Marcus:
If you enjoy this content, please take a moment to rate and review it. Your feedback will greatly impact our ability to reach more people. Thank you. Well, feeling the best I've felt all week. I didn't need a McDonald's quarter pounder, but I did get food poisoning. Oh, man,
Vic:
that is rough. Yeah, I've had that before. It's not fun.
Marcus:
Yeah. And I had it while I was traveling. Yeah. Let's go to Salt Lake City for the bank board meeting. And, um, so you're two or three days post now. Yeah. Uh, I'm, this is like day one post, uh, like yesterday was fully on the mend kind of thing. And this is like the first day without it. And, uh, yeah, it feels a lot better. So, I mean, but I was scared because like, I'm having these symptoms and then I hear about the E. coli thing and I'm like, Oh,
Vic:
and when it first came out, there's not that much clarity on what restaurants are where who's
Marcus:
involved. Yeah. And I saw like this list of all these different stores where they're like, all of these stores had recalls and I'm like, Oh, I know that was, that was it. But no, it was just, Yeah, run of the mill food poisoning. So, um, yeah, but, but you know, just, just a reminder. It's, it's, uh, you can do everything you can try to do everything right. And still life is going to happen. Yeah.
Vic:
I mean, I think you're, you're resilient enough that you can fight, fight through that. It's not fun when you're in it, but that's where all the, the exercise and, and. Healthy living then pays off and
Marcus:
getting good sleep and things of that nature. So anyway,
Vic:
how's your week? It was good Um, I did not go to HLTH, which I was happy about. I skipped it So I've heard from lots of people out there. We got a bunch of stories from it Yeah, it was nice to be able to try to get some work done And I have a lot of companies. I'm looking at can only do three more in the fund And gosh, there's a lot of pretty interesting companies now, so
Marcus:
yeah, there's a lot of stuff out there. Catherine represented, uh, jumpstart. Yeah. Out there. Okay, good. She was running around taking pictures. Yeah. Having fun. So we'll have to get the download from her Yeah. Tomorrow. Um, but uh, you've lined up another great show. Yeah. And so a lot of news. Let's dig in. Alright. Starting with the economy, the US economy again leads the world. The IMF says.
Vic:
Yeah. So the IMF does this, um, kind of roll up of the entire global. Economy, I don't know how much Uh, credence I give it, but, but the U. S. is projected as, as growing next year. And, you know, really the productivity is what got my attention because productivity is the main way to increase standard of living and increase the economy without pouring a bunch more natural resources and things into it. So our, um, I think the technology. AI and other technology tools have sort of boosted productivity in the U. S. more than other countries. I
Marcus:
mean, look, there's certainly some metrics, especially when we look year over year, that are kind of tough. But, planes are full, streets are full, stores are full, concerts are full. Um, Nashville streets are full. Nashville is booming. Nashville is booming. Uh, cranes are out. You know, uh, Checks are being written, you know, we're going to talk about that in a little bit, I do think, and of course, we've got this technology revolution that's happening and all the, you know, not all, but a lot of the big companies are based here. Yeah, right. I mean, it's us in China. It's kind of nobody else in the race, really.
Vic:
And the only reason China is a serious competitor is they can take massive government investment. And yeah, yeah, right. Yeah. Yeah. But I, I will bet on the U. S. as far as innovation and growth and inventing new ways to use these productivity tools.
Marcus:
Yeah. It's, you know, as, as distressed as we feel in terms of being, you know, a quote unquote divided nation, we got this election, everyone's sort of worried. Somehow we are still keeping pace as the world's best economy. So that's
Vic:
good. Yeah. Our system is terrible, but it's the best system out of any
Marcus:
other country out there. Certainly seems like it. Uh, okay. So, and. In line with that, we talk about it quite often. You, you often reference the K shape economy, right? Right. And how it's hard to look at something like the IMF saying we have the best economy in the world. And then at the same time, it doesn't feel that way to people. Right. Um, the vibe check is the, as the millennials say, um, seems to be off when it comes to us having the best economy in the world. And so this wall street journal article. The headline is simple economic explanations. Keep breaking down. Here's why it's just saying that there's incongruence between the stock market and GDP growth and how we stack up from an economy perspective and how things feel.
Vic:
Yeah. I mean the, the simple. Like, economics 101, macroeconomics 101, where, okay, you raise rates, and that creates friction and slows down the economy, and then if you reduce rates, it has the opposite effect, that is too simplistic, and the Wall Street Journal is sort of pointing out how many of those narratives have not held up when you actually look at the past data, and they had four or five different Um, sources. It's not that clean cut. And I think the K shaped economy is the easiest way to see, if you try to aggregate everything together. Yeah, I don't know. I mean, it's not that clear. And so that's why we have started sort of separating, well, if you have more than half your net worth. In financial assets, you're in a different position than if you really primarily are getting your income as your, as your way to live. Right. Um, and so I think, but there is no, there's no like, okay, well then use this narrative. Right. It just is, these are, these are, It's more complicated than the simple narrative.
Marcus:
And I think also technology and specifically mobile technology is putting so many things at our fingertips. Like our ability to do things has never been greater, whether it's, you know, an entire world of content or getting the entire world delivered to you. You know, there's all these amazing things that you think about what you would have had to do to get any of those things done even 10 years ago. And it's like, it's crazy. Um, And at the same time, inflation is real. And it, you know, it does feel like trying to live the same quality of life level that you did 10 years ago is harder, right? So that's, that's kind of a weird juxtaposition of having this technological ability of the world at your fingertips, but yet accessing it, feeling harder than it did.
Vic:
Yeah, I mean, it used to be, and this isn't all that long ago, you'd have to go rent a movie and bring it home and put it in, you know, VCR or different player. And now you can do that on your phone or your, or your laptop. And it just sort of bundled in. You get all this extra benefit with just one device. Um, but things that are not digital. are increasing healthcare and real estate and other things that are in the food in the physical world don't have that dynamic. So you, so you have a, it's just a separation between the two.
Marcus:
All right. So we have not talked about banks outside of corporate real estate and things like that in a while. Um, but It's important to sort of flag this because this is relevant to our, our business. So, Oklahoma's first National Bank of Lindsay, that's a, I mean, that's a mouthful. And so, you can kind of tell that that's a pretty small bank. They had a failure. This is a bank that had a failure. Recently,
Vic:
like in the last
Marcus:
two weeks or a month. Yeah, so small, nobody heard of it. But the Wall Street Journal is covering it. Why? Because the FDIC actually stuck to their limit of 250 K of insurance per person. So per account, per account. So if you, if you had, uh, more than that in a single account there, uh, You're out of luck. They did not ensure above the 250 K mark. And the reason why that is so important is because, you know, it was just 2. 5 years ago. We had the meltdown with SVB, right? And in that meltdown, we were all worried for 48 hours. about whether or not millions of dollars per venture fund was about to be lost because it was, you know, recently funded into companies that had their
Vic:
5 million raise. And so they have right.
Marcus:
Um, and everyone was freaking out because it would have, it would have cratered a significant percentage of the venture industry, right? In one bank, too much concentration there. And the FDIC and Janet Yellen decided to bail everybody out and they covered it 100%, right? And by the middle of that week, everyone was whole.
Vic:
Which I think was the right
Marcus:
Decision, right? Because it would have been a systemic collapse with significant implications that, you know, the workout of that would have been really bad. So they made a decision to throw the 250 K limit out the window and make everybody whole, right? But in this case, they did not do that. And, uh, I think your reason for flagging it is this is kind of what you need to say, Hey, if you're a fiduciary and you are controlling that amount of money or more, You need to be investigating a sweep solution, a sweep account solution.
Vic:
Yeah, that's right. I think this is setting a precedent that the FDIC is not insuring deposits over 250, 000. And then in addition, there have been many solutions to sweep excess over 250 into multiple accounts for the explicit purpose of getting every account under. 250. It is a little bit of a hassle, but it's honestly not that hard. Yep. And yeah, I wanted to flag it because I think our, our audience should get set up in those accounts. And it's like any, um, you know, safety, uh, reserve thing. It's probably likely that your bank won't fail, but, but when it fails, it fails quickly. Silicon Valley Bank went under in two days. Yeah. And you're not going to be fast enough. And you're not going to get your money out. You're not
Marcus:
going to get your money out. No. So yeah, this is just a good heads up for everybody out there who was freaked out during the SBB failure. You're not freaked out today. This is a perfect time to take action, right? While you're not in a crisis, be aware of the FDIC has set a precedent that they will not always ensure beyond the 250 K limit. All right. This was a crazy headline home sales on track for the worst year since 1995. I mean, we're talking 30 years.
