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In this episode, Marcus and Vic discuss Trump’s rejection of a meeting with Democrats as a government shutdown looms, small business optimism data, Fed comments on rates, a series of major venture capital deals in virtual care, neurology, oncology, PBMs, maternal health, and organ preservation, policy shifts around Tylenol and autism claims, the $100,000 H1B visa fee, the creation of an independent vaccine advisory agency, challenges for regional nonprofit insurers, Humana’s Medicare Advantag...
In this episode, Marcus and Vic discuss Trump’s rejection of a meeting with Democrats as a government shutdown looms, small business optimism data, Fed comments on rates, a series of major venture capital deals in virtual care, neurology, oncology, PBMs, maternal health, and organ preservation, policy shifts around Tylenol and autism claims, the $100,000 H1B visa fee, the creation of an independent vaccine advisory agency, challenges for regional nonprofit insurers, Humana’s Medicare Advantage commission changes, Ascension’s return to profitability, Privia’s acquisition of Evolent’s primary care unit, Kaiser strike threats, new interoperability moves from Epic, big pharma acquisitions in obesity and liver treatments, Eli Lilly’s Texas expansion, Bitcoin treasury consolidation, the VA adopting AI note-taking tech, Unity AI’s scheduling agents, Nvidia’s $100B OpenAI investment, Citi’s AI agent pilot, a controversial social app selling voice data to AI firms, and PwC’s trillion-dollar healthcare report that highlights the innovation divide
Links
2:08 - Trump Rejects Meeting With Democrats as Shutdown Approaches WSJ
5:45 - Small Business Index -Hits All Time High US Chamber
9:36 - Powell Describes Rates as ‘Modestly Restrictive,’ Keeping Door Open to Cuts WSJ
10:22 - Sevaro Health Secures $39M for AI Powered Virtual Neurology & Workflow Augmentation HIT
11:30 - Caregility Raises $25M in Funding FinSMES
11:51 - Thyme Care lands $97M series D backed by CVS Health, Humana, Morgan Health and Memorial Hermann Fierce Healthcare
14:00 - PBM Capital Rx rebrands as Judi Health, banks $400M funding round Modern Healthcare
15:17 - Seven Starling Raises $8M to Expand Access to Maternal Mental Health Support MedCity
16:46 - Until Labs Raises $58M to Pioneer Organ Cryopreservation and Medical Hibernation HIT
18:50 - AmplifyMD Snags $20M to Help Hospitals Scale Virtual Specialty Care MedCity
21:05 - Trump Issues Warning Based on Unproven Link Between Tylenol and Autism NYT
24:29 - Trump’s $100,000 H-1B Visa Fee Sets Off Scramble Across Corporate America WSJ
27:25 - The Doctors Building a Public-Health Universe Outside the Government WSJ
31:50 - Regional nonprofit health insurers falling behind competitors Modern Healthcare
32:44 - UnitedHealthcare unveils direct-to-consumer tool to shop for health and wellness programs Fierce Healthcare
33:42 - Humana ending commissions for some Medicare Advantage plans Modern Healthcare
36:10 - Ascension returned to profitability in 2025 Healthcare Dive
37:33 - Privia acquires Evolent’s value-based primary care unit for $100M Healthcare Dive
38:42 - More than 46,000 Kaiser Permanente workers have authorized strikes as contract expirations loom Fierce Healthcare
Every week, healthcare VCs and Jumpstart Health Investors co-founders Vic Gatto and Marcus Whitney review and unpack the happenings in US Healthcare, finance, technology and policy. With a firm belief that our healthcare system is doomed without entrepreneurship, they work through the mud to find the jewels, highlight headwinds and tailwinds, and bring on the smartest guests to fill in the gaps.
If you enjoy this content, please take a moment to rate and review it.
Your feedback will greatly impact our ability to reach more people.
Thank you.
What's up man?
I'm good.
It's good to talk about international.
We've gone international now.
Yeah.
In our home offices or, or I don't know where you are actually.
You're not home.
No, no.
I'm, I'm in a coworking spot.
Uh, but I'm in Mexico City at the moment.
Uh, I'll be back in Nashville next week.
We, we've got Nashville healthcare sessions happening next.
Uh.
