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Vic and Marcus cover the Fed’s first rate cut, stagflation risks, and fiscal dominance; Oracle’s surprise wins with TikTok, Paramount, and OpenAI; robo-taxis arriving in Nashville; venture deals in pediatrics, maternal health, AI doctors, and genomics; policy turmoil at the CDC, telehealth’s temporary extensions, and a $50B rural health fund; scrutiny of nonprofit hospitals; Apple Watch’s hypertension approval; Amazon boosting worker benefits; Hopkins vs UnitedHealthcare; Lilly’s GLP-1 lead a...
Vic and Marcus cover the Fed’s first rate cut, stagflation risks, and fiscal dominance; Oracle’s surprise wins with TikTok, Paramount, and OpenAI; robo-taxis arriving in Nashville; venture deals in pediatrics, maternal health, AI doctors, and genomics; policy turmoil at the CDC, telehealth’s temporary extensions, and a $50B rural health fund; scrutiny of nonprofit hospitals; Apple Watch’s hypertension approval; Amazon boosting worker benefits; Hopkins vs UnitedHealthcare; Lilly’s GLP-1 lead and pharma’s $350B U.S. expansion; plus crypto ETFs, tokenization, Gemini’s IPO, and hospital AI rollouts at Sutter
Links
3:07 Fed Lowers Rates by Quarter-Point, Signals More Cuts Are Likely WSJ
9:08 U.S. Investors, Trump Close In on TikTok Deal With China WSJ
15:50 Lyft, Waymo Partner to Launch Robotaxi Service in Nashville WSJ
17:49 Imagine Pediatrics lands $67M to expand hybrid care for kids with special needs Mobi Health
19:15 Dualitas Therapeutics launches with a focus on bispecific antibodies C&EN
19:43 Synthesize Bio Launches with $10M Seed Round to Accelerate Generative Genomics BioSpace
20:56 Startup Assured picks up $6M to slash the time it takes to credential providers Fierce Healthcare
22:34 Inbox Health secures $20M, bringing total raise to $55M Mobi Health
23:07Lōvu Health Rakes In $8M for Maternal Health Platform MedCity
24:20 Doctronic secures $20M to scale AI doctor platform Mobi Health
25:38 Former CDC Director Details Her Firing in Senate Hearing: Key Takeaways WSJ
33:45 I Run the F.D.A. Pharma Ads Are Hurting Americans. NYT-Op
34:13 CMS opens state applications for $50B Rural Health Transformation Program Fierce Healthcare
36:33 Western States Issue Their Own Vaccine Recommendations to Counter Kennedy NYT
37:51 New York and Other States Form Health Bloc as Answer to Trump’s Policies NTY
39.28 GOP bill extends telehealth flexibilities, sidesteps ACA subsidies Healthcare Dive
43:10 America First Global Health Strategy US State Dept
46:59 Nonprofit hospitals' community benefit spending faces lawmaker scrutiny Fierce Healthcare
50:21 Apple receives FDA nod for hypertension notification feature Mobi Health
51:50 Amazon bumps pay, lowers health insurance costs for warehouse workers Spokesman Review
53:06 Johns Hopkins, UnitedHealthcare officially end talks after failing to come to terms on new contract Fierce Healthcare
54:51 Eli Lilly’s Diabetes Drug Tops Novo Nordisk’s Oral Pill in Trial WSJ
55:18 Drugmakers Have Pledged to Invest $350 Billion in U.S. After Tariff Threat WSJ
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.
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Thank you.
How's it going?
It's going well.
Been a busy week, it feels like it's always a busy week.
I don't know.
Every week's kinda busy.
Yeah.
Indeed, indeed.
I was, uh, last week I was in Mexico City and then I was in Boston.
Mm-hmm.
For an LP event.
Yeah.
And then I was in, uh, Nashville.
And then, uh, and we recorded, yeah.
And then I went to Sleepy Hollow, uh, for HFMA board retreat, and then back to Mexico City and then back here.
Wow.
You're getting a lot of miles.
You're racking up a lot of miles, man.
Holy cow, dude.
Yeah, it's, it's been, it's been kind of crazy, but it was, it was actually fun to be in Mexico City for, um, independence Day.
That was, that was kind of neat.
Oh, yeah, yeah, yeah.
Um, cool experience.
First time that, uh, female president ever did what's called the Rito from, uh, the National Palace across the Olo.
Uh, it's all over social, so if you wanna just like, go check for, like, check it out.
If you just, if you just search anywhere for Claudia Sheba, like you'll see her, her doing that.
Which is, which is, uh, you know, it's, it's a. History making moment.
So that was, that was kind of fun to experience.
And now back here in Nashville hitting the ground.
And um, you know, I mean, I reviewed the stories and I don't know, it feel, it feels like on the Senator House floor was, was kind of the, the main Yeah.
Storyline of the week.
Yeah.
There's a lot of policy.
I mean, the administration keeps sort of flooding the zone with all kinds of policy.
Yeah.
I get a little bit numb to it.
Totally.
I mean, there's a lot of policy, but Totally.
Yes, but not a lot of industry.
I mean, it wasn't much on the industry side this week.
No.
Pr a a pretty, a pretty slow week.
Um, you know, Larry Ellison continues to, to dominate, um, the, the airwaves over the last month.
Really impressive.
Yeah.
Uh, so we'll, we'll get into that late when we talk about ai.
Um, but yeah, not, not like a, I mean, obviously we're gonna, we're gonna get into the Fed and, yeah.
Not that much though this week, right?
Yeah, I think that's right.
It's sort of, uh.
I dunno, maybe we're waiting for something.
I don't know.
We were all kind of waiting for the Fed to be over.
Well, I mean, look, we're, we're, we're not gonna go too deep into it, but obviously, you know, the Charlie Kirk situation continues to just still just like, hang over taking all the oxygen.
Yeah.
It just hangs over everything.
Yeah.
Um, you know, and, and you and I discussed it.
I mean, we, uh, you may be listening to this podcast, you know, to get a reprieve from that.
So we're, we're just not gonna spend our time and energy on that.
We're gonna focus on what we do best here.
There's plenty, plenty of podcasts covering that in detail.
That's Yeah, that's right.
That's right.
So we're gonna do what we do best and, and continue to track the intersection of, you know, healthcare innovation and, and the economy.
Um, and, uh, we'll, we'll, we'll do our best with on a Light Newsweek, right?
Yeah.
Alright, so with that, let's dig in.
Finally, I mean, look, this is a little bit historic, like finally three years, 5.5% higher for longer.
And I guess it took the, the whoopsie on almost a million jobs to get the Fed to finally cut, and they cut a quarter point, you know, which I can't tell if that's a, we're not willing to admit that we, you know, are a little late on this and we, you know, we're just gonna make a, a, a small incision.
Uh, or they have already planned out that they're gonna be cutting, you know, every meeting mm-hmm.
For the foreseeable future.
And so they should start with a quarter point now because we'll continue to see these quarter point cuts, you know, for the foreseeable future.
What, what do, what do you think about that?
I hope that's what they're gonna do.
I, I, I mean, the Fed is frustrating.
I mean, we do not have a 2% inflation goal, but they won't, they don't admit that.
But we're, we're at 3% inflation.
Right.
And I, I, I agree.
They should cut, but that means that we're never gonna get to two.
Um, yeah, I think it would be good to cut three or four meetings in a row that there's about an 80% chance on poly market that they'll cut next month.
Um, I think we're gonna get a little bit uptick in inflation from what I'm seeing, so we'll see if, if they are willing to kind of cut, even though inflation goes to 3 1 3 2.
Right.
I think we're gonna get the September inflation the week that they have their meeting.
So it's gonna be a exciting week in late October, and then there's a December meeting, so I don't know, we'll see.
Uh, you, you track hedge eye a little bit closer than I do.
I mean, it seemed to me that that Powell was em admitting without saying the word that we're in stagflation.
Right.
You know, in.
Inflation while not run away is, is durable.
Very, very hard to deal with.
And at the same time, now jobs are, you know, at risk, right?
Yeah.
So, um, that's basically stagflation.
Uh, did, did, uh, the hedge I folks have anything to sort of say,'cause I know that that's a, you know, that's an important quadrant that they track, you know, what, we head into that type of environment.
I mean, we have some inflation and no growth right now, but we're gonna have growth in the, in the third quarter.
That's what hedge I thinks at least.
So we'll have growth and inflation both.
Okay.
Which should be, they call quad two.
Yeah.
Quad two.
And then it probably will go to quad one, which would be stagflation and, and still inflation, but, but not growth.
Mm-hmm.
