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Vic and Marcus mark 9/11, condemn political violence after the Charlie Kirk assassination, and review economic shifts including inflation at 2.9%, job revisions, rising unemployment, record markets, and healthcare’s outsized role in job growth. They cover major healthcare and policy moves (Strive’s $550M raise, AI voice agents, Epic antitrust case, drug ad limits, California PE scrutiny, CMS pressure on Medicaid payments), rising employer costs and PBM battles, payvider and consumer health up...
Vic and Marcus mark 9/11, condemn political violence after the Charlie Kirk assassination, and review economic shifts including inflation at 2.9%, job revisions, rising unemployment, record markets, and healthcare’s outsized role in job growth. They cover major healthcare and policy moves (Strive’s $550M raise, AI voice agents, Epic antitrust case, drug ad limits, California PE scrutiny, CMS pressure on Medicaid payments), rising employer costs and PBM battles, payvider and consumer health updates (Kaiser in Nevada, Hims & Hers testosterone, Instacart tackling food insecurity), pharma news (Novo layoffs, Novartis acquisition, J&J bladder-cancer treatment, GLP-1 weight-loss challenges), and tech/AI shifts from billionaire longevity pushes to tokenized securities, Robinhood’s social trading, Oracle’s AI-first EHR and $300B OpenAI deal, and the first AI-made feature film
Links
4:52 - Charlie Kirk Assassination Raises Fear of Surging Political Violence NYT
6:31 - In Public and in Private, New York Prepares to Mark 9/11 Anniversary NYT
6:36 - Inflation Rose to 2.9% in August WSJ
10:42 - U.S. Added 911,000 Fewer Jobs in the Year Ended in March WSJ
11:03 - US Initial Jobless Claims Jump to Highest in Almost Four Years Bloomberg
12:12 - Hiring Stalled in August, With 22,000 New Jobs WSJ
12:32 - Healthcare Jobs Are a Rare Bright Spot in the Stalling Labor Market WSJ
14:30 - All Three Major Stock-Market Indexes Close at Records on Hopes for Deeper Rate Cuts WSJ
15:57 - Inflation Erased U.S. Income Gains Last Year WSJ
20:09 - Strive Health Secures $550M to Advance Value-Based Kidney Care Model MedCity
21:42 - Hello Patient secures $22.5M as investors bet on AI voice agent growth Fierce Healthcare
22:16 - MAHA Commission's 128 recommendations on kids' health include more research on vaccines, antidepressants Fierce Healthcare
24: 54 - Healthcare software giant Epic must face rival’s antitrust lawsuit, US judge rules Reuters
26:49 - Trump Moves to Crack Down on Drug Advertising NYT
28:52 - California Bill Would Put Private-Equity Healthcare Deals Under Scrutiny WSJ
30:11 - CMS issues guidance on limits for state-directed payments in Medicaid Fierce Healthcare
30:45 - Supreme Court Agrees to Fast-Track Trump’s Tariff Appeal WSJ
33:33 - Health Insurance Costs for Businesses to Rise by Most in 15 Years WSJ
35:34 - New survey finds more employers are weighing the switch to a transparent PBM Fierce Healthcare
36:23 - CVS Caremark hit with class-action lawsuit over decision to drop Zepbound from formulary Fierce Healthcare
39:02 - Kaiser Permanente, Renown Health unveil insurance, outpatient joint venture Fierce Healthcare
39:36 -
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.
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Thank you.
Alright.
I'm back buddy.
Yeah, I'm glad you're back.
We had the two good guest hosts, but it's nice to be back with the original.
So.
Yeah.
And, uh, well the original but new office.
Um, yeah.
So we don't have the kinks totally worked out.
I'm not sure how sound light other things.
You know, we got this window back here that we gotta kind of work on.
It's a beautiful office with lots of light until we wanna record.
Right?
Exactly.
Exactly.
Exactly.
But we, we, you know, we got the, the wiring done and the cameras are up and the audio's up and the recorder works and so, so so here we are, man.
Good to be back.
Thanks for holding on the fourth for a couple of weeks while I was gone.
Lots of great shows.
You launched, um, I saw the Kevin Holleran one just went live.
Yeah.
Which is, which is fantastic.
Uh, Mitch, you know, that was very good.
Mm-hmm.
So, you know, kudos to him for standing in.
Just uh, thanks for holding down while I was gone, man.
Yeah.
I appreciate it.
Our full of companies are pretty good.
You know, we had Jean N and Mitch both.
Yeah.
Uh.
They did a great job.
Yep.
So agree.
Agree.
Um, and, uh, any, anything you you want to touch on before we, we jump in?
No, I mean, the world is changing before our eyes, so let's just jump in.
There's a lot to talk about.
Yeah.
I mean, I guess I'll just say, you know, this will come out on Saturday, uh, which I think will be nine 13.
Today is nine 11.
Yeah.
Um, and, uh, you know, it, it just, uh, it never fails to bring me back to that moment.
Yeah.
Whenever I like look at the calendar and realize that the day is approaching or like mm-hmm.
It's on the day.
Um, I was actually talking to, I know we're gonna talk about, you know, the, uh, the assassination of Charlie Kirk here in a bit.
Mm-hmm.
And I was texting with my, my, uh, my son Yeah.
Who is 24.
Mm-hmm.
And, uh, he was, you know, because I just, so I, I saw a, I saw a post, uh, that was probably the, you know, so many sad posts out there about what was happening yesterday.
But I saw one post that was probably the wisest post I'd seen that said if you were not.
Under 30, you don't know what today means.
Right.
Talk to your kids.
And I was like, yes, you're right.
I don't know what today means.
Yeah.
I, I, I actually don't know what today.
I know this name Charlie Kirk, I see him as an ex account.
Yeah.
But like, he's not, you know Yeah.
He doesn't mean anything to, so our generation, he is not meaningful.
Right.
He, he's, he's meaningful, but if you're under 30, there's a lot of people that, um, that that willingness to debate and have this uncomfortable discussions, I think is really valuable.
And part of what, what made young people attracted to 'em?
Whatever side you're on Yeah.
Yeah.
Attracted you either, you either, well, either way, didn't like him or you did like him.
Correct, correct.
Because of that, he was certainly polarizing, but you, but you couldn't ignore him.
Yeah.
Right.
And so, so I was texting with my 24-year-old and, and we were, you know, I was just like, Hey, I just want you to know, I just want to listen and, you know, understand.
And he was sharing his thoughts with me and, and it was this interesting opportunity for me to.
Listen.
Yeah.
Say, I, I understand, understand more.
He's more plugged in than you are.
Yes.
Yeah.
Yes.
And then also share with him, uh, you know, when I was his age, you know?
Yeah.
You know, for me to tell him, Hey, I, I absolutely, um, think you are growing up in a harder time than I grew up in.
Mm-hmm.
And having said that, when I was your age, you know, I was texting with him yesterday.
Yeah.
Tomorrow.
Yeah.
Nine 11 happened.
Right.
You know, literally when I was his age tomorrow, nine 11 happened and, um, you know, and he was less than 1-year-old right at the time.
And I lost seven people that day.
And, um.
And it was incredibly grim and mm-hmm.
You know, certainly made me jaded about the world because those are really hard things for a 20 something Yeah.
To sort of experience and try to process and understand, like, you know, and what I said to him was, you know, it, a really unfair trade happens in these times.
You know, you, you lose a little bit of hope and you lose a lot of innocence.
Yeah.
And you gain wisdom and perspective, you know, and it's not a great trade.
Right.
It's not fun.
You don't like going through it.
Yeah.
It's not a great trade, but you do, um, the things you get help you make it through the next one.
