A Conversation About “Made in America”


In 1990, China only accounted for 3 percent of the entire global manufacturing output by value, a number that's since skyrocketed to a whopping 25 percent. Add to that the fact that the Chinese make things we tend to use more frequently (such as computers and smartphones) and suddenly it seems like “everything" actually is made by this powerhouse of a country.

For example, The Economist reports that China produces roughly 70% of the world's smart phones, 60% of its shoes, and 80% of air conditioners. This rapid rise in efficient, money-making factories in China has naturally inspired other Asian countries to follow suit, which has resulted in roughly 50% of the world's total goods coming from Asia Pacific's “Factory Asia."

Cue the fervent push to “bring jobs back to America" and to increase the number of product labels that read “Made in the USA." In theory, it sounds like a brilliant, no-brainer of an idea. Boosting U.S. manufacturing means that we increase the number of jobs available to America's own, right? Sure, but not without cost.

The Cost of Bringing Jobs Back to America

It's no secret that Asian factories are often more efficient, easier to work with, and more cost effective than their U.S. counterparts. This, of course, translates to cheaper price tags. For example, Marketplace crunched some numbers and discovered that if every single part of an iPhone was produced within the states, the retail value would hover around $2000. And here's a real-world application for you: Levi's currently sells two versions of its “Original Shrink-To-Fit Selvedge Jeans" – one that's produced outside of the states, and another that's made in the USA.

These are two identical pairs of jeans, but with two different production locations and therefore two different prices. The first pair of jeans retails for $128 while the USA-made jeans cost $148. While that's only a $20 difference, it's still a savings. Before you assume everyone would naturally fork over the extra Hamilton, consider a 2016 Associated Press-GfK poll that asked people to choose between a $50 pair of pants made outside of the USA and a USA-made $85 pair equivalent.

Despite the current outcry for “Made in the USA" labels, the poll found that 67 percent of people would choose the cheaper pair. What's also important to note about this poll is that individuals in high-earning households ($100,000 or higher) were no less likely than lower-income Americans to choose the less expensive, made-overseas product.

What's the Solution?

While there's an ever-increasing push to produce more goods in America, there's also a complacency (on the consumer's part) and fear (on the company's part) driven by these bargain-priced products. Ultimately, producing more expensive, American-made products can potentially shove companies out of an already fiercely competitive market.

An interesting case study of “Made in America" products comes from luxury brand Shinola, which was founded as an experiment of sorts in 2011 by Tom Kartsotis, the Texas mogul who famously founded the Fossil Group out of his garage back the in the '80s. Kartsotis chose Detroit of all places – easily one of the country's most untouchable cities – and poured $225 million into his new company. The two primary goals were to bring well-paying, benefit-laden jobs to people who were out of work in Detroit, and to see if Shinola could actually produce and sell watches made in America.

In an April 2017 lecture for the Savannah College of Art and Design (SCAD) Style conference, Kartsotis shared the original vision and evolution of Shinola, and expressed that he really wasn't sure if this “experiment," if you will, would work. Fast forward to 2017 and the company has since expanded from watches to leather, bicycles, paper products, and recently audio and jewelry. They're even planning to build a hotel. Despite the (comparatively) higher price tag on many of their goods, consumers are still buying Shinola because they believe in the brand and their mission.

Interestingly, though, when an aspirational clothing designer student asked Kartsotis if he had any advice for those going into the garment-producing industry, he offered the non-sugarcoated response of “Garments? It's tough. It's very difficult. We're staying away from that one for right now."

This answer is assumingly two-fold: it's hard to break into the garment industry in the first place, but it's also tricky from a retail pricing standpoint. He mentioned that the cost associated with producing an American-made, Shinola garment was almost double the price of equivalent current market products, which may make Shinola non-competitive even as a luxury brand.

Clearly Shinola is doing something right – and creating jobs in the process – but the truth is that not every business is savvy enough to pivot to U.S.-made products and sell $850 watches to the general public. Not to mention the insane amount of shifting and re-sourcing this would require of companies. Apple's current assembly line spans over 20 different pieces in at least nine countries.

Interestingly, some companies – particularly those specializing in electronics – have taken a “meet you in the middle" approach in which production takes place overseas, but assembly, crafting and designing occurs within the U.S. This hybrid approach alleviates costs while allowing for more localized quality control, and arguably supports both the global and American economy.

