151 - The Alarming Rise of Long-Term Unemployment & What It Signals for the Economy

Show Notes

In this episode of Health Further, Vic is joined by guest host Emily Evans to cover the rise in long-term unemployment, Trump’s criticism of the Bureau of Labor Statistics, and the struggles of working-class Americans in a K-shaped economy. They discuss potential Fed leadership changes, a housing supply push in New York, Apple’s $100 billion U.S. investment, and tax law changes spurring corporate spending. The conversation covers venture funding in autism care, cardiac imaging AI, IPO news, and AI-driven drug discovery, along with cuts to mRNA COVID-19 vaccine funding, legal challenges to Trump’s tariff powers, and opening 401(k)s to private assets. Payer updates include Blue Shield’s price tool, Oscar Health’s losses, Hy-Vee’s ICHRA plan, and UnitedHealth’s acquisition of Amedisys. They also explore Hinge Health’s earnings, Hims & Hers’ expansion, major pharma moves, fall prevention, AI in heart failure care, consulting disruption, OpenAI announcements, AI market manipulation, and the threat of AI-driven propaganda.

Links

0:57 Unemployed Americans Endure Longer Job Searches in a Cooling Market WSJ

6:43 Trump Seeks Bigger Overhaul at Labor Statistics Bureau, Adviser Says WSJ

7:48 Why the B.L.S. Regularly Revises Jobs Data NYT

12:35 Earning More but in Worse Shape: Hardship Overwhelms Many American Families WSJ

17:41 Trump Just Got a Fresh Shot at Bending the Fed to His Will WSJ

21:35 How an NYC Suburb Is Actually Managing to Bring Rents Down WSJ

25:10 Trump Announces Additional $100 Billion Apple Investment in U.S. NYT

27:53 Cash Windfall From Trump’s Tax Law Is Starting to Show Up at Big Companies WSJ

31:15 Positive Development Rakes In $51.5M To Grow Developmental Therapy Model for Autism MedCity News

32:50 Ultromics nets $55M to boost its AI ultrasound software for detecting hidden heart failure Fierce Healthcare

35:28 Heartflow pumps up IPO plans to $300M Fierce Healthcare

36:08 OpenAI-backed Chai raises $70mn for AI-driven drug discovery FT

38:22 Kennedy Cancels Nearly $500 Million in mRNA Vaccine Contracts NYT

42:57 Trump’s Tariffs Questioned by Appeals Court WSJ

48:06 Trump to Sign Order Easing Path for Private Assets in 401(k)s Bloomberg

51:19 Blue Shield of California launches new prescription price transparency tool for members Fierce Healthcare

52:27 Oscar Health misses estimates in Q2, plans layoffs and inks Hy-Vee-branded ICHRA plan Fierce Healthcare

56:15 UnitedHealth, Amedisys to sell off facilities in settlement with DOJ Fierce Healthcare

58:46 Hinge Health beats Wall Street expectations on revenue in first public earnings Healthcare Dive

59:06 Hims & Hers stock falls 12% on revenue miss as company plots expansion into lab testing, longevity Fierce H

HF Site

YOUTUBE
INSTAGRAM
TWITTER
FACEBOOK
LINKEDIN
TIKTOK

What is Health:Further?

Every week, healthcare VCs and Jumpstart Health Investors co-founders Vic Gatto and Marcus Whitney review and unpack the happenings in US Healthcare, finance, technology and policy. With a firm belief that our healthcare system is doomed without entrepreneurship, they work through the mud to find the jewels, highlight headwinds and tailwinds, and bring on the smartest guests to fill in the gaps.

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.

Okay, Emily Evans, thanks for joining us.

A guest host today, Marcus is off enjoying some much needed vacation on a beach somewhere.

Good for him.

And, uh, you're filling in.

I really appreciate it.

Glad to be here as always fresh, uh, uh, from the DMV, so hopefully you survive that.

Okay.

Yeah.

But nothing like getting your chip for your driver's license.

Yes, I'm well, I'm overdue.

I think I was supposed to do this three or four years ago.

Yes, yes.

Okay.

So a lot going on in the world today.

Uh, let's dig into the stories.

So we're gonna start with the economy like we normally do.

Yeah.

And so, uh, the first story here from the Wall Street Journal, unemployed Americans are enduring longer job searches in a cooling market.

So this, this is, uh, the continuing, uh, unemployment.

So after the initial Yeah, you sort of refile, I, you know, sort of pulled this out 'cause I, I think this is a, actually a better signal about the health of the economy than the, you know, initial unemployment claims.

Yeah.

Which is the higher, um, we'll talk about that in a minute actually.

But the higher, uh, kind of bigger headline is usually on the initial claims.

But when people can't find a job after that initial period is when I think there becomes to be a problem.

Yeah.

And so we're seeing, uh, for those of you listening and not watching on YouTube, first of all, it's much more exciting to see my pretty face on YouTube.

Uh, we're looking at the Wall Street Journal here.

There's a good chart about the number of people unemployed for at least 27 weeks.

And of course, COVID I, uh, is a big outlier there, but it's, it's creeping up in a way that's, you know, we haven't seen since 2017, if you take COVID out.

Right?

Yeah.

And the, and, and one, I have a lot of questions about this because the, as the, the stock market behaves the way it is, uh, you have, it's, it's see something, right?

It, it's, it's counting on something 12, uh, 18 months from now happening.

Yeah.

Um, and we had a good earnings season.

Yeah.

Um, which may be because some people lost their jobs.

Right.

We got those sg a lines under, under control.

Um, but another, so one of my questions about the unemployment situation is how much of it is.

Reshuffling of people in and out of different industries.

You know?

Um, healthcare employment has declined, um, fairly precipitously, like I haven't really seen in a very, very long time.

Beginning around the first of the early 2024, but really taking off in April, may of 2025 really declining then.

So, um, so where are those people going?

Why aren't they needed?

Are they going into other things?

So it could be, there could be just a reshuffling going on here.

Yeah.

But there could also, it could also be more systemic, uh, and, and secular.

We, we, we probably need more information.

Yeah.

I don't think we know, but I'm watching this.

'cause I think the, the healthy turnover where you lose your job, maybe unemployment for eight weeks and then you find a new job.

That's how it's supposed to work.

If you're out of work for more than 27 weeks, that's six months, essentially, or?

Yeah, unless there's, unless there is some sort of secular shift, like healthcare is no longer be gonna be theri, let's, I'm just using a scam.

We're no, not gonna be the driver of, of, um, employment because there's this huge withdrawal of, of, uh, federal funding.

Yeah.

For it.

Alright.

Those people have to go somewhere.

Um, and maybe some of them are being displaced by automation.

Um, but they're gonna go somewhere and, and if you have to rescale or you have to move, it is gonna take more than Yeah.

27 weeks.

That's a, yeah, that's the optimistic view, I think.

Yeah.

But that, that's, that's a question I have.

Yeah.

So this, to me, this is the one to watch, like if the Yeah, I agree.

Long term unemployed grows too much.

That that's really negative for the overall.

Economy.

Yes.

Uh, but you're right, the stock market is, is not worried about that right now.

No, they're not.

And I suspect that's what it's telling us is, is they don't need to be worried about it.

And the bond market, the bond market, you know, has been act, has not been acting like a recession is coming.

Yeah.

And the last couple of days have been a little bit, a little bit more like that story in anticipation of, of cuts.

Mm-hmm.

But the, the, the, the bond market hasn't said, oh yeah, we've got a recession coming.

Yeah.

You don't see that.

Yeah.

I think there might be a secular shift in kind of the, the share of corporate earnings, but shared between capital CapEx that could be, and, and human labor.

Yeah.

That could be, um, we're getting more productive on a per person basis with technology, but I, I think we need fewer people in general.

Yeah.

I mean, it depends on the industry of course, but I think in every industry it's, it's you're getting more productivity out of fewer people.

Yeah.

If you do it right, you know, you have, you know, one primary wage earner in every household if you do it right.

And then you might have a secondary wage earner or a non wage earner doing other things for which she is Yeah.

Is not paid.

Um, but if you do it right, that's, that's what you want.

Yeah.

Obviously those things, op being optional, not required.

Yeah.

But, but if you do it, if, if it, if you can run productivity up, um, high and you could in salaries and wages can reflect that increased productivity, uh, then you, you get a, a nice big.

Wage boost.

Right.

Right.

That's, that's what you want.

But there may be a time of transition.

Yes.

And, and capital is known to capture those earnings, capture that delta between those two.

Yeah.

And, uh, and not be as generous as it should be.

Yes.

There's ways, there's ways to address that too.

Yeah.

So I intentionally wanted to start with a different labor topic than the next one we have, which is Trump, uh, was really frustrated with the, uh, bureau of Labor Statistics on Friday, Saturday, Sunday.

Yeah.

Welcome to the club here from the Wall Street Journal.

Trump sees a bigger overhaul at Labor Bureau.

Yeah, I agree.

People have been talking about this for years.

Yeah.

Um, Trump just turned to it.

He has a bigger microphone than a lot of us.

Yeah.

So a lot attention.

Yeah.

I'm shocked that people are like, oh, what?

There's gambling going on in here.

Um, it, it's, it's a, it's been a problem for, for.

A, an acute problem, meaning an obvious problem for three years.

Okay.

Yeah.

Um, ever since COVID, something has not been working well.

Yeah.

And when you look at, um, uh, and, and, and you have, you know, wall Street sort of figures it out on, on its own, but when you have the kinda revisions that you've had since COVID, you should be saying, all right, should, how should we do this differently?

Yeah.

You know, the way we, the way we invented in the, you know, thirties and forties, is that really getting the job done, and that's, we didn't, and that got the president's attention and he responded to it.

Yeah.

And so the times, the next story and the times, they did a good job of showing graphically this chart we're looking at here.

It's the difference between the first estimate and the third.

So the way it works is an estimate comes out in, say, now for the month of July, and then they'll, they'll update that.

Next month.

Right.

And the following month.

And so the times here is showing, um, there's been different periods of time when it has run consistently for a period of time.

Overestimating, um, the, like recently the first estimate has been too high and then they've had to revise downward.

Yeah.

That's what has been happening most recently.

And then in the really after COVID, and sometimes before COVID, there were times when they underestimated and had to add.