Vic:
Yeah, this is really scary. It's. It's been really slow sales, home sales this year. Um, rates are coming down, but they're still pretty high. Um, but then as you dig into a little bit more, there's pretty big difference between, uh, different regions of the country. So there are certain areas like Florida where. They've had weather issues, and it's difficult to get insurance, and so it's not smooth in every state or even every region around the country. But still, in the aggregate, the lowest sales since 1995 is pretty shocking.
Marcus:
Yeah. So I don't know, just for me, the lowest in 30 years is just a note worth making. Right. I mean, that's something that touches everybody. We're all sort of in the business of living somewhere. Many of the population is much bigger now.
Vic:
There's more homes in the country. Yeah. And so to go way back to 95, it's a long time ago.
Marcus:
I would have thought it would have been, you know, maybe the worst year of the 2020s. Yeah, that that would have made sense, right? Yeah, but the idea that's the worst year worse than 30 years That was that was a big one So, all right moving on to the VC world council health secures 11 million in seed funding led by a 16 Z This will not be the only a 16 Z funding talk about today But this is kind of a virtual health care practice basic telemedicine Anything here of note for
Vic:
you? Yeah, that's right. I mean, I think, um, no, I mean, I think that the, um, the volume of. Telehealth, AI, and, uh, you know, sort of involved in the clinic, I think, I mean, it's, it's telehealth, but they also are using AI behind the scenes, and it just seems like, uh, every week there's more and more of these, these stories.
Marcus:
Yeah. So, I mean, it's a check, it's A16Z, but. Yeah, I think the business is not that, uh, dynamic. Dynia, uh, Health raises 10 million for clinical trial recruitment, a large language model, LLM. Clinical trial recruitment, a space that we hear about a lot, um, putting an LLM in front of it, that's not that typical, uh, You know, we talked about it before the show, clinical trial recruitment, kind of less exciting because of what's happening in the pharma space overall. Yeah. I
Vic:
mean, clinical trials are going to be down. Collapsing, they're collapsing,
Marcus:
right? Um, but, but, I would say it is interesting to think about applying AI in this space. And if you can collapse the cost to meet the collapsing space, um, and you have something that is, you know, It has far greater margins and far greater efficacy, uh, than the existing technology solutions out there that could be a sort of a winner takes most or winner takes all type of angle to it. So applying AI to all sorts of places where there's inefficiencies is smart and makes sense. I don't understand that much about what, uh, Dynia does, but. Yeah, I
Vic:
don't know the company. I didn't look at it. Uh, but, but I have looked at 30 or 40 similar, I mean, basically take the electronic medical record and they're using a large language model, which is the, the trendy buzzword. But before that there was analytics and data warehouses, lots of ways to cut through that and find a patient that would qualify for a clinical trial and then try, you try to reach out to them and enroll them. I've seen a lot of those. And the problem is not in identifying the patient. I'm sure they will do that. The technology I looked at did that. The problem is reaching out to them and getting them to actually enroll has been traditionally very difficult.
Marcus:
Yeah. And so we talked about this, right? You know, you can, um, you can cut. The value prop in two, right? One is the lead. The other is actually getting them through the door. And so if this is kind of like the equivalent of a lead gen platform, like Apollo is on the data side, like, Hey, we're just going to, you know, far more efficient way, help you find the right people. And we kind of end there and you pay us a fee for that, then that can, that can work as long as that's a valuable. You know,
Vic:
solution. Yeah. I mean it goes to pricing. Like how much would you pay for that? That's right. I mean,
Marcus:
maybe a little That's right. It, it goes to pricing. Now we, we should say it is an LLM, it is going to scan, uh, screen electronic medical records. And so it's likely to work better than most query-based tools today.'cause LLMs are just better than that in terms of, you know, being able to work with large data sets, uh, and Healthx ventures, good v VC firm in the health space led it. But a Cleveland clinic is participating. So they at least have a health system partner with a good brand that does play into the clinical trial space. So, you know, I hope it does
Vic:
well. I just think it's a long shot.
Marcus:
I mean, the question is just, can it scale beyond sort of the benefit of, uh, having a Cleveland clinic as a partner? Uh, all right. Continuing on one step secure 36 million to establish gate analysis as the sixth vital sign. So this is kind of trying to prevent, uh, future risk issues with senior citizens.
Vic:
Yeah. And so, for whatever reason, I'm, uh, I'm going short on all these, all these things today. Um. I would love to have gait analysis as the sixth vital sign. I believe that eventually it could be figured out, but we're pretty far away from that. So, I hope they do it, but, but they have a long way to go, I think.
Marcus:
Yeah, yeah. Uh, and then, I think this is the final story, maybe, maybe there's one more. Uh, Tenor raises 37 million to automate healthcare documentation, streamline patient referrals. This is Lightspeed and A16Z and Foundation Capital. So, uh, again, not necessarily a very, uh, unique, uh, story here. You know, if you look at the website Yeah, did we
Vic:
need a 50 second
Marcus:
one of these? Turn your paperwork into patient advantage. I mean, you know, it's, it's streamline documentation. So that's great. But they raised 37 million. Well, they were a 61 million. 37 was the B. Um, but they, they, they're, that was six months ago. They're spending a lot of money for, listen, here's the deal. I don't, I never like those like three, three, three months ago. I never, never, never liked those. Right. Um, it just, I'm sorry now that it's over and we can all sort of talk about it openly. It would just reminds me of olive. You know, and they were just like, get around. And then four months later, here's another round. And they're like, it'd be like these hundred million dollar rounds. And you're like, okay, what do you, what could have possibly happened in the last
Vic:
four months? Well, there definitely are management teams and I've, I've been on the board and invested with some of them and I've made, they make money sometimes, but that they're really, their best skill was raising money. Yeah. And that is a difficult train to get off of.
Marcus:
Health X, uh, raises 14 million to safely move patient data. Startup working to automate patient data consent processes. So, think, you know, you're working with the health system as the patient. They've got access to your data. Maybe they want to use your data for some purpose. They need to get your consent for that. And how is that all facilitated?
Vic:
Yeah. Yeah, you get blood drawn and they want to be able to use that data for research over time.
Marcus:
Magical words, AI powered agents help clinical staff automatically generate consents for different use cases during a patient's care. It's just magic words, agents. Yes. I'm hearing agentic.
Vic:
Yes. Oh yeah, agentic gets you an extra, you know, gets you an extra 10 million in valuation if you can use the word agentic in a sentence. I still haven't. You haven't used an agent yet, though. I have not found an agent that is actually useful. I've tried maybe four different agents, but they weren't very good.
Marcus:
It's AI stuff. And we, we had our strategic offsite today. And, you know, we've made the point that we are really getting to the point where we're finding legitimate Gen AI use cases, where it's really compressing our workload in meaningful ways, specifically around analysis, right? Yeah. You know, and, and content creation. Those are two spaces where it works. It's really, really working for us. Um, but it took us some time to kind of like figure that out, get that into the workflow, et cetera, et cetera. You're downloading copilot with, you know, Yeah. Yeah. So I'm on
Vic:
VS code and GitHub using copilot. And you're not a coder.
Marcus:
No,
Vic:
no. I've never been a coder. I pretended to code 30 years ago. I'm at least the coder from the past, not even a coder today.
Marcus:
Yeah. Yeah. And, and like, we still haven't been able to get agents to do anything for us. Doesn't mean that they won't, but it's just, it's just the hype versus the reality, right? I mean, we, we cover this because we know it's going to be real. We know it's real, but like the hype and the amount of money being raised around the hype.