Mm-hmm.
Like, you know what I mean?
Yeah.
It, it builds a sense of resiliency to let you know, like humanity will continue.
Yeah.
Right.
So anyway.
Yeah.
Yeah.
So I agree this today they're doing a moment of silence.
Up in New York.
Mm-hmm.
At nine o'clock we'll be recording, I think, during that.
Um, and then people will, will listen a couple days from now.
But yeah, definitely thinking of all the victims, all the, there's a lot of cancer victims still are hap are coming now.
Yes.
Like after the fact.
Yes.
Yeah.
Yes.
Still.
So anyway, um, with, with that, uh, let's, let's dig in.
Uh, so, so quickly we will just start by, uh, acknowledging, you know, the, the assassination of, of Charlie Kirk.
Um, political assassinations are awful.
Always.
There is no, but there is no asterisk to it.
Yeah.
Um, they're always bad, um, because they, they erode civility, they destroy families.
They traumatize all those who are present for their, them happening, and they divide us further.
Yeah.
Um, and they make everyone scared and they're, you know, murder is always bad.
Yeah.
Violence, murder is always bad.
Violence is never an answer.
No.
This is the first time in a long time that I can recall that the, the killer.
The murderer is not, is still at large, at least right now on, on Thursday morning, it's still at large.
So, um, that's pretty scary too.
Yeah.
So, uh, so yeah, look, uh, I don't think we need to talk more about this because it's being talked about all the time.
Yeah.
But, uh, but obviously, you know, a a, a dark day in, in, in America and look, and not the first political assassination we've had this year, you know, or attempt, you know, the attempt of the, the, the governor of Pennsylvania.
Yeah.
You know, what happened in Minnesota.
Um, I mean this, this trend is just awful.
Really bad murder in North Carolina last week.
Yeah.
I mean, this, it's continuing, unfortunately.
I think it's maybe speeding up and, and getting worse, which is not good.
Yeah.
So, so hopefully our leaders can find a way to engage the public and get us to simmer down, you know?
Yeah.
This, this is, this is not.
This is not a good trend and, and it, it makes everyone more worried.
Right?
Yeah.
Um, and, and as we, as we noted it is, it is nine 11.
Mm-hmm.
Um, and so, you know, we'll, we'll have links to both the story from The New York Times on Assassination of Charlie Kirk as well as, um, the anniversary Yeah.
Of, of the terrorist attack on American soil on nine 11.
Uh, okay.
Moving to the economy, inflation rose to 2.9% in August.
This is a continuing trend, and I think what is interesting about it is everyone basically believes that we're, we're about to talk about jobs.
Mm-hmm.
And, you know, the Fed.
While they have a dual mandate, um, they have been very, very focused on inflation.
Mm-hmm.
And I think that's because they didn't, you know, they're very much backward looking data.
Right.
Um, you know, driven.
And the data they had has now been heavily revised, so Yeah.
Uh, they're gonna have to switch their tune.
Isn't that right?
I think that's right.
I mean, it's a dual mandate.
I think the Fed is back looking.
They were still worried about the post pandemic, really high inflation when I don't think, that's, my opinion is that's really not on the table anymore.
That was a, it's been, it's been gone for a while.
It's been gone for a long time.
So, but, but we're also not likely to hit their 2% goal.
No, I think in the future.
Ever.
Ever.
No, I mean, yes.
So they're in this box that they have created themselves by, by setting a goal that's, I think, very aggressive or unattainable on one side.
And then, you know, the jobs picture is, is becoming more and more.
Dire.
So we'll get to that in a minute.
Vic, I think we should look to bring on a guest at some point in the very near future to talk about, uh, the difference between monetary dominance and and fiscal dominance.
Yeah.
Because it, it, it's clear now that that's, you know, I mean you've mentioned it so many times Yeah.
But we are clearly in this fiscal dominance Yeah.
Model where the Fed is weakened because, you know, the interest payments are just so Yeah.
Significant that that's what's actually driving everything at this point.
Their tools are just not that effective in this moment.
Mm-hmm.
And we talk about the Fed and these rate cuts all the time.
I think, I think we started talking about them because they were really impactful to us as venture capitalists.
Right.
'cause they, they, they pulled a lot.
Hey, I, I got a, I got a little term for you that I, that I heard.
Oh, okay.
Uh, I was at a GP event on Monday and it was great.
I'm not gonna say who.
Yeah.
You know who the LP was, but it was a great GP event.
They had brought in sort of heads of investment from, from the firm and uh, the head of investment said, we've gone from, uh, Tina to Tara.
Uh, and I'd never heard this before, but Tina is, I know Tina, there is no alternative.
Right, right.
To the dollar, really?
Or to us.
Well, well in this case we're talking equities.
Yeah.
Okay.
There is no alternative to equities, to Yeah.
To terror.
There are reasonable alternatives.
Oh, interesting.
Yeah, yeah, yeah.
Yeah.
And so we, we've been in a terror mode.
Yeah.
Now for a long time.
And this is why venture capital has constricted.
Mm-hmm.
This is why, you know, private equity is constricted, uh, and.
And so we've been covering the Fed for that reason.
But I think we're at this point now where we have to acknowledge that the, the geopolitical forces, the, you know, the currency alliances that are forming the trade deficits that are constantly, you know, on, on display.
Mm-hmm.
Even after the reconciliation budget, it's like it did nothing to the deficit, right?
Mm-hmm.
You know, um, it basically traded out dollars from entitlements to dollars for, for defense and ice.
I, I, I'm trying to over, I'm oversimplifying, but it didn't do anything to the deficit.
Yeah.
You know, um, you have to have a serious goldilock scenario for actual deficit shrinking to happen.
Mm-hmm.
Um, based on the reconciliation budget.
And so, um, and what alternatives is he, was he or she referring to like crypto fixed internet fixed income.
Fixed income, yeah.
Fixed income.
Fixed income.
Right.
I mean, it's, you know, uh.
Yeah.
That's gonna be a, well, I, I'm, I'm just saying.
Yeah, yeah, yeah.
This is why we have less capital.
Yeah, that's right.
Yeah.
And we have for three years straight now.
Right, right.
So, um, so anyway, let's, let's keep moving, but, uh, alright.
Going into the jobs, I'm, I'm gonna, uh, flash through these quickly.
Yeah.
And let you Dr. Sort of drive the narrative and then we'll have a short discussion.
So, uh, wall Street Journal us added 911 fewer jobs in the year ending March.
So this was the story of re they were, uh, BLS revised several months and course 12, wasn't it?
I think it was, yeah.
I think it was all 12 and it was a revision significantly down.
Yeah.
Yeah.
I mean, almost a million, right?
Yeah, that's right.
Almost a million.
Okay.
So then the, the next story is about jobless claims.
Yeah.
This week.
This week.
So we went from long term to really short term.
Mm-hmm.
I think maybe last week there were go, maybe go to the chart.
Okay.
There is a. I mean, BLS does this weekly and then they roll it up to monthly and then they do quarterly and then they do the whole year.
And it takes a long time.
And we just got the year ending March final numbers in September.
Mm-hmm.
So it's pretty backward looking.
Uh, but, so we don't know how accurate this is.
Right.
That's what I mean.
But, but the, it jumped up to the highest in about four years.
You know, last week more people, 263,000 people filed for unemployment.
And this, the note really was the rate of change in my mind.
It, it really jumped up dramatically.
And that may be just a blip for some reason something happened, or it could be the start of a pretty worrisome tr trend.
Yes.
We don't, I don't know if we really know right now, but just to note it.
Yep, yep.
Alright.
And then more job data.
Yeah.
So in August, so this is the monthly report for August 20th, 2000 new jobs.
