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In this weekly rollup, Vic welcomes guest host Jinesh Patel, CEO of Uptime Health, to unpack a packed week across the health and tech economy: a stronger Q2 GDP print alongside rising jobless claims and pricier equities, the AI-driven efficiency wave and large-company layoffs, venture updates from workflow and dementia-care AI to immigrant-care platforms, policy turmoil around the CDC and HHS budgets, a Google antitrust outcome that stops short of a Chrome spinoff, payer and provider shifts (...
In this weekly rollup, Vic welcomes guest host Jinesh Patel, CEO of Uptime Health, to unpack a packed week across the health and tech economy: a stronger Q2 GDP print alongside rising jobless claims and pricier equities, the AI-driven efficiency wave and large-company layoffs, venture updates from workflow and dementia-care AI to immigrant-care platforms, policy turmoil around the CDC and HHS budgets, a Google antitrust outcome that stops short of a Chrome spinoff, payer and provider shifts (Cigna’s specialty-pharmacy bet, SCAN’s MA expansion, UPMC’s rebound, HonorHealth’s clinic pickup), the aging-alone crisis and home-care labor headwinds, the Web3 through-line from a high-profile Bitcoin listing to Polymarket’s U.S. push, and new AI moves like Epic’s model trained on massive EHR data and OpenAI’s product-testing acquisition—plus how all of it hits frontline operations and revenue in care settings.
Links
14:29 U.S. Economy Grew Faster in Second Quarter, New Estimate Shows WSJ
17:25 US Initial Jobless Claims Rise to Highest Level Since June Bloomberg
20:50 U.S. Stocks Are Now Pricier Than They Were in the Dot-Com Era WSJ
23:31There's new evidence the job market is softening Axios
25:27 Oracle lays off thousands—or more—globally amid rapid AI shifts Fast Company
27:49 Predoc raises $30M to scale AI health information management platform Silicon Angle
29:34 NewDays Secures $7M To Expand Treatment for Cognitive Impairment, Dementia MedCity
32:01 Welcome Tech raises $7.5M to expand AI immigrant services Mobi Health
32:39 VCs Had No Time Off This Summer. Blame AI. WSJ
36:59 We Ran the C.D.C.: Kennedy Is Endangering Every American’s Health NYT-Op
37:58 Robert F. Kennedy Jr.: We’re Restoring Public Trust in the CDC WSJ-Op
Enough is Enough Letter: website
43:47 House Republicans propose 6% budget cut to HHS for 2026 fiscal year Fierce Healthcare
45:35 Google Dodges Worst Penalties in U.S. Antitrust Case WSJ
48:30 Cigna’s Evernorth invests $3.5B in ex-Walgreens specialty pharmacy Healthcare Dive
50:23 SCAN Health Plan to expand MA footprint into Washington for 2026 Fierce Healthcare
51:26 UPMC is flipping 2024's operating losses halfway through the new year Fierce Healthcare
52:14 HonorHealth to pick up Evernorth primary care clinics in Phoenix Fierce Healthcare
53:41 More Older Americans Are Aging Alone. Who Will Take Care of Them? WSJ
56:47 Trump Brothers-Backed Bitcoin Mining Company Surges After Nasdaq Listing WSJ
58:27 Polymarket cleared for US users X
59:39 Comet: A New Medical Intelligence for Clinical and Operational Insights Epic Website
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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Your feedback will greatly impact our ability to reach more people.
Thank you.
Okay, welcome everyone to Health further.
We have the weekly rollup show.
Marcus is traveling over the last couple weeks.
I have another guest host tonight, Janes Patel, uh, CEO of Uptime.
Thanks for doing this.
Really appreciate it.
Oh, thanks for having me on, Vic.
So just as we get started, maybe give the audience a little bit of your background.
Um, we invested in uptime a few years ago, but maybe, uh, talk about.
What the company does and, uh, how you got involved and started it.
Of course.
Uh, yeah, you guys were, I believe, our first outside check back in 20.
Yeah, I remember.
And, uh, some background about myself.
I'm a biomedical engineer by training.
I'm my masters in it.
I'm my MB as well.
Uh, the biggest thing that I did in my background that formulated uptime health was I was the clinical engineering manager of a large health system in Austin, Texas.
And that's where I learned all the important aspects of medical equipment management, compliance management, environment of care, and making sure equipment's always up and running for the most affordable costs.
I don't really think about, but there's a lot of equipment that docs and nurses and med techs rely on to do their work well.
That's kind of the, that was kind of the thesis I had because being as biased as I am from what department I was helping run, I started seeing the world as healthcare is delivered, when you have three variables present, you need a patient, you need a provider, and you need some kind of medical instrument, at least in 2025.
I can't think of many, if any.
Kind of medical procedures that don't require even the most basic fundamental instruments like your vitals monitor or even your thermometer or your scale.
Yeah.
And it was this thought that was bubbling in my head as we started looking for outpatient clinics to bring into our health system and I had to go audit them to see if they would fall under our mm-hmm.
Equipment umbrella.
We compliant day one.
And none of them were.
And that was a little bit of a shocking, like 0% were Yeah.
Oh percent.
And that was a shocking moment to me because obviously I didn't go in trying to fail people on my audit.
I was just trying to make sure I knew what to do to correct them.
'cause I was about to manage'em if we acquired them.
And, and that was the part that it dawned on me that the people in outpatient, whether it's urgent care owners, surgical center owners, or whatever it might be.
It's not really their fault as much as it is still the responsibility of why they don't put a lot of attention on it.
It's because they're really good at patient care and patient workflow and you have a lean operation where everyone's wearing 10 hats, uh, especially if you're a single, single kind of doctor and equipment management somehow goes out the mental window.
Mm-hmm.
It's so vital to delivery of care.
'cause if you don't have an x-ray in your urgent care, you're not doing x-rays if you don't have Right.
It's like, it's, it's, it's such a driver of revenue, but also operational dysfunction.
If something is broken, you have to work around it and it creates burnout.
Yeah.
And it feels like, I don't have the stat, so you may, in the last 20 years we have moved more and more care out to the edge, to the suburbs, to the LP facilities.
And those facilities typically don't have full-time it, you know, staff managing the devices.
Yeah.
So it's harder to be compliant, harder to keep up with it all.
Yeah, they have none.
In fact, they all rely on third parties in those worlds because there's no basement full of parts or people like me.
And to their credit, it makes no financial sense to have somebody like me full-time, like completely in their right to do it.
But they're not managing it well outside of that system.
Yeah.
And so what I realized was the same thing you did is the trends of moving healthcare from the health system into our homes and the journey that it takes, whether it's community health, then to your local strip malls and then down to your home.
Yeah.
Further away you get from the health system.
The less people know about equipment management and good practices.
Yeah.
Uh, less people are that expert.
So as the further away you get.
Yeah.
And the, the other thing that was jumping out at me was the fact that the people who we use and rely on to service and repair and maintain these things in those new environments, since you don't have a hospital system basement, are dwindling by the numbers in terms of a labor force.
Mm-hmm.
So we see a mass movement of care going in these directions and going back to my equation of equipment plus patient plus provider is care.
That means the equipment has to make the same journey mm-hmm.
To get that sense of care in this direction.
But now it's more fragmented than ever before.
So things are harder to reach As a service provider, you don't have a density of failure.
You don't have a hundred broken things in a given week that you might have in a large health system.
You might have a hundred broken things, over a hundred different locations, all with an hour of drive time in between.
And so you take this very anemic labor force and you ask them to go service an even more, spread them across a hundred miles or whatever.
Yeah.
And everything is more urgent and it fails more often.
So like it's because there's no redundancy.
You have one or two sterilizers, one's broken.
You're not sterilizing.
You have one x-ray room.
Right.
It's broken.
You're not doing x-ray.
So it's like, it's such a lean operation that there's no redundancy.
So everything's an emergency.
They're not doing good equipment, hygiene and maintenance.
Mm-hmm.
And so breaking down more than it needs to be.
So imagine all of this demand getting burdened onto this labor force that just can't survive.
And the fact that they have no apartment full of ba, or sorry, basement full of parts.
If something doesn't depart, it's an extra two truck rolls in 24 hours of downtime because they most likely don't have the part in their van.
They gotta order it, drive back to their shop, come back to tomorrow.
It's the most inefficient thing you can think of.
Yeah.
And so that's what.
Kind of gave me this aha moment of like, somebody needs to solve this problem because I want care in my home and in my communities.
I'm not trying to say, don't get it.
Yeah.
But you feel good about it.
I want the equipment to also be calibrated, maintained in quality as well.
Yeah.
That was, that's kind of uptime.
Yeah.
So, so you, so you founded Uptime to try to address that, that kind of growing need in this outpatient, uh, journey as we move here outside the hospital.