Right.

Um, and so it is, there's a lot of revisions pretty consistently being revised.

Yeah.

And they're large, really since COVID.

They're big revisions and, and a lot of them.

And that's not what you wanna see in government statistics.

Um, and it's unfortunate that this was played as Donald Trump wasn't happy with the, the number, and he fired the.

Head statistician.

Uh.

Because what everybody should be asking is why is this so inaccurate?

What, what's happened here?

And I think the answer probably lies in the survey methodology.

Um, it definitely lies in the way they, I think the way they measure state and local government employment.

Mm-hmm.

Which, which I would, I was watching that throughout 23 and 24 in particular, and going, this is really bizarre.

These big jumps in state and local employment, you see jumps in state and local, they're not even jumps.

Right.

State and local employment's so huge, you just don't see jumps.

But you would see these increases outside of the months, the, the spring months and um, uh, and summer, which is when budgets kind of get reset.

Yeah.

Right.

And.

And I was like, huh, that's weird.

Why would that happen?

And one of the flaws I think of the system is they apparently use, uh, their own model for state and local and, uh, government estimates of employment and not, uh, not the survey data.

Yeah.

So don't call up governments and say, how many people do you have working there?

Yeah.

And I, I think.

Whatever.

Whether you like the results or don't like the results, I think it's clear the results are not as accurate as, as we need them to be.

Oh, yeah, yeah, yeah.

And but at the same time, there's a lot of Wall Street firms that, that have these figures as key, as key inputs into their models.

Yeah.

Into their evaluation models.

They macro models every model.

These are our mo the he, uh, healthcare, uh, employment, because healthcare is a very unproductive field.

You have to have people giving care ultimately, you know, it's very unproductive and it's highly regulated.

Yeah.

I might, I might say it's very labor intensive.

Uh, it's, it's, I guess it's unproductive.

It's, it's got a low productivity ratio.

Yeah.

Sorry.

Yeah.

We use a lot of people for the output.

You need a lot of people for the output and, uh, and so we look at that labor, that employment number.

It's a really important number.

Yeah.

Yeah.

To tell us what's going on in healthcare, right.

In terms of demand for, for services.

And so if that number's not accurate.

Then we can't accurately assess what's going on in demand for services, which yeah, we need to do our jobs.

And these should be, I mean, there are facts somewhere here, like there, there are a number of people that work for the state of Tennessee and work for the, you know, metro government here in Nashville.

They get paid every Friday or whenever they get paid.

That should be something that is knowable.

It is knowable.

And that's the point I think, which is, is there another way a DP keeps track of this through payrolls?

Yeah.

Okay.

Is there another way to do this job?

And I think the answer is yes.

And I think that's kind of the response to, to this kerfuffle.

Yeah.

Which is, yeah, maybe, you know, the, the.

President should have not said it, said what he said, which is a refrain we can repeat.

Yeah.

You know, for the next three and a half years.

But, but the, the problem still remains, which is it's not a number you can count on.

Yeah.

Yeah.

I think a lot of things with the Trump administration, I don't really like the style that the message was delivered in.

Yeah.

Or the way, the wording that was used.

But the, but the core concept I think does make sense.

This is the eternal struggle of, uh, analysts like me, is that you have to, and, and then you have to go to parties and say, oh, well, he didn't say that.

He's, and then everybody gets mad at you.

Yeah.

Okay.

So the Wall Street Journal had a good story about.

Earning more, but in worse shape.

Hardship, overwhelmed.

Many American families, they, they went to upstate New York and talked to a couple different families.

The first one is a woman.

Uh, she has three children and she earns 37,500 a year.

Yikes.

Yeah.

Which is above the poverty line.

She's, she's not actually below the poverty line, but it's not very much money to manage all the expenses that she has.

And I thought the general did a good job.

We talk a lot about the K shape economy.

Yeah.

But it makes a difference when you actually interview the pe the real people that are doing, you know, whatever work they can do to make money.

Yeah.

And they don't have the education that you and I have, don't have the opportunities and they're doing the best they can.

I am.

Concerned about this part of the K, the lower part of the K. So I'm, I was happy that the journal followed it.

I wanna keep covering it.

Yeah.

And the, the bottom part of the, I mean, this is the, this is the story of the American economy for the last, you know, 30 years is the number of people at the bottom of the K has gotten bigger.

Right.

And the people at the top have gotten smaller, you know?

Yeah.

Less this.

And, uh, and that's, that is when we talk about, we talk about the structural inequities in the economy, that's what we're, we're talking about.

And, and this goes, this is, you know, the, what I think the president is getting to with the tariff question, um, and, uh, among other things is like, right, are, you know, are, are we, uh, why are, are these people in upstate New York not, you know, working at the Corning glass plant like they did?

30 years ago.

Right.

Um, that's probably a bad example.

'cause Corning still makes a lot of, and Apple just did a thing where they're trying to bring business to.

Yeah.

And that Corning makes, you know, a lot of their glass.

Yeah.

Um, but, but maybe that's a bad example, but you get the idea is that there's a Yeah, so I mean, in the story, Felicia Allen, 39-year-old nursing assistant.

So she's working at Healthcare Wilson Medical Center right near, near Bingington, New York.

I actually have a fraternity by that lives in Bingington.

Um, she makes $20 an hour and then got a raise to 2290 last year.

Mm-hmm.

And she has four children.

Right.

And when you read her story, which I recommend people listening, should, will have the link in the show notes, should read it.

She works the night shift, she comes home and then she has to get her older kids to school, take care of the younger ones.

I read through her day.

There's no time for sleep in the day.

Oh yeah.

She's like stealing a nap when her three-year-old is napping.

It's a really hard life for a nursing assistant.

So that mean this is a healthcare worker, right?

Yeah.

And she doesn't have enough money even though she's working really hard.

Yeah.

And if I were to roll back the clock 40 years, what would she be doing?

She wouldn't be working in healthcare.

You know, healthcare's become the default employer Yeah.

In a lot of communities.

And it's, and it, because it's very labor intensive.

It, it's sort of a su substance existence, you know, in, in a lot of communities.

And, um, and one of the, I think the questions is, okay, by rule black clock 40 years, would she be working in manufacturing plan or, or some other job that had.

Better wages relative to the cost of living.

Yeah, that's the thing is the cost of living inflation and the cost of living has gone up faster and wages faster than wages.

And, and in particular, and I think one of the most depressing charts I have is of the average hourly wage in healthcare versus the number of people employed in healthcare.

So people have came into healthcare as an employment option really.

There's three infl, I call 'em the three epics of healthcare.

But, um, the COVID being one, which we'll set aside, the other being 20 10, 20 14 when the Affordable Care Act, uh, was implemented.

Um, and when the, the pe the you, you see the employment chart going up, num more and more people coming into the, that sector.

But the wage, hourly wage numbers flat for all practical purposes.

So we brought in many more people, but paying, so we demand paying each person.

The same, even though inflation over that time period has gone up dramatically.

Right.

So we, so we had more demand for those people.

That's why we hired them.

Yeah.

Right.

Uh, or another alternative, and I beginning to think this is as much as it is, is, or that we regulated healthcare in such a way that we never allowed it to become productive and therefore never allowed it to, to pay.

Yeah.

That's what I, maybe some of both, but Yeah, maybe some of both.

But it's, it's depressing.

It's like there's no, there's no wage.

There's no future working in the low wage areas of mm-hmm.

Of healthcare regard, even though we demand more and more people work in it until very recently.

Yeah.

Well, so what we're gonna keep covering the bottom part of the K because I think it's important to follow a woman, a Biden appointee, Adrian.

Adrian Kler.

Adrian Kler has only been on the, uh, fed governor board for a couple years, but she was filling in for someone, so her term was gonna end, right.

I think next year, maybe end of this year.

Yeah.

But she left early and so Trump has an open seat now that he can fill and there's a lot of speculation that he, he might fill it with the air apparent that could become the next chair.

I think that's the game plan.

Yeah.

Yeah.

And so that is interesting.

Mm-hmm.

And we'll see who he names and it'll be.

Um, I haven't, uh, I know most people don't enjoy this as much as I do, but, um, uh, I, I am kind of enjoying the throw down between j Powell and, uh, Donald Trump.

It's, it's, it's somewhat, it's somewhat entertaining.

It is somewhat entertaining, but it's having not a good effect on policy.

I mean, I think Trump is beating on the fed to cut rates and Powell's response is to, I think, to actually hold off from cutting, just to dig his heels in and prove that he's not bending.

Yeah, well, they're both, it's a very childish debate.

We, we can agree on that, yes.

Okay.

Um, but we can also agree that.

J Powell's records aren't particularly good here.

You know, he missed inflation in 22.

He, he, he, you know, he got that whole transitory thing wrong.

Yeah.

Uh, we knew it wasn't transitory.

Wall Street knew it wasn't transitory.

Yeah.

There were thousands of people literally saying, are you crazy?

This is not transitory, but that's what the White House was saying.

Yeah.

So he said it too.

Um, so, and then he cut rates right before the election, and he shouldn't have done that because it wasn't transitory.

It was still kind of, you know, getting worked out and now he won't raise rates.

So it looks like he's, he's, he's, he's acting.

Yeah.

I think he should cut.

So, I mean, last summer.

My recollection is he didn't cut in July, and then we had a problem in Japan and it was almost like a credit crisis internationally.

Yeah.

And he had a double 50 point basis cut in September to sort of catch up.

Right.

Which also was before the election, so it right before Democrats, although it didn't matter.

Yeah.

Um, and he's I think, repeating the exact same mistakes for different details, but he's gonna have to cut in the fall.

Yeah.

Yeah.

I, he, the, I I think that, uh, Scott Besson's Right.

You know?

Okay.

You, you spend a lot of money every year.

You have a lot of economists working there.

You should get it right than anybody.

Yeah.

And you're not, and, and it, it is because it, the Fed, and you gotta go back to the beginning of, of the time when the Federal Reserve was created because banks like.

The Morgan Bank, for example, had this crazy amount of influence over public policy.

Yeah.

And not only that, they have this crazy amount of influence over foreign policy.

You know, they're lending money to countries that aren't necessarily aligned with US interests.

Right.

Uh, just 'cause they need money.