Very anemic report.
Anemic report.
Not many new jobs.
Yeah.
I mean, if you're, if you're watching, we've, we've also got the chart here, and you can sort of see coming from 2022 down to present moment, it's, it's a, it's a pretty clear slope down downward.
Yes, that's right.
And so then healthcare right has been by far the largest job creator in the economy, which is great.
We're all healthcare people, mostly they're listening.
Uh, but we also know there's several storm clouds on the horizon in the healthcare industry.
And if that's the one thing holding up the.
Jobs part of the economy.
I, that makes me worried.
So it's, it's good news, bad news.
I mean, I guess it's good that healthcare is holding up compared to other groups, but it's worrisome.
Yeah.
And to be really clear, again, if, if you're, if you're watching, not listening, you can see this chart that we've got here from the Wall Street Journal.
And uh, it's one of those bar charts where they show you, you know, the total amount of jobs, but they'll show you like the key sector they're trying to highlight and how much it makes up.
And it's a serious concentration risk issue at this point.
Mm-hmm.
Like basically, without healthcare, you're flat.
Effectively.
Right.
I mean, it's something just by eyeballing it, it looks like it's 90% of the jobs.
That's right.
Yes.
That were added.
Were all in healthcare and what we know is it's gonna be staggered over the course of a decade, but we know we're taking a trillion dollars outta healthcare.
Right.
You know, uh, and everyone's looking to use AI because the rates are coming down and you're not gonna be able to pay the people.
So, you know, I think we're gonna look month over month to see if healthcare continues to be this concentration risk and jobs added to the, to the, um, overall market.
But if this is where we are, if one single industry that we already know based on reconciliation budget, where it's headed over the course of the next 10 years is the only job engine that we have, uh.
Then we don't have a job engine.
Yeah.
It's really dangerous.
We have no job engine.
Right, right.
Um, so I dunno if there's anything more to say to that other than, than like No, that's right.
And so people believe that the Fed will cut rates in a few weeks when they meet.
Of course we don't know, but I think they should, even though inflation's beginning to tick up, I think they almost have to try to at least start the process.
Yeah.
Alright.
All three major stock market indexes close at records on hopes for deeper rate cuts.
Yeah.
So that's the craziness of our stock market is that bad job news makes people think, well that means the Fed was more likely to cut and that'll be good for stocks.
Right.
And so stocks all three, the Russell, the s and p and Nasdaq hit all time highs on Wednesday.
So it's counterintuitive, but, but it is true.
I think that the stock market.
Benefits more from fed cuts because the jobless amounts and the cut of jobs might reduce overhead and increase profit margins, and yet they're gonna get a lower fed rate.
So anyway, they, they're to records.
I am, I don't know about you.
I am hearing the term Ks shape economy more Yeah.
And more and more in the general discourse.
Yes.
Like people are becoming more, it's almost now common.
Yeah.
Right.
Yeah.
Right.
Yeah.
It, it, it felt like an industry kind of thing.
We were having to explain it when we started and Yeah.
Industry, insider term.
Yeah.
And now it's pretty common.
Yeah.
Yeah.
I mean, and it's, I mean, I don't know what else you, you need to say, right?
It's like continued all time.
High records for stocks and, well, then, then, so the next low, let's go to the next story.
This is part of the K shape.
Um, so this is Wall Street Journal.
Inflation erased income gains last year.
But the chart that I want to talk about is a five-year view.
Uh, income meaning incomes adjusted for inflation really is stagnant over the last five years.
And so if you are relying on your wages to fund your lifestyle, your, your house payment, your rent payment, your car payment, food, you're losing, purchasing power or go or trading water based on what segment you're in.
And the more, more vulnerable segments, the lower, lower income minority segments women, all of the, the more, uh, at risk segments are worse off.
Yeah.
Yeah.
Um, and, and, and I guess like when we think about stocks, right?
And the stock market mm-hmm.
And then we think about inflation against income.
Uh, it's, you know, inflation is consistently, it's a tax, right?
I mean, it's consistently devaluing the dollars that you hold.
Stocks are a shield against that because they're assets and, you know, they're, they're kind of, they benefit from Yeah, yeah, yeah.
They benefit from that.
So they're not just appreciating, they're also appreciating relative to the dollar, right?
Yes.
Um, and then, but you have to have excess capital in order to buy the stocks.
Yeah.
Because, you know, you need the money to take care of your cost of living.
And if you're flat to going down, or, or especially like if you're down in, in near poverty or poverty, you have no chance at getting to the assets.
And so you're, you're losing, you're losing, you're losing.
And it, it becomes really hard socially because there's, I mean, from like the society, not, not individual social, but Right.
You don't have much hope.
You're working a full-time job.
Maybe you have a second job and you can't keep up, meaning you can't, um, buy the same things you used to be able to buy.
Even though you, maybe you make mo you know, nominally you make a little bit more money per hour, your purchasing power has gone down.
Right.
And that is not a good place for large segments of the population to be just from a motivation and where they go next.
Yeah.
So I, so I think that does that close out the, that closes out the economy?
Yeah.
That close up story.
Uh, it's, it is a grim picture, folks.
I mean, yeah.
You know.
I, I don't really know what to say because you and I, um, we are in the asset business, right?
We're literally in the capital asset business.
And so there's no other way to say it.
What, whether we've been struggling or not struggling, we certainly are on the upper part of the K Yeah.
It's just not, it's just not a question.
Right.
You know what I mean?
We have to keep it honest, but I think the, the truth is that duff not make a healthy society.
Um, it makes a more dangerous society, I believe.
Yes.
The fur, the further the K is allowed to diverge, the more dangerous society becomes, and you know, at what point does the upper part of the K realize that, you know, it's, it, it's, it's self-destructive at the end of the day.
Okay, you have all these assets, but like you, you know, the society you live in is, is melting.
It's Yeah.
Fundamentally melting, right?
I mean, it's, it's kind of like this really ugly Ponzi scheme.
It's, it doesn't end well.
I mean, I, I don't know how an individual can interact except to follow the, the financial and emotional incentives that are provided to you.
Right?
So the upper part of the K is gonna keep behaving the way that they're behaving.
'cause every single person is making their own little decisions for them.
And it, and it is the right set of IT decisions for their incentives, but the overall kind of population based direction is really bad.
And so eventually that's gonna end in a, not a good place.
But the question is when and how.
Alright, let's quickly move to vc.
Yeah.
Strive Health secures 550 million to advanced value-based care kidney model.
Um, this is Series D funded by NEA, includes participation by CVS, health ventures, capital G, echo Health, several others.
Yeah, so kidney care is, uh, one of the best examples of how you can really make a good, good impact on people's lives and on the total cost of care by getting in early and helping people stay out of sort of the end stage mean of disease and just stay in the sort of pre kidney disease phase.
Um, there's another firm here, another.
Private firm here in town, a monogram that's, that's also doing, and they've both had good success.
Yeah.
Yeah.
I mean, Mike Urchin friend, friend of ours, uh, they're in the first Cresty, um, portfolio.
Yes.
They've, they've done really well.
So they, I mean, those seem to be the two big names.
Right.
Those are two big names, you know, strive, strive Health and Monogram Health.
That's right.
Uh, and they continue to attract more and more capital, I think.
I think, uh, you know, like so many value-based care models, it would be interesting to me to know the actual financials.
They're both privately held.
Mm-hmm.
My guess is they're not incredibly profitable.
Right.
They're profitable at all.
But it's the model of the future.
It's going to eat the old model, it's going to eat away at the dialysis business.
Yeah.
And I think that's the bet that these later stage growth investors are making at this point.