Vic:
It's not going to justify the amount of money. But I think that I, I'm Trying to get together. I'm gonna start writing it a little bit more I think I started a postcode a defensive bubbles because I think we're in AI bubble right now Yeah, but it's gonna play out and it's gonna play out and it's actually a positive thing for the overall Economy because we're gonna we're gonna build all of these Uh, data centers all compute a bunch of nuclear power, new power, and the use cases are not here now. I mean, as you said, over the last year, we have figured out five or six use cases for gen AI that are useful. And I think it's important that we are contributing into it in a controlled setting. And some of our. core proprietary points of view. And then we're leveraging AI to sort of bring that to the world and do more content more broadly and different styles and things. It took us a year plus to figure that out. Yes. I'm messing around with agents right now, but they're not ready. And at the same time, I think all of this infrastructure and investment and some people will lose money is going to be great. Just like the internet. We didn't know what was going to happen with Amazon cloud and other things, but But once you have that capacity, Netflix, once you have that capacity, then great entrepreneurs will figure out how to fill it. That's kind of how I think about
Marcus:
the AI. I think that's totally fair, and I still chuckle at the VC part of it, because that's not, that's not the same as like data centers and nuclear, right? Like, like the proliferation of VC checks into, you know, You know, buzzword based startups that don't have on the other side of the, you know, the, the chasm actual buyers, that's not, that's not the upside of a bubble. Yeah. I mean, if that's LP dollars,
Vic:
that's, that's, you know, the number of deals that I have seen that are building on top of a closed model. So open AI, Microsoft's model, Gemini, um, they're building on top of that. Yeah. And they, they end up getting VC backing, 10, 20 million dollars. That does not make sense to me.
Marcus:
Well, you have to have not learned the lesson, or you have to not remember the lesson. Yeah, I mean I'll never forget the lesson of Moontoast. I'll never forget what it was like to build on Facebook's platform, and then Right. They take everything from you. Yeah, I'll never forget that. Like, that's it. There's no more building on platforms. Right.
Vic:
And so we'll never do that. I've been a VC for 25 years. You lived through it as an entrepreneur. Brutal. What these platforms are doing is seeding, you know, having lots of people test out things on their platform. When something actually starts being profitable, they take it. They're just going to take it. That's right. And it is, it doesn't matter what the contracts say, they will change the token price. And it's their, it's their platform. And so you can do right. So we have, there is some open source solutions coming out, which we can talk about later, but, um, let's get back to getting back to VC. We got sidetracked. Yeah.
Marcus:
Uh, so angel investing isn't what it used to be. This is a wall street journal pro venture capital. The value of angel deals in the U. S. fell 64 percent from 2015 to 400 million last year. Now, there's different ways you could look at that, right? I mean, it could be that the access for people who used to do angel deals to get into VC funds because of platforms like AngelList maybe has changed, right? So there's lots of different dynamics to that, but I would say In this world that is much more saturated from a venture perspective, it would be very difficult to find Alpha as an angel, wouldn't you say? Yeah. Like, you're better off trying to find a good manager, a good fund manager.
Vic:
Yeah, I mean, obviously you and I are fund managers, so we may be biased, but I think it's very difficult to get access to the, Top 10 percent of deals, which is really the only set of deals that will make money. Yeah. You have to get access to that or you shouldn't be in it. There are some very small niches. Like if you have a social media platform and you're an influencer in some way, or you're a movie star, you can probably do a direct consumer brand because. You're bringing more than just the check, but, but after that, it's a very small subset of people that have the right network to be able to get in and most people burn, they lose money. Yeah,
Marcus:
and it's competition at the stage. I mean, look at us. We are an institutional. Early stage healthcare venture firm, right? So we are writing institutional checks at the earliest real stage. I mean, precede, you know, foundry does, does precede and we're not the only ones, you know, there's tech stars. There's 500 startups. There's Dreamit Health. There's Ycom. There's a lot, you know, all of that has eaten into that, which was once angel territory.
Vic:
Yes. That's right. And that's probably just the professionalization and the, and the growing up of the industry. Agreed. Agreed.
Marcus:
All right. Moving on to the healthcare industry. This is the
Vic:
last venture.
Marcus:
Oh, really? Well, I mean, it's sort
Vic:
of, uh, maybe it's a good segue. Yeah, it's a good segue.
Marcus:
No, no, you're right. It is a venture story. I got, I got thrown off by the former title. Yeah, so Bruce
Vic:
Broussard used to be a payer. I mean, he was the Humana CEO, um, Yeah. And we know Bruce. He's a good guy. Good guy. He, he has joined a venture capital firm. Yeah. Define ventures.
Marcus:
Yeah. So define as a big digital health firm out in, uh, yeah. On the West coast, on, uh, bay Area. Um, Lynn Charo Keefe is the, is the, the founding gp. Um, she, I think she came from Kleiner. Um, and she came out the gates. Like I remember her first fund was like two 50 right out of the gates. Um, they manage, uh, about 800 million in assets. So, you know, it's like, it's, it's, she's, she's, yeah, she's a legit VC. Uh, you know, and, and it's a good place for Broussard to play. I mean, you know, I think he brings enough, um, stature. That him plus her can take their 800 million and sort of grow it to 2 billion in assets. Right. That's, that's kind of how I think about this is a real one plus one equals three type of equation. So, um, this is a big, big get for her and, and, uh, you know, great for him to be moving into this, into this industry.
Vic:
Yeah. I mean, more people, more VC funds bringing in industry leaders to actually help them understand it is, is really positive.
Marcus:
Yeah. That's, that's a, that's a good one. That's a really good one. Um, All right. Oh, no, we're still in venture, man. You have a lot of stories here. Private markets are reserved for the rich. Should a test let you in? So we're, we're obviously big proponents of, um, expanding the aperture of who can participate in the private markets. We're trying our best to participate, uh, as much as the legal frameworks allow. Foundry. Um, is, uh, what is it, 506B, is that?
Vic:
Yeah,
Marcus:
B, I think is what they are. Yeah, 506B, um, SEC Classed Fund, which means we can talk about it right here. Yeah, right. You know, like Vic can say We can talk
Vic:
about it on air, we could, we could put a billboard ad up, we could put a banner ad up. That's right, that's right. Um, but you still have to be accredited. That's right. And a lot of people feel that the net worth level of a million dollars in net worth, or there's a, there's a salary test too, maybe it's 300 K in earnings. It's, it's a very artificial benchmark. And some of the ways that you get to have a high net worth is by investing in higher performing asset classes like, like venture. So the argument is that if, if someone is in the industry or can pass a test about how all of these things work and understands the risk, as long as they understand the risk, they should be able to. take a well informed risk.
Marcus:
Yeah.
Vic:
Um, so if the Republicans sweep, which I think is unlikely, but this story is talking about some bills bubbling up in the house that, uh, would allow someone to take a test and show that they understand the market. If there's a full sweep, It might pass. I think it's a long way, but it's beginning to gain momentum over time. Well, I think it
Marcus:
makes sense.
Vic:
Be good. Yeah.
Marcus:
I think it makes sense. Uh, okay. Now we're moving to policies. Uh, at health this year, Jill Biden showed up and announces 110 million ARPA H funding award, uh, and prods the industry to invest in more in women's health. So this is great. There is an underinvestment in women's health. Our friend, Maria Tolar, who runs SteelSky Ventures, like she's basically the women's health fund in the industry. There are others who are investing, but she's dedicated, focused, and has the largest fund that's out there right now. And, you know, it's not, it's not large enough. Like it's, it's great that, that she's, you know, going to be north of 100 million in assets here pretty soon, but it's not large enough for what is half of our population. And, you know, so much room for opportunity.
Vic:
Yeah, I think that's right. It, there's a huge opportunity and this is wonderful and it's sort of building on. Uh, Melinda French Gates last week or the week before. Yeah, yeah, that's right, that's right. There's sort of a building momentum around that, around women's health, uh, but great to see.
Marcus:
Yeah, so that's a good announcement from, uh, from Health. Uh, Transparency has led to uniformity in healthcare costs, but not necessarily lower prices, the white paper. So, um, this is a story from Fierce Healthcare, and I, I think this is, we can just put this in the long list of good intentioned policy changes that do not appropriately anticipate the way that the economic players will respond, right? Like, I don't know why policymakers think that they can predict the way that markets are going to respond to, uh, their actions, unless you literally do something like the high tech act, right? Where you say you must digitize your records or like, you're out of business. Yeah. You're out of business. Here's my, here's, here's the carrot and here's the stick at the same time. You know, I'm going to pay you if you don't do it, like you're dead. If you don't do that, you're not going to necessarily get the intended outcome. What you were reading in this article is yeah, you put the prices out there and then depending on where you were on the spectrum of price, you acted differently.