At the end of the day, “Made in America" is a luxury label. It's certainly not a label for the poor, and is even a tough sell for the wealthy. Whatever the solution is, it's going to require decades of slow shifting and thoughtful consideration.

5min read

Turn Off Your Period: Why You Don't Have To Bleed Every Month

Let me share with you a female doctor and CEO's life hack: if you are not trying to 'make' a baby, you do NOT have to bleed every month. As doctors, we have seared into women's minds: you must have a period every month (if you are not on any medications). However, we now have the technology to safely and effectively "turn off" periods.

The idea of #PeriodsOptional first came to me when I was trying to get pregnant with my first child. Each month the uterus builds a rich blood filled lining to accept an embryo. But without an embryo, that lining gets shed, and the whole process starts over again. Basically, the only reason that we (those with uteri) bleed each month is because we didn't get pregnant. An average woman will begin her period at 12 years old, have two children in her lifetime, and remain fertile until the age of 50. That's approximately 35 years of incessant menstruation for no good reason.

Each time you build up that lining (endometrium) and slough it, you risk endometrial cancer. And each time you pop out an egg for that lining, you risk ovarian cancer. The only way to prevent ovarian cancer that we currently know of (short of taking out your ovaries) is to turn off the monthly egg-popping using birth control. Women who used birth control pills for 5 or more years have about a 50% lower risk of developing ovarian cancer compared to women who never used oral contraceptives.

Dr. Beverly Strassman, who studied the Dogon tribe in Mali, found that it might be "more natural" to have fewer periods. In the old days, we had about 100 periods in our lifetimes. Now, we have 350-400. Historically, we'd start periods at 16 (we now start at 12 years old), we'd have eight babies (we now have two on average), and we'd breastfeed for 20 months (we now do zero to six months at best).

Since the creation of the birth control pill, doctors have known that the one week withdrawal bleed (aka "period") is optional. Dr. John Rock, one of three co-founders of the birth control pill, was the one that pushed for a bleed one week out of four. It was to see if he could get the method through the Catholic Church. He said it was just to make the periods regular and thus Catholics could better utilize the rhythm method. He also thought that women would be more likely to accept the method if it was consistent with what they were used to. Thus since the beginning the birth control pill, women have been forced to bleed one week out of four. Needless to say, if I were one of the co-founders, I would have pushed for #NoPeriods or #PeriodsOptional.

Let's explore other benefits of skipping your monthly bleed:

  • You save money – we use 12,000 feminine hygiene products in our lives.
  • You save the planet from landfill.
  • You decrease your risk of certain medical conditions – ovarian cancer, endometrial cancer, and anemia
  • Certain diseases do better on stable hormonal levels – acne, PCOS, diabetes, seizure disorder, depression/psychological conditions.
  • Increased productivity – the number one cause of missed work/school in a woman under the age of 25? Her periods.

Using birth control to skip periods:

  • You can use the hormonal IUD, the implant, the shot, the ring, the patch and the pill. Note: You cannot use the patch for longer than 12 weeks in a row, because too much estrogen will build up in the blood.
  • You do not have to use "special pills" that come in 84 or 91 days packs. You can use any pill and just skip the last week (if it is a four week pack) or go straight into the next pack (if it is a three week pack). Though if you are paying cash, those are sometimes cheaper.
  • If you get breakthrough bleeding and have taken at least three weeks of active pills in a row, then you can stop the active pills for five days, have a bleed during that time, then restart on day six whether or not you are bleeding. This "cleans out the uterus" and allows you to start fresh.
  • There are 40 different formulations of the birth control pill. So if one doesn't work for you, there are at least six other progestins and two levels of estrogen to play with.
  • To skip the bleed on the pill, you want a progestin with higher progestational activity. Go to this chart that I created to review the options.

As the only female founded/led reproductive health company in the birth control delivery space, Pandia Health set out to make women's lives easier by sharing cutting edge, evidence-based women's healthcare. We commissioned a study of 1000 women ages 20-35 in the US to see what they knew about the topic. We found that:

  • 66% of women had never been informed by a doctor that they could skip their periods safely.
  • 46% have missed school because of periods.
  • 58% would turn of their periods if they knew it could be done safely.


So make your uterus a happy uterus. A happy uterus is one that is not "crying" unnecessary bloody tears.