They're not looking at like, when is this thing gonna turn profitable?
Yeah.
They're not trying to cash flow today.
No.
It's just gonna eat the, it's gonna eat the predecessor industry.
Mm-hmm.
Yeah.
And, and I think that that's why we're seeing, you know, half billion dollar checks being written into these companies at this point.
Right.
Uh, and hello, patience Secure is 22.5 million as investors bet on AI voice agent growth.
The voice, the use of AI for voice interactions in healthcare, um, is what, hello?
Patient does.
Mm-hmm.
I just did a guest episode with one of our portfolio companies, Alex Hart, uh, with Lena Health.
Same thing.
He, he uses AI for voice phone calls.
He does SMS messaging too in healthcare.
I think it's a trend that, so that'll be published probably a week from now.
Okay, great.
Um, but yeah, the, uh, this is sort of the, the next phase of AI, I think.
Voice.
Alright.
Moving into policy.
Maha Commissions 128.
Recommendations on Kids health include more research on vaccines and antidepressants.
Fierce Healthcare did a good job sort of pulling out, uh, maybe 20.
Of the most important of the 128.
Okay.
Um, and so, you know, there's, there's, the first one is full price transparency, but then a mental health diagnosis, working group collaboration with states on prior auth.
So, I mean, there's several really big, I mean, it's 128 Kennedy and Maha, and really the whole Trump administration has had this strategy to almost like to flood the zone, which just with massive numbers of changes and they won't get them all pushed through into regulation and policy and utilized, but they, they've been getting a lot of them.
Quick question, what do you mean when you say they won't get them all pushed in?
I mean, they've got the full stack, so do you think it's just a matter of change management?
It's just not possible to get these many things through because they, they, they don't, they, they don't lack any political will or ca or capability to do it.
Do you think it's a capacity issue to actually push all these things through?
It's just, yeah, I think there's just, um.
Bureaucratic.
Um, no, but no, but I guess my point is they're gonna cut half the regulations and, yeah.
By, by.
So I'm trying, when when you say, I, I always wonder when you say stuff like that, it feels like you're, you're pulling from previous administrations, like what has been typical in the past and I, I just always want to gut check, like, yeah.
Is that just like a typical, what we would say about a previous administration or is it, is there something specific about this group that makes you think they won't get all of it implemented?
Well, many of the things I think are kind of vague.
So let's just, we just gotta pick one out, pick one, pick one.
Promoting direct primary care model with health savings accounts, as well as enrollment into high deductible plans.
And so, okay.
They want to promote, it's not measurable.
It's not measurable.
It's not measurable.
Right.
So it's, it's gonna be a challenge, a new vaccine framework that certainly is being pushed out.
But the various physician groups and Got it.
And states and things that are fighting back, so, okay.
Like they're not gonna get 128 things pushed all the way to the finish line, but there's so many of them that they're gonna get lots of things Okay.
To change.
I, I, I, that's kind of what I meant.
Yeah.
I just wanted to clarify that because that, I think it's important.
I wouldn't think you have to read all 128 in detail and expect that to be the new administrative position.
Understand.
I think it's much more of a pushing everything forward.
Understand.
Okay.
Ware software, giant, epic must face rivals, antitrust lawsuit, US judge rules.
It's a big one.
Yeah.
We, we have, we haven't, you know, we, we covered the particle health story on antitrust.
It might be more than a year ago, right?
Yeah.
I think it's a long time.
It might be more than a year ago.
We haven't heard anything about this in a long time.
Right.
And Epic is now in the antitrust crosshairs.
Yeah.
And they have a lot of exposure.
I mean, Judy was a big Obama donor.
Yeah.
Yeah.
I, I look, I, I hate to say it, right, right.
But like that's, I mean, the Affordable Care Act made you do a lot of money.
I look e ever, ever since Bill Gurley's regulatory capture talk at the All in Summit.
Yeah.
I think it was 23.
Uh, and I would, I would encourage listeners, we talked about it Yeah.
Many, many moons ago, but like, go check it out on YouTube.
Mm-hmm.
It's probably has less than 500,000 views.
Mm-hmm.
Um, just search for Bill Gurley regulatory capture.
Yeah.
It's named after the number of miles between DC and, and, uh, Silicon Valley.
Valley.
Silicon Valley.
Yeah.
Okay.
Forget how many miles it was, but, um, go, go check that, that talk, because that to me was the first time.
A real thought leader in Silicon Valley, educated that audience broadly.
Yeah.
Not only about Epic's dominance, but also about the High Tech Act.
Yeah.
About, you know, sort of the way that everything got drafted and how much Epic benefited from it.
Yeah.
The amount of government investment that Epic benefited from.
Yeah.
And the fact that doctors got paid to implement it.
Right.
Right.
And really just sort of framed that as like, you know, the way he framed it was like, wouldn't you like it if the government paid your customers to take on, you know, to buy your software?
Right.
You know, it was that kind of thing.
Um, so yeah.
I mean, I, I feel like this has been building since that moment, honestly.
Right.
Yeah.
Uh, okay.
Trump moves to crack down on drug advertising.
This is a big deal.
Yeah.
So they are trying to crack down on all tv, all video based advertising, which is largely tv.
I think both Trump and Kennedy.
Working for him are very aggressively gonna go, go after that has several knock on effects that are gonna affect healthcare.
Um, but also there's maybe 50% of several cable TV shows are funded by by this.
It's gonna be significant.
Yeah.
I mean, there, there, it's, it's, it's twofold, right?
Yeah.
One, it will almost certainly crater, um, cable news.
Yes.
It'll cradle cable news.
It doesn't take a genius.
We've all watched cable news.
We know how much of it's funded by, by the pharmaceutical industry.
Right.
So that's one.
And then the second thing is it will then become very, very challenging for pharmaceutical companies to find a path to, you know what I would say?
I mean, we're gonna cover him and, and hers and some other groups.
Yeah.
But it really moves everything online where quite frankly, pharmaceutical companies have been behind.
Yes.
You know, they've been behind and this has always been a concentration risk issue, you know, where TV has been their channel to build awareness.
And it's, it's, uh, yeah.
And it's gonna, yeah.
I think it's, I think it's gonna be a, where has a lot of success, whether it is a.
That's another area that, I don't know if it'd be complete or not.
'cause there is still their first amendment in free speech.
But, but they're gonna cut back a lot of things.
And, um, whole new world, man.
It's gonna change everything.
Yeah.
Whole new world.
Yeah, I mean, I, you know, it, it will be interesting to see how much that impacts, um, cable network stocks.
I mean, I, I I I would imagine it's gonna be dramatically bad.
Yeah.
I would imagine that would be brutal.
Um, really bad California bill would put private equity healthcare deals under scrutiny.
The bill of weights action by Governor Gavin Newsom, a democrat who vetoed a similar measure last year.
The legislature in California is, you know, significant majorities in the, on the democratic side.
They passed a similar bill last year that Newsom vetoed, but Newsom has changed his stance pretty dramatically overall in the last 12 months.
And I don't know if that means he's gonna vetoed again or, or not vetoed again, but it's a pretty big risk for private equity.
Um, and I think we're definitely seeing, I'm seeing the states, whether they're blue or red, both sort of making their own changes in healthcare policy.
Florida, of course with the vaccines, it's doing all the stuff they're doing, which is maybe good for Florida, but, but not it's scary.
Typical.
It's, I think you can say it, it's scary.
I think you can say it.
It's scary.
And this is, this is also scary in a different way, right?
Like coming in and saying these for-profit investors have a different sort of set of requirements than some other, maybe a publicly traded company versus a nonprofit.
That that's also a, it's not as directly scary, but it's a scary trend.