Yeah.

Germany being a good example of that.

Yeah.

Right.

And, uh, and so that's why the, the Fed actually came into being, is to create this sort of neutral institution, you know, for that, uh, that that would be a US institution and not a global, uh, global bank.

Um, but, uh, and I think for a while they probably did a decent job, but, you know, since at least the eighties, maybe maybe the nineties, but definitely at least the eighties, it's, it's, it's been a highly politicized operation.

Yeah.

Then I have this story about how a New York suburb, they're talking about New Rochelle, which is right outside the city.

Mm-hmm.

Um, is managing to bring its rents down.

It's doing that by encouraging development of new, new housing projects.

Right.

And I pulled this out 'cause I think it is, it's important to, you know, we, we talk about the lower part of the K, we need to create housing for people that's more affordable, because that's a big cost, big aspect of their cost.

Yeah.

And a a, you know, a really, really good start would be a healthy monetary policy.

Yeah.

I mean, because that would go to building and everything.

Well, you know, one of the, the, you know, we're, and we're gonna talk about this in a few minutes, you know, if your economy is almost entirely asset based, which is really true.

Or asset asset manipulation.

Asset movement, capital movement.

Which is, if you look at the last.

30 years outside of healthcare, that's a lot of it.

You know, that's mm-hmm.

Real estate development, commercial and, uh, residential, for example.

And, and when you make that, you know where all the 1% monies go.

You, you distort things.

You know, housing is not supposed to be, uh, as expensive as it is relative to wages.

Now, I think new Rochelle's making a mistake there, because the real answer is not trying to get your rents down, because a decline in rents overall means a, your asset takes a hit.

Right.

Um, well, they're creating a lot more units, um, right, okay.

So if you, so there's more tax base, I think if you have an apartment here, building here, and you build a new apartment building here.

Okay.

And you use tax incentives or Yeah, whatever.

All right.

And the, this, each apartment here runs a hundred dollars a month.

These were renting for $200 a month, what are they gonna do?

They'll all be a hundred.

They'll all be a hundred or they'll be 150.

But so you're, you're diminishing the value of the capital invested in apartment building a, you know, um, for the benefit of people moving into apartment building B. This is, but you're not building, you're not making the whole pie are bigger.

Um, you, you could, but one, one of the mistakes people make when they think about supply and demand of housing is that people do not observe the arbitrary borders of New Rochelle or Nashville and Davidson County.

They can choose to live in Nashville, in Davidson County or in Williamson County or Wilson County or wherever.

Yeah.

And then drive their car.

So, so they think of the market.

Yeah.

So they can live in Queens or New Rochelle or wherever.

Yeah.

They don't think of the market as what does it cost to live in New Rochelle?

They think of the market as, where does it cost to live within reasonable proximity to.

My office.

Yeah.

You know, wherever that may be.

Um, so it's a, it's a, it's a, it's a mistake and we're making it here in Nashville, I think, because the answer is drive wages up.

Because if you drive wages up, if people are making more money, then the question of the cost of housing becomes much less of a concern.

And that's back to all those people in healthcare.

Yeah.

You know?

Right.

They have not seen any wage appreciation and then they got walloped by j Powell's failure to act right on with the inflation on inflation.

And I, I get back to it almost every single time.

It's this, this is a housing shortages of wage issue more than it is a, um, uh, more than it's a supply and demand issue.

Okay.

The next story is Trump announced additional 100 billion commitment by Apple to invest in supply, don't get wage supply in the us.

Yes.

So that a lot of money that Apple is moving.

Their supply chain chips, manufacturing glass, they, they literally talked about Corning glass.

Yeah.

Um, and they also are getting relief from tariffs mm-hmm.

Because of this commitment.

Okay.

Billion.

So I think a, a win all around, really win for Apple, win for the Trump administration.

A hundred million dollars being invested.

Billion.

And remember you said, you initially said no.

Yes.

Right.

You know, he, he initially said no.

And this gets to, and I think the president may be onto something here, which is you can subsidize people as much as your budget will allow through different programs.

Um, but really what you need to do is get their wages up, which means you get their economic options have to expand.

Yeah.

So our friend in, uh, Endicott, New York and the story, you know, in the, in the earlier story.

Yeah.

Yeah.

Um, if she gets to work at an expanded Corning plant, um, that's a, that's a great thing.

Now, the, the Tim Cook's argument early in this debate was, well, we don't have anybody in America to do that.

Um, which has been the story now for 30, 40 years.

Okay.

All this stuff went offshore because Americans wouldn't do it.

I think Americans can figure it out though.

It's not, I mean, we can Well, they never got a chance.

Yeah.

You know, nobody ever, they, everybody wall street's like, okay, we need to make our numbers, you know, let, let's, let's, let's buy, you know, that, that thing from, it'll be designed in California.

Not made in California.

Um, and, and, and so that was how it worked out and.

But then I don't know that there was ever an opportunity, and I, and I think it's, it's a mistake to say, you know, we're that dumb, fat, and stupid.

'cause we don't think we are.

Yeah, I mean, certainly Americans can learn, especially with a tech enabled manufacturing base.

Yeah.

I think it'll be, there'll be good jobs, right?

We're not, you know, years and years and years ago a manufacturing job was backbreaking labor for men.

Now what is it?

It's these.

Overhead robots that run on right trolleys, you know, and it's just magnificent.

Right.

You know, the kind of things that go on in manufacturing facilities for products that, that, that you can't, they're not t-shirts, you can't pack 'em up and Right.

And ship 'em.

Um, they're, they're automobiles and you go down to any auto, any automobile plant in the southeast.

I mean, it's, it's brilliant.

You know?

Right.

Stuff.

And they're good jobs.

Yeah.

And they're great jobs.

Yeah.

And everybody's happy.

And so related to that, I think it's related to that, it is related to that, um, the Wall Street Journal had a story about cash windfall from Trump's tax laws starting to show up at big companies.

So there is a hundred percent acceleration of capital expenditure Yeah.

Deducted from your taxes in the year you spend the money.

Mm-hmm.

And that has not been well publicized.

I appreciate the journal publicizing, but it's a big, I mean, the reason Apple I think is now willing to invest a hundred billion, it's one very beautiful bill, whereas four months ago they were not going to, is the one big beautiful bill now gives them an immediate a hundred percent match on the deduction.

Mm-hmm.

So they will get a hundred billion dollars tax deduction.

Right.

Which is, is a lot of incentive to, to, you know, and you can, you can spend the money in a tax payment.

Right.

That money never comes back.

Or you can put it into the ground in a producing asset.

Right.

And get.

Tariff or lease, which makes you more, that's kind of an easy, and that makes you more competitive, makes you more money over time.

Yeah, yeah, yeah.

Right.

So yeah, this, we're gonna see a lot of invest.

We already have seen a lot of in, but it's gonna be a lot of small business.

A lot of businesses are gonna invest 'cause it's, if you pay any taxes and there's a lot of, most people do physician groups.

Yeah.

I mean, I pay taxes.

I, I think it's, um, it's a big opportunity that people haven't fully appreciated yet, but over the next six months, I think we're gonna see a lot of investment.

Yeah.

Yeah.

And this is, this is, you know, the, the, and I I, I appreciate that people get super annoyed at, at Donald Trump and didn't vote for him and, and, um, are not, are looking for reasons why he's doing everything wrong.

I, I understand and appreciate that, but he is coming at the case shaped economy.

In a way that's very different than what we've seen mm-hmm.

For a very, very long time.

Yeah.

And, um, and it could get really, really exciting.

And I think that's what the stock market's telling you.

Yeah.

I mean the, well, those are different things to me.

The, the stock market will certainly, I mean if you, that's what the story is about.

If you reduce taxes, like at and t is expected to have 1.5 billion to 2 billion in cash savings this year.

Mm-hmm.

That's very positive for the at and t stockholders.

Right.

Whether that flows through to new jobs, it certainly will fill you with some new jobs.

There's just a question of when and how fast you, what I thought you were gonna say.

What I will say is whether I voted for Trump or not, I'm taking the damn tax deduction.

Of course you are.

I mean, it's, yeah.

It's an opportunity to save money.

I'm gonna, I'm gonna do it.

Yeah.

And so we will get a lot of investment.

Then hopefully that will result in construction jobs and then long-term jobs in 26.

It should, you know that that's there, there's not many reasons that it, it won't.

Yeah.

There are some externalities that occur, but, um, but that is, that is what drives economies is investment.

Right.

And not only that investment in productive, we politicians like to throw around investment a lot, um, when it's not really investment, right.

But investment in productive, um, productive activities.

Yeah.

Okay.

Moving on to the venture capital section.

Wow.

So positive development is a company that just raised $51 million to continue to, it's a series C to continue with their autism.

Developmental relationship based innovations.

It's a new approach to treating autism.

I hadn't really known much about it, but it, it, it's an important space.

What, what do you think about this?

Yeah, no, I think there's a, this is a, just based on families that I know that have worked, uh, through this, it's, um, it doesn't, it's, it's lived in this weird space between psychiatry and psychology and a little bit of physical medicine.

You know, it, it's really, and it, because it's difficult to define, right?

Yeah.

Um, and, and it's difficult to understand, you know, how, how it is because there's a huge genetic component, uh, to it.

So, um, so having, you know, having capital focused on, on that problem, I think does two things.

One, it might make the problem better, and two, it gives families more of a. Have to, alright, here's a solution that that can work.

'cause Yeah, and I think, I don't know their model well, but I think it is more around, uh, kind of helping the child and the family in communication.

Right.

Problem solving.

Kind of like work with what they can do and, and give them, you know, tools Right.

To be better.

Right.

Yeah.

I think it'll be an interesting, interesting developments there.

Okay.

Then we have a few different, uh, cardiac companies raising money.

Soxs raise $55 million to boost its AI ultrasound software.

So they have software rates, it's coming outta the uk, but they do have two FDA clearances to take standard echocardiograms and detect heart failure and.

You know, be able to more carefully look at the, uh, eject surf faction.

Right.

Um, what'd you think of this story?

Well, you know, the one thing I worry about is all the imaging people out there that are going to get trained for imaging, uh, they're, they're gonna have to do some secular shifting, you know, of their own.

Yeah.