Exactly.
What, what year?
Give people a frame of reference, like how long has it been?
So 2018 was pen to paper January through May, and then we took, I think actually Jumpstart Capital's round in November or October of 2018.
Yeah.
And we then through, went through Techstars in Boston.
We're a Boston based company and we eventually got our MVP out into the market, uh, I think around November of 2019.
Like we had beta customers and early adopters, but there wasn't anything we were happy to demonstrate to people who were willing to help us out, learn about.
In 2019, we started growing in the urgent care in surgical center markets.
'cause they're very close to my background.
I didn't have to learn anything new.
Yeah.
And knew equipment and what needed to be done.
And then when COVID hit, it really derailed us.
Right.
We had a lot of great momentum.
We even had a pilot with AmSurg Inked that was supposed to live March 17th, 2020.
Yeah.
Right, right.
When it all hit.
Yeah.
March 15th, I get an email saying all of our centers are closed.
This is that we're killing the pilot.
And I'm like, oh my God.
And so all that to say is that's where we started.
And then over time we realized we could not build this company in an unpredictable environment like COVID because unless we're selling PPE, no one's trying to deploy net new software inside of their operation.
Even if we could help with ventilator management, it just wasn't the toughest priority.
Yeah.
Right.
So that's kind of what happened.
And then over time, instead of it's like that do or die moment where we said we have to pivot or die, and we basically set our product at its core is a product that can help anyone that has medical equipment, that doesn't have an in-house expert like myself, helping 'em manage and maintain it, and that needs better predictability and automation.
So we, we took that definition and we started realizing, okay, it's not just urgent care and surgical centers, it's also dentist office, veterinarians, optometrists, med spas, it's, it's all these other health adjacent, even though dental and eyecare definitely healthcare, we somehow treat it as differently in Yeah.
Right.
Um, but we're like, these other markets need us too.
So what we decided to do is say who during the valleys and peaks of COVID cases.
Opened their doors again during the first valley, but didn't have to re shut back down when the next wave came.
Mm.
Yeah.
And dentist's office kind of popped up to the top.
Yeah.
So we said, that's our market to go attack.
'cause they're not, they're, they're kind of ready, they're open again, we can help 'em.
Yeah.
And, and again, they're kind of dealing with the patient waves the same way we are.
And guess what, if there's a high case account, they're probably not getting a lot of visits and that might be a good time for them to work on their operations and all the other things they wanna improve.
So, so all that to say is we now are heavy in dentistry.
Yeah.
Because we pivoted so early in our, in our journey.
Yeah.
Uh, but the good thing is that we proved our hypothesis earlier than we needed to because you always talk about how do you expand your verticals and how do you expand your tam?
And we proved that our product didn't change a bit.
We just changed how we talked about it.
And today we have over 2000 locations utilizing our software.
We service about over 5,000 locations with our services marketplace.
'cause if something breaks down, we'll help you find service really quickly.
Um, we've partnered with the largest distributors in the dental world that now push our product into their client bases because our system helps you manage the equipment.
So we have the best possible data of saying who owns what devices.
Mm-hmm.
Yeah.
They buy, how much did they pay for?
How old is it?
How often is it failing?
'cause they're servicing it through our system.
Yeah.
And we can mine this data to predict.
Replacement and failure events.
And guess who the number one user or wanter of the data of who's gonna buy the next devices.
The person who selling.
Selling it probably.
Right?
Right.
That's really where we started seeing our, our magic flywheel happen, which is we partner with distributors who want that data to help us sell this into their ecosystem.
Yeah.
Now they're more that that's the best lead, right?
This dental office, they're fixing their equipment too often.
They really should upgrade to the new version.
So the sales guy loves that.
'cause he can go make the case.
Yeah, and it's not even a nefarious data sourcing 'cause one, they're buying it from the partner, so they're already authorizing them to say, yes, you know what?
I want you to better help me.
It's not even a sense of, I don't want you to have it.
It's like I know as a dentist.
If you know what I'm gonna need, you're gonna show up to my office and go over the things I absolutely need because the data says so otherwise you're just selling me with the highest on your quota sheet whether I need it or not.
Right.
So, so both parties actually win here and we're getting rid of problematic machines before they become problematic.
Mm-hmm.
So like now we're taking away unplanned down events for planned replacement moments.
Yeah.
And last is the technicians love it because now they have less crazy emergencies for products that should have gotten replaced 10 years ago.
Right.
Like, they're like, why are you still band-aiding this thing?
I have too many other jobs to go take care of.
And so they actually benefit from not having, missing their SLAs with some of their vendors because they just have so much demand with all the breakdowns.
Because these things that should have been replaced are still on the shelf somehow.
Yeah.
So how do you sell it to a dental practice or a medical practice?
Is there a, uh, more uptime kind of pitch, or how is it, how's it framed to them?
So back in the medical world, yeah.
We were selling compliance because there is a compliance mandate to have a good environment of care and equipment management.
It's like, that's part of it.
You have to show that you have electrical safety inspections every, you know, year and all your maintenance logs, and we do all of that.
So we were kind of more or less selling compliance and peace of mind for the medical provider.
For the dentist.
Compliance isn't really a big deal, unfortunately.
It sucks to say that they don't, there is no compliance requirement, really.
Right?
Yeah, yeah.
Unfortunately there really isn't, even though there's a lot of best practices and then there are sense of compliance, there's no one really auditing the same way there is in medical.
Mm-hmm.
And so instead of selling compliance, which I learned very quickly that that wasn't gonna get us anywhere, we started selling uptime, truly what's in our name, uptime Health.
Yeah.
But we, we framed it in the sense of we're reducing the number of missed revenue moments and hours in your practice because of down and faulty equipment.
So for them it was all about bottom line.
Better predictability.
And as we started selling to the dental groups, it was about helping 'em understand what they should be standardizing on.
So there's a lot of m and a that happens in the dental world with, you know, these DSOs.
Yeah.
I feel like a lot of private equity backed rollups in dental too.
Yeah, that's, so that's, it's a huge driving force.
And what they do is they go through m and a, and then they end up acquiring a ton of assets and equipment that is non-standard across their platform.
Mm-hmm.
And so now they have to deal with lots of OEMs, lots of rules and regulations when they don't know who owns what.
So we come in and say, not only we're gonna help you reduce the number of down moments in hours to help with the bottom line.
But we'll help you get the data to say, all right, we have X number of this number or this OEMs sterilizer.
Yeah.
Here's the exact inventory you have.
And you can create a maintenance plan ahead of time, maybe.
Yeah.
And across your entire platform, here are the 50 devices that are over 15 years old.
So if you're doing a CapEx, like we can help you really zone in really quickly, which before that's a very arduous event.
So it it from that sense, we're selling standardization.
We're selling a sense of risk mitigation for group roll-up, and we're selling really less missed revenue hours because of downed equipment.
Yeah.
Excellent.
Well, I'm excited to be part of it, small part of it, and it's been growing incredibly fast, so it's been a fun trip so far.
Yeah.
We, we landed on the in 5,000 list this, this year as our first list.
We came in at number 110 out of all 5,000.
Yeah, that's incredible.
Number six in all of software, so that includes all other software categories.
Wow.
Yeah.
We're the least sexy company, I think on that whole, yeah.
Equipment management for like the people who live in the basement, were helping those guys out.
Yeah.
Right, right.
Well, I mean, I think boring and on.
In the Inc 5,000 top top 120 or whatever it was.
It's pretty, pretty exciting, even though it's maybe boring operationally.
So yeah, look at the end.
I want my equipment maintenance to be boring, that if it's not boring, something's wrong.
Well, I think the best part about it being boring is no one coming out of college like these whiz kids are like, I can solve that problem because it's fun and exciting.
It's like you have to really care about this problem to solve it.
Right?
So we have no natural competitors right now.
Right, right.
Yeah, it's beautiful.
Let's dig into the stories.
Okay, so we'll start with the economy, like we always do in the Wall Street Journal, uh, story this week, US economy grew faster in the second quarter, new estimate.
So, um, the government revised the second quarter estimate up, so now it is estimated to be, uh, GDP grew at an annual relied rate of 3.3.
What'd you think of this story?
I thought it was, I mean, interesting and obviously good for the economy, like they revised it up 3.3% and they said in the, in the first half of the year, they ends up averaging to 1.5% because I think there was a down.
Yeah, well, with the tariffs, I think people like loaded up on uh, you know, kind of imports and buying things in the first quarter, which actually counterintuitively it makes it the way that imports goes, looks bad.
So yeah, you sort of, uh, maybe average Q1 and Q2 to get more of a steady state of what we're doing.
Yeah.
And look, we sell equipment too, right?
Yeah.
