Healthcare AI's Productivity Drag, Frugality power, Cloud insecurity, Crypto payments remix
Do we want to achieve more good? With strategic frugality, we could.
🎧 Listen here or on Spotify
Up to speed in 30 seconds:
- 💡 Frugality as a Change Leadership Value — True frugality isn’t “cheapness” or poverty, it’s intentional resource use (money, time, energy). Leaders who master it avoid budget paralysis and enable purposeful innovation.
- ⏳ Intentional Time ≈ Intentional Money — Just as time management frees people to do more of what matters, intentional spending creates freedom to invest in growth, resilience, and impact.
- 🌍 Mission Statements vs. Reality — Despite lofty corporate missions (e.g., Walmart, Pfizer, Starbucks, UnitedHealth), budget excuses often block impact. Strategic frugality could unlock alignment between vision and action.
- 🏥 AI in Healthcare Faces Productivity Drag — Healthcare absorbs labor while delivering weak productivity gains. Rising compute and energy costs compound the issue, echoing Baumol’s cost disease. Example: Even with FDA-approved AI tools, demand for radiologists is climbing.
- ☁️ Cloud Security = Costly Risk Zone — With 70% of enterprises reporting overruns, cloud spend is now a board-level liability. Misconfigurations + new data-layer services (Databricks, Snowflake, etc.) heighten systemic risk — echoing the 2024 Change Healthcare hack.
- 💲 Crypto Payments Race Accelerates — Google + Coinbase’s Agent Payments Protocol (AP2) embeds stablecoin rails into AI workflows, while MetaMask readies its MASK token and mUSD stablecoin. Both moves challenge Ethereum’s role as the default settlement layer.
- ⚖️ Shifting Ecosystem Value — Control may migrate from base protocols (ETH) to wallets, custodians, and payment gateways. Stablecoin dominance, regulatory pressure, and AI integration are reshaping where value — and power — accrues in digital finance.
[perspective]
🏆Change Leadership Values: Understanding and embracing frugality
I see 2 kinds of teams:
- Teams that come up with great ideas for positive beneficial change and go do them
- Teams that come up with great ideas for positive beneficial change and then say "we can't do this because have no budget!"
The "we have no budget" phrase is usually a sign of one thing: unintentional spending.
The more accurate rewording might be:
- "We have no control over our budget" or maybe
- "We don't really know what happens to our budget"
This is where it's most helpful to begin exploring and learning about frugality. We should think of frugality as core value for change leadership. But it's really important to understand what a healthy practice of frugality is - and what it isn't:
- Frugality is not a sad, confined condition
- Frugality is not "being cheap" or always buying the cheapest thing
- Frugality is not poverty.
Shaunak Patel has a great piece on the difference between being frugal vs being stingy.
We tend to have a negative view of frugality - like "oh no, we have to be frugal because we're so poor what a bummer." That's not frugality. We may also think of frugality as a grouchy greedy way of living.
But frugality is not just being miserly for greed's sake.
Frugality is using money intentionally
Being intentional about how you spend your money is different from not having money. It is also different from being selfish or miserly.
Being intentional means being clear about how you are using the money or other resources you have:
- Am I using it now, or sometime in the future?
- Am I using it for limited time purpose (ie consumption) or for a longer term purpose.
- Do I want to grow it, or just throw it?
The initial impression isn't always accurate
Sometimes we may have negative impressions of things that are good for us.
One of the key skills we teach in Change Leadership is how to measure and manage your time. Part of your brain might have a negative response to this like:
"Oh no, time management...we're going to have to go through our day like robot drones doing all these tasks efficiently...That's no fun!"
Actually it's WAY different.
For me and many others it's very exciting to realize that - once you start being intentional with your time, you really can do all the things you want to do! Its liberating and exciting.
You can get the things done that are nagging at you, and you can build blocks of time to do literally nothing if you want to. (We call this downtime...scheduled blocks of time for doing nothing, napping, whatever...you actually do need it).
The key point is you've gained the ability to be intentional - to use your time the way you want to, rather than being forced into a time deficit, or being forced to spend your time in ways you regret because you weren't intentional.
It's the same with managing money.
Frugality means learning how to be intentional with money so you can use it when and how you want to vs being forced into deficits or spending that you really didn't intend.
You and I can learn spend based on what matters to you vs just spending and not realizing what's happening. And that is what it means to embrace frugality.
Zooming out: Why this matters
If you look at the mission statements of the world's corporations, they are generous, visionary, powerful:
- "We aim to build a better world — helping people live better and renew the planet while building thriving, resilient communities." - Walmart
- "We innovate every day to make the world a healthier place" - Pfizer
- "Nurture the limitless possibilities of human connection" - Starbucks
- "Improving the quality of life in the communities we serve" - Fidelity Bank
- "Make the health system work better for everyone" - UnitedHealth
(See 51 more mission statements here)
You can't help but think: Wow, if all of these companies were actually delivering on their mission statements, the world would be a healed and thriving place.
After all, these are the largest, most profitable, highly capitalized teams on the planet. They possess enormous pools of talent, technology and assets. So why doesn't more good happen? If you were to ask, you'll hear a version of that same phrase "we don't have budget". But you and I know, that if we went through the finances of just about every company we could find opportunities for more intentional spending. Opportunities for smart strategic frugality - more intentional use of resources, time and money to accomplish more good.