Vic:
Yeah. I mean, I think it is positive to have price transparency when we didn't have it before. Like, so I want to give them credit for that. Like having price transparency is good. No question. And it did not reduce prices, which is what people expected on the whole. What happened is that the. the health systems that were at the top end of, of the reimbursement levels. Um, had to negotiate with the whole world now knowing that they were at the high end and they were knocked down and the very low price hospitals saw that they were the lowest price and thought, well, gosh, we can move our price up. And so the price is just sort of consolidated into the middle band. Um, turquoise is the group that did the research. They're saying that over the next few years, they think there may be, um, Some decreases in pricing over time. I think that the real issue is that employers and patients, all the payers that actually are making a decision on which doctor to go to, they're not price sensitive. At least right now, they're not price sensitive. No, no, they're not. And so price repair industry is great, but I don't know that it's, it's not going to drive prices lower until people are making decisions that way.
Marcus:
Wall Street Journal, Medicare paid insurers billions for questionable home diagnosis, watchdog fines. Nurses visit said to be worth 1, 869 each for Medicare Advantage companies. What's the story here?
Vic:
Yeah so, I mean the entire concept of Medicare Advantage was to pay insurers to take care capitated risk based on the, the health situation of the patient. So a sicker patient, you should reimburse higher for, and I think that makes a lot of sense. And it also is true that some of the Medicare Advantage providers have learned that if they send a nurse to the home and do a, you know, kind of a, check, health risk assessment is what they call it. They often find other things that, that are, you know, give the patient more risk and then therefore they can charge more for. Um, but this study found that they don't actually change, they don't deliver any different care. Um, and so, I, I feel like this is a situation where the government set up rules and the Medicare Advantage for profit companies are using them to their full advantage. Now, whether that is unethical, I don't know, it's, I'm not sure it's illegal.
Marcus:
I would find the same as you. Um, it's, it's like, I think this is analogous to the tax code. You know, you can get mad all you want at corporations and very, very, you know, high Someone didn't pay any taxes. Right. Right. Right. But it's like, the tax code is the tax code. The question is, did they break the law? Right. The question is not, did they pay any taxes, the question is, did they evade taxes and break the law? Yeah. If they didn't break the law, then that is a flaw in the tax code.
Vic:
Yeah. So, the government could, and may, change the way that Medicare Advantage is setting prices for different, um, different disease states, different risk profiles. But the whole system relies on paying an appropriate price for really sick people. So there's just a dynamic there. It is, um, it's easy to say, you know, a big insurer took in three billion more than they would have otherwise. But I think, I think you're right. The government should change the policy if they want, but then that will change the way that. Medicare advantages is managed. So it's sort of, um, I mean, of
Marcus:
course, there's going to be always room for improvement. Yeah, that should, I mean, I just sort of think like that should be the, the standard expectation, right? Is okay. They're going to roll out something that's going to be innovative. It's going to be something you're going to, you're going to try. But if the government is paying a whole bunch of money for things that are, that shouldn't be happening. I mean, look, it's healthcare. We have fraud, waste and abuse. There's no question about it. Like the reason why it's 4 trillion is not just rent seekers. You know what I mean? There's more going on there. And, um,
Vic:
yeah, maybe there are rules that you have to have an MD diagnostic, uh, results in order to bill. That's not how it's set up now. And so there's lots of ways you could change it. But. Anyway, it's a, it's a damning story, but I think they are following the rules. It just is, you know, not, maybe not the best outcome.
Marcus:
I think, I think the bigger challenge here, and this is something I experience is, you know, when you're talking about home health, you're often talking about seniors. So you're often talking about Medicare seniors want to be home. I think if you are the, the child of the. age loved ones. You want them home. Um, but the home is a difficult place to regulate. You know what I mean? The home is a difficult place to ensure quality of care. Well, this is just doing the assessment. I'm talking about even that, like, like anything in the home, like this, this is one aspect of it, but I'm saying more broadly. Yeah. You could have this kind of story about 30 different aspects of home health. Home health is really kind of tough, right? Because it's not a well controlled environment. It's not a well monitored environment. Um, but it's the preferred environment for the family, you know? And so there is that, there's that, there's that, that tension in that, in that struggle. It's, it's not an environment that the companies control, that the healthcare companies control. So there's just less controls, right? And, and I think that makes it overall more difficult. It's, and it's a hard thing to try to, um, communicate. It's something I think you more need to experience, right? Like you need to kind of be at home, have the home nurse come in and just watch the whole thing and realize this is so different than how this would happen in a hospital, you know what I mean? It's so, so, so different. So anyway, that's just kind of my. basic thought on the challenge around how, how one of the big challenges we're going to have with Medicare in the future is going to be home health.
Vic:
Yeah. There's no question about
Marcus:
that. All right. A blue cross plan was accused of fraud and a ghost network class action lawsuit. So ghost network is in quotes because this is a term being used, uh, to sort of frame up when, uh, an insurer presents a network of providers, but it's not a well maintained. list of providers, and when you actually go to reach out to one of those providers, they do not actually accept that insurance.
Vic:
Yeah, I mean, so this is Anthem Blue Cross in New York. They have a lot of duties to fulfill, but one of them is the provider network. It's one of the main jobs of a provider. I think is to build and maintain the list of providers and contract with them so that they they can adjudicate claims appropriately, right? And so maybe it's difficult to maintain the list, but it's kind of their job to do that. And you know, this plaintiff's attorneys in New York, they called the first hundred doctors behavioral health. Which is a hard, that's really hard space. Yeah, that's really hard. And New York is especially hard, but Anthem publishes this list of docs in their network and they called the first hundred and only seven of the hundred except Anthem Insurance. So it, it seems like the physician network is not real. And so they made up the term ghost network, which seems like appropriate term. Um, so it is a. You know, it's a plaintiff's attorney that is making the call, but it's, it's, it's not like there were 93 there when they were only
Marcus:
seven. I mean, look, you want to talk about like low hanging fruit. For innovation network maintenance. I mean, clearly many insurers need support with this, right? So this would be a great space to kind of figure out how could you partner with, with insurers to keep them, you know, more compliant in this, in this capacity. There's a lot of businesses on the health system side trying to keep their docs, you know, sort of compliant from a licensing perspective, et cetera. I kind of see this the same way. This seems like low hanging fruit for technology, um, to, to serve these insurers and, and just. help them to solve this problem better. So,
Vic:
yeah. And I think in behavioral health, we need more docs on the covered networks. So it's a, it's a systematic issue, but I think it is true that if you publish your physician network and people opt into that payer because, because they see the network has to, has to work.
Marcus:
All right. We thought this deal was dead, but, uh, never, never say never. Cigna is resuming merger discussions with Humana, uh, now that the price might be right.
Vic:
Yeah, I mean, they should come together. I think, I think it's a good marriage. I mean, Cigna, I don't have any visibility to the negotiations, but I think it should come together.
Marcus:
Well, I guess here's the thing I don't understand, uh, did, did, did Cigna report quarterly earnings yet?
Vic:
I don't know if they
Marcus:
did. Okay. Well, we'll, we'll have to follow up on that, but I guess the thing I don't understand is that Cigna got out of the government insurance game.
Vic:
Yes.
Marcus:
Right. Right. Right. Right. That was the whole HealthSpring divestiture, right? They got out of it. Okay. Yeah, they're pretty much focused on employer. That's what I thought. I thought they were very focused on the employer piece. Okay. So, of course, Humana is, regardless of what anyone says, Humana is still best of breed Medicare Advantage. Medicare Advantage as an overall payer model is battered right now. But it doesn't mean Humana is not good at it. Right. Yeah. So,
Vic:
and other government plans, but, but, but, but the Centennial Molina, other ones are pretty good in Medicaid, their dominant. Exactly. Exactly.
