connects tourists with a system of hosting that they are already familiar with, thereby encouraging tourism into Cuba. My main worry, however, is the political environment, as pointed out by the author. While AirBNB can lobby to open up trade/travel with Cuba from the US, any actions on this front seems to be completely arbitrary based on the current climate of the government. However, even so, AirBNB steps provides a simple platform for tourists from countries around the world to get a taste and understanding of Cuba.

On December 1, 2017, Nina commented on Impact of Digitalization on Healthcare :

EMR is a big topic nowadays, especially with the mandate a few years ago for hospitals to all have electronic systems. This article is well-written and interesting as its focuses only on one healthcare system — Kaiser. No doubt, the EMR has helped increased efficiency as stated in the article. The main question now, however, is integrating this system across multiple systems. As mentioned in previous comments, Kaiser is relatively only known on the West Coast and while its EMR has been very helpful for patients who stay within the system, it most likely has been a headache for patients who are moving to other areas and health systems. The inability for EMRs to speak with each other currently and easily transfer information is a major problem.

Additionally, as a provider, I would say that the subjectivity of data in EMRs may actually not be that big of a deal, because doctors are trained to question previous doctor’s records. In other words, physicians are trained to take the history of a patient with a grain of salt, and to think through all possible differentials. However, because of innate human biases towards common vs. uncommon illnesses, certain diagnoses may be missed. This may thus be an area where digitization can be even more helpful — as mentioned, leveraging IBM Watson so that probabilities of differentials can be weighted in a more objective manner.

As the doctor shortage continues in rural areas, I have no doubt that telemedicine will be an expanding field. While it has been shown that treating patients in well-known clinics may result in better outcomes, thereby encouraging companies to contract with large and well-known health systems for their employees as it would be more cost-effective (https://www.advisory.com/daily-briefing/2013/10/09/walmart-lowes-enter-bundled-pay-deal-with-four-health-systems), I am hesitant to extrapolate the work of such doctors to be effective under all telemedicine settings. To better understand the utility of telemedicine, I am interested to see how the eHospital is faring in terms of effectiveness to its patients as compared to ICUs without a telemedicine team. While I agree that certain aspects, such as patient rest, may be optimized with such a system, I believe that clinical exams by physicians of patients in the ICU may be extremely important for such sickly patients.

However, I do agree that certain areas, such as surgeries, can adhere to the telemedicine set-up pretty easily, as surgeries are already being performed oftentimes by a junior (e.g., resident) with oversight by a senior (e.g., attending). But overall, outpatient telemedicine may be easier and more appropriate than inpatient. Thus, I would be wary about too optimistically using telemedicine for all of medicine.