Um, and, uh, that's the, the first thought, because imaging is very much a open for ai.

Yeah.

Yeah.

So we had one of our other, um, guest experts, Rick Sson on, who is a radiologist.

Mm-hmm.

And has really been forward leaning on ai.

What he thinks is there's an opportunity for radiologists who have always been sort of the.

The translator to other parts of medicine with new technology to step up and, and take a bigger role using AI to be able to get image intelligence more out there.

But, but they need to learn AI and, and maybe they won't be as many, but they could have a much bigger role.

Right.

And I think the, one of, somebody put it to me the other day where it's like, you know, AI isn't something that operates end to end.

You know, it's something that operates from the middle to the middle, you know, with a human here and a human there.

Yeah.

And then eliminates all the things that in, in the middle that, uh, but you're, I don't see.

Somebody's gonna have to speak for whatever outputs there are from ai, whether in cardiology or radiology, whatever.

Mm-hmm.

Somebody has to answer for the, those results.

And, uh, whether that, and the, and that's just, that's a litigation, uh, legal liability question.

Um, but it's also just sort of a good practice question.

Yeah.

And, and so it, what, how they approach it and how everybody approaches it, it's got to be recognizing that somebody has to answer for this at the end of the day.

Mm-hmm.

Yeah.

And I think, you know, I don't think AI is gonna replace all radiologists.

I think radiologists that really in.

You know, like AI and spend a lot of time with ai, radiologists that use AI effectively are the ones that are gonna really prosper.

It could end up being very, very, very good radiologists.

Yeah, that's right.

Okay.

And then we have sort of adjacent to venture capital, heart flow pumps up an IPO, it's kinda interesting plan on words.

So, um, they filed an S one HeartFlow found an S one to go public.

Uh, they're gonna sell a new public company.

A new public company in healthcare.

Yes.

Awesome.

And so, uh, they will be coming to market in the next month or so, few weeks.

Yeah.

This is, uh, we, we would like to see more of this.

Um, I think one of the goals of the treasury department in the SEC is to make us the home for capital formation.

And we have a lot of work to do when it comes to our public equity market.

Yeah.

So it's nice to see, um, see one of these.

Yeah.

Yeah.

So exciting to see that.

Okay.

And then, uh, OpenAI.

Back a company called Chi $70 million to do AI driven drug discovery.

Uh, so this, we've been talking about this a lot on the show.

Yeah.

There's an incredible opportunity to do a lot of the science.

In ai, in computer models before we go to the lab bench and test on animals, it's much more effective.

It's faster.

Yeah.

Um, I think it's gonna be successful.

Yeah.

One of the, um, the things that we've come to understand with the, the big sarepta, uh, Duchenne muscular, just, she dust up where the company had to withdraw and then didn't have to withdraw, but, but it had two deaths from liver injury.

And one of the problems with the, the, the data, the say clinical data, but you know, that disease progresses at different rates depending on Right.

Who you are.

And, um, but one of the things that is gonna be great as the FDA Digitalizes, its, its data, is you can see things outside of the silos that they're, they're stuck in.

And so, one, you know, I, I was talking to a biotech investor and she's like, yeah, one of the things we know there's a liver.

Injury that occurs with DMD.

Um, but if you have access to all that, all those, uh, analog files at the FDA, you may ha in, in the investigation of a liver drug, didn't you do DMD?

Right.

You might, you know, uncover things that we haven't been able to, to see as clearly mm-hmm.

As you can with, with ai, which is really kind of exciting.

And I think this goes to the same idea where you're, you know, you're, you AI driven, drug D discovery, somebody is still gonna have to answer it and it's still gonna be a human being saying, yeah, that's my, that's my drug.

Um, yeah.

But it's gonna, they're gonna go through millions of potential drugs.

Combinations Yeah.

Molecules in silica.

Yeah.

And then they'll find the, the three that work and do testing on those in the lab, which, which is much more effective process which speed speeds up your preclinical Yes.

You know, pretty dramatically.

And that can speed up your overall time to market.

And then, um, so we're now moving into policy.

Uh, Kennedy came out this week and canceled nearly 500 million.

This is in the New York Times in mRNA vaccine contracts.

You have looked at this extensively in your public company work.

Yes.

Because this, uh, Moderna is almost exclusively mRNA.

That's all they are.

mRNA.

Um, so you knew this space well.

What, what'd you think of this policy?

Uh, well, first everybody needs to, I think, uh, be, be understand what the policy is.

And the policy is that, um, the h the federal government is withdrawing funding for the development of COVID vaccines on the mRNA platform.

They're not withdrawing funding for mRNA research in other areas.

And there's mm-hmm there's some related, uh, to bird flu.

Um, and it's not withdrawing.

Research for vaccines generally.

Mm-hmm.

Uh, it's just specifically looking at $500 million that it barda had been gonna allocate for the development of mRNA vaccine.

That, that using that platform for COVID vaccine.

So, so, uh, I thought it was all respiratory, upper respiratory.

Well, he, he, which I think would think bird flu might be as well.

It, it might be, but it, it's not covered in this particular order.

Okay.

I don't think, 'cause he says COVID-19, but the, um, the, the, the, the short response, the short answer to why he is doing this is it doesn't work.

Yeah.

And mRNA vaccines for COVID-19, uh, did, they're not, not very effective.

Not very effective.

It's, it's, and this is really, uh, again, another topic that's been highly politicized, but this is a, this is a. Product quality question.

You know, this is a, a product, a consumer satisfaction question.

Uh, should we one suggest insurance companies pay for something that doesn't work?

Uh, and even demand it?

Should we make, we tell people, oh, you should get this when it doesn't work.

No, we shouldn't, we shouldn't do that.

Uh, and in a normal world, we would all conclude that's the case.

Um, but, uh, but that, that's, that's, that's all you say just doesn't, well, I, I would separate from, I mean, mRNA vaccines are much faster to get to market.

They are much fetch just wider happen.

I, right.

So I would say even with hindsight.

At the public health crisis time, I'm not sure it was a bad idea to try to get a vaccine out to market.

Not at all.

But now, five years after, yeah.

We are not in a public health crisis and we don't, we don't need the lesser vaccines.

Well, and we should focus on vaccines that actually work.

Yeah.

And the, uh, the original sin was unblending, all the COVID trials, you know, so everybody had a COVID vaccine and we couldn't really see the controls.

Mm-hmm.

At that point, uh, we didn't have a control.

Group, uh, at that point.

And, and I mean, who wanted to be in the control group?

Yeah.

Nobody, supposedly nobody wanted to be in the control group, but, but we eliminated the control group.

Yeah.

So we didn't have any, we didn't have any visibility into a lot of things that, that under normal circumstances we might have visibility into.

Uh, and then we compounded that original sin by making sure and mandating it, you know?

Right.

Everybody's gotta take it.

Yeah.

And people were like, okay, I gotta go take this thing.

And then they get sick.

It's like, wait, you made me go do this and I'm gonna get sick that I got the cos stupid.

And it, that's a customer satisfaction issue.

Yeah.

Yeah.

So, I mean, what I was trying to say is, I, I am.

I give people a pass for the, for the public health emergency.

But now we're beyond that, well, way beyond that.

And it's not, um, it's not the best science to make a vaccine and I, I would probably concede that it had a, a positive effect on a segment of the population that it was very likely to be, um, to, to get sick and die.

Um, and that would be during COVID?

Yeah, during co. Yeah.

And, and, and, and I was, yeah.

If you have, if you have.

Chronic disease, especially if you have COPD or something like that.

It was very dangerous.

Yeah.

But, and, and of a certain age, you know.

Yeah.

But when you start saying, you know, every kid needs it to go to college.

That, that was, that was crazy.

Yeah.

And, um, that's the fog of war or the fog of Well, that was, that was a long fog.

Yeah.

If you ask me.

But yeah, hedge, I, your firm has taught me this, but I want to cover it here.

So the Wall Street Journal published Trump's tariff are questioned by the appeals court.

Trump used, I'm not gonna get the acronym right.

A particular acronym, emergency authorization for charity in order to get wide ranging power.

In the executive branch without having to go to Congress mm-hmm.

To issue tariffs so that he could use them as a, as a negotiating tool and go back and forth as we've seen him change all the time.

That doesn't work.

If you had to go through all the congressional approvals.

No.

And he lost the first court case.

Right.

And then now this is at the, the next level, the court of appeals it.

I don't know if Trump will lose again or win, but it won't matter.

Either side is then gonna appeal.

Yeah.

To the Supreme, to the Supreme Court, which will be towards the end of the year.

Your colleagues at Hegi have convinced me that he's likely to lose.

He is likely to lose, maybe not hundred percent.

Great.

Paul?

Sure.

Our analyst on this feels pretty, he feels pretty confident that he'll lose.

So we have a really interesting situation where Trump is working on signing trade deals with a several countries.

He signed Japan, signed Europe, he signed several um.

Based on his threatening tariffs or issuing tariffs.

He's gonna sign some more between now and when it gets to the Supreme Court, but then eventually it's gonna be, um, no longer in force.

And so there's a period of time when he needs to sign these deals quickly, I think.

Right.

Um, I don't know if people are watching this as much as they should be.

It's gonna be, yeah.

And I, what I don't know is, okay, what's, what's the outcome?

All right?

You, they go to the Supreme Court and it says, okay, you can't do emergency, um, you can't use emergency powers for this.

Okay, fine.

Um, but you've already got a signed deal.

Is that now null and void?

Or, or, or, well, everybody agrees we should do this.

Does that have to go to Congress?

I don't know the answer to that.

Um, but I think, yeah.

So let's just take Japan for an example.

Is Japan gonna say we were forced to sign this deal?

Under a law that was non constitutional.

I don't think they will, I don't think they will either.

I think it's gonna hold up, but I don't notice.

Is there a mechanism that has to go back to Congress?

We'll have to get some clarity on that.

Um, but one of the, and, and Marcus actually taught me this, he grew up in New York, so he's been an observer of Donald Trump for a very long time.

And that is, well, you gotta remember, the guy was a real estate developer in New York City, and that means he dealt with two groups of people consistently.

One is unions and the other is, um, the mafia.

Yeah.

And so he looks at every problem as in politics, we call it mafia negotiation, where, you know, you, you, you kill your dog, you kill somebody's dog, and then you debate, you know, the next.