Yep.
Yep.
CMS issues, guidance on limits for state directed payments and Medicaid more.
Yeah.
So we've been covering this for a. Several months.
Yes.
More headwinds.
Um, the Medicaid game of increasing taxes, increasing payments, and then getting money from the feds.
Uh, they've been trying to cut it back, stop it, limited, and this is another attempt it's gonna happen.
They're gonna, they're gonna find a way to do it.
They sort of keep, keep working on things.
Yeah.
Yeah.
So just, just kind of a continued watch this space for when the shoe actually drops.
Right, right.
Uh, Supreme Court agrees to fast track Trump's tariff appeal.
So, you know, another step towards finality in mm-hmm.
Figuring out whether or not the Trump tariffs are legal or illegal.
Yeah, that's right.
And I think there's a more than 50% chance that even though Supreme Court is, you know, pretty conservative, I think they're more than likely they're not gonna say that d EPA terrorists are not legal, which is gonna be a huge change and the government will have to refund.
Money.
Money or they'll, they'll find some other way to charge terrorists, but it's gonna be a lot of chaos in November.
And so I'm just trying to keep talking about it so people pay attention.
We're ready for it.
Yeah.
I, I mean, you know, we'll see.
Yeah, we'll see, we'll see it.
It's certainly not a slam dunk.
This Supreme Court, uh, Supreme is supreme very behind.
Uh, that's why it's even 50%, the, the, the power, the very behind the power of the president, right?
Mm-hmm.
The president, the president's authority is very, very broad in the eyes of the Supreme Court, and so I, I just constantly worry.
I mean, it's, it's like I was, it's like I, I asked you to double click on the, the whole, what do you mean when you say they're not gonna get it done?
Mm-hmm.
You know what I mean?
Yeah.
It's like, I just worry that many analysts view this in an old lens.
You know, and, and, and aren't looking at, I, I, I forget, um, is, what's it called?
The unitary, um, authority, uh, theory.
I don't know.
The sort Presidential Power Theory.
Yeah, yeah, yeah, yeah, yeah.
I dunno, the, it's like unitary something, right?
Yeah.
But, but like, it's kind of this, like, the president can do whatever the hell the president wants.
Like there's, there's a theory out there.
Yeah.
That is like, the president is supreme.
Um, and you know, when I look at the decisions that the Supreme Court, I mean, I, look, let's talk, I mean, I don't know if you talked about it last week or not, but that decision about, about ice and, and, and being able to, to discriminately pull over people Yeah.
Based on profile.
Yeah.
We did not talk about it, but that I, I know that was scary too.
Yeah.
I, I'm just like, okay, like what can't be done then?
You know what I mean?
Like, we're, we're, we're getting to a place where, uh, civil liberties.
Do not appear to be the default anymore.
Right.
You know, and, and the government power, the government power, specifically the executive branch in the eyes of the Supreme Court, I think is, is very, very broad.
So I, I, I just, I, I struggle know, knowing, knowing the leanings of this court with, with a, with anything better than a 50 50 assessment.
Yeah.
That's just my, you know, it's my bias on it.
Okay.
Health insurance costs for businesses to rise by the most in 15 years.
Yeah.
So this drives a big part of my investment thesis.
Yeah.
Yeah.
I mean, the, uh, we've been talking about varieties of this story for a long time.
Costs are, are coming up, yeah.
Everywhere.
And that's gonna continue.
And eventually businesses are not gonna, not gonna provide coverage.
They're gonna, they're gonna shift to, you know, other, other means.
Um, and there'll be different ways to pull risk, but right now they haven't gone there.
But this year is the highest in 15 years, and over the last couple years it's been up and up and up.
So eventually this is gonna stop writing coverage.
It's, it's, it's so interesting, Vic, because you and I have been doing this full-time for 11 years.
You've been in healthcare longer than that.
Mm-hmm.
Um, not exclusively, but you know Yeah.
Longer as, as an investor.
And I mean, for how many of those 11 years did we just sort of say incumbents are gonna do the incumbent thing?
Yeah.
Status quo is gonna status quo and like we 29 of the 11 years or some Maybe 10.
Maybe 10.
I think 10.
Yeah, I think 10.
I, I I think 20, 25 is the first year.
Yeah.
That we can honestly say all the disruption we've been squinting to try to see when it's gonna land.
Right.
I mean, how many discussions did we have about the, when?
I mean that's all we talked, talked about.
It's always talked about four decades.
Yeah.
And like literally it was 2025 and it's like, oh snap.
Yeah, it's here.
Right?
It's here.
It's, and it's like all here.
Yeah.
And if you're not paying attention at the level of detail every week that we are, I think you could be too casual about it.
Like, well, I've heard noise about this for a long time.
It's not gonna change a lot of people in Nashville that are like that and Well, most of them have already made their money though.
Yeah, yeah.
Yeah.
That's fair.
You know what I mean?
Like, I think, yeah, I think that's the thing.
Like for them the stakes are not very high.
Yeah.
Right.
New survey finds more employers are weighing the switch to a transparent PBM.
Yeah.
So I put PBMs inside the payers.
That's fair.
Sort of funding.
That's fair.
Uh, pharmaceuticals.
Yeah.
So related to the, to the cost of insurance employers.
Ti are tired of PBMs that are, you know, very criticized and they are setting out to save money for the employer.
But I think employers now are, are saying, um, we're just gonna go to a transparent model.
It'll be cheaper with a lot of the medications, all the generics and things are, are less expensive.
And then we will pay a little bit more for the name brand drugs 'cause we're not getting the same kind of rebates.
But it's a trend to watch because it's gonna really affect, um, the overall market, I think.
Yep.
Yep.
Uh, CVS Caremark hit with class action lawsuit over decision to drop Z bound from formulary.
I mean, I didn't directly comment, but.
The PBM story is one I feel that we have been covering almost from the beginning of health further.
Mm-hmm.
Yeah.
Um, and there've been chinks in the armor for a long time.
Mm-hmm.
Obviously, the, the, the pretty bad probably trailing 12 months that, that the payers have had, has involved a lot of chinks in the armor to, to the PBMs, and now it, it, it just feels like they're, they're kind of defanged at this point, you know what I mean?
Mm-hmm.
Like, they're, they're just gonna be attacked on a very, very regular basis and, and, and they're not going to be a stable source of profits for, for these very, very large payers going into the future.
Predictably.
I, I don't, I mean, I think that's, I think this story is evidence of that.
I mean, zep bound, so what CVS did was they no longer have zep bound in the formulary.
They only have Wegovy Wegovy.
Right.
And they're being sued that, that.
Zep bound.
Some, some patients would prefer Zeep bound.
Yeah.
Or, or, or, or, or their doctors recommending it.
Or their doctors recommend Zep bound over Yeah.
Wago, right?
Like that's like zep bound is what is needed.
Yes.
And the, so, I mean, I think it's important.
It's not a preference, it's a need that that's sort of what the class actually, that's, that's the claim.
Yeah.
No, that's, I'm just saying like, it's not a preference that's being claimed.
It's a need that's being claimed.
Yeah.
A lot of the point of PBMs is to have a formulary that is limited so that they can drive volume up on those names and get rebates.
That's the, that's the basic PBM playbook and Ze Gobi are our direct competitors, and yes, they have a different method of action.
Slightly both GLP ones.
Um, sure.
Doctors might prefer one or another based on your.
Metabolism, your genetic makeup, what what they see as your other constellation of health situations.
But if CVS can't decide amongst direct competitors in their formulary, I don't know what A PBM does that, I mean, that's sort of their main job.