And that's why this matters: want to achieve more good? With frugality, we can.
[tech + economics]
🏥 Problems emerge with the "AI drives healthcare efficiency" theory
Andrew Cates explains a key issue that could complicate AI's ability to achieve meaningful healthcare efficiency gains:
- Labor keeps migrating to healthcare
- But productivity in healthcare remains weak
- AI will raise compute and power costs (not lower them)
Why? "Baumol's cost disease" - the economic observation that "When high-productivity sectors raise wages, low-productivity sectors must follow to retain staff, even if their output per worker doesn’t rise much. As labour shifts toward these “stagnant” sectors, aggregate productivity growth can slow."
This tends to dilute productivity gains especially under current conditions. 1 in 10 jobs are in healthcare, which is a rising share of GDP, but productivity gains are weak. At the same time, costs for cloud compute and power are rising.
Related: Radiology has more FDA approved AI medical devices than any other sector in healthcare. Why the demand for human radiologists is at an all time high.
☁️🔒Does Cloud have a (cost-effective) secure future?
Cloud security relies on foundational security components that enable the entire cloud security framework maintain security. However these foundational security components are coming under increasing scrutiny, amid questions of their cost and suitability for the evolving threat environment.
Cost and control factors are being complicated by the manner in which data platforms like Databricks, Snowflake and others are rolling out new services on top of cloud infrastructure provided by AWS, Google Cloud and MS Azure. This often introduces data usage patterns and security complications that were not foreseen when teams set up their original cloud security frameworks.
As noted previously, costs for cloud compute and power are rising. 70% of enterprises report cost overruns on cloud projects. Cloud spend is now a board-level liability.
Together these factors raise the risk of small misconfigurations enabling large security failures that paralyze a company or - as in the case of the 2024 Change Healthcare hack - paralyze an entire industry.
To start developing your team's strategy for cloud security in 2026 and beyond, see the S3T Cloud Security Deep Dive for Paying Members : 🔐Is your cloud ready for the adversaries of the future?
💲Crypto Payments Competition
Google, Coinbase, MetaMask, and risks for Ethereum
The battle for control of the next generation of payments — especially in the context of AI-driven applications — is accelerating. Two major announcements in the past week highlight the stakes:
#1: Google + Coinbase: Stablecoin Payments for AI Agents
Google unveiled its new Agent Payments Protocol (AP2), an open-source framework that enables AI applications (“agents”) to initiate payments autonomously. The protocol supports both traditional finance rails and crypto rails, with Coinbase as a key partner for stablecoin payments. This means that AI agents could soon handle recurring subscriptions, micro-transactions, or even peer-to-peer commerce using stablecoins like USDC. Google emphasized user protection through “mandates” and verifiable credentials — cryptographic authorizations that define exactly what an AI agent can and cannot spend (Google Cloud blog, CoinDesk).
This collaboration raises the prospect of crypto becoming embedded directly into AI workflows, a shift that could drive adoption of stablecoins at scale. But the choice of which blockchains to support will matter greatly: if AP2 routes stablecoin payments on fast, low-cost competitors to Ethereum, that could siphon off activity from Ethereum’s settlement layer.
#2: MetaMask: Token and Stablecoin Experiments
Meanwhile, MetaMask confirmed plans to launch its long-anticipated MASK token. While details remain under wraps, ConsenSys CEO Joseph Lubin suggested it is arriving “sooner than you might expect.” Analysts expect the token to support governance, user incentives, and potentially payments integration (The Block, 99Bitcoins). In addition, MetaMask has been linked to an experimental mUSD stablecoin in partnership with stablecoin protocol M^0 (CoinDesk).
Given MetaMask’s reach as the most widely used Web3 wallet, a native token and/or stablecoin could reshape incentives across the Ethereum ecosystem. Depending on execution, MASK could either strengthen Ethereum by decentralizing wallet governance or fragment the ecosystem if it competes with existing ETH-based projects.
Implications for Ethereum and Other Key Players
The intersection of these moves suggests several critical dynamics:
- Ethereum under pressure: Ethereum risks losing transaction volume if AP2 favors faster or cheaper chains for stablecoin settlement. At the same time, MetaMask’s token could centralize value capture at the wallet layer rather than at the protocol layer. Fidelity's 2023 Ethereum Investment Thesis may need an update.
- Stablecoin power play: Whoever controls the most widely used stablecoin rails — Circle (USDC), MetaMask (mUSD), or AP2’s chosen partners — will likely gain leverage over how AI agents and wallets interact with crypto.
- Shift in ecosystem value: Value could flow away from core protocol tokens like ETH and into wallets, custodians, and payment protocols that sit closer to the user and the application layer.
- Regulatory wild card: The rise of autonomous agent payments, coupled with new governance tokens, will almost certainly draw attention from regulators concerned about fraud, money laundering, and investor protection.
Bottom line: The crypto payments race is no longer just about sending money faster — it is about who owns the rails that AI agents and billions of users will rely on for transactions. Ethereum’s dominance is being tested, as players like Google, Coinbase, and MetaMask position themselves as gatekeepers of the next generation payments architecture.
Opinions expressed are those of the individuals and do not reflect the official positions of companies or organizations those individuals may be affiliated with. Not financial, investment or legal advice, and no offers for securities or investment opportunities are intended. Mentions should not be construed as endorsements. Authors or guests may hold assets discussed or may have interests in companies mentioned.
Member discussion