The next point of the negotiation.

Yeah.

And once, if their mind focuses much more after their dog's been killed.

Yeah.

And so, so once you, you know, understand, all right.

It comes in like a ton of bricks ignoring all of the niceties of, of negotiation in Washington, which almost always is.

A negotiation designed for the success of the political figure.

So the political figure has to come out of the negotiation, calling it a win.

Um, which isn't much of a negotiation if you're a super savvy, you know, right.

Political leader elsewhere.

And this was, uh, you know, the Oslo treaties, for example, but Bill Clinton, um, uh, negotiated, which was a, a path to, a path to path to, to deal with the, the whole, uh, Israel Palestinian thing.

And he, you know, walked around and said, look how great I am.

You know, I did this great thing, which was not bad.

All right.

Yeah.

But everybody on the other side of the table knew all he needed was to be able to say, oh, look what I did.

You know?

Yeah.

He didn't actually need results.

He didn't actually need it to deliver peace in the mid East.

Correct.

Yeah.

And then, and so this is a different approach.

Yeah.

Which is, I'm just gonna break your knees and then we can talk some more.

Yeah.

I mean, I, the, so there've been one of the things that about the Trump administration is.

They are pretty transparent.

There's no question.

It's just, and so everybody's uncomfortable with it.

Yeah.

You know, but what, but Lunik, I mean, they've said their game plan.

Yeah.

Trump comes out with like trying to, trying to, you know, establish anchoring at a, at a crazy level.

And then Lunik is negotiating the deal without Trump, and then he comes in at the end and like moves it around more.

Yeah.

It, it's the last second.

Yeah.

It, it's just relative to this question are what do, what happens next?

Does, do we, we haven't signed a deal with Canada, so like if, uh, or I don't mean China, but we have a lot of trees.

Pick the Right, uh, pick who you wanna talk about, but China, we haven't signed with China, we haven't signed with Canada.

Yeah.

We haven't signed with Mexico.

It's important to note that the emergency powers are not, uh, not used in the pharmaceutical and, and chip negotiations.

Yeah.

That we've, we've been talking about, which actually are the, the.

Probably ones that are national security.

They are national security yeahinteresting.

So anyway, so we've talked about this enough, but it's a story that not everyone's following.

I wanted to make sure people are aware of it.

Okay.

And then Trump signed an order allowing, uh, private assets into 4 0 1 Ks.

And this is including private equity, which I care about.

'cause it includes real estate, it includes venture capital, real estate, cryptocurrency, and other assets.

Um, so it is exciting.

I, I think that there's a lot of people that, um.

Are not accredited and that they, they can't invest in these alternative assets and they've, they've missed out.

Yeah.

And I, we have to see, I have not read the orders.

The details will, will matter.

Yeah.

About the accreditation issue.

And one of the facet, this is these unexpected things about politics.

Um, we, we learned LA uh, in the last session of Congress, the, um, there was a, a lot of hearings about liberalizing, the accredited investor rules.

And uh, and interestingly, some of the biggest proponents of that were the black caucus.

Yeah.

Because when you look at accreditation rules and you look at the size of 4 0 1 Ks, you know, you're not usually talking about the local barber, you know, in, in North Nashville.

You're not, that's not typically who you're talking about.

So you have this very uneven playing field, you know, by virtue of regulation.

Yeah.

The be the flip side of this, and I'll be interested to see how they deal with it, is that there's a whole lot of snake oil getting sold, you know, some of it through publicly traded companies, we should add.

Right?

Right.

But, um, but there's, how is that going to, how, how is, how, how is, how are things gonna be disclosed and people.

You know, learn about these things is, is gonna be a question one in, in one bill in the house that, that was, um, debated and passed last term.

Their response was, alright, if you're a registered investment advisor on your 401k, you should invest in that.

You become an accredited investor.

So you've had a professional advising you on, on that.

We all know that they are just looking for fees sometimes.

So, is that a good answer?

I don't know.

Um, but at least one of the answers.

Yeah.

I, I don't know.

I, I think that, uh, I mean, forever the accreditation rules have been intended to protect people from losing their money in very risky assets.

But also, I mean, I'm a venture capitalist.

I'm completely biased, but there are opportunities for.

Individuals to learn about it and then get better upside and not take that much more risk if they have a portfolio of these things.

But, you know, and if you're 27, you know Yeah.

You have a time horizon that's, you have a time horizon that's nearly, you know, it's 60, 70 years long.

Right.

Yeah.

You'll be okay.

Yeah.

Um, it, it, it, it, it's, I don't, I don't know how you create rules to keep people from being stupid.

I've never figured that out.

Mm-hmm.

Um, but, uh, but I, I do know that most of the rules are heavily biased against the development of a capital base amongst people who weren't born with it, you know?

Right.

Or weren't in highly paid, highly compensated industries.

Yeah.

Okay.

So moving into payer is Blue Shield of California.

This is in fierce healthcare.

They launched a new prescription price transparency tool for their members, um, which I think is great.

I don't know much about this tool price check, irx, I'm dubious, totally dubious the last people in the world that want transparency in your prescription drugs is your insurer.

I don't know about that.

I mean, I don't, it depends on what they're, they get too many kickbacks.

I'm sorry.

Uh, now giving you a chance to know, you know, through an app that makes sense.

So you're less likely to abandon, you know, the prescription.

Yeah.

You know, that, that's a, that's a nice thing to have, I think.

Um, but yeah, I, this is to me not one of those things that's gonna make pe do what needs to be done, which is for people to go, I'm paying what?

Yeah.

Or I could leave Blue Cross and go somewhere else.

Pay a cash price for less, right?

Yes.

And that's the thing they might not say, okay, Oscar Health, uh, relatively small payer missed estimates.

Uh, they've been struggling.

Uh, their MLR went from 79 to 91.

Yeah.

Because they're in the Medicare Advantage.

Yes.

Space and Medicare Advantage, and I have not gotten to the bottom of this, but they're all reporting, uh, MLRs in the, in the high eighties, you know.

Yeah.

Low nineties.

Um, and I think that the problem here is mispricing their plans, which I include benefits, added benefits in that.

Mm-hmm.

Uh, and they're gonna have to, um, they're gonna have to change that, which is bad because that means premiums will go up.

Yeah, that's right.

That's a political, you're gonna increase premiums and.

Yeah, it's gonna be hard on all the people.

It, it's a political problem.

Okay.

And then at the same time that they're doing that prescription, standalone prescription drug plans, which are typically paid paired with freestanding Medicare, uh, or, I'm sorry, traditional Medicare freestanding PDP plans with traditional Medicare, um, those are the, you're getting a lot of plan exits.

People are getting out of the prescription drug standalone plan.

So people are, if they want a prescription drug plan, they're getting forced into Medicare Advantage at Oh, interesting.

'cause that's the only place to get it.

That's the only place to get it.

So if you have Medicare fee for service in some parts of the country, it's difficult to find a Part D plan.

Uh, it's.

It's difficult.

You don't want it, you don't need it, you know?

Um, all you really want is, is to make sure you've got the drug benefit.

Um, but yeah.

In, in parts of this country where a net a hospital's not gonna join a Medicare Advantage network mm-hmm.

Because they're the only hospital in three counties, uh, that's, that's gonna be a problem.

So you, you're, you're, you're headed towards a con consumer choice problem.

Progressive wing of the party is gonna go, uh, I don't like that because that degrades Medicare, uh, advantage.

Yes.

I mean, Medicare fee for service and, but Medicare Advantage is increasing their prices and Medicare advantage.

Yeah.

So you, you're screwed either way.

So you're getting kids from both sides, right?

Yeah.

Right.

And then they also, uh, the more interesting part, I mean, I knew they were suffering and gonna miss earnings, but then they also signed a deal with Hy-Vee, which is a grocery store for an Icra PR plan.

Marcus and I had been tracking this icra, which is a individual, um.

It's a way to give employees at Hy-Vee, which is a grocery store, a pool of money, that then they can, on a, on a their own choice basis, buy different pieces of insurance that they would like.

Yeah.

And, uh, this is a, this is an effort, um, with I cer plans to decentralize it.

And so your employer has other options.

Your employer now has an option of, of running his own.

Program, running a program with a stop loss plan, um, and it, it becomes increasingly expensive.

And this is a icra is a way to get, um, to another option.

And it particularly really, I think of it as moving, it's a step towards like in retirement defined contribution Yeah.

Versus defined benefit.

That that's where you, that's where it's headed.

That's where it's supposed to head.

Yes.

Um, and uh, and this is one step.

The, the ICRA plans are small or not very many of 'em, I haven't seen enough evidence that they're catching on, but I mean, you give people few choices and Yeah, as I've said many times, I don't know that health insurance is a particularly good use of anybody's money nowadays.

Um, I'm gonna leave that one.

So, uh, United Healthcare and a medicist today.

Announced a deal that they, they got a settlement with the DOJ after a couple years of debating it for their acquisition.

So the acquisition can go forward.

Uh, Meis has to sell off 164 in 19 states home, home health, hospice locations across 19 states.

That is a huge number of locations to sell off.

I think it's a record, not maybe in the value.

They, they represent five over 500 million in annual revenue.

Um, but the, the volume, the number of sites has do j's never Yeah.

Mandated that many before.

Yeah.

Yeah.

They're, I and I, this is one of those things that's probably too late on the trend.

You know, the, the home, home health is a very inefficient model, you know, for the, um, uh, for healthcare.

'cause you know, people gotta drive from point A to point B. Yeah.

Uh, and same, unless you're, but that's where the patients are.

That's where they are.

And the whole idea is we'll have this value based care and we won't institutionalize them, but it's a very inefficient model.

Mm-hmm.

And, um, and what, uh, United Health Group has been using the model for are home visits, uh, for pay for.

Home health aides to come into the home and do a healthcare assessment so that United Health gets a, uh, in their mind, proper scoring, risk scoring of, um, of that particular individual.

There is a ton of evidence to suggest, uh, that those home health nurses are being a bit aggressive, uh, in how they, uh, and how they, uh, code diagnoses, which end up in risk scores, which means United Health Group, uh, gets paid more.

So, yeah.

So I agree with all of that.