In December, January.
Okay.
But I think the real point is that you and I have talked about, I don't know if we've talked about on airs we're, we're in sort of.
Fiscal dominance.
Yes.
The, the Federal Reserve runs monetary policy.
It, there's so much debt outstanding that their policy is not that effective.
Right.
I mean, it's not that it's ineffective, but it's not as effective as it was in the eighties or seventies.
And that's not gonna change.
I mean, the more, the more US debt that's out there is more and more every month we're at something like a trillion a month.
Um, in new issuance, it's gonna be hard for the Fed to really.
Make an impact.
So here's the, here's here's the question, right?
If that is in fact true, then should the Fed re-look at its mandate in a window of fiscal dominance and consider other factors, right?
So for example, um, we're hearing the, the talking point a lot about the fact that, you know, we right now.
Paying more as a country and interest payments than, uh, we are to our defense budget.
Yeah.
Right.
The only thing that's more than interest is healthcare.
Yeah.
That, but that's a talking point.
Yeah.
You're hearing Yes.
You know, over and over and over again.
Right.
Yeah.
But healthcare is also creating all the jobs, right?
Yeah.
Right.
Right.
So, so, you know, I think there's a question about, well, should you be trying to lower the interest rate to lower the interest payments mm-hmm.
From the country?
Yeah.
Um, you know, as a different goal here, right.
As a, because if, if you don't have the ability to actually impact either of these metrics, you know, can you at least impact the things you can impact definitively and, and obviously I, I think this is part of what, what Trump is pushing for.
He is trying to get these interest payments lowered.
Right?
I mean, he's saying pretty directly, we need to cut our interest expense.
I wish the Fed would cut rates so that we don't pay so much.
Right.
I mean, he's saying things like that on the speeches.
Right.
I think the problem is that.
If the Fed were to come out and admit that there's, there's no way to stop this train.
Like, you know, crypto people would say like it.
Yeah, it is.
It's hard to know how the overall economy recovers from that.
Right.
We we're going to either inflate and dBase the value of the dollar in order to get the debt back in a reasonable percentage, but that's gonna be very painful to everyone that is living week to week.
We're already living with it.
Yeah.
Or we're gonna default on the loan, on the debt.
Right.
Which is worse.
Right.
And so, yes, I think they're going to run the economy hot, let's say that.
Yep.
In order to try to make it less bad for working people and create more jobs.
But the effect of that is it's going to reduce the cost of capital, increase financial assets, the stock market.
Yep.
Bitcoin gold, other assets, which will further make the ship economy more and more worse.
And, uh, rough social impacts that we're already seeing.
And so, I don't know, I think German PR was trying to kind of hold things together as if he doesn't see that whole playbook rolling out, but he has to see it.
I mean, if we see it, he sees it.
Yep.
Of course he sees it.
He's, he's living with it.
Yeah, we, we just read about it.
Um, okay.
This was actually big news, right?
The TikTok deal is done and Oracle comes out the winner.
Yeah.
I mean, so out outta nowhere, the Ellison family, I don't want to just talk about Larry Ellison because his son is also in on all this.
Right.
So outta nowhere, the, the Ellison family now owns Paramount.
They own TikTok and uh, they have a very strategic relationship with OpenAI.
I mean, none of this was on anyone's sort Bingo card three months ago.
I mean, we, we, we knew that that Ellison's Skydance was, was talking to Paramount, but there was a lot of problems with that deal.
Yeah, right.
There was a lot of problems with that deal.
Um, and so, man, this is, this is a crazy.
A turn of events where now, uh, you know, Larry Ellison, who I think most people would view as sort of, you know, one of the stalwarts of the last generation, you know, like mainframe databases.
Yeah.
You know what I mean?
Like we're talking about Oracle.
This is an old school database company.
At the end of the day, um, even when I was a programmer, Oracle was like not a super innovative database.
Right.
Relative to like MySQL and, and Postgres Yeah.
And things like that.
Um, and now they're sort of born anew, right?
I mean, you know, they're, they're, they're tightly partnered with, uh, you know, the leading AI company in, in, in the country.
Mm-hmm.
Um, and they now have, you know, arguably the, the, you know, the fastest growing social network, uh, in, in the country.
And they also have, you know, one of the top media assets.
Country, this is kind of out of nowhere.
It's, it's just incredible deal making that has happened in 2025, uh, for a company that people thought was pretty sleepy.
Yeah, that's right.
I mean, I think Larry Olson is playing a much different game, a much longer term planning and strategic sort of moves.
I mean, he was talking about Oracle being a safe place to hold the TikTok data three years ago when it didn't seem like anything was gonna come together.
Um, but I agree.
Yeah, he has really been right on a lot of fronts.
Yep.
Yeah.
So this, this is, I mean, crazy, the entire operations of TikTok are now based here.
China, you know, has, has a minimal, um, ownership percentage down down to 20%.
Yeah.
I think what's gonna be really interesting now is to see how does the algorithm change?
Right.
Right.
And, and how does this change the kind of content that you see on TikTok?
Well, I think the, uh.
What sounded like the two big deal points that China won, that I think the Trump administration was fine giving them, is they get to say they license the Chinese created algorithm to America.
That's, that helps them.
Yeah.
With their narrative.
With their narrative.
Yeah.
But then they also wanted US creators to be able to publish into the TikTok Global network without a lot of, you know, bureaucracy and fiction and stuff.
And I think that also is important to, to allow TikTok to continue to be strong globally, not in the us.
Yeah.
And and I think that's probably good for us creators too.
No, I was gonna say this, it, that's for sure good for us creators.
Yeah.
That's not even a question, but, but I, I think the big question is how is the algorithm going to change the content that us uh.
Users see, um, that, that's gonna be just interesting to watch over time.
I I, I'm, I'm certain that it will, I'm certain that it will.
Yeah.
I mean, look, I mean, I think we have plenty of people that can know how to make a highly addictive algorithm.
No, no.
Listen, listen, we, we already have a, a, a proven use case around this.
Like the content that was seen pre and post Elon Musk takeover of Twitter is not the same.
Yes.
It's not the same.
Right.
Well, that, yeah.
So that's the question is, is this gonna be a Trump or Republican handpicked team of people or is it more of a, uh, commercially minded?
I mean, there are big groups, Oracle, silver Lake and Nutrition Hobert, that, that could run a, a system to make money and not necessarily for political gain, but we'll see.
I mean, no, there's no way.
Okay.
I mean, I, I hope.
No, no, that's not right.
But maybe it's probably right.
Look, I mean, silver Lake's a private equity firm.
I don't know the bullies or any of those people, like, they, they're not, they're not public other than like, you know, their, their investment in Chelsea, right.
I mean, like Right.
We don't, we don't really know much about Silver Lake.
Yeah.
Uh, in terms of like their political, uh, alignment.
I think we know there's no way they would be at the table of this deal if they were not aligned with the Trump administration.
Yeah.
There's no way they would even, even be at the table.
We know for a fact, Larry Ellison, Andre Horowitz are aligned with, with Donald Trump.
Mm-hmm.
That's not, that's not debatable.
It's, it's, yeah.
Public record stuff.
So whether it's stops with, with the owners being people who were really aligned with Trump, that, that, that's certainly possible.
That's certainly possible.
Um, but even if we think about, you know, Andreessen Horowitz and like sort of what their, what their, what their view is, um, I, I just, I just don't see how the owners of a social network don't put their thumb on the, on the.
On the content that we see.
I mean, they're, they're, they're publishers at the end of the day.
So I, my expectation is that, uh, the feeds will change and, and certain things that maybe got more, more promotion previous, you know, to, so will that be good for Meta Meta's doing the same thing?
You know, I mean, you don't think meta's just maximizing value to meta.
Maybe they're shifting it in political ways.
I don't know.
No, no, no.
They, they, they exp no, Zuckerberg explicitly came out like, not too long after Trump was elected.
Mm-hmm.
And was like, we're getting back to our roots no more, you know, like, you know, they, they're, they're copying X on the community notes, you know?
Mm-hmm.
No more censorship.
Like, you know, they, you know, mark is, you know, he's a good chameleon.
He knows how to shift with the political wins and Yeah.
And sort of, so no, no, like meta's already on record, like Zuckerberg's already on record, basically repositioning the meta algorithm and, and specifically, um, you know, their moderation, you know, in the direction that aligns with the Trump administration that he, he, he did that explicitly.
So my, my, my assumption is, is TikTok will adjust it in, in a, in a similar way.
Yeah.
Okay.
So Lyft and Waymo partner to launch Robo Taxi service in Nashville.