But I think your point is right, that they're being attacked and they're gonna, they're gonna have to settle these things because they're not in a position of strength at all.
Right?
Yeah.
It's, uh, obviously good for Lily, you know, to have this class action shoot in place.
Right.
Uh, but I, I just think, I just think the PBMs are embattled on a lot of different fronts right now.
Yeah.
Uh, okay.
Some good news on the Payvider side.
Yeah.
Kaiser Permanente and renowned health unveiling insurance outpatient joint venture.
So this is in Nevada and this is Kaiser bringing their payvider model to, um, to Nevada.
Yeah.
Yeah.
They partnered with a local, you know, relatively small, but been around for a long time.
Function payer.
Yeah.
Functional payer knows the market.
And Kaiser expanding, I think is.
Positive.
So it's great to see them growing high, high performing.
Right.
They know how to be profitable.
They know the Payvider model.
Yeah.
They have the, the whole horizon thing that, that is making them a national player.
Yeah.
Yeah.
So it's good.
Yeah.
Kaiser's a bright spot in healthcare for sure.
Right now, HIMS and Hers health expands testosterone offerings, so they're just continuing to cover, you know, these, um, these things that are in high demand.
Uh, especially for, you know, I would say probably Gen X, you know Yeah.
Demographic, right?
Our, our demographic.
When you think about, um, hair loss, right?
Erectile dysfunction, uh, and now testosterone, right?
I mean, this, this is, yeah.
It's a heavy focus on our generation, wouldn't you say?
Yeah.
Yeah.
I think it's our generation is the most utilization and younger also will use hymns and hers for, for whatever their needs are.
Yeah.
But age wise, I mean, it's, it's, it's your forties and you know Right.
When you start to care about healthcare Yeah.
Before that you're, and these things start to become issues.
Yes.
You know?
Yeah.
Testosterone drops start losing your hair in your forties for mostly, right.
Yeah.
You know?
Yeah.
So, HIMSS and hers is probably the largest of decent set of companies that are kind of stepping up as a direct consumer.
You know, forget about insurance, just, just when you need healthcare, come to us and we will help you get what you need.
Yeah.
And I think there's gonna be more and more people interested in that.
Totally.
Totally.
And, and I think the idea that, you know, I mean, it, they have a telehealth piece, but the core thing is they, they will get you what you want.
Yeah.
Right.
You know, they're focused on the things that have, uh.
Have a consumer demand.
Right.
There's so many things that require a diagnosis where the consumer doesn't know what's going on.
Right.
But these are things the consumer can self-diagnose.
Yeah.
Right.
You know what I mean?
I'm losing my hair.
Right.
I feel weak.
Yeah.
I don't have sex drive.
Right, right.
You know what I mean?
Right.
Yeah.
And it's like, do you need to talk to your own PCP or go through a health system for those things?
I mean, I think he don't, you know what I mean?
Right.
The other thing that I think this whole crop is doing, but HIMSS is leading the way, is they're really focused on brand.
Yes.
Right.
They are building the HIMSS and Hers brand.
And the app.
And the app and the experience in a way that healthcare has not done before.
Yes.
There are not strong brands.
Nope.
And you don't get to choose your doctor there, there are no doctor connections in hims and hers.
You, you're associated with the brand.
You don't care.
And you don't care.
Right.
You just want them to, to say yes.
Yeah.
And give you your stuff.
Right.
And that is a change.
Whereas in health systems, the doctors often are in leadership, but the doctors also are the connection that, you know, your doctor's name and then the health system brand, you know, you probably know it, but it's not really what you're there for, right?
And so I think that's a pretty big change too.
Pwee and Instacart team up to help community health workers address food insecurity.
So this is, uh, very, a very hopeful story because the constraints.
That, um, the receding of government spending, uh, on entitlements, we hope in the best case scenario, will spur capital investment and innovation.
Right.
And to me, this is a, an indication that we have that opportunity.
Para suite is an EHR that work that, um, serves community health workers.
Mm-hmm.
Instacart obviously, you know, grocery delivery service.
I think Instacart recognized that they were gonna be losing, you know, some businesses, um, snap and EBT was is sort of, uh, you know, dialed in a lot.
Right.
Um, and this is a, a, a JV with some capital investment that, uh, you know, helps to fill that gap.
Yeah, that's right.
It's hopeful.
Um, I mean, the people that need food delivery, because they are on the, at the poverty line or below the poverty line, getting that taken away is, is really bad socially and from a health.
Point of view.
And so this is great to see Instagram and, and payer suite kind of stepping up to at least begin to fill that need.
Yep.
Ozempic Maker Novo Nortis to cut 9,000 jobs.
So they are still very much in the process of, you know, turning the, the, the ship around this is 11%, uh, of their global staff.
So that's a big, big, big haircut.
Yeah, that's right.
And Novo, you know, they've been struggling for a while, but it's just a trend that these reasonably successful global companies are cutting, cutting staff.
Yep.
Agree.
Agree.
Alright.
Novartis agrees to buy tourmaline bio and a $1.4 billion deal.
So you pointed out that this was, uh, different.
We've been looking at a lot of 1 billion, one and a half billion dollars deal, but they've mostly been licensing partnerships, right?
Not acquisitions.
And this is a pure acquisition on the cardiac side.
Yeah.
Yeah, that's right.
So I think it is, um, just interesting to watch.
I mean, there was a trend that this is an outlier against.
I don't know that it changes the trend.
Good to see sort of the, you know, Novartis continue to build strength in cardio FDA nod for j and j drug device treatment gives bladder cancer patients and other options.
So this is some, some heavy science here, but I think the, the big deal is we're moving some from something that is, you know, we're dealing with a very aggressive form of, uh, of bladder cancer.
Mm-hmm.
And.
Therefore there was a very aggressive form of treatment that was radioactive in nature.
Mm-hmm.
So not pleasant for the patient.
Patient, hard for doctors and nurses, doctors to administer.
Not for the patient.
Family cannot be around the, the person.
So there's isolation there, and that's very, very difficult.
And now we're moving to something that's just much more humane all the way around.
Yeah, that's right.
So it's, it's, I mean, it's good to see any situation where there's a second treatment option where there's only one, but in this case, there's a lot of.
Reasons like this might get adopted.
Decent scale.
Uh, OMA finds that six in 10 members maintain weight loss after discontinuing GLP ones.
So I mean, by school grades 60% would be a D. Um, and as you pointed out when we discussed in the prep for the show, this is not just six in 10 people dropping it and maintaining weight loss on their own.
This is six and 10 on the OMA program.
So yeah, leveraging all yeah.
Of support, all the guidance and the support in the community and the best practices, um, and the tools.
Uh, after discontinuing the GLP one, you got 60% success, right?
So as we have feared, you keep the weight off as long as you keep injecting the drug every week.
If you try to titrate off, you have to work really hard at keeping it off.
Change your lifestyle, change your eating habits.
That's maybe just life, but, but I think it is, you're right, it's a d it mean it's presented as a positive in the story, but six outta 10 means that four outta 10 gained the weight back.
That's right.
Yeah.
And I guess it's positive.
I mean, it's, it's positive.
It's, it's, it's better than, than zero.
Yeah.
It's moderately positive.
It's better than zero, but it, it shows, it's hard, it's hard, I guess what it shows it's hard to maintain, it's hard to weight off.
It's hard to maintain once you get off the drug.
Yeah.
Right.
That's, I mean, I think that's the, that's the the point.
Alright.
Health and us, although it ain't us, because you and I are not billionaires.
Right.
And I would say very few of our listeners are billionaires.
But, uh, back to the kha economy, it's, I I was at Health Evolution on Tuesday here in Nashville.