We predict a sell.
We also hand do that.
And so we saw the same thing.
So we actually were somebody who realized that this moment was true, uh, that we had people either stopping buying what they normally would buy so they can front load those cash dollars on like foreign products.
Mm-hmm.
Since they knew that the price was gonna increase over the next 90 billion according to Trump.
Right.
So I think that's where it was a real thing.
And we even felt it like we didn't see as many of our US based product sellers, they they should have.
Mm-hmm.
Yeah.
And then probably that, that reverse in the second quarter 'cause people then had to buy the stuff they normally buy.
Yeah.
I think the other interesting thing about that article is it talks about the investment in software.
So going back to like, you know, the, I know there's a couple other articles we have related to software.
It said that this was the fastest growing investment in software for what's been purchased since 2007.
So that was a little bit of like an eye-opening stat to me.
Yeah.
And which I was like, 2007 is a, is a tough year to be compared against.
'cause that was sort of the last year before the great financial crisis.
Yeah.
Right.
And, and it was a big year where social media, like all these big platforms are starting to become their behemoth of that they are today.
And so, like I knew there's a lot of spend on software there.
That's like a 16, like what is that, like an 18 year gap?
Yeah.
That at least makes me excited for one things that we do, but also is seeing that people are investing in operational efficiency, which I think also plays into some of these other articles.
Yeah.
And I think part of the, uh, the new tax law or the, the Trump two tax plan, they give you immediate, uh, write off for software or any CapEx really.
But, but you can, you can invest capital in equipment which might be good for uptime or software things and then write it off your taxes right away as opposed to having amortize it over five, 10 years.
So I think that will drive a lot of CapEx in the next year.
Yeah.
But overall, I was happy to see it bounce back.
Um, and then less positive, uh, we just got today initial jobless claims for last week and they were up, so it increased to 237, uh, for the weekend in August 30th, which was.
It's on an uptrend.
If you're watching on YouTube, you can see on the screen here.
It's been sort of a slowly trending up and this is the highest since June.
So you know, a month or so ago.
Yeah.
So we have a tale of two economies right there.
There is, um, GDP seems to be positive, but the jobless claims, the job environment is still difficult.
It seems like.
I think this is, oh, and I hate to say this, but this is kind of the trend where I don't see this trend slowing down, and I don't think this is any indication of the administration.
I think this is just what the world is doing.
We're using AI, to my point earlier in all these other kinds of operational efficiency tools to reduce FTE count.
Mm-hmm.
Like that.
Yeah.
Purpose is more efficient margins, more efficiencies in our buildings.
And so we don't need departments of people doing what AI can do now.
Yeah.
And I think we're, we're seeing the, the joblessness pains come from that, but then we're also seeing GDP go up because those actually both lean into operational efficiency in my mind.
Yeah.
So we'll probably get productivity gains, gains.
I think the stock market will do well, but it's gonna maybe take a while for that to filter to employees or new jobs.
And I'm, I'm hopeful that AI will not, uh, destroy jobs, but instead there'll be new kinds of openings or new opportunities for people.
But it's gonna take a little while for that to filter through.
I think.
Yeah, it's gonna be a reckoning.
I think people who thought that there was a career in X amount or x kind of what, whatever it is.
Like maybe it's accounting where I know there's a lot more AI for accounting and just bookkeeping, like some of the more administrative type jobs where they are pursuing a career there.
Those might not how to shift to where there's a lot of demand, which.
There's other areas of this world in this, this US economy that do need people.
Yeah.
And I think now I'm gonna start over time filtering new college graduates to say, look at these job markets.
Right?
Yeah.
And I think honestly, healthcare is, is, uh, gonna be a bright spot.
I mean, there's a lot of.
Care that really can't be automated away.
You need a, you need a human to sort of interact with another, with the patient.
Yeah.
Using a device like you said.
But, uh, yeah, and I think as we're in that last little bit of like this weird kind of, uh, boomerang effect where we went to this world where I, I don't know if you get the same frustration where you call in to like a customer support line and then you go through like 10 minutes of pre-canned like telephone tree to eventually maybe ever talk to somebody.
Probably not.
And now consumers like myself, and probably you and others are valuing a human picking up on the other side.
Mm-hmm.
We don't want AI human, we want a real human.
Yeah.
So I think there's some industries that did have that efficiency that they'll boomerang back and you're like, that's actually a worthy spend now because people appreciate it.
Yeah.
Definitely.
I mean, I don't mind it being automated, but it has to be accurate and understand me when, when it's just kind of like cycling through things and doesn't understand me, I get, I get frustrated.
I agree.
Yeah.
I came up with that idea.
'cause yesterday I was in a loop for 20 minutes with the same and I kept saying, agent, agent, agent.
Right, right.
Speak to someone person, whatever.
It doesn't work.
Yeah.
And so, yeah, you're right.
We had to get that on there.
Um, okay.
The next stock also in the Wall Street Journal, uh, US stocks are now pricier than they were in the.com era.
So this is, um, from a PE multiple, actually it's price of sales multiple.
And again, on, I have a graph on the screen here, but back to 2000, um, it, it peaked in the dotcom area of two, almost three, just under three times, uh, price to sales ratio.
And we now have got up to three and a quarter, so we were even higher.
So what do you think is the stock, uh, market overvalued?
Is this just a trend or maybe productivity is, is, uh, making it worth more?
I don't know.
What are your thoughts?
My thoughts are these are like, the investors are banking on more layoffs.
Unfortunately they're banking on the fact that these larger companies are creating better ways to produce their product or their service with less overhead.
And so they will realize this over time and some of the bigger tech companies, which are, you know, what is it like the magnificent seven or whatever?
Yeah.
Like they're the ones that can benefit the most.
That's why we had, I think we have an article coming up about one of the large players out there that had a big layoff.
But I think people are banking on that happening and, and this is, yeah.
They're sort of forecasting that and maybe a front running it, trying to get, uh, buy stock ahead of that, which is prepping it up.
Yeah.
And the only thing I'd say is a comment from just like a startup founder perspective is I also then get this feeling that these publicly traded companies are gonna go through some of the pains we do as startup founders, where you, we might raise money at a certain valuation.
And then we're scrambling and working as hard as we humanly can to go meet the merits of that valuation before our next raise.
So with these kinds of outsized multiples, you have these CEOs of these big companies that are now saying, I gotta go chase that un maybe unreachable number in their head and trying to figure that out.
And I think that's where I'm very interested to see what happens.
And I know now we're starting to see some companies get taken private, even again from the public sphere, because I think the public is sometimes putting these undue expectations where they're based outside of reality.
Yeah.
Well, I mean, I think that's a good analogy.
I think probably CEOs of public companies are happy if their stock is up, but it does create expectations that, okay, now you gotta deliver In the next year you gotta deliver earnings growth.
Or same thing with the startup.
You, you get a big valuation, uh, uptick, which everyone's excited about, but then you gotta fill in that value and sort of build the company around it.
The benefit of the publicly traded CEO is they probably have a nice bonus package when they're right versus startup founders.
Like, I still need my liquidity event.
Right.
Okay.
Then a pretty good story at XiO os new evidence that job market's softening.
So this is related, you know, the same, we sort of have two themes that the economy is doing okay, but employment is not doing great.
And so, uh, Axios had a pretty good chart where job openings is now sort of about equal to the number of unemployed people.
So this is not the weekly, uh, unemployment, uh, job list rate.
It's, it's the total.
So there's seven, a little over 7 million unemployed people and 7.2 million jobs.
Um, typically it's been much, many more jobs.
'cause of course it is not a one-to-one match.
You need, you need to get the right fit.
Um, so I dunno, it, it's, um, there's several signs now that the job market is kind of fraying or, or weakening.
Yeah, I think it said it was at 0.99 in terms of, like you said, it's flipped on the other side where there's just more unemployed people than our job openings.
When in the past it's usually been 2, 3, 5 times, like the spread, right?
Yeah.
And I think we, we just said it, right?
There's a whole GDP argument where it's like, we're doing fine.
And then there's this where we're like, oh, well are we, because if people aren't making money, then what's happening underneath this?
Yeah.
Marcus and I talked about the khap economy a lot.
Seems like almost every week, because the K you know, like in the k if you're, if your net worth is more than half in financial assets, stocks, bonds, real estate, you're doing pretty well.
Stock markets at almost all time highs every week it seems like.
But if you're in the bottom part of the K where.
You know, most of your net worth is in your, your earnings per month.
You're not doing that well.
You're not keeping up with the cost of living.
Yeah.
And unfortunately, I think that's just gonna create some more disenfranchisement with either the job markets or whatever, or the people in those.
And I think it's just gonna create some turmoil in the next little bit.
Yeah.
Okay.