I, I think, uh, Mesis does a lot, I mean, they're here in town.

They do a lot of visits that have nothing to do with nothing to do with it risk, but that's why United Health, but they do have a piece of that.

But that's why UnitedHealth bought them.

And that was, that was a, to have to cover more territory, yeah.

To have more home health aides.

Mm-hmm.

That was the, the whole reason to, to have, have that.

Yeah.

Have that additional capacity.

Yeah.

So they got, they made it through the process of an extended, uh, negotiation over several years.

But they, they got it done or they were close to getting it done.

I wonder if they wish they just hadn't, but we'll see.

Okay.

Good story from healthcare Dive here.

Hinge Health, which went public about three months ago, three or four months ago, is they had their first earnings call and they did really well beat expectations.

I mean, you kind of expect this on the first one.

They should have had it, uh, kind of, you know, lined up for the first one.

Yeah.

But still good to see them do well.

Yeah.

Okay.

And then HIMSS and hers, which has been just a volatile stock, up, down, up, down, they felt 12% missing revenue and they are expanding into lab testing and longevity.

Yeah.

Which was kind of interesting.

Well, longevity, a big play.

That's a lot.

You're gonna hear a lot about that over the next, A lot of people are interested in longevity.

I don't know how much volume there is, uh, across the country.

It's more of a wealthy person thing.

Yeah.

It's, and, and the transhumanists, you know, who just don't, don't wanna, yeah.

Don't, don't wanna die.

Right.

You know, um, sorry to break it to you, but, um, the, uh, HIMSS is interesting, uh, for this reason.

Um, they are obviously pushing the envelope when it comes to compounding the Glip one drugs.

Yeah.

You know, they're being, they're, I don't, I'm not gonna suggest that they're violating the law.

They're pushing it as far as they think they can go.

And, um, and so they're, they're doing, and they're doing this like grassroots, they have public perception as a, at least a piece of that strategy.

It's a huge piece of that strategy.

Meanwhile, you know, off on the side, the president of the United States is telling 17, uh, drug companies, look, if you need help.

Getting a DTC direct to consumer model set up for your branded drugs or your new entry drug, new entrance entrant drugs.

We we're here to help.

You know, we, we wanna, we wanna know what you need, you know.

Um, and so what could be going on here with HIMSS is that we're actually starting to break the model.

And the model is drug company develops a drug frequently.

Keeping in mind what the pharmacy benefit manager is gonna do with respect to formulary placement.

So we're gonna spend a bunch of money, we're gonna price this drug, and we're gonna do it with an eye towards what Caremark in, et cetera, are, are gonna say for their formulary placement.

Mm-hmm.

Uh, which is a dis distortion from the beginning, right?

Yeah.

All right.

Then once you're, you've got that formulary placement, then you use your sales channels, and that includes direct to consumer advertising.

Yeah.

To drive, drive adoption, to drive, uh, sales, to drive adoption.

And the more desirable your drug is, um, the, the, the more negotiation that goes on between you and the pharmacy benefit manager, you know, the more distorted the price gets.

And, and certainly when you compare that, if you have an Eliquis prescription and.

And Pfizer opens up a channel for you to send your script, which now are automated, right?

They're all automated.

Mm-hmm.

Um, sends your script to some pharmacy and they'll send you the direct consumer price.

They get it out of the PBM universe.

That is the, that, uh, frankly, is the only hope I can think of for big biopharma.

Um, and, and I think HIMSS will end up being the forerunner of that.

Now then we're not talking about branded drugs with himss, we're talking about lifestyle type things, but there's no doubting what they're doing here, which, they're building a constituency of people who were done with all that.

They're done with the pharmacy.

It's closed half the time now anyway.

They're done.

They want, they want what they want and, and they get it from, they get everything else, you know, dropped on their doorstep.

Why not this?

That's, yeah, I think that's right.

I mean, I think it's.

It's the way that consumers want to engage in healthcare.

It's HIMSS and hers is telemedicine mostly.

Right.

And they are, they solve your problem quickly.

Right?

You want a GLP one and they get it to you.

Right.

Um, they are more for, I mean, you can see in the ad if you're watching on the video, that it's targeted at younger people.

Mm-hmm.

This, this is not, not a lot of Medicare folks No.

Going to himss.

Yeah.

Um, who, you know, they have, they have a certain set of things, but it's a limited set and, and weight loss is one of them.

Right.

Yeah.

And, but you know, it wouldn't take much to, to make that other things, especially when you have all this loss of ex exclusivity going on in biopharma.

Mm-hmm.

So things are moving into the generic channel.

Yeah.

They're moving off patent.

They're moving off patent.

So that, that, but hims is, is not worried about the patent.

They, well, once things move off patent, they really don't have to worry about it.

Right, right.

Okay.

And then Pfizer, uh, interestingly raised their profit outlook.

Even though they seem to be struggling, they've done a lot struggling, a decent amount of cost cutting here.

Yeah.

Pfizer is, you know, and they had a decent Yeah.

You've, you've researched Pfizer a lot.

I know.

Yeah.

And their, a lot of their revenue came in from, uh, from the COVID-19 vaccinations.

Right.

That we, as we've discussed, um, the federal government has acknowledged they don't work particularly well.

Uh, and because they, theirs is an mRNA vaccine too.

Yes.

They have an mRNA, and I don't think they can run away from that fast enough.

They, they, they depend on it because it's.

Part of their, pretty significant part of their revenue model while they try and backfill some branded drugs.

Yeah.

And that's turning out to be pretty tough.

Um, so yeah, their pipeline is not that strong.

Not at all.

As far as becomes at all.

And the hope for Pfizer and these other drug companies is that direct to consumer channel I was just talking about.

Mm-hmm.

Where, you know, if we can, if they can figure out a way, um, with the help of the White House to fill prescriptions and get those prescriptions delivered to people who, you know, have an Eliquis prescription or whatever, and they cut out all of that excess of, of pharmacy benefit managers and wholesalers and whatever, you know, they get their prices into, uh, the universe of like actual reflection of, of what Yeah.

What the, what the price is.

That's a fairly significant gain for them.

And then they can build brand around that and do some other things.

Yeah.

So I think, uh, one of the, that's their hope.

One of the, well, we'll have Nova first, so, um, we're gonna get to Lilly in a second, which I was trying to jump to, but before we get there, Novo Nordis, um, they pre announced last week, Marcus and I talked about this last week.

They, their, their sales for Wegovy grew 67% year mm-hmm.

Year over year.

So it's growing incredibly fast, even though, um, they got rid of their CEO new CEO and they pre announced that they were gonna miss earnings.

Right.

So it's sort of a two tail of two things.

The Wegovy is still doing really well.

Maybe not as well as people had hope, but 67% is pretty good growth.

Yeah.

It's, it's pretty good growth.

You know, there, the problem with the Glip one drugs is the price, uh, and that's their.

That's the reason they're a compounders come after their business.

Yeah.

Right.

That's the reason the White House is, it's the price.

They're charging too much.

Yeah.

And, and, uh, and they don't wanna do anything different, um, at, at least at this, at this point.

But, um, but they're still making drugs.

You know, it's a lot of, it's very exciting what Tim's is doing and it's very controversial.

It's still not very big.

Mm-hmm.

You know, relative to the whole market.

Yeah, yeah.

Compounding.

It doesn't scale the same way that, um, mass producing would go through.

No.

Having a whole manufacturing, you know, facility, it's different than having a compounding pharmacy.

Yeah.

Okay.

So Lily has been early, they had Lily direct, one of, I think it was the first, one of the first, going direct to consumer.

They're, you know, they, an American company, one of the best pharmaceuticals in my mind.

They had.

An announcement that their pill, their weight loss pill, so it's a GLP one pill form, has shown really good, uh, clinical trials results.

It's not yet approved, but they're applying with these results.

Yeah.

And I think once you get into pill form, you're, you really have a, um, uh, first of all, it's harder to compound.

Yeah, right.

So, um, harder to compound much more, uh.

Many more people will, will take a pill than will get a shot.

Yeah.

But you also have an expansion of the market.

That's right.

Yeah.

Right.

Although, you know, if a question is, do I save five or$600 a month with an injection?

Oh, you know?

Yeah.

Well, Lily has that too.

Yeah.

Um, okay.

Getting into the, the new section, uh, about health and US seven ways in the Wall Street Journal, seven ways to track your risk of falling and prevent injury.

So falling and breaking your hip is the most common way to end your life.

Yes.

And so, and a lot of the preventions in people should read this Wall Street Journal, but, but they are.

Pretty basic things like the, um, the th area rugs, the throw rugs.

Yeah.

Need get rid those, get rid of, you need to have good lighting.

Right.

You need to watch your blood pressure so you don't get dizzy.

Right.

Pretty basic things.

And then I'm gonna add, you need to work on your sort of core stabilizing muscles and balance Right.

Before you are at a place where you're falling.

Yeah.

'cause you, it's hard to, you need to do that over many, many years.

This is one of, I think, one of the, uh, trends that I really like seeing in healthcare.

Um, it's mostly coming out of the wellness group, the mm-hmm.

You know, which is now sort of, and you see this with HIMSS kind of merging with the Yeah.

Medical world.

Um, but, uh, but also, you know, you've talked to a concierge doc, you know, he'll say the same thing, which is, you know, the goal here should be.

Whatever was in a, you know, usually your actuarial table or whatever was gonna, you know, make you ill at 60.

Let's see if we can't move that to 65.

Yeah.

Right.

And, and then once we get to six, let's make sure we get that to seven.

And so you just keep pushing out these problems and you do that starting when you're healthy.

That right.

That, that's a, that's a very, and, and you, you associate that message with, you know, the make America healthy again.

Mm-hmm.

Movement and, and some other things.

And, and one of the, you know, we've been just lamenting the healthcare cost curve and, and all of the medical spend.

But when you teach people how to be healthy.

You know, they're going to, they, they might need, they might consume less healthcare.

Yeah.

They, I think they would.

Yeah.

And they'd also have a longer health span and maybe be happier.

Right.

Or have more, more productivity.

Yeah.

So, so there's a lot of ways to bend the healthcare curve without cutting reimbursement.

Mm-hmm.

And one of them is cutting demand.

Yeah.

And that, that's that.