Um, I guess maybe three or four months ago I started seeing Waymo's driving around town.
Oh, you have?
I haven't seen that.
Yeah, yeah, yeah.
I started seeing Waymo's around town kind of mapping and mapping everything, uh, you know.
I didn't know that Waymo, um, had partnered with Lyft at all.
I still don't know that they had partnered with Lyft in the past.
And whenever I hear people, they have different partners in different cities.
Is that how they do it?
So I think they have another partner who, Lyft.
But then in Dallas, there was somebody else there.
There, there.
Think there.
It seems like they're intentionally using a variety of partners.
Okay.
Okay.
So, so basically, uh, I mean, I think Nashville has become this really interesting, uh, battleground for autonomous vehicles.
Uh, we have the boring company that is going to put a Tesla only tunnel, um, between the airport and, uh, the downtown campus where the music city center is.
Uh, and now we have Waymo and, and Lyft announcing a partnership.
Obviously, you know, bringing, bringing some strong innovation.
Mm-hmm.
Both between Lyft and, and Alphabet.
Uh, this sounds like a lot of transit innovation happening in the city of Nashville.
So I, I would say behind San Francisco and Austin, Nashville appears to be sort of third in line with, with really getting a lot of, uh, robax action going on.
Yeah, I'm excited about it.
I mean, I, I don't.
I don't know much about the fight between the two, but I think it'll benefit people that live in Nashville.
Yeah.
Look, I'll get to try it out.
Look, it, it makes sense in cities that have not been able to figure out mass transit.
Yeah, that's right.
Um, and we have not been able to figure out mass, mass transit, so it makes sense that this would be mm-hmm.
Um, you know, sort of a, a center point.
I remember when, when, when arm mayor was, was running for office and he was talking about light rail, he was like, listen, we're probably gonna get autonomous vehicles, aren't we?
And like, here we are, you know, um, three years later Yeah.
We, we have, uh, you know, a war, uh, kind of brewing right.
Between the, between the two big factions.
So, uh, that's pretty cool.
Alright.
Moving into VC deals.
Imagine Pediatrics lands 67 million to expand hybrid care for kids with special needs.
This is Moby Health News.
I think this is a great story.
I mean, helping kids that need a lot of support, I think everyone's in favor of that.
Mm-hmm.
And raising money to do that and do it, um, in a much more holistic way, I think is.
It's good.
They have really good investors.
Optum Oak Rubicon, I think it's a strong company.
Yeah.
So, uh, I, I, what what stuck out to me was that this is, uh, 24 7 virtual and in-person care, um, for children with special healthcare needs in Texas, Florida, and the dis the District of Columbia.
I don't know much about DC as a, as a market per se, um, you know, but Texas and Florida are great markets for healthcare.
Right.
Um, and so, uh, Rubicon is, uh, Adam Bowler, you know, um, former head of innovation right at, at CMS knows, knows the American healthcare markets inside out.
And so when you see this kind of, you know, services based, business, tech enabled, services based, business focused in those markets, that to me just shows Yeah.
Smart money, right?
That's right.
I mean, I have an investment in the really early stage pediatric, like OTPT, uh.
Mitch Mitch from Ladder Health was the guest host a couple weeks ago.
Yeah, yeah.
Yeah.
It's a, it's a great market.
There's a lot of needs and we just don't have enough people there, so we need more solutions to elitist therapeutics launches with a focus on bispecific antibodies, and they have raised 65 million in their series A to make that happen.
This is chemical and engineering news.
Yeah.
So I think we're starting to see filtering out now sort of some of the benefits of AI being brought into biotech.
Mm-hmm.
Where we get much more targeted solutions.
So I think it's great.
I, it's, the science is a little bit over my head, but I think it's gonna be really, really helpful to see this come out, synthesize bio launches with$10 million seed round to accelerate generative genomics.
So we see a lot of people talking about leveraging AI to help with drug discovery, but this is a case where, uh, this company has foundation models that are gonna simulate the results of gene expression experiments.
Um, so it's just cool to see, uh, companies be able to move into the biotech and drug discovery space, um, with much smaller round sizes.
Right?
I mean, 10 million is, it's a, it's a good size round, but it's just not that big of a Series A for something that is, is gonna be impactful in the bio space.
Yeah, and I think this is the third kind of large language model specifically designed for DNA expression.
We talked about EVO two, maybe three or four months ago.
And then Google has of course alpha fold as well.
So it's great.
I mean, I don't know the differences between the models, but seeing how.
Um, the expression of genes is realized is a pretty powerful thing.
Yeah, no.
So it's, uh.
O obviously we need to get more efficient so that we can get more robust and more prolific in drug discovery.
Right, right.
And these are, I think, very exciting fulcrums for, you know, um, technologists to, to add to the drug discovery mix.
Yes.
Startup Assured picks up 6 million to slash the time it takes to credential providers.
So I thought this was.
This was an interesting, uh, story just because credentialing has been something that's been targeted by, you know, um, healthcare innovators for a very, very long time.
Uh, but this platform says that they are the first one to be, um, certified by the National Committee for Quality Assurance.
Um, that they can credential a provider in two business days to, uh, compared to the typical timeframe of two to four months.
So NCQA is a, you know, pretty important organization in the world of credentialing.
And so to me it's just interesting that an organization that is just raising, you know, 6 million is the first org for NCQA to certify, you know, um, that they can do it in, in this amount of time.
Yeah, I mean, we have tried to attack this market two different times in the last 11 years, and it's a hard thing to get the incumbents to start using it 'cause they're so set in their existing ways.
Uh, but it's a huge opportunity.
It's very inefficient today.
So, yeah.
But also, I mean, there, there are winners in the space.
Our friends, you know, over at Provider Trust.
Yeah, yeah.
They've been great.
They, they're, they're crushing it and, and you know, quite frankly, both because they're friends, but also because they're.
I know how well they're doing.
Yeah.
But that's why I stopped.
That's, I stopped investing anyway.
Yeah.
Yeah.
That's why I won't invest in this space.
So, you know, like, let's, let's see how these guys do and whether or not what they're doing is, is fundamentally different from, from mm-hmm.
You know, what some of the leaders in the space are doing today.
But I just thought it was interesting to only be raising 6 million and to have that kind of, you know, the ability in, in a press release to say, you know, right.
NCQA has got you.
You know, um, pegged Inbox Health Secures 20 million, bringing their total raise to 55 million.
So, uh, inbox, health patient billing and communications platform, uh, they've been making waves, uh, and, you know, helping patients pay their, their medical bills and, and handling, um, all the quality assurance, uh, things.
Lots, lots of good news stories coming from this company.
And 20 million is certainly, you know, nothing to sneeze at.
Yeah.
Yeah, that's right there.
This is an one of the use cases that I think is pretty.
Pretty well documented as as easy to au to automate and make much better.
So yes.
Yep.
VU Health Rakes in 8 million for maternal health platforms.
So it's a Series A, it was led by SJF ventures and, uh, participation Rogue Women's Fund, symphonic Capital, ML I Ventures and Magella Ventures.
So, um, I, I think there's a cluster in, in California, uh, of, of maternal health companies.
Yeah.
That is probably, uh, something like five to 10 x the maternal health companies, uh, in, in the rest of the country.
Yeah.
From a, from an innovation perspective and getting funded, uh, I think there's just a lot of people there that care about it, that have capital to put into these companies.
Um, and it's, it feels to me like there's gonna have to be some level of consolidation.
Now I know that women's health is so under invested in, but at some point you gotta.
Kind of consolidate and wrap this thing up into some company that can meaningfully make an impact in the industry.
So, you know, best of luck to, to lo vu health, but mm-hmm.
I think also watching the space over the last five years is it's, it's, uh, you know, I'm kind of looking for a series C or a series D out of the space Yeah.
That, that's meaningful and scaling and, and uh, you know, we're just, we've just been seeing a lot of series a's quite frankly.
Yeah.
Yeah.
That's, that's right.
I mean, there, there is a need for it, but there's a lot of.
Competition.
Yes.
Yeah, that's right.
That's right.
Doc secures 20 million to scale AI doctor platform.
So this is a, a, um, a, a doc in your pocket, a free personal AI doctor.
It's 24 7 accessible.
Um, and this has got some, some big blue chip, uh, VCs, uh, on board Lightspeed, uh, lead the round participation from Tusk Mantis vc, union Square Ventures, uh, who we don't see in healthcare that often.
Yeah.
And certainly haven't seen in healthcare for a while, but legendary VCs.
Um, and so $20 million Series A with those names.
That's pretty good.
Yeah.
And, and the one that caught my attention was Tusk because the.