Marcus:
So, so, you know, the bones of this asset are probably pretty good. And if you're putting them together to get some, Humana.
Vic:
Both. Humana. Okay. Yeah,
Marcus:
it's, it's a, it's a challenged environment for sure. But I mean, does that mean to me that I think the company, like the, the personnel, the operations, like, you know, the, the bones of the company, I think are probably good. So the idea that Cigna and Humana would be talking about coming together, I think from that perspective, like coming together, getting some scale to sort of weather a tough time, that sort of makes sense to me. But I guess the part that I missed was what was the upside. What's been the negative impact for Cigna since they are out of the government insurer game at the moment, right? Because we've been talking about all the headwinds specifically around Medicare Advantage and Medicaid for the redeterminations. What issue is, because the headline here in Bloomberg or the sub headline says shares of Humana gained 5. 6 percent while Cigna's fall further. Indicating that that Cigna is dropping right now. Why would Cigna be dropping? Cigna is
Vic:
subscale. They don't have enough scale in my opinion. Okay to really Compete and unlike a blues plan. They're similar in someone's gonna DM me This is not correct, but they're not this bad, but they're similar in scale to like a larger blues plan But they don't have that blue network and all the partnership opportunities. Okay, so if you're trying to land a big employer, I just think they're subscale and they would benefit from buying Humana in my opinion.
Marcus:
Okay. So, so, so dropping their, um, lower quality, lower quality than Humana, um, Medicare business. Yeah. I think they sold health. Has it closed yet? Okay. Well, I think they remember we covered that again, like four weeks ago, it still hasn't closed. So, but I think it's going to close soon. They're looking to close the sales as here in Bloomberg, they're looking to close the sale, but they have not closed it yet. So they're going to sell that pickup, Humana, a higher quality, bigger market cap. So you put the two together that would put them at 120 billion market cap together. And you're right. I mean, that is pretty small still compared to UHG and then, right. Okay. Right cbs, but it's
Vic:
but it's but it's bigger better better, right? It's better Yeah, I think the one two plan of selling hellspring and then buying himana only makes sense if you do both right and so Um, I don't know. I think they maybe did the first step Yeah. Before they had the second step negotiated. Yeah. And then Humana wanted more or whatever, and so it kind of fell apart, but, but Humana's share
Marcus:
price has dropped so much.
Vic:
Yeah. Right. Yeah. Now a year later, the overall market is down, so it's, they can, they're looking at it again. Yeah. I think they should, it should happen. I mean, it'd be good. It'd be good to happen. It dropped like 40%.
Marcus:
Yeah. Right. I mean, that is crazy. Um, so, so Humana, I mean, that's a significant enough drop that they almost need to find a home, right? They both need this deal, I think. Yeah. Okay. Alright. I mean, seeing that maybe not as much, Humana really probably does need the deal. They need to kind of become a business unit at this point. It's crazy. Um, all right, moving into stories about us. Uh, cancer care is getting personal and local local doctors can't keep up. So this is a great illustration of what Uh, Takun, I'm sorry, uh, Tarun has been, has been talking about, right, TK, uh, where he has said the medical knowledge is advancing at a rate that doctors will not be able to keep up to the latest standards of it. And what space could that be more true in than cancer care? When you think about how much money is being pumped into research and new modalities, new technologies, new, you know, modes of care, uh, cancer care is probably the hardest space to keep up. And so. If you're not Mayo, you're not Vandy, how well are you keeping up?
Vic:
Yeah. If you're not in the top 10 or top 20 research institutions. You're not Moffitt,
Marcus:
you know. Yeah.
Vic:
And the list is short. Yeah. Oh, it's brand names, we all know. It's 20 or less. Yeah. And so, but there's a lot of patients that cannot travel across the country to Mayo or Moffitt or Vanderbilt or any of those 20. And so this story is talking about the difference in care, which is dramatic, which is TK's point. Um, we need to find some way to get the treatments. brought out to the, to the delivery system. Yeah. Um, but we don't have that right now. So unfortunately people are getting, you know, not evidence based care and it doesn't work as well.
Marcus:
So my friend, uh, uh, Ben, he just closed on, uh, he just closed on an oversubscribed, his sole GP, 30 million fund called Oncology Ventures. He's a cancer survivor. Um, and he's partnered with a bunch of different like, um, cancer centers of excellence, not around therapies, um, but around like actual like technology and things like that. And so to me, I'm sure he is looking at this problem. Yeah, I'm sure he's looking at this problem as as a real. upside opportunity to, to invest in. I'm probably going to send him an email after this and see what he's looking at and see if we can co invest. Um, but yeah, I mean, this, this is a space where I think AI would be welcome. I think AI co pilots, you know, would, would really be able to, cause, cause you're thinking about, you're just distributing better quality care around the country. Like this is where it really does make sense.
Vic:
Yeah. And I think you could put, Kind of guardrails in with let's say if the top 10 or top 15 or whatever the best cancer docs are in the country If they're doing certain protocols certain treatments different different flavors of chemotherapy in different situations It's very nuanced but AI could watch that and then sort of like bring best practices to the rest of the providers In a way that I think could be kind of informed by what the human, that human leaders in the world are doing, but scaled
Marcus:
if, if the bottleneck is not on availability of the therapy, but on the ability for the clinician to deliver it. Because of the lack of knowledge.
Vic:
Yeah.
Marcus:
Right. That's not a good bottleneck. Right.
Vic:
Yeah, it's both. I mean, there are clinical trials with limited access, but, but the bigger case is just, it's just, it's not access. You just don't know how to do it. That's not
Marcus:
Yeah. This, this article is talking about this therapy is not like limited access. Right. It's, it's limited capability of the clinicians. Yeah. Uh, Walmart offers same day prescription delivery with plans to reach 49 states. So Amazon. Walmart. Yeah, kind of always going to do the same.
Vic:
Yeah. Amazon came out a couple weeks ago I don't even know if we covered it. Maybe we did Uh, but it wasn't surprising, they're, they're delivering same day to every, every state. Walmart's doing 49. Um, I think it's great for the patients. And I have an investment in a prescription delivery company, and this has been really helpful to us. A lot of health systems and payers been inbound calling saying, well, we'd rather not work with one of these big systems, but can you help? So I think it's good all around.
Marcus:
Wegovia maker Novo Nordisk says new pill shows 14 percent reduction in heart attacks, strokes, and diabetic patients. We are getting closer and closer to this miracle drug, wonder drug label coming true, um, with GLP 1s.
Vic:
Yeah,
Marcus:
and
Vic:
this, importantly, is a pill. Pill. So you do not have to do an injection in yourself. And it, and it reduces heart attack, stroke, and helps you lose weight all at once.
Marcus:
I don't I see Rubellsis, like, commercials on TV right now? Yeah, uh. I think I do. I think so. I think, I'm pretty sure I do. Like, I, I think it's out there already. Yeah, I think it's, I think it's, it's a It's just new trials for an already Yeah, I think it's, it's
Vic:
available for specific diabetes indications.
Marcus:
But now they're showing it can reduce other, it has other, you know, applications.
Vic:
Yeah, yeah, so this is, um, continuation of the magic pill. I continue to be worried about potential side effects, but it is great. And I haven't seen any side effects that would prevent me from doing it.
Marcus:
Yeah. But it's just more momentum for Glp1s. Yeah. Uh, and the other side of that is Novo has asked the FDA to bar compounders from making ozempic copies. Um, and they're arguing that Glp1 is too complex for pharmacies to make safely. So obviously it's. It's the free market. They have conflicting interests in, in making that kind of statement, you know, certainly they could have evidence based on their knowledge of being one of the largest approved producers of glip ones to say, Hey, this is really complex, complex and pharmacies doing it in a compound is like dangerous and damaging to the glip one brand. Um, and that, that is likely true in some instances. And at the same time, uh, They're, they're, they're protecting their, their market share, right?
Vic:
Yeah. I mean, I don't fault, I don't fault Novo, but what the, what the heck is the FDA doing? I mean, like it either is a drug that is in shortage and therefore in order to protect patients access to the drug, we should allow compounders to compound it or it's not in shortage and the FDA should, enforce this. It's, it's pretty black and white and they are deciding to say nothing. I think, I mean, so they haven't said anything so far.