And, um, one of the sort of, you know, hallway conversations that kind of continued was, you know, all these billionaires wanna be vampires.
They, they, you know, they, they don't wanna, uh.
They don't wanna die.
They just wanna sort of live forever.
And how that is just so not on the mind of the average human being on earth, right?
It's such a small group of people who are thinking this way right now.
And maybe this becomes something that technology makes of accessible and available to all people.
I think, I think that is the way that these people are thinking about it.
But, um, you know, I, I think given all the challenges that we have in the world, uh, this comes off really, really poorly.
Yeah.
This, it's, no, no question.
It comes off poorly.
I don't know that it's intentionally bad.
People don't have bad intentions, but, but they're spending billions and billions of dollars on research to extend their own life.
And maybe that will filter to the general population, but.
I think it's a long way from, from that.
Yeah.
And so, and look, I mean, uh, I mean, Larry Ellon, we're, we're gonna talk about Oracle and the incredible, you know.
Path that, that they've been on, uh, since, uh, focusing on healthcare.
But, but I think he's also in this group, right?
Yeah.
I mean, look at him.
He's, he's over 80.
He looks incredible.
And I, and I, and he, I think he is living proof that if you have a whole lot of money, uh, yeah, you know, there is, there is quite a bit you can do.
There's quite a bit you can do.
We're into Web3 now, folks.
Uh, NASDAQ makes a push to launch the trading of tokenized securities.
This has been, uh, a week of themes in the Web3 crypto space.
Uh, one of the big ones is that we're gonna tokenize everything.
Y'all, uh, and we've been talking about it for a while, but here, here we are, um, NASDAQ.
NASDAQ is saying it's time to launch the, the trading of tokenized securities.
And now there's a question around are these tokenized securities?
Actual securities, are they wrapped securities?
Um, you know, does this mean you can trade 24 7 or are you still limited to being able to trade 24 5, et cetera, et cetera.
Lot lots of questions here.
Um, but we are rapidly moving to a world where Web3 is going to be the financial, um, system.
Yeah, that, that's right.
And Nasdaq, um, has the power to really embed Web3 into the exchange.
O obviously where it, it is, it's no different.
It's the same.
They're equal.
You can buy the token, you can buy a share of stock.
One share is exchangeable into one token and it's back and forth.
And I think it will end up being 24 7 trading.
Um, the pace and how we get there might be staggered, but yeah, it's coming pretty much faster than I had expected at the beginning of the year.
Yeah.
Very, very quickly.
Uh, Robinhood, a broker built for social media age to launch its own social network.
Um, this is one story of several, so I just wanna sort of, uh mm-hmm.
Mention that, uh, that base, which is part of Coinbase mm-hmm.
Uh, is also right now in, in a private launch, launching relaunching base, which was previously coined base wallet as a social media app.
Mm-hmm.
Um, and forecaster, which has been the social, the social media network of, of prominence for crypto, um, already today is allowing you to share your trades and things like that.
And so I think by the end of this year, we're gonna have three and, and, and base is built on forecaster.
I don't know what Robinhood is built on.
Yeah.
From a social perspective.
I couldn't find it.
I don't know if they've announced it.
Yeah.
So that's something I, we will need to kind of, you know, do some offline research on, but, uh, at, at least base is using the same protocol.
Mm-hmm.
Um, it's, it's all built on open protocol, right?
So it'll be interesting to see if Robinhood is building everything on open protocols.
But by the end of this year, y'all we're gonna have like three, at least three viable, well-populated social networks focused around financial transactions where it's actually an open market for creators.
Where you can be compensated for your activity, not from meta when they pay you because you get ad impressions or not by getting paid by X, some centralized player, but where you get paid by the open market.
Because every post is itself a tokenized asset, right?
Everyone, every post, right.
And the technology is getting pretty good where it, it is not a hundred percent transparent, but it, it's pretty behind the scenes and, and almost as easy, I mean maybe I think it is as easy, I think Twitter, think podcaster, you can, you can make the plain podcast is as easy as Twitter.
Yeah, it is X, whatever, right?
But then on, on any of these three platforms that are Web3, I own my tweets or posts or messages, whatever they're called on that platform.
But then also I can take my users, I can take my followers and.
Stay there, go somewhere else.
And so they truly are assets.
Whereas if you're on Twitter or Instagram, your followers are not yours.
And if you decide to go to another platform, you can't take them.
I mean, you can put a tweet out and say, please meet me over there, but a large number are not going to, you can't just take 'em like that.
Yeah.
Yeah.
So thi this, this is pay, pay attention is what I would say.
Because especially as, you know, these other platforms just continue to be cesspools.
I mean, quite frankly, it, it's, they're getting less and less.
It's hard.
Usable to It's hard.
Yeah.
It's hard to use them.
They're getting less and less usable.
They're more and more distressing every time you log onto them.
Mm-hmm.
It's, I've been curating my ex. I mean, I keep taking people off and I keep having to take more people off.
Yeah.
It's just, you know, and especially on a day like, like yesterday, right.
It just is so ugly.
Um, that, yeah, I mean these are, these are really big, um, you know, innovations that are coming to the social media world.
So very cool.
Uh, okay.
This startup thinks private equity style deals will kickstart crypto adoption inversion labs, plans to acquire low margin companies and outfit them with blockchain to turbocharge efficiency.
Uh, love this idea.
Um, it's, you know, we need this both in blockchain and in ai, right?
Mm-hmm.
People who are going to do the hard work of taking these transformational technologies into existing real world assets and real world organizations, um, and transform those organizations so that they work for the new world that, you know, these technologies will, I think, dominate the world for at least the next 10 years.
Mm-hmm.
Um, and but it, but it takes focused companies to go in and do that work, right?
Yeah.
And, and so this, this to me is really, really cool.
They raised $26.5 million in a seed round at a hundred million valuation.
Um, and this is, this is great.
I think, I think like the idea that putting existing companies on crypto rails to make them more efficient.
Right now when Nasdaq is talking about tokenizing stocks, right?
When BlackRock is going all in, like it, it's a very, very smart deal.
And this is how I think we're going to get more and more adoption, right?
Through intentional shepherding Yes.
Of existing companies onto these technologies.
Yeah, that's right.
I mean, they're gonna buy kind of basic economy like a auto mechanic company, which might be small, maybe it's just here in Nashville, but then they're going to really make it much more effective with a bunch of crypto Web3 backend tools, build up the infrastructure, and then beginning acquiring others on the platform now of auto mechanics across the country.
And I think you're exactly right.
That will catalyze, it's gonna force other, that example, other auto mechanics to, to figure out what is, how are we getting beat this way?
Um, and then it just sort of, it's a slippery slip and then everyone starts.
Having to compete on that front.
It'll be better in the long run, but it's gonna put a lot of strain, which will be healthy maybe eventually.
But, but these people are smart, but they're gonna catalyze the whole economy, I think.
How, how much of this do you think is driven by, um, it's just sort of a question.
How much of this do you think is driven by stable coins?
Like, like really sort of making this viable, stable coins are the foundation?
None of it's viable without that.
That, that's what I think.
Yeah, yeah, that's what I think.
Yeah.
Wealth Span Health and General Catalyst expand partnership to test out and scale AI technology.
So this was news to me.
I actually didn't understand the General Catalyst had, um, a health insurance transformation partnership that was mm-hmm.
Uh, you know, I I would say as important as Summa Health, Summa Health, health is the acquisition.
Right?
But this is pretty big.
It's an eight hospital health system.
And, uh, and they're like doubling down on their, on their relationship.
I didn't know this.
Yeah, I didn't either.