If you start going into the clinical medicine thing with AI, direct to consumer policy, there's gonna be a lot of policy related to that.
Yeah.
And that's what Tuska is really.
Yeah.
Policy they're great at.
Yeah.
Yep.
Yep.
Absolutely.
Yeah.
So, you know, they, they make sort of a claim here, um, and I don't know that it's the company as much as it is Lightspeed, but they basically say that like, you know, doct is, is giving you a doc in the pocket with clinical oversight.
Uh, the article doesn't explain that in a, in a super deep way, but that's something that we're all sort of looking at and trying to understand.
And, and I, and I'm interested to understand more as well.
So over time, we'll track not just Doct, but the other, um, AI docs in your pocket mm-hmm.
To, to understand how they are integrating the doc in the loop from an oversight perspective.
Moving into policies, former CDC director details, her firing and Senate hearing key takeaways, Susan, uh, Monez testified after recent turmoil at the agency under Health Secretary RFK Jr.
This was like the.
Anticipated, you know, huge on tv.
Everyone was watching it this week.
Uh, I mean, I didn't find that much new coming out.
I mean, the basic assertion is that Kennedy wanted her to take direction from HHS and then eventually the White House.
And she bought because she was gonna wanted to follow science to where science took CDC and I, maybe that is a change, but it's not that surprising to me.
I mean, I think Kennedy himself would, would say things similar to that.
So, I don't know.
CDC is not an independent science only institution.
It hasn't been since COVID at least.
And that's, I'm sad about that, but I think that's just what is what it is now.
These are political animals.
Yeah, it's, it, it's interesting.
I find myself, um, I mean, I, I believe I'm.
I'm deep in the phase of acceptance at this point.
Mm-hmm.
Um, and so I'm, I'm kind of aligned with you.
Yeah.
Uh, and, and, and let's just be clear.
Acceptance doesn't mean happy about, right?
Yeah.
Yeah.
I wish it wasn't that way.
Yeah.
Acceptance is not happy about, uh, but this is what I mean when I say this is the circus, right?
It's like, do I need to spend time watching a testimony?
Um, that is, you know, clearly going to flare up political arguments on both sides about a difference in beliefs that it couldn't be more obvious.
You know what I mean?
Like, like we know how different this is.
Avoid any inflammatory language.
Yeah.
We know how different RFK Junior's perspective is on how HHS should be run than any secretary of HHS that we've seen in the last, I don't know how long, right?
I mean, how many decades?
So, I mean, this, this ever, I think ever Yeah.
This is such a, a significant departure that of course, you know.
The standing CD, c director wouldn't be aligned because, you know, well, what's interesting is that he put her in there so they could have talked about this.
She was only there for a month.
So like, I don't know, I think that's where it fell down.
Like maybe she shouldn't have accepted or she should have known what she was getting into, or he should have, but either way it didn't work out.
I think people, I'm guilty of this, right?
People think they can change people.
Yeah.
He ain't changing nobody, you know?
I mean, I think it's really hard to change Robert F. Kennedy.
Yeah.
I mean, yeah, that's, I I think that's a long road.
Yeah.
So anyway, look, I, I mean, it was a big story.
We're covering it.
It was not that surprising.
Yeah.
No, no.
Everyone watching it.
They came in with a certain opinion and they left with the same opinion, I think, on both sides.
Yeah.
And, and I, I, I mean, I, I think this, this feels like, like a, like a point in, in the recording for this is not something that's gonna stand, you know, hopefully we continue to grow our audience, but for those who've been with us for a while and listening, you know, I think our, our job is to sort of track all these stories and try to chart what path is available to us.
Mm-hmm.
To innovate and make this healthcare industry and situation, you know, for all of us better.
Um.
But by reading the tea leaves, right.
And, and at a certain point, as investors, you gotta sort of decide, am I an investor or am I an activist?
Right?
Yeah.
Like we are professionally investors and, um, you know what I say over my dinner table with my ones, that's a different, that's a different thing.
It's completely different from what Vic and I are gonna talk about on this podcast.
You know what I mean?
Mm-hmm.
Um, and I, for one, I'm just not interested in, in, um.
I, I, I'm interested in trying to bring as many people together around the table to innovate.
Mm-hmm.
Um, you know, on this.
And, and clearly like, you know, there, there's never been more political division.
And so I think as much as possible as, as we can, um, accept political realities as a fact and sort of the way that the, the, the game board is laid out, and then talk through how innovators and investors are gonna navigate that game board as it is currently laid out.
Uh, is is the direction I want to try to take, um, you know, this podcast, but like, how do you feel about that, Vic, before we go any further on policy?
'cause I, I mean, I, I think I go back to why you and I started doing this, which is really to understand what is happening in the world and then know how to invest in our portfolio or make our portfolio succeed in that environment.
It's not really to try to change the situation.
Especially in DC now, we Right.
We might make incremental changes by creating a startup that makes a difference in some way.
Right.
But I don't wanna run for office and I don't want to be a lobbyist, and I don't have any money to, to like, to do those things, to play in those games.
Right.
And so I, I agree.
I think we, I am trying to interpret what am I hearing, and then maybe where are these personalities gonna go in the next few months?
Right.
The fact that I wouldn't run HHS the way that Robert F.
Kennedy runs HHS is immaterial.
I mean, it happens to be true, but that's not what I think our job in this podcast is.
Yeah.
It's also true that you're not going to run hs.
I'm not going to run HSS and I have no interest and I wouldn't be selected and, and on and on, on my opinions don't really matter in that front.
So I think we have enough challenge to try to interpret what is happening.
Yeah.
As opposed to what we wish were happening.
There's a lot of podcasters that are.
Trying to change people's opinions for some political reason, or I don't know why to influence thought.
I think we are more trying to interpret policy for our investments, for our portfolio company, maybe for a future decision.
Something along those lines.
Yeah, I I, I think it's also true.
And then, and then hopefully we can keep moving on, but I think it's also true that, um, it depends on what your objective is, right?
So, uh, for anyone who does not create a lot of online content, there is this thing called audience capture where, you know, you get really caught up in growing your audience.
Yeah.
And, and also not losing your audience.
And the thing is, you know.
Uh, these audiences are, are, are gained on channels that are driven by algorithms and, you know, they're kind of rage machines.
Mm-hmm.
And so you end up feeling compelled to, uh, engage in the rage.
Yeah.
Right.
You gotta feed into it if you want to keep going.
Yeah.
If Yeah.
If you wanna sponsors and whatever.
I mean, there's a reason we don't have sponsors.
Yeah.
Right.
Exactly.
I think you said it well, sort of, um, at the beginning that we are trying to sort of sift through this and interpret it for ourselves.
Yeah.
So, yeah.
Yeah.
So, so, you know, um, I I, I do want to grow our listenership and, and, but I, but I want to do it for people who value, um, our curation of the information and the Yeah.
And the conversation we have to try to make sense of it and, and wrap it into a narrative.
Right.
Yeah.
Like that's, I mean, I should have been more clear in the beginning you said like, maybe people are coming to this podcast to listen to healthcare as it is today and avoid some of the.
Vitriol and fights, right?
And other podcasts.
And that's the audience we wanna attract, that are trying to make a difference in healthcare.
They need to build in this environment where there are regulations, there are policies that are being changed that, that we need to know about our portfolio, need to know about, our investors, need to know about.
But the overly like, uh, I don't know, stir up, uh, fights is not.
It's not our audience and I don't think we wanna attract that audience, really.
Nope.
Nope.
Sure don't.
Alright, moving on.
Morning.
McCoury did a, a guest essay in the New York Times to sort of punctuate the fact that there is alignment, uh, amongst the heads at hhs, uh, around this whole drug, uh, advertisement bit.
So we, we talked about this last week.
Yeah.
Um, I don't we need to go into too much.
I just wanted to have it in the, in the show notes if someone wants to read it.
It's been, it's just more of the same.
Yeah.
The Trump administration is coming after the TV ads in pharma.
Yes.
And that's what he said.
Yes.
And that's gonna be a big deal.
Uh, CMS opens state applications for the $50 billion Rural Health Transformation Program.
This is from Fierce Healthcare.
So, uh, are there a lot of details around how this is gonna work in this article, Vic?
No, they did not give a lot of detail about how it'll be graded.
I mean, there there is an FAQI looked through it.
It's, it's a lot of.
Typical things like they want to improve health in rural America and they want to bring technology to bear, and all things that are positive.
But it wasn't clear to me like how they're gonna award the grants, but we'll have the, the link in the show notes people can look through.
I think it's good that they are starting.
But we won't really know until they start making the awards.