Then you were alluding to this, Oracle has, uh, this week been laying off thousands of people.
It might be more than thousands.
This is in a fast company.
Oracle lays off thousands or more globally amid rapid AI shifts as the headline.
This came out of the last couple days, sort of in rumors on X and with people sort of sharing it in, you know, kind of forums and this was the story that came up today.
I think we're gonna see a lot.
I think this is sort of one of the early, big companies to do this, but I don't think they'll be the last.
What, what are your thoughts about Oracle, um, making these changes?
Yeah.
To me this is just that proof point of the kind of comment that we were making earlier where big companies are gonna start shedding people and not by the hundreds, but by the thousands.
And that's where they're gonna get their EBITDA multiples back or their price to earnings share ratios back into under control.
Uh, so I think it's something that we're all knowing is gonna happen, but this is a big domino to fall to say it is happening and it blames AI shifts.
Like, and when I say blame, I'm not saying in a negative way, but it's saying that was the result of using AI in these bigger companies.
Yeah.
Yeah, that's right.
And so it's gonna be a transition at least where maybe there are jobs that get created, but there's not gonna be like a immediate match.
People will have to go search for a job for six months, nine months, whatever.
Yeah.
I think the biggest thing was, I think on the X article you had sent me was just the, how they went about it, which yeah.
More of the story than actually happening.
'cause I think everyone can see the writing on the wall for these companies to make this happen.
Yeah.
But I think it was just, it came out of almost nowhere.
People were getting informed in real time.
Yeah.
Yeah.
And, and people, uh, people's teams were being laid off without the manager being fully aware.
Yeah.
Uh, the way that they rolled it out, maybe, I mean, I'm sure there were reasons for it, but it, but it wasn't very easy to go through for the rank and file employees.
'cause you didn't, no one knew what was happening.
And a lot of people lost their jobs, unfortunately.
And it basically said like the team was gone.
The manager didn't know, then the manager was gone and their SVPs didn't know that the SVPs were gone.
And it was almost like this, this weird feeling of the event.
And I think that's what Right.
A lot of people versus it actually just happening.
Right.
Okay, so moving into the venture markets, um, pre-doc raised $30 million to scale AI information.
So, um, they raised money.
They were founded in 2022, but raised money as sort of continued to grow.
What, what'd you think of pre-doc?
I thought it was interesting.
I mean, I feel like I see a lot of companies trying to tackle the interoperability problem of health systems and their networks, and so when I wanted to read this article, I was trying to see what was the real result of their product or is it another kind of like Me Too product?
Like we all do the same thing, we just do it with difference.
But I thought it was cool when they basically said.
You know, they built their products specifically to integrate within existing workflows instead of replacing them.
And I see this as the new way of doing things, right?
The, the way to work with your existing infrastructure without having to retrain and re adopt everything new.
So I think they're taking that approach the right way.
Yeah.
And sort of connecting disparate, siloed, uh, kind of centers together.
So, so that it's more efficient.
Maybe you don't lose information.
Yeah.
And you're not telling the end user to say, all right, you have to now enter in information to this system and do it this way and change your work habits.
So now keep your work habits the same, that you're already now a power user of this old product.
We're just gonna suck in the data.
And then I saw that there was a 70% reduction and how much time it took to re like retrieve like health records and how much time it took for clinic clinicians to review those health records.
So 74% reductions in gigantic.
Huge, right.
I, I think this is the kind of AI that speaks volumes of what it can do in healthcare.
Yeah.
Really changing the workflow in a way that is.
Better for the users and much more efficient.
Yeah, I like that one.
Yeah.
Okay.
And then new days, uh, raised $7 million to expand treatment for a cognitive impairment and dementia.
This is a huge problem.
Uh, general Catalyst led the seed round and they have basically like an ai, um, companion type, um, tool, but it is also screening you and helping you with, uh, cognitive impairment, right?
Um, as you age.
So what, what'd you think of this?
Well, I thought it was, this one was good in a different way.
Again, it's using AI but in a very useful fashion.
And according to them and what they're solving, they're really solving for a unique bottleneck in the cognitive impairment, dementia care space.
What they said is all the articles and all the research, and I think you even have like Harvard based research backing this thing.
That having somebody do structured conversations, that's a, like an actual provider that can do this really well.
Like the scientists that are, and the doctors that know how to talk to you in a way that helps build this cognitive function back.
It can delay from up to six months to two and a half years is what the research says.
But the biggest problem is there's not enough of those specialists for the number of people that are suffering from this.
Right?
So I think this is a beautiful use of AI where they're saying we will use ai, train it with the best and the brightest in this industry, do those structured conversations in a different way.
So at least we're giving you some help and not saying just wait your turn in line to see the real specialist.
And it's built by specialist.
So I think this is again, another good niche case that it does need a lot of attention.
Yeah.
And I think it, it's sort of, um, it's the thing where we we're not able to meet the demand of patients today and there's a big wave.
With the boomers agent, there's a big wave of new MCI patients coming, and so this maybe won't be quite as good as a human, but it'll be a great, uh, alternative and it might even like, uh, screen and bring them people that need it most to, to the caregivers.
Yeah, I think that's the biggest key there.
It's, it's probably the best triaging agent you can have because there might be some people who are like, you know, this is good enough for me.
I'm already seeing improvement.
There's probably people who are in a rapid decline that need to see that specialist first, but it's hard to weed through that without any data outside of the provider advocating for you.
But now you can probably use this as a better triaging method on top of solving the problem.
So I kudos to them for figuring that out.
Yeah.
Okay.
So, uh, then in Mobi Health, uh, welcome tech raised seven and a half million dollars to expand, uh, immigrant services.
They're also using an AI engagement platform.
This is in la um, bringing care to undocumented workers.
This just came out, um, recently.
I don't know how much you got to review it, but what'd you, what'd you think of this deal?
This one I didn't have a chance to review.
Yeah.
Uh, so I can't really comment on it too much, but I I, I'll take a look at it after this.
Yeah.
Yeah.
I mean, it's, it's a huge space.
It's also a hard population to engage, to get engaged, uh, but a big opportunity, they can figure it out.
Okay.
And then the Wall Street Journal, um, they have a vc, uh, pro section dedicated to venture capital, and they ran a story this week, headline VCs had no time off this summer, blame ai.
So, um, you know, when I started 25 years ago in 2000, 2000 1, 2, 3.
August was pretty quiet in venture.
And I don't know that this summer is, uh, different than last summer really.
I think, I think it's ever since COVID, it has really changed pretty dramatically, whether there's no, there's no four weeks of August off anymore.
Uh, but certainly AI has made it much more competitive.
What, what were your thoughts on this?
Yeah, I think we were talking about this before the recording.
I, I enjoyed this article a little bit, tongue in cheek because it felt like, it felt like it was a little bit of complaining versus like just saying, do your job.
Yeah.
Um, so like one of the partners, uh, I think M 13 said that she had just talked to this really impressive startup founder, you know, two days in a row on Tuesday.
And then she's like, well, I'll get back to em on Monday after the weekend about how I felt about it.
And by Monday she realized they had taken up an offer from somebody who worked with em on the weekend to get their stuff warmed up.
And in my mind I'm like, if you're really excited about something.
If you don't wait four days just because you think you can, you get the job done.
And so I think it was one of those where it's like maybe VC is waking up to the world of.
You can't just sit around and call the shots anymore as you used to be able to do in terms of, yeah, the summer's off.
As startup founders, we all had to understand that there was a lull in the summer for deal flow, and it's almost like you guys are teachers, like what?
You have the whole summer off.
Like what is this?
While we still have to hit these aggressive goals ourself, but yet we're watching VCs kind of do this very.
Easy path and dance.
Yeah.
And the other one I saw was just the guy who was commenting on the fact that he's like, I spent eight hours with this founder.
I never thought I would spend that much time with the founder.
And then I hammered out a deal with him and it was such a great thing.
And I was like, that just feels like normal.
Yeah.
Right, right.
That's kind of your job.
So, yeah.
And, and so I was kind of like laughing while I was reading this.
I was like, it just felt like these people were detached from reality of like what it is to kind of roll up your sleeves again.
And so I thought it was just humorous from perspective as a, as like a founder sometimes dealing with the long lag times, getting ghosted and feeling like there is no interest from actually his interest.
And so I think that was a, a humorous thing.
Yeah.
Yeah.
I think it, I think it's healthy.
I mean, it is, uh, it is getting more competitive in the venture space.
Uh, there's all kinds of size firms there.
There's, you know, one person firms that are, that can be on any time scale you want.
And then there are other very large firms that only have invested kid meetings, you know, every two weeks, every three weeks.
Yeah.
But I think it's great to see the sort of, uh, the competitive aspect in venture.