Monday and Tuesday, I'm gonna be doing the panel with, uh, the focus of Barclays and Welsh Carson.
Uh, and then, uh, we'll be recording in our Nashville office next Thursday.
Uh, but, uh, yeah, yeah, everything is, uh, rainy as per usual here in Mexico City.
Um, same in Nashville.
Really.
Yeah.
Yeah.
Yeah.
But lovely, lovely.
Nonetheless, uh, busy week, uh, in, in the news for sure.
Um, you know, Tylenol seems to be, yeah.
All anybody can, can manage to, you know, talk about Jimmy Kimel and Tylenol.
It's kind of like, uh, yeah, yeah, yeah.
Jimmy Kimmel's back and it's probably his most popular show ever, was his come back show.
Yeah, of course, of course.
Well, now, now he, he, you know, it's, it's amazing all these accidental icons, you know what I mean?
That are, that are, uh, becoming right.
I mean, it's like, yes, they stood for things.
Yes, they, but, but in this moment, uh.
Each side, uh, politically is, is really like rallying around, you know, different figures.
And it's, uh, it's, it's just, I don't know.
I, I, I feel like it's something we, we read about in history books and here we are living it.
It's, it's a, it's kind of a weird thing.
Um, all right, well, we got a, we got a long show, a lot of stories to, to run through.
Um, and uh, why don't we just go ahead and start and dig in, starting with Trump.
Uh, Trump rejects a meeting with the Democrats as the shutdown approaches as we were preparing for the show.
You know, I think we're starting to just see that there are many, uh, stories where, I don't know, this is episode one 60 and some of these things just kind of cyclically keep coming up and Yeah.
And so I, I, I think they are less, um, kind of critical for us to focus on, um.
But also it's important to sort of be aware and also think about what might be different.
Right.
You know, this time around from previous, near government shutdown.
So Yeah.
You know, what, what do you see as potentially different this time?
There's two differences here that I think are worth talking about in our show.
So the first is the Democrats are, I think, demand, I use the word demanding.
You know, they're at least suggesting that they would vote to keep the government open if the Republicans extended the subsidies for the, uh, Obamacare exchanges.
And so it's a healthcare, whatever healthcare requests that they're demanding.
I don't know how likely that is.
Both Trump and the leaders on the Republican party of Congress have said no.
Um, but that's the first thing.
And then the second thing is, for whatever reason, I, I don't know.
I mean, you and I have to work, but they took this week off in Congress, so, so they're on recess.
And so they're gonna come back on Monday.
There's no clarity on how they will extend payments for the government.
Um, and they have two days to do so.
And it's my sense that Trump is sort of just not, not that concerned about it and, and gonna view it as a way to, you know, cut costs, which is not the best way to cut costs.
Obviously, if there are costs to be cut, which I think probably we should cut costs, it'd be much better for the two sides to be adults and do their job and figure out what, like any company would do, figure out where you need to cut costs, um, as opposed to this, uh, just kind of run, run outta money.
And then it's gonna give the office of budget management and budget OMB pretty wide discretion to, to make changes, which is not gonna be, I don't think it's gonna be positive, but we'll see.
Yeah, I mean, uh.
There've been people who've been calling for the Democrats to use this as a moment to, you know, they don't have a ton of power, but this is kind of one of those moments where they do have some power and yeah, they do have some leverage.
They, they can't pass it without the Democrats, so.
Yeah.
Yeah.
And so, you know, there, there have been people who have been calling for the Democrats to use this moment, uh, to, you know, get as much as you can and also, you know, really be willing to dig your heels in and go over the cliff.
Like, you know, people have been saying like, you know, what the hell do you have to lose?
So, to me, that actually feels like, uh, a third difference I would focus on, um, you know, because I don't recall hearing that from Democrats in the past, ever.
Right.
Yeah.
You know what I mean?
They, they've, they've always sort of been like, we've got to keep the government running, right?
EE even, even when they were not in control, um, of House and Senate.
And this, this time it does seem that there are some calls for them to behave in a. Um, a, a more activist way, so, so we'll, we'll, we'll see how it plays out.
Uh, you know, I, I agree so far, we've never seen it actually go to anything longer than a, you know, a a a short sequester gave to, right?
Yeah.
Yeah.