I think, uh, in the article, uh, one paragraph states that the National Rural Health Association and Manat Health, uh, released an analysis projecting that the $50 billion fund would only address a maximum of 88% of the bills.
Medicaid cuts, assuming a hundred percent of the funds be directed solely to rural hospitals and not other healthcare providers being hit with, hit with the reductions.
Under no circumstances does this cover the, the right, the financial impact.
Um, you know, that 12% is very significant when you're talking about, you know, razor thin margins.
Yeah.
Or in many cases, uh, already negative margins.
Right.
A 12% haircut to the, to the overall, um, you know, top line revenue coming into these, uh, these, these systems is, is obviously like.
Beyond significant.
And again, that is only if a hundred percent of the funds were directed solely to rural hospitals, which is highly unlikely.
Right.
Well, and they, they outlined five strategic goals.
So we can go through those.
I mean, they're, you know, pro promoting preventative care increase providers efficiency.
Like I think that means technology, healthcare workers, innovative payment models, great access, digital tools.
It's stuff that I like, but it may not necessarily mean that it goes to the top line revenue of a hospital.
No.
Because it's gonna be people bringing new technology, new approaches, new ways to attract workers, that kinda stuff.
Yeah.
I mean, it's called a transformation program, right?
Yeah.
And so, and so it's positive, but I don't know it's gonna replace the, the same revenue like they're talking about.
No, no, certainly not.
I mean, there, there will still be many, many, many community hospitals Yes.
And, and safety net hospitals closing that.
Yes.
Nothing about this.
Stop.
Stop.
That's right.
That's right.
Right.
So, okay.
New York Times Western States issued their own vaccine recommendations to counter Kennedy.
So this, um.
I, I think you could have seen this coming, especially on the heels of the, the, the Florida, um, announcement from their, uh, certain general and, and governor DeSantis around the removal of any vaccine mandate for children, uh, in the state.
You know, we're, we're now moving into sort of a state's rights, you know, um, level on, on this vaccine bit.
Uh, lot, lots of little storylines out there, none of which I can verify that are kind of pointing to an ending of herd immunity.
Um, you know, I, I certainly went and had blood work done to confirm that my, you know, MMR shot is still working.
Mm-hmm.
And that I still have that immunity.
Uh, but it, it does seem kind of crazy, you know, that we are, uh, in this place where we had some of these things nailed and, uh, now there's recurrences of, uh, of, of measles.
I mean, yeah.
Yeah, there's, there's no reason for measles to come back as a real threat.
Not immunizing kids is a bad step in that direction.
I think it's also, it's a bad sign that groups of states and that the next story is on the East Coast, so there's, there's the blue states on the West Coast.
The blue states on the East coast are, are all kind of pairing up to create their own public health infrastructure.
Yeah.
I mean, that is not positive.
I, I'm in favor of states rights, but grouping up blue and red states is a.
Precursor to bad things in the future.
Yeah.
By fear, I mean it's, it's a, it's a predictable thing.
Yes.
And, and it's also an understandable thing, right?
Yes.
It's also, it's also understandable.
Yeah.
Uh, so it's not bad in the sense of like, they shouldn't be doing it.
No.
It's just worrisome for the future as an overall trend.
Yes.
The, the, the kind of chain reaction of these decisions and of this radical change that we see, you know, happening in terms of guidance on, on, on what is best for public health.
Yes.
That's worrisome.
It's bad.
That chain reaction of events is worrisome.
Right.
The loss of credibility in a federal institution.
CDC is negative.
Yes.
Because parents shouldn't be confused.
You should get a measles vaccination period.
Now there's other vaccines that we can talk about, but.
Having no one who is in charge is not positive, and now we're gonna have these groups of states and it, it just is not a, it's not a good sign of the future.
Yeah, but I don't know how to turn the clock back.
I mean, it is what it's, yeah.
I'm gonna stop short, uh, of, of, of saying much more.
The GOP bill extends telehealth, flexibilities, sidesteps, a CA subsidies.
I mean, I think the underlying story here is we are, once again, at a fiscal cliff.
The government has got to figure out how to align between the House and the Senate to keep the government open.
And it's shining a light on the fact that here we are, you know, September of 2025 and we still do not have a permanent telehealth rule.
Like we're still on these temporary emergency stays of telehealth, which is ridiculous.
Like, how can, how can that be the case everyone is in, I think everyone on both sides of the political hour in favor of making a permanent, they just can't get their act together to pass anything.
Well, it keeps being used as this terrible political football or it's just, it never rises.
It.
At the level of importance to sort of stand on its own as something, as a law that Congress should pass.
Yeah.
But like, I mean, how do you say you're for rural health transformation and you can't just get a permanent Yeah.
Telehealth bill done.
I mean, you know, I don't, it's just doesn't make any sense to me at this point.
No.
I mean, luckily they, at least the house extended it.
I think the Senate will extend it assuming they they pass anything.
Yeah.
But the constant extending, but there's no reason, there's no reason to keep extending it, right?
No, no.
Like all the trends make really clear, we need every technological advantage we can get in order to deliver care.
We, we we're, we don't have enough physicians like we, we don't have enough anything.
Yes, that's right.
Yes.
You know, and so they extended it.
They are not engaging around the a CA subsidies.
Also as a healthcare thing, that would be really positive.
But I don't think the house didn't pass that well.
No, they're, they're, they're defanging.
The a CAI mean, you know, they're do Yeah.
You know, without removing it.
Yeah.
They, they're taking away It's gonna be very expensive.
Yeah.
' cause subsidies are gone.
It seems to me that when this is all said and done, there will be an a CA marketplace with a few insurers forced to hold the bag as the rest race to get off of the market.
Yes.
Because the risk pools are bad and because people who have options won't buy from it.
'cause it won't make sense.
Too expensive for the, for what you get out of it.
Right.
And, and then they'll be able to point to it and say, the thing is non-functioning, it doesn't work.
Right.
Yeah.
Like, just kill it now.
Like, it doesn't work.
Just, just kill it entirely.
Mm-hmm.
Right.
Yeah.
Not to say that they won't keep a market in place, but it won't have the requirement for you to have it.
And you know, they gotta figure out how to get catastrophic in place and on there.
And look, to me, some of this stuff is good and so far as like there needs to be an easier way for the average citizen to just buy catastrophic and kind of take on all the rest of this stuff themselves at this point, right?
Yeah.
You know, 'cause we're gonna get to the other side of the price transparency thing and realize that if you have the means to stitch together your own system between concierge and more Cuban and, you know what I mean?
Like it's, it's just better.
But, and you just need the catastrophic piece.
Um, and right now it's too hard to get that.
But it look, elections have consequences and this is the prerogative of the party in control, um, to Yeah.
And if you have chronic disease that it.
Do it yourself option is gonna be hard.
No, it doesn't work.
Right.
Right.
It doesn't work for you.
Right.
Yeah.
So it's, it's, you know, to me there's a lot of people that are, make too much money for Medicaid and they have some kind of chronic disease.
Yes.
That, that they're gonna, I don't know where they're gonna go.
It's not gonna be good.
Yep.
US Department of State America First, global health Strategy global, released on September 18th.
And, uh, basically, you know, this is part two.
Part one being we removed ourselves from every, you know, global, um, health aligning organization, uh, most prominently the World Health Organization, but I'm sure there's a long list of ones I don't even know about that we, um, removed ourselves from U-S-A-I-D is a big one.
Yeah.
Well, yeah.
Well, I mean, we didn't remove ourselves from that.
Yeah.
We, we, we killed it.
It was our own thing.
That was ours.
Yeah.
Uh, and now we, we've laid out this America first global health strategy and now I just have to say that, you know, um, it is, uh.
It's predictable, right?
Um, but, but if you're, if you're really in, in, in the healthcare industry and you've been reading the Commonwealth Fund, um, annual analysis that, you know, the, the byline is that we, we, we have the most expensive healthcare in the developed world, and we deliver among the worst, if not the worst outcomes for our citizens in, in the developed world.
The idea that we are going to lead the world and the way that that healthcare works is highly presumptuous.
Um, and maybe, maybe wait a couple years and let your Maha strategy kind of play out, um, before you take that, that kind of position.
It's just not where we are today.
We, we don't have the proof, you know, as a country to, to be a leader in, in, in this respect.
So that's, that's just my, that's my view on it.
I mean, don't think, I think that is correct in rational and humble.
Three things that, that this statement is not.
So, I mean, this is, this is a stump speech, this is a fundraising thing.
This is, uh, put America first and if we're gonna spend money, we need to get something back for it.