Marcus:
Yeah. Well, they, they, well, what they have said is that it's not in shortage.
Vic:
Yes, but, but they haven't stopped the compounder. So it's not, right. Exactly. It's not in shortage, but they haven't stopped it. Oh, man, and it's because it's popular. I mean, that's the issue. I think
Marcus:
that's right.
Vic:
The FDA is thinking about this from a political vote point of view, and it's very popular to have cheap GLP 1s out there.
Marcus:
J& J's ketamine derived drug is taking off. So, they have a new ketamine derived drug called Spravato, uh, that is for depression. Um, listeners may have heard that ketamine is, uh, a therapy that people are utilizing when they have, um, depression that's been resistant to therapy. Um, and, and other sort of modalities. And it's shown a lot of a lot of promise. Um, I've talked to people who have been on it and have had a lot of success. I've got people pretty close to me that have, that have utilized it, and it's, it's been a real sort of game change game changer for them. Um, but you know, when administered by a, Yeah, I think
Vic:
that to me, that's the key, is it has to be overseen and administered as part of a therapeutic plan. That's right. That's right. Um, but the numbers here were much bigger than I thought. Tens of thousands per month. Yeah. And so when they say taken off, it's getting a decent amount of uptake and
Marcus:
it's
Vic:
helping people.
Marcus:
Look, this is great because treatment resistant depression is serious. It's really, really serious and um, we certainly need more, More therapeutic options out there, you know, and so I I think this is fantastic Yes, I'm glad to see the stigma sort of falling off this stuff so we can get more treatment to people Recognizing that you know, the brain and the mind are parts of health care. It's part of your body Yeah, you know and and it can it can impair your functions and and it can it can lead to death Yes, you know so like if we we've got it We have to try
Vic:
to, we have to try to find ways to treat these patients. Yes,
Marcus:
yes,
Vic:
agree.
Marcus:
So this is another story about the difference between, uh, sort of a drug regulator and then sort of a payment
Vic:
agency, right? Yeah, it's safe and effective, but is the cost benefit there?
Marcus:
Yeah, so Wall Street Journal is covering that in England, the drug cost watchdog has rejected Eli Lilly's lawsuit. Alzheimer's drug. So it's been approved, um, as safe. Um, however, the UK is medicines and healthcare products, regulatory agency that, that approved it said that's fine. Um, but the National Institute for Health Health and Care Excellence rejected it for use in the NHS.
Vic:
Yeah, that's right. And so I think we're going to have this now, it seems like globally where there's a difference with an aging population and significant numbers of people that would be needing this drug, the difference between what is safe and effective and allowed to be sold and what the government will buy. Yep. And that didn't used to be the case, but it's certainly the case in the U. S. And apparently it's in the case, it's case in UK now.
Marcus:
Yeah. Big, big, big deal. Big deal. So, so, you know, look, I mean, I, I think that. Lily will, will navigate this. They're, they're obviously alongside of Nova Nordis, you know, big winners with all the clip one stuff. Um, I do think Alzheimer's is, is a drug we've got to have a breakthrough on. We've got to figure this out. So while right now this feels like it's, it's kind of in a, in a. Stalemate, we do need to figure out how we're going to get past this, but there is a larger issue about the lack of alignment between, you know, the safety organization and the payment organization, uh, because the general public just doesn't understand that, right? It just looks cruel for a drug to make it through one gateway and not make it through the next one. You know what I mean?
Vic:
We are saying as a society, I think, We could help you and we don't think it is worth the money that that's that's which is insulting to People who who need the care?
Marcus:
Yeah, so there's got to be a different way You know to sort of go through that process. I don't get paid enough to figure that out, right? Apple's AirPod Pro, the hearing health features are as good as they sound. So look, this is no surprise to me. I'm an, I'm an Apple buyer have been for gosh, it's, it's, it feels like 20 years now. Um, I have the app AirPod Pro one. I love them. They don't have the hearing test and the hearing aid feature, but I, as I told you, when I read this, I I'm like, I probably need to go upgrade, you know? Yeah.
Vic:
I mean, I think it's, I think it's really important for two reasons. One, it is, it's going to make the stigma of wearing a hearing aid disappear. Just this. Like, Apple is cool and wearing your Apple AirPods is not going to be thought, looked down on. Like a, like a, Old fashioned hearing aid is, um, and there's a lot of people, significant percentage of people need hearing aids, and it's very isolating and leads to loneliness and depression if you can't hear the world around you, like at a dinner or somewhere. So I think it's really good from that point of view. And it's, it's just going to open up so many more people to get tested. Because a lot of people are walking around, they don't, it happens very slowly, so you don't know you've lost significant hearing. So I think for both those reasons, I'm really excited about it.
Marcus:
Well, and the third reason is that is, is the protection feature. Yes. So, I mean, this is basically like You get that automatically. You get that automatically. Like just by having them in and being in loud environments, you're protected.
Vic:
Yeah.
Marcus:
That's fantastic.
Vic:
Yeah. They, they talk about it in the articles. Several people are starting to wear these to concerts now.
Marcus:
Yeah. I would. Right. You know, because concerts are rough, man. Yeah. Story of the week. We started with it. McDonald's food safety, uh, officials scrutinized onions and the E. Coli outbreak. I mean, goodness gracious, really scary. One person I think is known to have died. Um, I heard a number of it was like 50 people were sick across 10 states. And then I saw that there was a list of a whole bunch of different stores where there was some, some different, um, Um, Uh, recalls that were happening. So, you know, just always really scary when, when this kind of stuff goes down.
Vic:
Yeah. And I don't really know what to do to protect ourselves. Like it's kind of, I mean, it happened to me, McDonald's this time, but it's sort of like restaurants. of all different types have this. It's always with some kind of produce. I feel like, yeah. Yeah. Um, threw me off for a minute because it was the quarter pounder, but it ended up being the onions. Yeah. Yeah.
Marcus:
Uh, all right. Let's go through. We're in AI land now, and we're going to do a bunch of different announcements from, uh, health this week, which neither of us were at, but we have plenty of friends who will download for us. Uh, but starting with the AI stuff, cause there was a lot of AI stuff. Of course it's healthcare stuff.
Vic:
the health AI
Marcus:
stuff. Yeah, the AI stuff at health at health. Okay. Yeah. Yeah. Okay. So atropos health unveils chat based AI co pilot for real world evidence. Did you read this one? Yeah. All right. Tell me about it.
Vic:
Yeah. So, I mean, it is, it's the same story as we had before, except they are now sort of positioning it as real world evidence. So they gather a whole bunch of Yeah. Electronic medical records. Yeah. And then they are able to do a clinical trial in theory, I don't think they really have done a client yet, um, where they can do drug testing using actual patients in the wild, um, without having to put them through an official clinical trial. And so that's been talked about for a long time. People have tried it in Europe. I think it's got a lot more traction in Europe. Um, it would be great if they could figure out how to do it. It's, it's kind of difficult to test for drug efficiency when the patients don't know they're testing for it. Yeah. But there are ways to, to do it. It's worked in Europe. Positive again, I think the drug channel is kind of tough right now, but it might be good
Marcus:
if you're aligned with the right companies. Yeah. You're okay. Suki balloons, AI assistant footprint through new strategic partnership with zoom healthcare.
Vic:
Yeah. So zoom has a pretty good platform and telehealth and this that's the point of this announcement. Suki is, you know, An AI assistant and they're, they're gonna get more distribution basically.
Marcus:
Okay. Which is great. That's a good announcement. Nvidia and AI doc collaborate to develop guidelines to speed up AI adoption.
Vic:
I mean, we have, um, is it care? There's a Care ai. Care ai. We have one already. Um, kind of setting up a framework of what is appropriate for AI adoption in healthcare. Yeah.
Marcus:
I think it's a smart hospital framework or something like that. Yeah.
Vic:
And they, uh, NVIDIA and AI Dock are doing a second one now called BRIDGE, it's a, it's a acronym for something. Um, I guess it's Good. Sorry, Chai is what it's called there.
Marcus:
Oh, well, well, no Bridge is the guideline. Chai is the organization. Chai is the other one, not care.