Uh, jumpstart is designed so it's easy for me to say 'cause we're designed to be really nimble and fast because we're, so I'll give you kudos on that part, Vic.
I 'cause dealing, even with Jumpstart on my side, I will give you guys kudos.
You guys had your diligence quick.
We had a, a few follow up meetings, like back to back the next week or two and we got a decision within a week or so.
And I think I was very impressed when that was back in 2018.
So I think it was right.
Right.
Yeah.
I mean I think, uh, it is been forever sort of a, we love to disrupt markets and innovate, but don't disrupt us.
Yeah.
So, uh, it's kind of nice to see, uh, maybe they're getting a little bit of their own medicine in this case.
Yeah.
And, and again, I, and it's not, and it was more of a tongue in cheek humor thing for me.
'cause I felt, again, I felt and lived of, of some of this pain.
But at the same time, I think the benefit of it is there is a little bit of a wake up.
I think the thoughts of seasons and down seasons are starting to fade away, which I think is beneficial to everybody involved.
'cause then innovation doesn't have to wait for the summer, right?
'cause we, for funding to develop innovation.
So it's like what we were all just taking a break on innovation for the summer, sometimes new companies.
And I think it's gonna create a more fast-paced deal flow environment, which is beneficial to the founder as well as getting the technology into the ecosystem.
So I think it's a win-win all the, yeah.
Okay, good.
So, uh, okay, let's jump into the policy.
So we had, um, wild week with the CDC last week and this week.
Um, of course the head of it was fired or resigned depending on who you.
Uh, I believe last week and then this week we have three articles.
I'm gonna summarize each of them and then let's come back and talk to 'em.
'cause they all sort of, uh, it's like maybe three different views of the elephant kind of.
So, uh, in the New York Times and Opinion piece we ran the CDC Kennedy is endangering every American's health.
And so this is from 1, 2, 3, 4, 5, maybe eight.
Several previous leaders of CDC over the past 15 years, 20 years, um, they all got together and expressed their concern for the way Kennedy is running HHS, particularly related to CDC.
Um, that was on September 1st, and then on September 2nd, Robert Kennedy Jr.
Didn't exactly respond, but he addressed these exact issues in a Wall Street Journal, op-ed.
Um, and took the position that CDC has been sort of, uh, creeping their scope and not really following what they have been talking about, about evidence-based science, uh, focus.
That he is trying to bring them back to their core mandate.
And then we have, uh, the, the last story is kind of a, um, I mean it's a letter signed by over a thousand CDC employees.
I think, uh, calling for his resignation.
It is time for Robert Kennedy Jr. To resign in big red letters at the top.
Uh, and this was, this came out on September 3rd, so three days in a row.
Uh, you know, these kind of opinion pieces.
This is, I guess not an opinion piece, just a, a letter on, on the internet, you know, basically chaos at CDC over the last month or so.
What, what are your thoughts about this whole craziness?
Yeah.
This thing I think has been in everyone's face for the last couple days.
Yeah.
And importantly, so, I mean, when was the last, outside of COVID being a really big moment where the CDC took an authority position to say, we need to figure this out and here's what we're gonna do.
I don't think we've talked this much about the CDC in decades past.
Right, right.
And I think, uh, to me, I, I feel like there are some people out there who believe, like, definitely scope creep happens.
We might not be following the science.
It might be paid for science.
We've all heard about certain, you know, industries sometimes paying for the science they want the results for.
Yeah.
So they can, so they know that there's already so distrust.
From my perspective.
At the same time, the CDC is one of those groups that is nonpartisan and should be and is full of scientists and nerds.
And, and that's who you want creating decisions and data that care about that data being accurate.
I think some people, you know, especially Kennedy comes in, he's not an expert, he's not a doctor.
He has no real background in medicine outside of what he promotes, just as his own self.
And I think that's what's gonna create a lot of concern for myself and a lot of people where they look at these and they start seeing, you know, there's a, there's even a statement in these articles where it talks about during the largest measles.
Epidemic or outbreak in the United States.
Dr. Kennedy, in the, in this, in the HHS, is pushing unproven tactics to administer against it, as well as downplaying the benefits of vaccines.
And it's almost like you can look at that objectively and say, what on earth?
We solved measles a long time ago.
Right Now we're re-litigating that.
So I feel like that's a big deal.
Look, Dr. Susan Menez, I forget how you say her last name.
It looks like people, again, from all administrations, all walks of life who have dealt with the CDC look at this resignation or stepping down or whatever it might be as a bad thing, and that they just kind of confirmed her, what, a couple weeks ago or, yeah, yeah.
And, and touted her for being somebody who follows science.
And all of a sudden you're saying she, she doesn't, I think that just, it creates so much confusion in a place.
Everyone wants more certainty.
And so I don't think anyone's winning in, in this Robert F. Kennedy fight.
Yeah, yeah.
That, that's kind of where I come down on it too, is that there is, um, there are gripes on each side and there are probably some truths on, on each side, but the credibility of our kind of governing institutions is suffering.
Yeah.
And when having some states kind of going further and requiring, uh, even some more vaccines, we have Florida, you know, not requiring.
So you're gonna have all the states do all kinds of various experiments because there's no sort of, uh, federal.
Credible group saying this is what science says, this is the best we know today.
And it's really just sad.
I don't think there's anyone that's right or wrong.
It's just sad in general that we're losing our credibility.
I think the people that get hurt the most are the most vulnerable populations of this.
'cause they can't afford any expensive treatments outside of what might be coming to them from the government.
Right.
And that's the tough part for anyone to stomach.
You know, we also saw, again, he's running things that I think a lot of people can agree with and I think just how he's implementing is not what people are happy about.
Mm-hmm.
The food additive stuff.
Right.
I'm actually for less food additives, like I thought that was a great thing to go figure and figure out, but it doesn't seem like that's part of the agenda anymore.
And then you see like the whole fluoride debate right now.
There's a municipality states that are removing and actually not removing, banning fluoride from community or municipal water lines.
So it's not even like, do it at your own risk or like whatever.
It's like, no, they're straight banned.
And that's a big deal for, I don't wanna get the banning piece.
It should be just do it your own.
Look, if you don't, for some reason you're not somehow familiar or trust the science, which a lot of people have litigated and there's so many research articles about, again, something like measles shouldn't be rethought too much.
Yeah, right, right.
I think there is even, 'cause now I'm having the dental industry we're talking Yeah, yeah.
That's, that's in the middle of fluoride's for the Yeah.
We're talking about the fact that as soon as that announcement came up, all dental stocks jumped because they realized there's gonna be more dental care.
Right.
And we're like, that's the market saying they understand the results of this not even a partisan issue.
And I think that's where I'm a little concerned.
And I believe, you know, again, I'm looking for stability in the governments and institutions that we should all rely on for data.
The more distrust we so in it, the less we can trust that data and the less progress we can make.
And with all AI needing data to feed.
So the future of all these innovations, we might not be able to rely on a lot more of this government sponsored research as much as, yeah, no question.
Okay.
And then Fierce Healthcare had an article, house Republicans proposed 6% budget cut to HHS for 2026.
So this, so this is, the proposed budgets not passed, but obviously a cut to the healthcare spending is gonna be a challenge.
What, what are your thoughts about this?
Obviously I'm not really super happy about the cuts on the department, but I think, you know, those are preempted by a lot of these firings and layoffs.
So maybe there's a little bit of a wash there.
I don't understand.
The reason why, I believe a couple of things that they called out in this article was they called out a specific$48 billion to say this is money that we're gonna dedicate to countering.
The growing threat that China has with their scientific research.
Great.
That we're gonna dedicate funding to make us a research powerhouse.
But then you go back to this Kennedy ordeal, which is like, where is that research going and is it going to real research or something to somehow disproven already proven fact.
And I think that's part of the worries that I had.
The one thing it did say that I'm actually, uh, in favor of is they want to start requiring NIH grant holders to buy American supplies as part of that funding.
Now I know again, we can get things cheaper.
We may not, not be able to manufacture everything, understand all of that.
But I think where we can.
We're using our own federal dollars, might as well invest back in federal or like, you know, US based companies.
Yeah.
That was, if that wasn't already part of these grants, which I don't know, so just humor me there.
Yeah, it should be part of it.
I mean, that would be good call.
If there's only one source in the globe, then okay.
But, but if there are many sources we should buy for American for, right.
Because it's our own.
Right.
So this should be helping fund our own economy.
So I think that was the one thing, again, if this wasn't something that's already done, I like to see that it will be done.
Yeah.
So moving on, Google got sort of a lighter penalty than they maybe could have gotten.
So this was the case where they, the government requested that they, that Google be forced to spin off Chrome due to anti-competitive practices.