It is a, I was, I was shocked to see it come out from the US State Department, that we have this America first global health strategy.
Um, I shouldn't be shocked anymore, but there's, you know, that it was very surprising.
Came up today.
So it mean it's kind of new.
Yeah.
And look, a lot, a lot of it is, is around money and trade and, you know, how, how, uh, foreign assistance is gonna go that like this, this is your prerogative.
That's fine.
Yeah.
Yeah.
That's your prerogative to establish how you're gonna do any of those kinds of things.
It's just the, the, the parts where, where you're talking about like, you know, basically we're going to be, you know, uh, a, a leader in, in, and.
You know, preventing outbreaks or, or any of those types of things, uh, that is just challenging with our track record.
Right?
That's, that's all.
Well, yeah, that's true.
I think it's also we're using health aid and health, uh, support to other countries for us strategic priorities from the State Department, and we always have done this.
We, yes, but we've always done this.
It was, it was packaged in a nicer form.
It was pa it was packaged differently.
Yeah.
Yeah.
But, but that, that is consistent with this administration.
I mean, we we're getting out of the business of, of, you know's, America First.
It's pretty, it's pretty clear we're, we're getting out that business.
So that, that part, you know, if, if you're consistent, I don't, I don't that part, it's just, you know, that's the position of Yeah.
Of the, of the administration.
So I don't, I don't take issue with that in particular.
I, I think it's more just the, like, I. I just don't think America is in a position today to be a leader on, on health given, you know, our costs and our outcomes.
Right.
Like we clearly have work to do on that front.
Yeah.
Um, so that, that positioning just feels a little, little out of pocket fierce healthcare, nonprofit hospitals, community benefits spending faces lawmaker scrutiny.
Congress continues to question the nonprofit tax status of health systems.
And I, I, I'm not even that against this, but it doesn't feel like the right time.
I mean, nonprofit health systems are struggling right now.
We just talked about rural systems having, you know, a lot of difficult time in the next few quarters.
And so it is true that, um, there's a lot of, you know, people here in Nashville that, that we're friends with that, that run for-profit systems that will point out and many times over dinner with them pointing out.
Nonprofits have an unfair advantage competing against them.
And so that's true.
But this seems like rough timing to me.
So I mean, look, my, my view is just that, and, and, and, you know, I, I sit on the board of HFMA and I mean, it is just, there's just so many headwinds for nonprofit hospitals right now, LA Lar largely just from HR one, right?
Like that, that alone, it just, right.
An unbelievable amount of headwinds for nonprofit hospitals.
So this has been an issue for decades, for 50 years.
Why we need to have a hearing about it now.
I don't know.
But I mean, I, I, I, I just want to know like, what does DC think is going to happen if, you know you have a collapse of these institutions, like a kind of a wholesale broad collapse of these, of these institutions?
Like there's not that much margin there.
You know what I mean?
Yeah.
Like they, they can only handle so many knocks before there's a real deterioration in the services they're able to provide for their communities.
Yeah.
Some are certainly in stronger positions than others based on demographic, um, trends and those markets, right?
Yeah.
Based on balance sheet strength, based on, you know, their size.
I mean, b based on a lot of things.
Yeah.
O operational competency leadership is always a, a big factor, but man market is probably the biggest factor.
You know, you could, you could have the same exact leadership team, same exact clinical staff, all those things.
And the one that's in Pittsburgh, right.
Versus the one that's in.
Miami has drastically different demographics.
Yes.
And a drastically different outlook and forecast.
Right.
For how they're gonna navigate this.
There's just very different margins.
I just think if you care about all of Americans, and, and also like, let's not forget, the health services make up, I don't know, 90% of the jobs we, that we counted up in in August or something like that.
So I don't know to, to me it's like.
I'm, I'm not trying to say that, that that hospitals, um, have played it perfectly over the course of the last 20 years, you know?
For sure.
In my estimation as a, as a whole, there was an overreliance on lobbying and not enough work to sort of self disrupt, to kind of prepare to be more antifragile for a moment like this.
That's, that's my view.
Yeah.
As an outsider, you know, innovator.
That's true.
But that we, you can't fix that now, but there's enough pressure on Yeah.
On, on the system.
That's what I meant timing wise.
Like, I actually agree with this, but not, not really now.
Yeah.
Right.
Exactly.
Yeah.
Exactly.
Like, like enough, like, like give them enough time to actually respond to, to all the stuff that they gotta face right now.
Okay.
Moving on.
Apple receives FDA nod for hypertension notification feature.
The Apple Watch just continues to, um, make, its, its March forward as the everything consumer grade mm-hmm.
Uh, medical device.
Yeah.
And so they, they have consistently gotten more and more.
DA approvals for this device to provide medical grade health readings to consumers.
They haven't really packaged it and sold it that much, but I, I think they gotta be.
Pulling that together over time.
Well, I mean, look, what, what would be really interesting and, and, and Tim Cook was at the table with all the big tech players at that dinner that Chamath, um, you know, organized, uh, you know what would be really interesting would be.
To see what kind of, you know, relationship Apple is developing behind the scenes with, with HHS, right?
Mm-hmm.
Because RFK Jr has already stated, uh, that he wants every American to have a, have a wearable, right?
Yeah.
And, and, and I'm sure they want it from a, you know, an American company.
And, and so there, there's a Yeah.
A lot of 'em already have iPhones so that it's not a big leap.
Yeah.
And it's already the number one smart watch by like leaps and bounds, right?
And so there's, there's a real role for Apple to play in the, in the future of the US healthcare system.
And I, I'm, I'm, I'm very happy to see these Yeah.
These kind of consistent green lights for the app.
Look, I'm, I, I wear an Apple watch.
Yeah.
Right?
I'm, IM happy to see, uh, this device continue to march forward is something that can help us all take care of our, our health more.
Yeah.
'cause we're gonna be more on our own.
Okay.
Amazon bumps, pay lowers health insurance costs for warehouse workers.
So this is, uh, positive news for, for Amazon's base.
And, and you know, I know it's Bank of America also talked about raising their minimum wage.
We we're not covering that story, but it just seems like.
While we've got all these sort of worries out there happening around the job market that some of these big employers are, are looking to present cases of how they are being employer, employee friendly, um, increasing wages and, and improving the healthcare benefit situation.
Yeah, I mean, it's a, it's a, it's a bright spot this week.
I mean, Amazon deciding that they're gonna need a lot of human workers and they're going, they should take care of them, giving them a raise.
And then also, I think it's $5 a week is your healthcare premium.
Mm-hmm.
Mm-hmm.
Five copay too, and then five hour copay, five copay is great.
I mean, uh, I need to go pick up some hours there because I, that's a much better deal than I have.
Yeah.
Five, five, $5 copays.
Yeah, it's great.
That's, that's fantastic, right?
I mean, I think it will attract workers, so it's Oh yeah.
No, of course.
But, and also, like, there's not a lot of jobs out there, right?
So, you know, Amazon is a, is a stable employer and so far as like the company's not going anywhere, right.
Um, so yeah, I, I, I will accept it as a bright spot as well.
Johns Hopkins in UnitedHealthcare officially and talks after failing to come to terms on a new contract, you know, two sides to every story.
Uh, but this seems like a fairly ugly one for, you know, two very, very big brands in healthcare.
Um, and some, some real fundamental differences in, in the, you know, the story that they're telling about the, the issues in the negotiation.
Yeah, I mean, it's hard to tell from this story, all the details, but both sides are making pretty aggressive and negative claims about the other.
United is saying that Johns Hopkins is, is demanding to be able to refuse treatment even, even if you're in one of their networks.
And that's kind of the main thing a payer delivers.
And so if they can't agree to that, I don't know what the contract's worth.
And then Johns Hopkins is claiming that UnitedHealthcare does all these pre, you know.
Pre-auth and reviews, which of course they do, but I don't think that's that much of a change.
So I don't know.
It's definitely, he should see Sid.
They're both mad at each other.
It's not so surprising that they're fighting 'cause you know, strong.
Groups have fought each other forever, but the the terms they're fighting over are new, I think.
Yeah, yeah.
For sure.
So I mean, I, I, I hope this gets resolved.
Uh, but you know, all, all across the country we've seen a lot of like full on fallouts, especially with the blues.
Yeah.
Not so much with the United, uh, you know.
Mm-hmm.
I think a lot of the United and Cigna, uh, you know, yeah.
Issues that were made public get resolved, but a lot of the blue stuff just didn't, you know?
Yeah.
And so this is one of those ones that, that you hope both sides can find a way forward.
Yeah.
You know, understand negotiations are difficult, but like, know you hope they can find a way forward.