So I think this is a, a trend to watch, um, for, you know, quite some years to come.

Yeah.

Um, okay.

Getting into ai, we have one AI health story, which is, I think it's Lena, maybe I'm not sure how to pronounce it.

It's a redesign health, uh, company.

And they have an AI driven approach to preventing heart failure readmission.

And we were talking about this ahead of time.

They use an AI system combined with high touch care teams, which is an interesting phrase.

Yeah.

Um, I think I used to call those extenders.

Yeah.

I think that's what.

They are.

Um, and they're using AI to, to help those teams be more effective and sort of wrap around the patient with much more, um, kind of timely messages and applicable messages.

Yeah.

And this, this company is interesting because first of all, there's money in it, right?

If you reduce the readmission rate for Yeah.

A hospital, you know, they're eligible for, um, for different, you know, quality, uh, yeah.

Bonuses.

Then, um, the second interesting thing about this is that we've had these, uh.

Requirements for information from hospitals to deliver to CMS that are, um, related to readmissions.

So you gotta like pretty vast pools of data Yeah.

To tell you, all right, here's, here's what's, what's.

Yeah.

And, and it's pretty, you know, not great results now.

40% Yeah.

Of heart patients are readmitted within 90 days.

Yeah.

And that's exactly what they're going after.

Yeah.

And that, and there's a, and there, there's actually, uh, gold in those hills as we, as we might say.

Yeah.

Right.

McKenzie is, um, AI is coming for consultants in the Wall Street Journal, uh, inside McKenzie.

This is an existential risk.

I'm glad somebody's coming for consultants.

Yeah.

Yeah.

McKinsey.

Um, I think McKinsey will do Okay.

McKinsey runs, but they're under existential risk, I guess.

Um, AI is a topic at every McKinsey board meeting.

They have many thousands of AI agents in the McKinsey platform and.

They're deploying agents to help with making slides and help with writing.

And we were talking earlier, I think it probably this was your comment, but it helps that the first year, McKinsey, uh, new employee be much more effective.

Much more productive.

Right.

Right.

That, uh, and, and so that mean maybe means you need less people because a first year is gonna be less productive than a third year.

Uh, maybe that means you need less people.

Uh, either that or you expand your business.

We'll, we'll see.

Um, uh, and I think that, I was listening to someone say, yeah, AI is, everybody's worried about AI taking jobs.

Um, what they haven't, you know, really talked about is the jobs they're taking are these soulless white collar jobs.

You know that?

Mm-hmm.

Where, where it's just mind numbing, you know?

Stupid repetitious work.

You know, like a, um, you know, an analyst on, uh, an investment banking analyst on Wall Street.

You doing the two year rotation that you, they traditionally did to, you know, put on your resume, it gets you into business school and then you, you're, you're off to the races, you know, and you work, you know, 18 hour days, you know, 12 hour days.

Uh, and it's a lot of, it's a, a computer could do, you know, it's just computers weren't sophisticated.

A lot of it is painful and monotonous.

Right.

And I think it also is, I mean, it's one of the best ways to learn about lots of different industries and how business is financed and it is, and learn very quickly.

And if we take that away.

The pipeline of talent I think has changed somehow.

Yeah, I don't exactly know the impact, but what I was just looking at is the most used agent that they have is one that helps employees write in what they call the McKinsey tone of voice.

And I think they're probably, um, were hours and hours of times when the partner or a senior, um, person would, would sort of go over the written piece and say, well, no, we need to change that, and that and that.

And they're sort of teaching the other human right, the McKinsey tone of voice.

If we go to a bot that does that automatically.

I guess my question is.

Does anyone learn how to write in the McKinsey human voice, or you just don't even worry about it?

You just sort of put in anything?

Maybe, maybe you don't worry about it, maybe you don't need to.

I don't know.

I mean, I've, I've personally stuck my, some of my stuff through, somebody told me to send that through Chad GPT and my response to that was I just, I don't, I don't, I don't like that.

Yeah.

Yeah.

And, uh, so I know, we'll see, but Mc, McKenzie, uh, sort of has traded on, um, having, you know, really strong, intelligent people advising.

Right.

And if intelligence goes to be a commodity, I don't know what McKenzie's gonna do.

So Well, uh, and you know, they did spend about 25 years saying outsource it to China, which the president is now reversing.

Right, right.

Yes.

Okay.

It was a big week for OpenAI.

We have three stories about OpenAI, um, and we'll try to do 'em fairly quickly, so.

Two days ago, they released two open model, open source models, right, where you can download the entire model, the weights and everything.

They don't have the training data, but they do have the full weights on many open source platforms.

And then you can play with it.

You can change the weights.

You can, there's one that you can put on your laptop and just use at home.

Uh, they haven't, even though it's called open ai, they haven't opened source any of their codes since GPT two, which was maybe four or five years ago.

And so I think it's great, uh, to have one of the leading American AI companies, open source, a really strong, actually two really strong models.

Yeah.

You know, that open source is better for a lot of things.

Productivity.

You know, you think about it, the first open source was probably standardization of parts.

You know, in the early, late 19th century where okay, every, every cog is going to cogs are gonna be this big, this big yeah.

This big.

You know, they're gonna have this many teeth, you know, otherwise you're, nothing's gonna Yeah.

Work and your thing's not gonna work with this thing.

And, you know, and so, uh, what we, so what we know about open source, um, whether that's standardization of parts or, or chat GBT, uh, is it accelerates product, it accelerates innovation and productivity.

Yeah.

You know, because people were working in a standardized environment or maybe standardization ist.

Exactly.

The, yeah.

I, I think of it as like, it raises the floor of, you know, what a startup could use, right?

They, you can download this model for free and run it yourself on your laptop, and that's a good thing.

That means that startups around the world now have access to.

A really high quality AI system that's completely free to, to run right now, you have to pay for the electricity and the compute and things, but the, the actual core software is free.

Right.

Uh, prior to this, the best models were Chinese made, and I think it's good that America is starting to have open source models.

Well, yeah.

And you can't have, you cannot, for this kind of function, you can't have, um, you can't have that kind of international dependency, you know, especially if it becomes, uh, I mean if it, if it, it's probably not gonna matter that it's, you know, all up in a, uh, in McKinsey.

But you know, when you start deploying these things into more sensitive areas, it matters.

And, uh, and you can't be, you can't have that international dependence, I don't think.

Okay.

And then the next story from then, uh, OpenAI released GPT five today, which has been a long anticipated.

This is their new cutting edge frontier model.

Um, it came out today, so we don't have that much information about it.

I have watched two reviews, uh, from two people that I trust that got it early, and then they released their reviews today and they're very complimentary.

It's the best motto in the world, has beaten all a lot of benchmarks.

Um, importantly, they now have changed the standard where previous to this they'd be like a, a reasoning model and an inference model and a video model.

There are all these different right versions and open has changed all that.

With GPT five, there's one, just one model.

It handles.

Anything you need.

Okay.

And it, it knows, it manages itself if it needs to reason or not.

Okay.

Based on what you're asking it.

Which I think is how it should be.

I mean, why does the user have to decide whether they need reasoning or not?

Um, it's much easier just to use one model.

Yeah.

I would say you're, you're talking to somebody who wouldn't know the difference.

So, um, yeah.

But I do like this article from Axios where it says you get instant access to PhD level expert.

I don't know that that's a, that's how, that's how Sam Altman, um, marketed it.

So when he, he announced it live on YouTube or somewhere.

There's a lot of crap in PhD level research.

Yeah.

Yes.

As we, it, it, it, there's a lot of crap in there.

Yeah.

Especially in like nutrition, science, um, uh, drug development, you know, those kinds of things.

Yeah.

Yeah.

Well, I think his point was that, um, chief, I'm not gonna get his quote right, so someone will be in the comments, but, um, GPT-3, uh, he said was like a high school level intelligence.

Okay.

GT four was a sort of a college graduate.

Oh.

And now we're a PhD and GG his PhD. Okay.

That's what he, that's sort of, he was more like a relative to other models.

Okay.

All right.

Not necessarily that a PhD level science is good or bad, just it's more Yeah, it's higher.

I got it.

Okay.

All right.

Well then, and uh, then the most interesting thing that they did this week, so this is all this week, um, they also announced a huge partnership with the US government, uh, which I think has been in making for a while where they're gonna give entire agencies use of their models for a dollar a year.

Uh, which is pretty smart, I think, because it gets them sort of embedded us.

The standard, or at least a very cost effective way to get into the US government.

We will have to see what the, what the standards they're having to meet there.

Because I think it was, I think it was a chat GPT model a few years ago where the federal government said to people on the hill and so forth, do not use that.

We can't, we can't secure mm-hmm.

Against that.

Um, uh, especially when you're talking about, you know, sensitive stuff.

Yeah.

I think that has changed with the Trump administration.

Oh, has it?

Okay.

Um, and open AI has been, uh, working with the Defense department Right.

And sensitive areas, but I think this is for any federal agency.

Okay.

All right.

That, that'll be, uh, we'll see how that goes.

I won't be surprised if philanthropic and, and Google and other people match it.

I mean, what I think it is kind of a no-brainer.

Yeah.

Um, okay.

And then Bloomberg had a story, dumb in quotes, AI bots collude to rig markets, Wharton research five.

So these researchers at Wharton ran, um, trading simulations Yeah.

With AI bots, and these were not, you know, chat GPT five.

These were very simple, um Right.

Relatively simple bots.

And they let them, you know, to their own, let them to their own devices to, with a profit motive.

And they, they consistently were colluding with one another.

Not, I'm shocked not communicating like, but they just would like infer, yeah.

Oh, this other bot is traded this way so we can both make money if I do this.

As long as the other one, I would argue we didn't even need warden to tell us that.

Uh, pretty sure that's been going on for a while.

Why, so you think it's going on now, like, uh, with humans or with, with AI traders or both?

With, with, with, with, with trade, with automated trading systems.

Mm-hmm.

You know, you can see this thing, do that thing, and therefore you, you, you, you have a system for, you know, doing that thing too.

Or, you know, if, if someone is, you know, going long, you can go short and neutralize the market.

You know, that, that's, that's been, that's I think, I suspect it's already a big part of Yeah.

Some trading strategies.

Yeah.