They were not forced to do that.
So Google's able to keep paying Apple and others to, to install Google search as the default search.
They can't, they can't require it as the only one.
Um, and they could still make payments to make it a default.
I thought it was a pretty friendly to industry ruling by the judge mostly.
I think because AI is changing the competitive landscape so much that he doesn't, he didn't think that it was gonna be, you know, the market will take care of itself basically, is what he said.
Yeah.
Like what was his name was Judge Amit Metta.
Like, I think when I was reading his rationale, I was very surprised to see how levelheaded it was.
Not saying judges aren't levelheaded, but.
I think when you get these big monopolistic kind of cases, you tend to try and make some sense of an example or do some dramatic event.
I thought spinning Chrome out of Google was kind of an insane thing, but you know what it is, if it happened.
But what you said was a part that when he brought it up, I was like, he's actually thinking about the world out loud.
And he's saying, look, back in the day when we all went to the Googles, the Yahoos, the Bings, whatever, to do our search engine, Chrome was the end all be all, and it was an every Apple device, and they paid the Apple $20 billion every year to make sure it was their default browser of choice, even though they had safari.
And I was like, okay, yeah, you're kind of building a dollar moat that makes it very hard to compete.
But then his comment about with the resurgence of AI and how many much, how much more search volume is going through AI chat versus traditional Google search, that's where I was like, okay, he's actually creating this world where yes.
Maybe it was anti-competitive in the past, but this new net new world, it's not as much as it used to be and and therefore it doesn't make as much sense to make them spin it off.
So I thought this was a really levelheaded judgment.
They also talked about different things, or some of these counter protest parties are saying, look, at least when you're setting up your iPhone, instead of it being the default, can we have some optionality for default?
And like at least adding that one sense of confirmation might spread the playing field a little bit more.
Yeah.
And then they're gonna, they have to share more data around search so that other people can compete, which was good.
I think so.
Yeah.
So I think that where it ended, I'm actually kind of happy about, and I'm a very pro business person.
Again, I have my own company.
To me, it's all about inventing the unfair advantage.
Yeah.
Almost cementing it in stone and building the wall is a million feet high as possible.
And Google did that in spades in this one, so I can't, you know, hate Yeah.
It's hard to hate on them when they were successful.
Yeah.
Yeah.
And it's like we all strive to do that at some level in our comfortable.
So like, uh, but I'm actually happy with that ruling and how it came.
Okay, great.
So, uh, now moving into the payer, uh, story.
So Cigna's AOR is investing three and a half billion dollars in the Walgreens specialty pharmacy shield.
So Walgreens just went private last week, ing from Sycamore, bought it, took it private, and they, on the day, they spun it private, broke it up into five different independent businesses.
And now a week later, Cigna's investing three and a half billion into one of them.
Uh, what'd you think of this story?
I thought it was a who, Sycamore is more just like I respect the brilliancy of the play.
It's like you spend $10 billion to bring something private.
You split up into five and one of your five arms was able to grab $3.5 billion in cash.
Yeah.
It's, dude, you got 33% of your investment back to put his operating cash immediately.
Right?
Yeah.
And I, I thought it was brilliant.
What I see there is like more vertical integration.
So now you have a payer that's helping with specialty pharmacy, whether it was logistics handling and script writing before.
Now they actually can do the specialty pharmacy with this investment or at least be way closer to it.
I'm interested to see what efficiencies are gained by it, or if this is really just like a dollar play.
I think that's what I'm looking for next is, which just as a clever play to make a ton of money as a PE firm, which is what your mandate is.
Mm-hmm.
And then you spin it back off, or is it.
We, we wanna run this.
I mean, I think though I think it's both end.
I think, I think it will be, you know, the sum is worth more than the total.
The parts are worth more than the sum.
So they break it up and then the total will be worth far over 10 billion, which was basically what they bought it for.
But I think they will have to run it, run these different groups for a year, two years.
So, so getting some capital in to be able to grow, um, the specialty pharmacy business, which is a great market.
I don't know this business compared to other specialty pharmacies, but, but it's a great opportunity, really.
It's a good move.
Okay.
And then scan, which is really, I think as a California plan, they're expanding into Washington state, which I think is good.
We have, we have stories of lots of, of payers sort of cutting back their Medicare.
This is in Medicare Advantage, cutting back their Medicare Advantage footprint and abandoning states where they don't have a big market share.
They don't have.
Enough clout, uh, so good to ccan expanding.
I, I felt the same way.
It said that, you know, some of these departures from these bigger groups like UnitedHealthcare, 600,000 former enrollees, were gonna be left without any kind of care.
And I think this is coordin nationwide more than anything else.
But it's, to your point, bigger groups have been taken a step back.
And so seeing people say, no, we're gonna come in.
Right.
Uh, because we actually believe in the philosophy of what we're doing versus just the dollars and cents behind it.
I'm interested to make, see how it goes, and hopefully they survive and other people do the same.
Yeah.
I mean, I'm a cheerleader for them.
I think it's hard to open up a new market in MA if you don't have the density of customers, but I, I hope it's successful.
Okay.
Now moving into health systems.
So this is in the Fierce healthcare.
UPMC's flipping 2024 is operating losses halfway through the new year.
So they're making progress.
Uh, UPMC's had a, had a difficult year last year.
And they've begun to turn it around.
They have a positive operating income and I think on the right path.
Yeah, it said last year they lost I think a little over 300000001st half of this year, they're already making that much in profit.
So there is a big foot.
Right, right.
But the only positive to make sure these people are surviving and they can give that care access to everyone around them.
Yeah.
Yeah.
The Pennsylvania market's very competitive.
It's a hard, it's a hard market.
So lots of competition there.
Uh, so good to see UPMC, you know, beginning to turn it around.
Okay.
And then out west in Phoenix.
This is in Fierce Healthcare again, honor health is picking up ever North's primary care clinics in Phoenix.
And so ever north, you know, that we just talked about investing, especially pharmacy, they're divesting their primary care 18 centers in the Phoenix area.
And so it's honor health, which a big health system out there.
Yeah.
What do you think of primary care?
Well, I, I think primary care, I, I think it's just hard for anybody in these big markets to find good primary care.
Like any, I'm in Boston and so I'm on wait list to go.
Yeah.
Boston.
It's hard to get access.
Right?
Right.
So at the end of the day, I, I mean, it's a good pickup for somebody who wants to invest and expand it.
And it sounds like, you know, Evernote is more or less going away from it.
So maybe that was their signal saying, we're not trying to build this to be more than what it is today.
Somebody else take it over.
So I, I appreciate anyone who's gonna come in.
'cause that usually means.
They're gonna grow it instead of shrink it.
And that's only gonna help us all.
Yeah.
And I, I think primary care is a hard specialty to spend a lot of investment in, unless you can look at it from the overall kind of integrated care network and it's going to then, you know, have referrals into other parts of honor.
From a payer point of view, I think it's a hard business to, to justify really.
Yeah.
Yeah.
I think that's where we saw that move.
Like you said, they're divesting from things that might feel difficult and they're investing like into specialty pharmacy where they feel like they know how to make money and they're part of the value chain.
Right.
Uh, from a delivery standpoint.
Okay.
And then we have a story in about health and us, uh, this is the Wall Street Journal.
More older Americans are aging alone who will take care of them.
And so it's a story about a food delivery service in Virginia.
And this guy that they profile kind of drives around bringing frozen food to elderly folks that live alone.
Um, and it was kind of shocking to me how many people are living alone at a pretty advanced age and with, with not a lot of support.
Yeah.
It what, so the number that I saw was 16 million people over the age of 65.
And then I thought about what that percentage and likely it was in the article, 28% of 65 and above people in the United States live alone.
That's triple the number.
It was in 1950.
Mm-hmm.
So that means a couple generations.
We've seen more of that loneliness epidemic kind of hit now in the US I think it's been in Japan for a couple decades and people have been talking about it.
So the only kind of silver lining there is we can, we can look at what they've already started working on to do to solve the problem and hopefully emulate it and do with the American equivalent of that, or at least what has worked well.
It was a shocking number when I heard, when I saw 16, I was like, that can't be right.
And then obviously it's.
Based in data, but it was just a Right.
Yeah.
Yeah.
It makes me worried about, um, you know, the, if the economy gets worse or gets more bifurcated, this is gonna get worse and worse I think over time.
Uh, so I don't know, but we, yes, it is true.
I hadn't thought about that angle that you could look at Japan, maybe Italy, some other places like that where they're, they're ahead of us in this demographics and kind of learn from them.
Yeah.
And the other thing that kind of stuck out to me was when I was reading that article, there was people that talked about, they hadn't seen another human in two weeks.
Right.
There's a lady delivered the food to, and she's like, the first human I've seen in two weeks.