Um, Eli Lilly's diabetes drug tops, Novo Nortis oral pill in trial.
Just the continuation of, you know, Lilly kind of, you know, beating a snot outta Novo Nortis.
Yeah.
Yeah.
Lilly's on a tear right now.
They're doing well and Novo's not doing great.
Yes, that's right.
Yeah, it just feels like such a turnabout'cause when we first started covering the Glip one, I've just felt like Novo.
Was really breaking down.
Yeah.
They sort of had a lead in the beginning, but the Yeah, in the very beginning.
Yeah.
But their tech has not kept up.
No, no.
Uh, drug makers have pledged to invest $350 billion in the US after tariff threat.
Uh, GSK and Eli Lilly are the latest to unveil plants that manufacturing and increase other operations in America.
Um, yeah, we've been, we've been tracking this for a while.
So 350 billion is kind of the current, uh, tally.
I, I expect that to continue to go up.
Yes.
Um, but it's a, I think this is a big win for, uh, American manufacturing and a big win for the Trump administration.
Yeah, I think that's right.
And it's a, it's a kind of reshoring from the Ireland games, all that stuff, which is good.
Yeah.
Look, I mean, I, I, I think it's, it's.
It's clear now that, uh, the idea that we were just going to be knowledge workers and, um, you know, push bits around on, on keyboards mm-hmm.
You know, while the rest of the world built everything.
Yeah.
It was, it was not a, it was not a good strategy.
Right.
Yeah.
It was not a good strategy.
Um, cer certainly leveraging expertise, uh, in, in certain areas.
Mm-hmm.
You know, and, and maybe seeding certain spaces, but man, we kind of gave it all up.
Yeah.
Um, and so this kind of intentional long-term investment I, I think is gonna be needed because, you know, the American economy is, is, is not looking great.
Um, yeah.
Advanced manufacturing, complicated products, pharmaceutical products.
Yeah.
We have no ability to do these things.
We to do.
We need to be able to do that.
Yeah.
Yeah.
Yeah.
We have no ability to do these things right now.
Alright.
Moving into Web3.
The SEC paves a way for crypto spot ETFs with new listing rules.
So this is going to mean.
Um, all sorts of new inflows coming in.
Yes.
Um, into, you know, not just Bitcoin and Ethereum, but Solana, Dogecoin, many other types of tokens.
Uh, you know, I I would say probably, you know, if you go on Coin market, uh, cap and you look at the top 10 coins there, they probably all can make a, a case for, you know, ETFs.
Spot ETFs.
Now.
That's right.
I mean, if there is, I don't know what the market cap is.
Uh, a billion, something like that.
Maybe even less than that.
You're gonna have an ETF now.
Yep.
Yep.
Exactly.
Brian Armstrong, this is on X talking about the market structure, you know, legislation and, uh, this is, this is a big deal.
There's so many signs pointing to this happening, but the, you know, getting market straight structure legislation really, uh, means the tokenization of everything.
Right.
Um, and, and moving.
Uh, to me it means we, you know, we're moving our transactional economy on chain.
Yeah, that's right.
And it's, it's coming.
I mean, I don't know fasts too.
I don't know if it's gonna be this year.
Yeah.
But dude, he wants to be this year.
But whether it's this year or next year, it's coming.
It doesn't matter.
It's doesn't matter.
Like, it's, it's so fast when you think about the, just the Yes.
Mean, we're talking about all transactions.
Real estate.
Right.
Yeah.
You know what I mean?
Like securities, commodities.
Uh, just, I, it's, it's so big.
It's so big.
Yes.
I mean, it is.
10 times bigger than the transition from paper to electronics in the eighties and nineties, which was big.
And it's gonna, it's gonna affect everything.
That's why we started covering this'cause by next summer, it's gonna be full on tokenizing the world.
Yeah.
Yeah.
And, and if you're not tokenizing claims into smart contract adjudication, you need to be w why aren't you?
Yes.
Right.
Right.
Is is a question.
So, so yeah.
That, that's, that's why we're covering it.
You heard it here first, y'all.
Yeah.
Wall Street Journal, Winklevoss backed, Gemini Soars and latest IPO market win.
If you don't know who the Winklevoss twins are, they are the co-founders of Facebook.
Yeah.
Along with Edward Severin and, and Mark Zuckerberg.
Mm-hmm.
Um, they've been in crypto and Bitcoin for quite a while.
Um, and so congrats to them.
Gemini is, is their platform and they have, uh, taken it public now.
I'm happy for them, I guess.
I mean, they've been working on this for a long time, so.
Uh, when they sort of left Facebook, I think they got tired of social and went hard into crypto maybe 10 years ago, 12 years ago.
Yeah.
I mean, they were early in Bitcoin, so like they were rich.
They're much richer now, right?
Yes.
And now they're even more rich as their company is now publicly traded so that the Winklevoss twins have done just fine for themselves, even though, you know, they didn't stick with, uh, with Facebook.
Yeah, they've done just fine for themselves.
Uh, GPT powered Hiro Partners with Health Systems, Sutter Health.
Moving into the AI space, Sutter Health will deploy Hiro's conversational AI platform across the California health system to automate routine patient interactions through chat, voice and SMS.
So this is a good story, uh, talking about, you know, a rolling out at a big system in California.
We had a guest show maybe a week ago with Alex Harp at Lena.
He's a, he is a competitor to high, high row, uh, more in the Texas, uh, suite of health systems.
But this is a great use case, you know, where patients, you know, they want to get their information about their next appointment, their lab results, whatever they wanna get it eight at night and they want to get it through whatever platform they want.
Chat, SMS, text Voice and Solina and, and Hiro and several others are, are, I think filling a great position where humans don't want to be there doing this.
And then you can sort of introduce the call.
I mean, at least with Alex, I was talking about, they can make the connection and then hand it off if, when there's, when there's deeper questions, more things.
So it's a great use case and it's good to see Sutter.
Point, you know, they didn't pick the wrong horse, but still good.
Yep.
Okay.
Meta unveils, new smart glasses with display and AI abilities.
Uh, I, I saw a bunch of things talking about they, they had a demo that didn't go over, go over that well.
Oh, I didn't see the demo.
Okay.
Uh, yeah, apparently there's some issues with the demo.
Okay.
Um, live, but, you know, regardless, they, they've gotten new, new smart glasses to me.
You know, because of their, their partnership with RayBan.
Um, you know, their, their glasses are viable.
They're real.
Yeah.
Their AI is, is behind.
Um, yeah.
You know, but, uh, I mean, I don't know what what, what are your thoughts?
You, you own a pair now, right?
Yeah, so I got a pair for my birthday about a month ago.
Okay.
And I was excited to try it out and it's, it's cool.
The camera works well.
The speakers are really impressive'cause it's, it's just glasses.
Yeah.
But you can hear Yes.
Through, I don't know how it works, but you can hear very well Yeah.
Spatially it's like, it's not quite the same as AirPods, but I mean, mean it's, yeah.
But it's about 80% it or something.
Yeah.
Yeah.
The AI is not, I mean, I use a lot of different.
AI models.
Yeah.
And it's subpar.
Yeah.
I mean, it's not, it doesn't understand, I mean, I, I was trying to text my son who gave me the glasses and it di it couldn't find him.
And I've texted with, it's kind scary from Meta man that their AI is so far behind and they can't keep the talent that they've Yeah.
That they've hired.
That's right.
And, and I mean, it's like, yeah.
So, eh, I think that AI is progressing fast enough.
That open source is gonna end up being good enough for Meadows purposes.
Right, right.
But But they're now not gonna be a frontier leader.
No, they're not a leader.
They're not a frontier leader.
Yeah.
The glasses are, I have the last generation, I don't have the pop-up display 'cause it wasn't out a month ago.
But yeah, I mean it's promising, but the AI's gotta be better.
I mean, you know, people are used to.
Speaking to it, and it understands what you want and does it, and it's complicated stuff.
And here's the thing, they're not a hardware company, they're a software company at the end of the day.
Right?
I mean, you know, they have these side quests, uh, in in, in AR and, and, and vr, but like Meta makes their money.
Well, they're forever, ever worried about not having the full vertical stack.
And they don't, they don't have a phone.
They don't, they don't, they don't have chips.
They're trying to get a use case and the glasses are, are the right one to focus on.
Yes.
But they ha it has to work.
Yes.
Open AI's funding challenges loom over Oracle.
Broadcom deal Spree.
The world's largest startup needs more paying users, but it isn't clear whether they will materialize soon.