I mean, it was news to me and I think it's, it's great that, I mean, it's one thing to watch their work in the health system that they now own, but it's very different to work with an arm's length health system and they, they're going full on into AI technologies and really trying to scale it across the ecosystem.
Similar to the, you know, kind of basic economy, starting to use crypto.
If we start to get good results from this, or just results at all, I think other health systems can learn.
We can learn from you and I can learn from it.
Everyone will learn from it.
Yeah.
Yeah.
So that's, that's awesome.
Alright.
Modern Healthcare, Oracle highlights new AI tools for hospitals and takes aim at Epic.
Yeah, so Oracle's had a big week.
We have two stories related to them.
They had their event down in Florida.
I was not there, but I talked to several people there.
They, they announced that they were going directly at.
Epic and they are bringing sort of a new and improved Oracle Health VHR built like from the ground up with AI at the center and really kind of picking on Epic and others as using bolt on AI technology.
And I think it's great for our industry to have, you know, alternatives.
Epic is, has a great product.
They're under a lot of scrutiny right now.
And for them to have a significant competitor like Oracle with you know, plenty of balance sheet strength is great.
Yeah.
And moving to the next Oracle story, Oracle and OpenAI signed a $300 billion cloud deal and this drove a huge increase in the stock price.
Yeah, I mean the stock has been up about 40% this year so far, which is a huge.
Growth in one year, and then it went up another 40% yesterday, and it's basically because they signed this $300 billion multi-year deal with open ai.
Obviously that's gonna grow their business significantly.
And there was not much coverage on it except for on X.
But I sent you several posts, I think on X to show that like Oracle simultaneous to this deal did like a major layoff.
Yeah, right.
Uh, you know, kind of like un Yeah.
We covered it last week.
Oh, did And I covered it.
Yeah.
Okay.
Okay, cool.
Yeah, yeah, yeah.
So they, they, I forget the numbers now.
It's in the show from last week.
Pretty significant.
Yeah.
It was a, it was a pretty big layoff and they hadn't announced this until yesterday that, 'cause they did their earnings release and everything, but they certainly knew they were gonna be so profitable and growing and layoff anyway.
Yeah, that's right.
Layoff.
Anyway.
Uh, and meanwhile, um, Microsoft, I mean, we, I don't think we have a story covering it, but Microsoft is, is working with Anthropic now.
Yeah.
Um, and so what we have is a divergence of that Microsoft Open AI deal.
Right.
Clearly the two partners are moving in opposite directions.
They're moving away from each other.
Yeah.
And I think the quiet winner here is Google.
Um, they did the deal with Apple.
We covered it last week.
Um, they just, they don't have to give up Chrome.
Yeah.
They just keep sort of marching along.
And OpenAI is, is, you know, they, they're, they're gonna be great but they have a lot of work, a lot to work on.
Yeah.
Agree.
Uh, Volkswagen to invest $1.2 billion in artificial intelligence by 2030.
Yeah.
So I mean this is one of several stories that we were choosing between corporate America is, is continuing to go like full on into AI in all in Yeah.
I mean a lot.
There was a story a couple weeks ago that a lot of projects are not bearing fruit, but I think it was 95% are not sort of being followed.
Uh, pilots are not being followed up, but 5% are, and I think corporate America is learning from that and then sort of just doing more and more.
'cause it's.
Profitable for them.
Yep.
Uh, and eBay is also Yeah.
Uh, going to look to become an AI leader.
I mean, you know, look, it's, it's like I, I, I think there's like three things going on right now.
If you are a flailing publicly traded company, somebody might come along, do a JV with you and turn you into a bitcoin holding com holding company.
Yeah.
Right.
Uh, or if you are a large, sort of once great, but not that great tech company, why not just turn yourself into an AI company?
Right.
Right.
Um, and SPACs are back.
So like all three of those things are like happening at time all simultaneously at the same time.
Yeah.
Yeah, that's right.
And I don't mean eBay.
Now you take, you should, if you read, you take a picture, you wanna sell a table, you take a picture, upload the picture, and eBay does the rest of the listing.
Holy.
What?
That's, that's what they do.
You take a picture, you upload it, they do the description, they do the price, they do the comparison to other things.
It, it's, it's, now you can edit it, but they give you a full on That's incredible listing, totally AI generated.
So it's not about use case.
I mean, I think it's gonna be easier.
I don't, I, I really think there's never been a greater time to have agency as an individual.
Entrepreneurial oriented capitalist.
Yeah.
But like if you have, are someone who is dependent on institutions for sustenance.
My God, you have to be, my God, you have to take your own initiative.
You, you can't rely I, yeah.
This whole like finding a job thing.
Yeah, dude.
Yeah.
And is, and, and like so many people, like that's the game they were taught to play.
Yes.
And it's gonna be difficult for people to pivot that quickly, man.
Alright.
Bring up the rear open AI executives rattled by campaigns to derail the for-profit restructuring.
So, um, this is the last ditch prospect of leaving California.
If the regulators complicate the transition for, to a for-profit company, I, my bet is they leave California.
Yeah.
I mean, they're probably gonna have to, they, they, they have to turn into a for-profit.
They have a several billion dollars, maybe tens of billions of dollars that relies on that.
Every, every high profile aggressive company in the southeast to include the state of Tennessee.
This is my bet, and this is not real knowledge.
I need to just Yeah.
Huge disclaimer.
Right.
I don't know what I'm about to say for fact, but like, I know, uh, ecds, you know.
Yeah.
I know.
The people who run economic development, they read this headline, they're all reaching out to Sam Altman right now.
Yeah.
Offering him all the things to relocate.
Yeah, of course.
That's right.
Of course you are.
It's the company of the future.
Yeah.
Like, you know what I mean?
Yeah.
And, and, and California's got a glut.
They're, they're, you know, they're willing on principle, I think, to give this one up.
Yeah.
And, and Sam Altman and OpenAI cannot afford.
They, they won't survive if they don't turn into a for-profit.
No.
'cause all the money has to, can, can be taken back.
Yes.
And so it, it's not a choice.
They have to figure out a way to get to for-profit status and they may have to leave California and final story open AI backs and AI made animated feature film that was going to debut at the canned film festival called Critters and looks very much like a Pixar film.
Mm-hmm.
And so this might be the parting shot to California on the way out.
We're gonna take down Hollywood.
Yeah.
So they are doing this in partnership with the UK based production company.
And it's a full length gonna be in theater's movie.
They're doing it in nine months, which is about 25% of the time and less than 25% of the capital.
Now it needs to be good.
So we'll see if it's good or not.
But, um, but yes, they're, they're leaving California and then they're, you know, throwing this at Hollywood and video, but doesn't really need to be good.
It's just, it's just a proof of concept.
Yeah.
Or, you know what I mean?
Like, it's, it's a proof of concept.
It doesn't actually need to be good.
It needs to be viable.
Right.
Yeah.
And that's fair.
Improve the model Yeah.
To, to, to then eradicate the existing model.
Yeah.
I mean, my, my bias is the existing model's already dead.
They're just zombie dead walking.
They don't know Deadman walking, right.
Yeah, right.
Deadman walking.
Yeah.
Uh.
Man, thank you for bringing me back to the world.
I was out for two weeks.
Uh, I was in Yeah, welcome back.
Was in another hot space.
Yeah, right.
And, uh, you know, certainly a grim week in terms of, you know, occurrences in, in, in America, um, to return to.
But uh, also the news, you know, the news never stops.
And as Lynn Alden, who we both, you know, watch often says Nothing stops this train.
Yeah, that's right.
So I, I appreciate the opportunity to sit down and constantly, um, track it and try to understand what it means with you.
Yeah.
Yeah.
Thanks my friend.
See you next week.