And I'm like, wow, that's really sad.
Yeah.
And, and they talk about the fact that some of these people aren't.
Whether it's wealthy enough or in the right places to get home health workers to help them out, walk around.
There's a dude who was in his story.
He was talking about vacuuming with his walker and how difficult that is.
Yeah.
And like all that to say is, you know, whatever you believe about that, that immigrant population that has come in.
What I also Google just to see what the stats were, is immigrants make up 32% of the home care workforce.
Mm-hmm.
And we see what's ever happening now in the US in the, whether, again, don't care what side of the aisle you're on, but what is happening is there's less interested immigrants coming into the us.
But what that will mean is less home care workforce.
Probably more loneliness because people aren't being able to be affordable in these houses, uh, to come help these groups out.
Yeah, no.
So either people are gonna be.
Having to pay more for home health or they're just not gonna be able to, to get a home health worker to come.
Yeah.
And I think that's the problem, that it's more than just a workforce problem, it's a loneliness problem for those that relied on some kind of companionship.
Okay.
So, uh, moving into Web3, just I wanted to quickly touch on this.
The Trump family, uh, had a company that they control, American Bitcoin did their public listing yesterday.
So the Trump family made roughly$5 billion or, or maybe monetized$5 billion of illiquid stock.
And I just take this as a sign that, that, you know, the powers that be in dc, the Trump family and all the Republicans, they, they are very involved, let's say in the Web3 crypto space.
And so I think that's a sign that it's going to continue, at least for the next three years to be like an open pro crypto, pro Bitcoin pro Ethereum kind of marketplace.
Agreed.
I think it's one of those where there was some articles talking about how this is why we don't want politicians, especially the, the leader of the country to have open business investments where they can affect the policy that then enriches their family.
So if you are in the Web3 world, this can only be seen as good for you in my mind.
Like regulations are probably gonna come down, you know, there's probably more willingness to work with Web3 companies or environments, maybe even within the federal government.
And so I think overall the Web3 community's gonna benefit from, from this move.
Uh, because yeah, we, we just started covering Web3 about a month ago, kind of because Marcus and I saw this coming.
It's gonna be.
Uh, over the next three years, it's gonna be kind of ingrained into our financial markets, into our economy.
And then almost no matter who wins the elections, it's gonna already be there.
You can't really put back in the bottle that easily.
It's hard to unwind something that's as big of a financial instrument as like crypto.
Right.
The more you get out in the ecosystem, the harder just to pull back.
Yeah.
And then on X poly market announced that they are going to allow Americans to, I guess you'd say, gamble or, or contribute to the, to the surveys and putting money on various outcomes, which I think is great.
I mean, being able to bet a couple dollars on, uh, an election or whatever, getting us, uh, votes in there, uh, voting with their dollars, I think will make the outcomes more likely.
Yeah.
No, I'm, look, I, it's fun to me for people to be able to maybe put dollars on things they feel like they know better than the other groups.
Like Right.
That's where you have sports gambler.
I know gonna crush that team.
Well, there's some people who live in other markets that aren't necessarily sports that wanna be able to, to gamble on it outta like a fun side hobby.
So it's very interesting.
Yeah, and I think again, mean I will look at, uh, poly market for like what's gonna happen with interest rates for instance.
Yeah.
It's pretty accurate and I think the more people you have able to, to contribute, so getting Americans able to do it, I think will make it more accurate.
Yeah.
It's the law of large numbers, right?
Like you ask.
A million people to say, what's the weight of that horse?
The average is really freaking close.
But if you have a small sample size, it's wildly inaccurate.
Right?
Yeah, exactly.
Okay.
Moving into ai, so Epic, uh, this is on the Epic website.
Uh, they announced yesterday that comment, which is a new medical intelligence for clinical and operational insight.
So it's, it's like an LOM trained on all the epic EHR data, about a hundred billion patient medical events, and they claim it can be used to help forecast what are the potential future pathways of this patient given their health record to date.
Pretty interesting new approach to AI coming out of.
You know, really the dominant incumbent EHR.
What, what are your thoughts about Epic's move here with Cosmos?
This is where I wish I was very rich and epic was publicly traded.
'cause I would give them a ton of money, mainly because they, they have the most amount of data possible to learn on and it's all within their own system.
So it's not like they have to work through random API calls and whatnot and hope they can parse the data correctly.
It's their data.
Yeah.
And we're able to train this thing on a hundred billion patient records and now you can say, alright, 20% chance this person gets readmitted, 15% chance there's an in inpatient stay for at least one day, whatever it is.
The ability for a health system to use that to better plan for patient care.
Oh my God, I can't believe it.
I think so.
I think in general they're using AI for again, the right thing in this world.
And wasn't it just about a month ago they, they announced that they have their AI scribe, but Epic seems to be leaning pretty heavily into the AI world.
They're gonna, they're gonna crush the competition.
Yeah.
So, yeah, I think it's actually, you know, as a vc, it's actually fairly hard to invest in AI business models that will not.
Be subject to sort of complete disruption and taking, you know, all the profitability out by a big incumbent, either from Epic or Oracle or from Open ai, Google.
Yeah.
The frontier models at Tropic.
Yeah.
Like I have a few comp, I have a few friends that have subscribed companies, AI scribe companies in healthcare.
And when that news came out, we're all kind of talking about it because there was over a billion dollars invested in the last two quarters in describe style companies that worked to build efficiencies in that charting workflow or whatnot.
And when Epic announced it, it's basically gonna crush them all overnight.
'cause many of them built their products as marketplace or app marketplace items for Epic users.
Yeah, right.
Like their, their plan for distribution was to sell through the Epic marketplace, which Epic obviously they control, so they will.
That'll turn off totally for their own product.
Yeah.
So, so from a, from a patient and healthcare facility perspective, this is a really cool thing, right?
From a, from a startup and maybe even investor perspective.
It's a really tough thing.
'cause now you can't place as many bets as you thought you would on this kind of stuff.
Yeah.
But you should have known too.
I mean, it is not a new thing that Epic controls it.
No, no, no.
That's, and that's the funny thing, it's like almost when people even get upset about Amazon, it's like, oh, well you do, now you have Amazon Basics and you're competing against my battery and my household.
Essential.
Right, right.
What do you think they were gonna do with all that data?
Right.
Yes, they're gonna enrich themselves.
Um, okay then next story is, is in, uh, modern Healthcare Banner and Anthropic Showcase AI space race.
So it's good to see, um, anthropic partnering with Banner.
You know, one of, one of the more forward-leaning, uh, health systems.
We have some friends over there.
Uh, so, so they're partnering up to sort of bring AI into the health system and, and try to do better with it.
What did you think of this?
Yeah, I just think it's a good partnership.
You know, whenever you start seeing companies try and come into the medical or healthcare world that really didn't have that background to begin with.
I mean, we saw that back in the day with Amazon or with some of these bigger players saying about healthcare.
Yeah.
Like they think they're just gonna roll it over and take over the whole thing.
And healthcare is more complicated than that, is you need to partner.
Yeah.
And Anthropic being one of the biggest players in AI now saying, look, we're not gonna say we know this world.
We're gonna work with a banner to really understand it and build what's needed.
I think that's, that's a really good, smart move, right?
Yeah.
And then, uh, related to that, anthropic closed a new round of funding, $13 billion.
They closed right after Labor Day.
Uh, and it set their valuation, um, at 183 billion.
So about three times over the last eight months or something.
They've grown in their value.
So incredibly large numbers, obviously.
Uh, what, what do you think of aro?
Have you played with Claude, or what do you, what do you think of the technology?
I use Claude Chat, GBT and Gemini, like just, yeah, same with me.
Those the exact three I use.
So why I use Manus too.
Have you tried Manus?
I've not tried, man.
No.
Maybe I'll try that next.
But I, I use 'em all for different things and sometimes I use them for the same thing to see if the results are the same, to kind of gut check me, like to be like, oh.
Three different systems are saying the same thing.
So there's some sense of Yeah, well they definitely have different tones or different strengths and weaknesses.
I think so.
Yeah.
Yeah, yeah.
Some are really like anthropic I would never use for any kind of creative or design work.
It's really bad, but it's really good with like true research and logic reasons.
Anything else?
And so I think it's, I mean, 183 billion amazing valuation.
The fact that it three Xed in like a couple uh, quarters essentially.
Yeah.
That was a thing that kind of stuck out to me.
But look, with the banner thing that we just talked about.
Yeah.
I feel like there's good justification to be bullish on 'em.
It, it's almost like that the stock price going really high per, per, yeah.
Back to your first story where like you land, I mean they are a startup.
They land this huge valuation, now they have to grow into it quickly.