So it's interesting, the, uh, I guess the ability to ingest all this data from the market, the AI bots can tell what the other strategy is, right?

Without having to communicate.

We're humans.

Where we have regulated is, we said Vic cannot email Emily with inside information.

Right.

And you don't have enough.

Ability to look at all of my activities and know what I'm doing.

Right.

But the bots can do that.

Yeah.

And one of the things about Wall Street that's different from a lot of parts of the economy is that we've had data that you can ingest for quite some time.

Mm-hmm.

You know?

Um, yeah, because volume, it's more standardized.

Yeah.

It's standardized volume, price, um, uh, velocity.

We have, we have all these tools and, and we have scraping tools and we have, um, you know, we have we data ingesting from the federal go, all of it.

Uh, and, and, and I expect that we probably also have, you know, trading strategies that do what if do, if this thing happens, that thing happens, you know, kind of, uh, collusion kind of thing.

'cause Yeah, they don't need to talk to each other.

They just need to know, you know, that particular trade went through there and that means this.

And I can, you know.

At some level that was the entire high frequency trading Yeah.

Concept.

Like they found little, little trends that consistently would pay out small amounts.

Right.

Uh, for short periods of time.

Um, and they didn't last forever, but they would last for six months, 12 months at a time.

And you can make a decent amount of money before the market On The thing to remember about Wall Street is it's constantly iterating.

Right?

Yeah.

Right.

That only works for a period of time and then it starts, and then you start something.

Once too many people know about it, it's still Yeah.

Then you start something.

Yeah.

And then you turn to the next thing.

Right.

And the next thing, the next thing after that.

Okay.

And then we're gonna end with, this is an opinion piece out of the New York Times.

The error of AI propaganda has arrived in America Must act.

Um, and it's two Vanderbilt researchers, um, that specialize in national and international security, and they are documenting a Chinese company called.

Go, I guess.

Gala Galaxy.

Galaxy, galaxy.

Um, and I wanted people just to become aware of this.

Galaxy interacts with thousands of individuals on social media and it builds a relationship with you and then tries to move your opinion slightly in its favor.

Right.

And whatever, whatever concept it's trying to go, it has not been seen in the US yet.

It's mostly been in Hong Kong and Taiwan in, in United Asia, right.

Countries.

Um, but these two Vanderbilt researchers saying that they expected to come to the US.

That we're not prepared.

Which, which I, I think I agree with.

No, I think that's probably true, but I don't think it's gonna last much longer.

The, we, you know, we, as we get into the information age, you know, the, uh, starting with broadcast, um, television, uh, the what, the early Walter Cronkite, Edward Armour, what they were selling you was trust.

I saw this thing, I looked at this thing, I talked to these people, and you can believe what I say is true.

Mm-hmm.

Uh, and um, that whole system began to break down, you know, with the internet age, um, where information is like, it's everywhere.

Right?

Yeah.

Well, and there was some kind of, you're gonna know what it is.

There was some.

Regulation that changed.

News didn't have to be balanced.

Yeah.

That at some, maybe 19 95, 19 98, somewhere in there.

It was some, I think it was in the early nineties.

But, um, there was a, you know, a, if you do say one thing for a, or covered one thing for political party, you had to give the other view.

Right.

And that, and that went away.

And I don't know that it was that effective, but, but what happened with the information ecosystem is it went from.

Tr little bit of in less information, but you can trust me 'cause I'm gonna give you information that you need and want and it is accurate.

Um, two information everywhere, you know.

So it just became so cheap and worthless.

And I was giving you the analogy the other day, print media courses is.

Went from being expensive, you know, over several centuries to really cheap and now non-existent.

Mm-hmm.

Um, and uh, where my grandmother would go to the grocery aisle and there was always the National Enquirer, you know, with the stories about two headed babies and, and, uh, and Elvis was not really dead and Right.

You know, and things like that.

And so there's a whole in that ecosystem of information, there's a whole lot of two-headed babies and alien abductions and Elvis Presley is still alive.

And there are people like my grandmother who may or may not think Elvis Presley is still alive.

Yeah.

But it's fun to read it about it.

It's fun to read it and, and, and, and talk about it.

But I think the biggest kind of problem we have is that you knew that that was entertainment.

And there's probably a lot of people that if they encountered the Go Laxy bot would know it was a bot and, but still be entertained by it.

Mm-hmm.

And enjoy.

Conversation, I guess.

Um, but what is the trick here is going to be all those people in the grocery aisle that didn't pick up the national choir.

They picked up, you know, the New York Times or, you know, the Washington Post, which are now terrible examples.

But still, um, those people are gonna have to maintain their critical thinking facilities because there's a whole pool of people, or not, either because they like to be entertained or because they can't really tell the difference.

Um, and then there's this other pool of people who are smart enough to go, uh, I just don't really buy what you're selling, you know, kind of thing.

And don't forget, never forget.

And I keep reminding people this, when it comes to things like AI and the information ecosystem, there is a giant chunk of people that don't touch that all day long.

Mm-hmm.

They're plumbers, carpenters, you know, a nurse, a nurse, a lifeguard doctor.

Yeah.

You know, they, they don't, they don't.

And they're not even in that loop.

And they're gonna be shocked when the aliens land.

Yeah.

Yes.

And so with that, we will end this session.

Um, Emily, thanks for doing this.

Very good.

I think, uh, there's a lot, like every week there's a lot of news coming at all of us very quickly.

Yeah.

Uh, just how do you keep up with all of the, all everything, all day?

What, is there something you read or another podcast you listen to or, uh, people get tired of hearing me all the time.

What, what do you go to for information?

Um, oh gosh.

You're not gonna, um, you probably aren't gonna like this.

Um, so I am a heavy, heavy reader.

Um, and so my mission with news flow is to place it in context, not just the near term context.

'cause I think this is a mistake.

Uh, and when I. Uh, but to place it in a historical context, you know, and so when something happens, the first news question I have is, okay, when, when could that have happened before?

You know?

Mm-hmm.

So my main source of information is reading books.

Actual, yeah.

Books that are much longer form, much longer so than, uh, not even a. A news article, but forget it.

Social media post that's really short and, and ethereal.

Right.

And, uh, and then the second thing, uh, I try and do is stick with, uh, reading the trade publications.

Although that's gotten really hard, uh, where I don't, I don't really actually, I don't need a lecture on Donald Trump every time I read.

He's a known quantity to me.

Mm-hmm.

Yeah.

And there's no, there's no additional information I get from people griping about Donald Trump.

So the trade magazines tend to be, uh, 10 or because they'll dive more into.

They'll die.

Healthcare policy or Yeah.

They're talking to somebody like me.

Yeah.

So, so inside health policy is a hill rag, which, um, is, is pretty good.

Which I, uh, I enjoy, uh, X, which I should not look at it 'cause there's a lot of two-headed babies and dead s on X. Um, but when it, when there's news is moving, it is probably the sole, the best.

Yeah.

That for, uh, breaking news, I think X is, is for, for breaking news.

It's outstanding if you curate your feed for reporters, uh mm-hmm.

That you.

Trust and know and like, yeah.

Uh, it's, it's pretty good information.

I've started, uh, getting into Substack where you get actual, you know, individual people that I, that I like.

Substack is actually a, a, you will look back on it as the golden age of media because you have a lot of people, a lot of people in there were expelled from.

From traditional media.

Yeah.

And are just making their, or they wanted to do the journalistic writing that they wanted to do, and, and their editor or their publisher were trying to force 'em to do something else.

Something else.

Yeah.

Right.

Exactly.

I subscribed to Racket News, which is, um, a, a former rolling stone writer.

It couldn't be more left of center.

I think he's a socialist, you know?

Uh, but he's a great writer.

Yeah.

Um, and, uh, and he follows national security issues, you know, really well.

Yeah.

And, um, so there's a, that's how you have to, that's how I, you almost have to curate your own, uh, sources.

You have to, you, you think, what I think of it as I'm, you know, instead of picking up the New York Times and getting everything I need to know, I have to pick up substack and, you know, and put it together.

And that, that's, that's how the think about it.

And that's what, you know, relative to this last article, that that's really what most people need to do, because I'm not.

I, you know, I, if the pharmaceutical industry cannot do direct consumer advertising via it to cable news, cable news will de it'll close down.

Yeah.

It'll, it'll, it'll go the way of, you know, a number of things.

That's interesting.

Yeah.

'cause if you watch a Fox or CNN either side, almost all the ads are pharmaceuticals.

Exactly, yeah.

And, and which means that they can't report on a very important US industry, which is pharmaceutical, because they don't wanna be dragged into the, you know, editor's office.

'cause he got dragged into the publisher's office and, and, and to talk about these things.

And these things matter.

You know, when it comes to information, it really matters.

And, uh, and, and that is.

I think unappreciated.

Mm-hmm.

Um, by a lot of people.

Linear media lasted way too long.

It needed to go about 10 years ago, and I think it's gonna be gone before, uh, before the, you know, probably 20, 28.

Yeah.

Yeah.

I think, um, as traditional media or linear media has deteriorated, I think, um.

Kind of grassroots, uh, things like podcasts, like this podcast.

Yeah.

And substack where there's an individual writing.

Right.

Uh, have really proliferated, but, but it takes a lot of work.

You have to find a podcast or find the substack that you, that you resonate with.

Yeah.

And, and you have a, and then you have like publications, like the free press that you know, are emerging.

And you have, you, you, these are, these are things that are all, they're remaking media.

Mm-hmm.

It's just that there are a whole lot of people that are, you know, tethered to a very traditional way of, of consuming media.

Right.

Which, you know, at least for healthcare, I can't speak for every part of the, the economy, but at least for healthcare is not.

It's not helpful to me.

Yeah, it's not really, there's not much in traditional media about healthcare that's, that's new or interesting.

Yeah, it's, most of it's regurgitated stories and, and they follow the same storyline and nobody wants to think about it any differently.

So it's not valuable to me.

That may be valuable to others, but it's not valuable to me.

Okay.

Well, Emily, thanks for filling in.

Um, happy to do it.

Excited to have you on here.

Glad to do it.

Glad uh, Marcus is getting good rest.

Yes, yes.

Thanks everyone for listening.

Marcus will be back next week and we will have a whole slot of stories again.

I'm sure.