Tim O'Reilly discusses the 'clothesline paradox' in relation to sharing economies and emphasizes the need for businesses to create value rather than simply extract it for profit. He critiques modern capitalism's focus on shareholder profits, illustrating his points with references to economic theories, the growth of open-source software, and examples of sharing economies like Airbnb and crowdfunding. O'Reilly concludes that fostering a culture of giving and collaboration can lead to a richer and fairer economy for all.