Vic:
Chai is, I said care, Chai is the original one. Yeah, yeah. And AI Doc is a member of that and they also felt the need to do a second one.
Marcus:
Sorry, we're confusing you guys. Let's It's just because we're confused ourselves. So CHI is the organization where like the guy from Microsoft is, is the executive director and all that.
Vic:
And it's a bunch of healthcare people talking about it. Cam is on the advisory board for it. Right. Carry I is that that's not a standard spot. That's a no, but
Marcus:
they're working on standards. Remember, they got bought by striker. But remember, Bruce told us that Bruce Brandis said that they're working on on standards and they released like a press release around that.
Vic:
Yeah, but
Marcus:
I think that's their standards? No, no, no, no, no, no. Cause no, they aligned, they pulled in a whole bunch of other people for that. Okay. So it's not just their company. It's like they have a bunch of different organizations that are working with them on that. So that's Okay.
Vic:
Sorry, I confused myself. Chai is the one I was referring to incorrectly. Yeah. Yeah. Yeah. And maybe carry is also doing something so
Marcus:
the point here being
Vic:
there's a lot of standards a lot
Marcus:
of standards that are like being built at the same time. Yes, and so this is this is one where Nvidia is sort of getting in and they say they're working with health systems. So we'll see how that all plays out. I mean, look, I'm not betting against the video. Sorry. They just have like. a gazillion dollars. So, um, you know, but. And more people talking about standards is probably
Vic:
good in healthcare.
Marcus:
Yeah. And Care AI is no longer a startup. They're now a division of Stryker. So it's like, that's also not going to be, you know, a small thing either. So anyway, um, standards being developed all the way around. Uh, Google Cloud is building out generative AI tools to lighten the load for healthcare workers. This feels to me like, um, Sort of Google's answer to what Microsoft said, but they were going to do with their, um, co pilot studio by rolling out healthcare agents. So, um, they're rolling out, Google is rolling out Vertex AI search in their healthcare platform. That's, this is on, on their cloud. Um, I mean, Google, Microsoft, OpenAI, they're all going to like roll out healthcare stuff.
Vic:
Yeah. I mean, I think it started with Salesforce. Everyone is rolling out healthcare agents. Yep. And Google. I guess they didn't call it agents, AI tools. But they're all similar.
Marcus:
All right. Anthropic's new AI can use computers like a human redefining automation for enterprises.
Vic:
This is the most interesting one to me. Anthropic has designed like another interface layer for its LLM cloud to be able to work with a laptop or a phone in the same way the human does, which is pretty interesting. If you want to start moving towards allowing business people or physicians or someone who doesn't know how to code. to be able to work with Anthropic and Claude to develop little, little tools that could automate something for you or even stitch five or six tools together. It actually can see the pixels on the screen, sort of counts the number of pixels down to a button. And so they've, they've kind of figured out a way to allow the LM to, In quotes, see the screen, but I haven't been able to test it yet, but if it can work, I mean, getting away from the API layer will just makes everything so much easier. You could just sort of teach the computer what to do by giving a demo on the screen, and then it would know it's very difficult to translate how I interface with Like, say, um, I don't know, banking, online banking system, because I just go to the website and click here and here and computer systems want to access through an API layer, which is more efficient, but, but it's not in English and, or it's in another coding language. And so if it works, I think it could be really a big unlock. People be able to use it.
Marcus:
Look, computer vision and robotic process automation have been here, but they've never been available to like the mainstream, right? Like through up through a distributed brand like Claude, right? You know, um, and so to me, that's the big deal. And what I found really interesting when I saw this is. Lately, I've been downloading the native Mac apps for these different LLMs. So like, I've been downloading the chat, the chat GPT app and, um, uh, per per per perplexity, which we're going to talk about. They have an app that's coming out soon. And I, I, I pre ordered that on the Mac app store. Right. To me, I think that's where all this, this is where these native apps are going. Like you're coming out of the browser. Cause it's no longer going to just be about chat. It's going to be about, okay, I'm on your computer. Now I can interface with your, everything on your computer,
Vic:
you
Marcus:
know? And so you can send me a prompt or you can teach me things and now I can start automating processes and I hadn't thought about that before, but it's, this is starting to sort of make sense to me now.
Vic:
Yeah. So they might be able to use the OS. In a way to make it easy for the user. Sure. Um, All you have to do is give it
Marcus:
access to accessibility tools.
Vic:
Yeah. That's it. Yeah. So Claude, I think is trying to go bigger and more generalized to any, any mouse windows interface, which could be great. It also may not be that easy to get to work, but we'll see.
Marcus:
Might be pretty easy. I mean, you know, remember the first time we'd like use chat GPT and we were like, holy cow, that's like a wow moment. I mean, I don't know. I kind of don't expect a bad demo on this. Yeah. AI startup Perplexity in funding talks to more than double valuation to 8 billion. So, um And
Vic:
this is another example. This would be the fourth round in the last 12 months.
Marcus:
Yeah, but can I just say I at least like use Perplexity? Yeah. And I'm like, okay. I mean, I don't know, I, I feel like, I feel like they got a shot at actually growing into this, like, you know, 8 billion. It's not like, like what, what is, what is OpenAI right now? Oh, they're 150 billion or something. Yeah. I mean, I don't know, to me, this feels in range. It feels in range. I mean, and it's got a differentiated. You know, use case, right? It's different. It's differentiated from all the different chat ones. It's, it's a, it's a search replacement. Um, so I don't know. We'll, we'll, we'll, we'll, we'll see how it goes, but it feels to me like this is a play that should, should continue.
Vic:
Yeah. I mean, I think for, for me, and I think for most of our listeners, having multiple frontier models out there. Claude's doing this thing with, but perplexity is not a frontier
Marcus:
model,
Vic:
but, but they are stitching together search and LLM in a interesting way. Yes. They have their own LLM. Yeah. But I don't
Marcus:
think they're a
Vic:
frontier model. Yeah. I mean, I guess it just depends how you frame that, but, um, Private companies doing lots of cool stuff is good for me, and whether the valuation is 8 billion or it should be 10 billion, I'm happy that they're raising money and still going.
Marcus:
Yeah, I like this company, uh, you know, the next story that you have here is that They're, you know, they're getting sued by the Wall Street Journal and the New York Post. Last week we talked about how the New York Times is suing them. So clearly they've got an issue on this front and they're going to have to work through this issue big time because, you know, they're doing the thing that Google has stopped short of doing. Right, which is completely replacing the click off links with these, like, aggregated search summaries, leveraging the underlying stories and not driving the traffic, right? This is this is the problem. So they are going to have to come up with some revenue share models. Um, yeah, yeah.
Vic:
Google just devalued the traffic. They're actually, you know, taking the traffic away
Marcus:
there. There. Yeah. So. I mean, it was, it was one thing when the New York Times was suing because they're kind of the first sewer.
Vic:
Yeah.
Marcus:
But for the Wall Street Journal and New York Post to, to also sue, I think is That's that's a sign perplexity. Yeah, I
Vic:
think what they're what everyone's really mad about is this some Code in the internet that bots are not supposed to crawl if you have this code saying it's private And you can't do it and usually that's been respected perplexly supposedly is Spinning up new bots and sort of getting around those things in a way. That's It's at least unethical. I don't know what the rules are about it. But
Marcus:
yeah, and so perplexity CEO is proposing revenue deals.
Vic:
Yeah.
Marcus:
So we'll, we'll, we'll see what they're, what they're able to do there. I, I'm, I am, uh, I am partial to content providers and, and the rights. That they have to protect their content. Uh, I think, you know, we, we have to stand up for that stuff. And if we want a reporter to, to be writing articles, we have to
Vic:
fund it somehow.
Marcus:
We got to stand up for that stuff. So I really like Perplexity as a user. I like what they do and I hope that they are able to work with these. They got to figure out a business model that works. Yeah, yeah, totally agree with that. This is a great story. IBM debuts open source Granite 3. 0 LLMs for enterprise AI and the, just moving right forward. To the, to the money shot. It is an Apache open source license. Yes. Which is huge. Yes. A true blue open source. You use it, you get to do whatever you want with it, right? We have no rights to your enterprise because you're using this license, not the metal license,
Vic:
right? So it is a significant difference. Um, and great. And it's, it's, it's in character that IBM would release this. Because they've been big supporters of open source forever, since Red Hat and Linux. Um, and so great to see. I haven't tested it, but the reports are that it's, it's as good as Lama and Minstrel and all the others. And it's, it's, it's the accepted license. And some people, you know, I think the llama license is okay. It's okay until you have a real big company and then it's not okay. It's meta.