So, I mean, at the end of the day, is it the, is it the funding challenges or is it the ridiculous valuation that, you know, you gotta grow into that is based on the idea that you're going to collapse all labor, you know, all knowledge, work, labor, and, uh, and you're just a voracious, you know, consumer of energy.
Yeah.
And, and Gemini passed them in, in all counts this week.
So like, they're number one on the app store.
They're, they're more users, more tokens, more everything.
I don't know.
I mean, I, I have, I was always long Google on this.
Yeah.
I was not a fan of the CEO, but they had, they did, they did have a. The best product in the history of, of product releases.
Yeah.
And it's still used by, I don't know, seven, 800 million people a week.
So they probably can figure out something.
But again, Oracle is in like the NOL lose situation, right?
They, they are gonna be the, the, like data center technology.
They've got capacity, they've got capacity, everyone needs capacity.
And then if something happens, then they're gonna end up sharing it with Microsoft, just splitting up the spoil.
So like it's sort of no lose for Oracle and Microsoft.
Yes.
And it's a, it's a high stakes game that Sam's playing.
He's got a lot of issues with trying to go to change the corporate structure, figure out how to raise money, sell more products against people like Google that don't necessarily need the revenue the same way.
So it's a, it's a hard set of things I wouldn't build my entire business on.
Open ai, but people are, no.
And and, and I think the other thing is like open AI doesn't have an angle.
Like rock's got an angle X. Yes.
You know, anthropics angle is coding and it's like others are trying to get there.
But like the Claude brand in the coding world is so strong now.
Yeah.
Yes.
That like, okay, maybe you could swap something out.
But I don't know.
It's getting pretty sticky now.
I, I think the Anthropic brand around, around, you know, the best coding model's, pretty sticky.
Google's got Gemini, but Google's got a million other businesses, you know what I mean?
Like, you know, we just talked about Waymo.
Right.
On this show.
And YouTube.
And YouTube.
Right.
Exactly.
I mean, I think the data, unique data is really the lifeblood of AI companies.
And Open Eye has some, they've licensed some.
Tech some data, but, but not, I don't think enough.
Yeah.
Oh, and not just YouTube.
I mean, I, I, I would say maps is another one.
I mean, like, yeah.
Maps, where do I go when Im trying, I'm trying to figure out, yeah.
Search gmail.
Yeah.
My, my, my, my, my whole, you know, workspace, uh, account.
So yeah.
I mean, Gemini.
Super clear use case.
Claude super clear use case.
Yes.
Gr.
Yes.
Pretty clear use case.
Honestly, pretty clear use case, like, like when I'm asking a current event question, I go to Grock.
Yeah.
That's where I go.
Uh, like it's, it's the one I trust.
Yeah.
And Elon came out with that battery pack.
You see that?
No, I know.
And yeah.
Yeah.
I mean, he, and he, he's, he's, he's now about to compete with Nvidia, you know what I mean?
Yeah, yeah.
With with his chip clusters and stuff.
Yeah.
So, so all of a sudden open AI is actually looking kind of weak.
Yes.
That's what I think too.
I mean, look, it's an opportunity for Sam Altman to prove his medal amongst the big boys, right?
Yeah, for sure.
'cause he, because he's, he's swimming, he's, he's swimming in deep waters now.
Uh, Google puts its popular AI video generator into YouTube shorts.
So we were just talking about Google and, and, and their AI ability as well as YouTube and VO three, I think is right now still the clear and away leader in terms of a video model.
Yeah.
Yeah.
VO three has, what has propelled them to the number one app in the app store.
Yeah.
I mean, 'cause it's a, it's a viral, like, shareable thing.
You can play with it.
It's super fast.
I think you get a hundred free token images.
Yeah.
The, yeah.
The tokens are just, if you're not a, not a page user, get a hundred free a day.
I mean, I don't know how ridiculous.
I'm sure there's a way to use more than a hundred, but it's hard.
Yeah, it's ridiculous.
So, so creators are now are using that now it's being embedded into YouTube, right?
So it's even gonna be used even more.
Amazon is using AI to grow their ad sales by automating the creation.
So, uh, you know, and look to me, there's a concern here that we're just going to get so much AI slop, you know, out there in, in ads and, and social stuff.
I mean, I still have yet to see a piece of AI content that is like meaningfully compelling against all the human created content.
So there's, to me, there's just still, it, it, I'm, I'm like, wow, it looks cool and, but like the compellingness of it is still not, not quite there for me.
I don't know.
I mean the, those ten second ads that run before a. A video or like, just lounge?
Well, I, I don't watch any of them.
Yeah.
I don't either, but, but they're not hard to replicate.
Yeah.
But I, I, I don't, I I don't listen, I don't care about any ads.
Well, that's what they're, that's what they're building, right?
I, I, so like, if you're in Amazon care about any ads shopping for, I mean, the example they gave here was a bird feeder.
Yeah.
You're shopping for bird seed.
They serve you this.
AI generated video of a bird feeder camera thing.
AI's gonna replace all the ad stuff.
Yeah.
It's easy.
There's no reason that doing one's watching it anyway.
So that's what I'm saying.
There's no reason to have humans doing the ad stuff.
'cause no one wants to watch ads anyway.
I, I'm more concerned about the broader content generation, you know, stuff that's gonna go on out there.
But look, whatever, I don't wanna be that old dude.
Like it's, it's coming, you know, it's definitely coming and I'm definitely old, so I need to just like, get with it.
Uh, okay.
Final story.
Nvidia, to invest $5 billion in Intel furthering Trump's turnaround plan, the SOS of Intel went nuts and Trump Front ran this investment.
And, uh, so the US does quite well on, on, on this investment, doesn't it?
Yes.
I mean, amazingly, I, I shouldn't say that.
Are, are you, are you, are you against insider trading?
If it's the United States of America?
I, I don't think so.
I mean, I, I, I think, I don't, I don't, I don't know that I am, I mean, that's, and then if you control the SEC, there is no insider trading is there?
I I, I guess that's kind of the point.
Yeah.
I, I guess that's kind of the point, right?
I mean, like, like, I, I feel like on principle the answer is supposed to be yes, but it's like, it's for America and we're, and we're, we're in such a huge deficit right now.
It's, it's a, it's a tricky one.
It's a weird, it's a weird, it's a tricky one.
Yeah.
You know?
Yeah.
It's a tricky one.
Yeah.
And if you had said to me, I mean, even three months ago that Nvidia was gonna in invest in Intel and kind of bailed 'em out, I would've laughed, but, but they invested $5 billion and they're bailing them out.
Yeah.
But I mean, can you imagine what the business terms here are in exchange for that money?
That, that, I mean, and dude, you know, Nvidia is like.
Future proofing themselves against it Intel through this investment.
Yes.
Right.
Yes.
I mean like, like, yes, Intel can do just fine, but like Yeah, it will always support Nvidia.
Yeah.
Intel's gonna have the second run, you know, cheaper chips, I think.
Yeah.
It's, it's, it's, it's their minor leak.
Yeah, that's right.
And they'll probably have them just go beat up the rest of the minor league players.
Yes, that's right.
And end of the day, I guess it's two American companies quasi getting together in a sort of joint venture slash.
Merger ish and we got bigger problems to fight against China.
So, I don't know, I guess it's okay.
But it was surprising.
Was surprising.
I mean, Intel was so far from being competitive with Nvidia.
Yeah.
They were never gonna do, like, it doesn't even, they were gonna fail, like not exist anymore.
Yeah.
So I think it's good that we have a another player that's still gonna exist.
Yeah.
Agree.
Agree.
Uh, it's, it, it's, and yes, Trump made a great deal probably because he knew all this was gonna happen, but still the US made a bunch of money on the Intel trade.
I look, we we're, we're running a brutal deficit right now.
Yeah.
Anything we can do to offset the deficit, uh, it seems, seems like fair play to me.
It's, it's a, it's a weird thing to say, 'cause it, you know, it seems fairly clear.
There was some knowledge that Yeah.
That this was likely gonna happen.
Um, but elections have consequences.
That's all I'm gonna say.
That's all, that's all I'm gonna say.
Elections have consequences, you know?
Yeah.
Yeah.
And I mean I think it, these kind of things like the US government taking an ownership position in order to facilitate global trade, you can't put that back in the bottle.
No.
Like the next election doesn't matter like that.
That already is a thing now that the US does because it's gonna be very lucrative, obviously.
It's gonna be very lucrative.
Yep.
So the world is wild, but we will keep covering it here, I guess.
Yes, indeed.
Uh, thanks for putting the show together.
Uh, next week we'll be remote, but we'll be on.
Yeah, right?
Yep.
Alright man, look forward to it.