That, that's where I think I'm gonna be interested to see how, how quickly they can and if they do.
Yeah.
Yeah.
I'm pretty bullish on the, the way it's, it's sort of building out is you, you have I think, pretty clearly two startup ish.
It's hard to call 'em startups when they're multi-hundred billion, but, but I guess they're startups, open AI and philanthropic that are gonna be, you know, head to head competitors.
And then you have larger companies taking their own approaches.
Of course, Gemini is probably the best positioned, uh, but then you have meta doing whatever Meta's doing.
Kind of almost flailing around, but, but trying hired a lot of people and X and Microsoft kind of hanging around.
There's, there's a bunch of players in this space, which is, I think healthy.
I think it's healthy too.
I think it creates good competition, and maybe that's why they need the a hundred, three 83 billion like valuation to say, okay, we're somewhat competitive now to the Microsofts and the Googles of the world.
I know it's hard to reach those value caps, but like, we're not tiny players.
Yeah.
But they can sell to Banner or anyone because they, they have sufficient balance sheet strength to keep up.
Right.
So I think that's where it can actually come through.
Okay.
So then in BGR, uh, following lawsuits from last week, OpenAI is now maybe a little bit too late, but, but I guess better late than ever, bringing parental controls to chat GPT.
So they had the suicide story.
We covered it last week.
Chat.
GP does not have great controls for parents and minors to sort of be able to work with the technology in a safe manner.
I, I put my analogy to what's happening with these chat models or these open language, large language models is what's kind of happened at the beginning of the internet being super publicly facing and, you know, average consumer usage is people are gonna go do crazy stuff with it and then you kind of build the guardrails around it.
And I think we're, I'm not saying yeah, you almost need to have a car go off the road before you realize, oh, we should put a guardrail right there.
And I'm not saying you couldn't have forecasted this, so I'm not trying to give them like the cover there, but what I'm trying to say is people are gonna misuse and abuse these products in ways that probably were not considered or thought through super well at the beginning.
And nor did you think it was gonna be an imminent threat.
And yet here we are.
Yeah.
I think there's that whole saying of, you know, you can plan for the stupidity in the world, but they'll always outsmart you at the end of the day.
Yeah.
And so, uh, I think that's where.
You have these things happening, and yes, you need some of these controls and like you said, they might be late to the party.
I think it's just part of the evolution of big seismic technology shifts that we all have to adopt to, and, and over a decade we'll get way, way better about this.
So I, I think these are the things that we're learning in real time.
And then, uh, they all open AI also two days ago, bought a product testing company.
The stat sig, I think, is that how you say it?
I think it's Stat Sig.
So it's like an AB testing kind of, um, company.
They bought it for 1.1 billion, so a good, good exit for them.
Uh, I didn't really know this company.
Do, do you know this company or do, what'd you think of this deal?
It's fine.
I didn't know this company ahead of time, but when I was reading about it, I actually sent it to my CTO, my co-founder and CTO to be like, are you using this?
Or something like it, because, and we, and we end up r with a bunch of different tools.
So we are using about two or three tools.
That sort of like cobble together that would, would sort of do this ser this kind of functionality.
Yeah.
Yeah.
So to me it's interesting enough for us to take a look at it.
But they do everything to your point, like AB testing, they do feature flag control, they do, um, in app analytics and statistics and predictive behavior modeling and user journey flow.
So all the things that you wish if you could pay somebody to be like, try and make my product as efficient to use as possible and tell me what the least path of resistance pathways are to get to the value of the product and being able to almost like ask a product to do it themselves.
Yeah.
I think that's where these guys are kind of building a little bit of the future of that and I think it's really valuable.
Yeah.
I'm excited about this acquisition'cause I'm kind of tired of the chat, you know, the chat interface.
I'd like different products and so hopefully they'll have new interfaces, new new ideas coming out.
Yeah, just read my mind.
Why do I have to tell, why do I have to chat it down?
I just need Right.
Just plug in and then give the output I want.
Yeah.
That's what neural lynx I been trying to do with Right.
The, this story out of, um, the, the mid east.
So, uh, it's in United ai, new micro display implant offers hope to restore site to millions.
So, so this is, um, technology company in Dubai and they have, um, the way I understand it, like you wear glasses if you're, if you can't see, and it's a camera like in the glasses and then they have a chip.
I think it's embedded in the retina or in the eye somewhere that somehow takes the camera images and puts it into your optical nerve at some level.
So it is pretty science fiction related, but I thought we would end on that.
'cause some of these things are super exciting.
I mean, literally allowing blind people to see is, would be incredible if it, it works.
Yeah.
I, again, these are the parts of AI I get super excited about when people are saying, Hey, we're innovating this way to your point.
I don't need another chat model to tell me what to do.
I feel like I can get enough right now, but Right, right.
I'm using it to say I'm gonna cure blindness.
Like, that is super cool in my head.
Yeah.
You know, my, my own story about this is I have really crappy eyesight.
Like I have negative eight is my contact prescription on both eyes.
Oh, wow.
Yeah.
'cause I think I have bad in minds negative 4.25.
So negative A is serious without my contacts.
I'm, uh, basically I would've gotten eliminated by, by Darwin's Theory of Survival Buffet.
And so like I've always wanted to help people better their eyesight.
Just, I've always dealt with really crappy eyes and so to see somebody do something as innovative as this is really cool and the ability and how much science and research went into it, I can only imagine.
But it sounds like there's a lot of good doctors and researchers on this.
They've been doing it for a little bit.
They said there's 12.7 million people currently awaiting this.
Implant.
Yeah.
Right.
So it's, I mean, there's a lot of people that can benefit.
It's not just like one-off thing.
Yeah, yeah.
It's like there's that many people saying, I need a solution.
'cause there's no one, and you have this immediate demand and it, it either way I'm, I'm loving the fact that we're using technology to cure blindness and stuff.
Yeah.
Yeah.
And I'm, I've been following the Dubai and the Ate and even Riyadh.
There, there are a lot of really interesting stuff in, in the Mid East that I think is gonna be up and coming over the next couple of years.
Yeah.
Did I tell you I went to like a, we pitched at the World Entrepreneurship Competition that was in Riyadh.
Oh really?
No, I, Marcus went last year.
I want to go, I've never been over there.
We were, we were one of the, we were actually the one of the first cohorts to go in and we landed in the top 40 in the world.
And this was back in 2019.
We got to meet Star from all over the world.
Right.
Yeah.
We had three US representatives who were one of the three, and we had a couple others and I got to see some technology coming from T, which is their big university out there.
And one of the ones at one first place or second place, which I was super impressed with, was, uh, I know this is going way off topic, but it's just more like demonstrating that.
Yeah, yeah.
What, what was they were trying to solve, the water conservation and the water problem.
Right.
We're running into a place where we're gonna run outta water, clean water for the world.
Yeah.
Especially in that, in that region.
It's a huge topic, I'm sure.
Yeah.
Yeah.
And they said 70% of the, the water that's safe for drinking is used for agriculture today.
Like whether it's water and crops or whatnot, which is fine over that water through the nutrients over time, but 70%.
And so what they said is, if we could grow vegetables and fruits a different way where it doesn't take the water that we can drink, that's safe for drinking to do that, instead let's do it.
So what they ended up doing is they sort of breeding crops and they have this tomato that can actually grow in the Red Sea.
So salt water.
Wow.
And they can farm it.
When you eat it, it already ha it's pres salted because it's part of the Oh, yeah.
Yeah.
Interesting.
And so like, I was just blown away.
I was like, that is a really, that's pretty cool.
Yeah.
How they're trying to put their next crop in there and they're, they're call it Red Sea Farms is the company.
Yeah.
And essentially you're just growing crops in the ocean so you don't have to use our water instead.
And I was like, that was, and so, so they've modified the, the seeds or the crops so that they are can tolerate the salt water.
Exactly.
Yeah.
And I was like, holy crap.
That's amazing.
Yeah.
Yeah.
It's pretty exciting.
All this stuff, um, happening kind of simultaneously right now.
So yeah, we're living in a great timeline and also crazy timeline, but a good one at the same time.
Yeah.
Yeah.
That's right.
Alright, Jans, thanks for doing this everyone.
Check out Uptime health if you need devices supported and help with you know, all your field technology.
Genes, uh, maybe give your website so people can find you.
We'll put in the show notes as well.
Okay, perfect.
Uh, websites uptime health.com.
So U-P-T-I-M-E-H-E-A-L-T h.com.
Um, you can Google us, find us online, but you with all the recent articles about us being in the, in 5,000 Yeah.
Most.
Yeah.
Not hard to find.
You will pop up somewhere.
Yeah.
Okay.
Thanks for doing this.
Really enjoyed it.
Appreciate it.
Thanks.
Having me on.