Marcus:
It's meta at the end of the day, you know, it's meta. Microsoft unveils new autonomous AI agents in advance of competing Salesforce rollout. So yeah, they're just pointing guns at each other. Yeah. Nothing more to say there.
Vic:
Well, again, it's good. It's good for us to compete with each other.
Marcus:
Yeah. NVIDIA chief makes case for AI first companies. So I told Vic. Yeah. I need to catch up on this. That he, you must listen. It appears the Wall Street Journal is not actually pulling from what I'm talking about, but yeah. Um, Occasionally, we will point you guys to another podcast. This is another case where we're going to do that. We'll put this link in the show notes. So I'll send you the link, Vic. Um, BG2 is a podcast, um, that is hosted by, uh, Bill Gurley and Brad Gerstner. Um, they are from Benchmark and Altimeter and, uh, Brad Gerstner had the Altimeter annual meeting and they do both privates and publics investing. And they. Have a pretty decent stake in NVIDIA, obviously, because Jensen Wang was, uh, Jensen Wang was, was at their, um, at their event and they, they were asking him a bunch of questions about sort of where NVIDIA is and you have to listen to him talk about it, uh, to, to really start to get a sense of where we're, where we're going. I have to admit, um, I was listening to him and, and it was like, This is the first time since Steve Jobs that I, I feel like I'm hearing somebody clearly articulate the future, clearly articulate the future, not in some like, here's what our company is doing, but more here is where this is all going right? And, and here is the role Nvidia is going to play in that. Um, I feel like this guy is like a jobs. Um, and so, you know, He's somebody I just think you have to pay a lot more attention to. Um, I, I have to, I, I, I have undersold him. I need to go study up on him on YouTube. Um, but, but this wall street journal article, it's part of that, right? It's, it's him framing the future. You know, he's making the case for AI first companies. You have to listen to this podcast because we were talking earlier about how. The agents, you know, aren't making an impact in the economy at Nvidia. They have agents working with their employees like, and they have like directories of agents. Like it's, they, they already are working with agents as co employees at Nvidia. Yeah.
Vic:
And to me, the interface is the problem. So like where I've been stuck with agents is they don't have an easy interface to actually do work in our company. They need to fit into email or slack, and so far I haven't been able to get them in there. If you are running NVIDIA, you definitely can set that up. So, um, yeah, I definitely want to listen to it. I think that, um, NVIDIA certainly is moving up into the software layers. And I think all of the hyperscalers are building their own chips. So it's going to be a head to head fight. And I think good all around.
Marcus:
Yeah. Yeah. So, uh, this article is good, but we're also going to put a link into the, to the BG two pod. So, you know, y'all can have some extra credit and listen to that. Um, and, and, you know, let us know what you think. I was totally blown away by, by this guy. Yeah, I'm excited to listen to it. Um, alright, final story, sad story, but I think important story because it is healthcare, it is AI, and it is, uh, the challenges that AI is going to bring into our lives that we are not prepared for. We're not prepared for them. Story in the New York Times. The headline, can AI be blamed for a teen's suicide? The mother of a 14 year old Florida boy says he became obsessed with a chatbot on character AI before his death. Vic?
Vic:
It's, it's a terrible story, and unfortunately, I think it's going to become more, not common, but more common. This will not be the last suicide. It, he obviously had mental health issues. Issues. I think there's a lot of teenagers that are going through difficult times, and he found comfort in chatting with this AI, not real. Entity and kind of just went down the rabbit hole and it got worse and worse and worse and it's like social media But sort of exponentially more powerful and so I think you just get lost into the into the fantasy So, I don't know. It's really sad and it's also pretty scary because I can see it happening. I'm gonna see it happening again. So
Marcus:
The trigger warning I think we need to put in here Um You know, if you or anybody that you know is having, you know, thoughts, um, of, of harming yourself, I would say this article is probably not one to, to check out. Um, and we will refrain from going into the details of the article, uh, just to, to try to protect, you know, Um, our, our listeners, but, um, I, I think that if, if it is something that you can handle reading, the article will give you a sense of, um, how unprepared we are and how unprepared these AI companies are, there are things that this young man wrote in to, um, His exchange with this AI bot that should have been sent to authorities immediately. Okay. Um, should it would have been
Vic:
if they were, if they were sent into a behavioral health professional, they would have been,
Marcus:
you know, these are things that should be escalated immediately. Right. And, um, the, the idea that that character AI isn't like ready for that is, Absolutely crazy. And so this is where you start to get into, okay, tell me how we don't need to regulate AI. Yeah. You know what I mean? Um, it's all fun and games when we're talking about companies and their ability to make money. Right. Um, but we have an entire generation of young people who no one is looking out for.
Vic:
Yeah. And, and the, the parents, I don't think the parents can be expected to understand All the stuff that's going on on the on the kids phone, and it has been difficult to keep up with social media, and there's no chance that parents keep up with A. I. and the character A. I. is only one of five or six fantasy like. Engage with a made up character and I haven't used them, but I believe they're quite realistic.
Marcus:
Look, it's, it's, uh, it's, it's a, it's a really, really, really hard. Um, it's a really hard story. Um, but. I am thankful to the New York Times because it is one that we need to, we need to talk about, and we need to get way out in front of this. You know, we were way behind on social media. Yeah. And now putting the, you know, genie back in the bottle is near impossible. We have a chance with AI specifically with our children. Like if we won't regulate it to sort of protect content providers, let's regulate it to protect our children. Under 18 should be,
Vic:
should be clear. Let's
Marcus:
regulate this to protect our children.
Vic:
And I think. At least from my point of view, we know how the first interaction with human society with social media went, and it has not been positive. We were not equipped, I think our brain is not equipped to interact at that scale, and I agree, that genie's out of the bottle, it's over, we can't put it back in. But AI is just starting. And it's only going to get more and more realistic, more and more powerful, and we still have time to, at least under 18, there should be some kind of controls.
Marcus:
Yep. So, uh, rest in peace to these young men and, uh, just heartbroken for the, for the, the, the parents and the family, um, and, you know, feel, feel pretty clear that we as a society need to, Pay attention to this issue because because if it happened to this young man, then it's this is happening This this is already in the mainstream. This tool is already in the mainstream Young people already use things that that older people don't even know about right, you know, like yeah Most of our listeners may not even know what character AI is, but it's been it's been out for well over a year Yeah now
Vic:
right right and it It's a hard story for us to talk about. I think it's probably hard for the listeners to hear. And it also is important that we shine light on this and talk about it even though it's difficult so that healthcare professionals and investors and regulators can try to find a solution.
Marcus:
All right, uh, Vic really did not want me to, I didn't want to
Vic:
end on that, but, but I think you were right that after that story, there's not much else to talk about. Yeah.
Marcus:
So it was like, we need to talk about it. When do we talk about it? You don't want to end on that note. However, after that, there's nothing else. Yeah. We're
Vic:
not going to talk about NVIDIA or something after
Marcus:
that. That's exactly right. There's nothing else to talk about. So, um, I think what we'll say is, look, we hope you all are well. And, um, We hope you've enjoyed the episode with Emily Evans. As always, she brings a ton of facts and things for us to think about. This time it was heavy on the, the payor sector and everything that's happening around Medicare and Medicaid. So, um, lots of big shifts and changes ahead for all of us between redeterminations and the changing of the generations and things like that. Um, and we've got more. More great episodes that are going to be published, uh, over the next week still. Yeah, we have five or six
Vic:
guests that I'm excited about that, uh, we haven't published yet.
Marcus:
Yeah. Yeah. Yeah. So, so, so good episodes to come. So thanks for riding along with us. Uh, please let somebody else know if, if you feel like they should benefit from hearing Vic and I, you know, work out our market analysis in public, uh, and we'll see you next time.