So, I don't know.
It's not anything I'm paying a ton of attention to.
Okay.
US Chamber of Commerce Small Business Index for Q3 of 2025.
You pointed this out because, uh, I guess you, you, you found that it was, uh, an all time high, meaning small businesses are feeling that the economy is better than ever right now.
And I, I just kind of questioned, I, I just kind of questioned that.
Right.
So, so, um, tell, tell me a little bit about the, yeah, I mean, so the US Chamber of Commerce pulls small business owners.
I'm not exactly sure how you qualify for that, but, um.
They've been doing it for a long time.
Maybe go down and show the viewers, people watching on YouTube that there's a chart in here.
They, uh, small business owners are more optimistic than they ever have been before, which is really surprising to me.
I, I would not, that's not how I feel now.
It's a little bit of exaggeration.
I mean, it is an all time high, but, but it's pr as you can see from the chart, it doesn't vary that much.
I mean, the way they score the index Yeah.
Seems to be pretty, you know, bounded between 75 and and 60 and we're at 72, um, this quarter as an all time ho.
So, I mean, it was noteworthy to me'cause it's so, so different from how I am feeling or what I'm hearing from small business owners now.
I don't talk to that many, but certainly our portfolio.
Um, so I don't know.
It's just interesting.
I think it's valuable to, to pay attention to these outliers, you know?
Maybe they see something we don't see, or maybe they're late to the party.
I don't know.
Yeah.
I, I am, I wanna be careful because I, I, I certainly don't want to come off like I'm having a particular, um, partisan bent to my thoughts on this, but I, I feel like my, um, my sense of confidence in, in these kinds of data points, uh, is, is, is really much lower than I think it's ever been in the time we've been doing this podcast.
Yeah.
You know, um.
Whether it's the revisions or the political, you know, bureau hiring or hiring just clearly was not right.
Yeah.
It was not good.
Yeah.
Yeah.
And, and, and I recognize this is not a.gov thing, you know, it's, it's MetLife, it's got a corporate sponsor attached to it.
Um, but even when I'm looking at the, you know, the, the highlights and the talking points, they, they feel kind of partisan, honestly.
You know, um, you know, heavy focus on, on, uh, the negative stuff is like regulation.
Mm-hmm.
Um, you know, maybe they didn't have enough time to, to respond to some of the most, you know, recent.
Things that have, that have come out, but, uh, and I'm talking about like the H one B Visa and things like that, but Right.
Um, you know, I, I, I could see you saying, hey, you know, sort of everything being even, but I, to me, I'm just like, with labor costs and, and artificial intelligence and, you know, like, I'm like, okay, if you're in small business and you're in hospitality, like how has ICE not impacted you?
You know?
So I'm just, I don't know.
Healthcare costs are going up, like how Yeah.
How for, for employers?
I'm, I, I just, I'm struggling with the whole all time highness of it.
Yeah.
It's like, it doesn't seem like small business index would correlate with the, with the stock market.
Right.
In terms of like, all time highs.
So, I don't know.
I just find it, yeah.
I don't know.
I mean, um, small business owners may be on the upper part of the K and have a lot of investments.
Um, I, I just, I, I don't know.
I, I an outlier.
So, no, but that could be a way to look at it.
That, that that could definitely be a way to look at it.
Um, alright, let's, let's, let's keep it moving, uh, quickly.
Let's just, Powell, you know, came out with some comments, basically, uh, continuing to play the middle and not commit to doing significant rate cuts in the future.
Yeah, yeah, that's right.
I mean, we have, you know, a long lot of news between now and the next meeting.
I think that it's gonna be interesting.
My guess is inflation is gonna keep slowly creeping up, and yet we're gonna need to have support on jobs.
And so he's gonna have to balance that process and we'll see.
I mean, hopefully he will cut a little bit more, but I have no idea what he's gonna do.
He certainly position it where he, he's giving himself space to cut again by saying it's modestly restrictive.
Yep.
Agree.
All right, let's move on to VC deals.
So the first one, Safara Health secures 39 million for AI powered virtual neurology and workflow augmentation.
This round is led by Vals and Intermountain Ventures.
So strong, uh, strong partners alongside on this one and neurological care with AI and virtual solutions.
So this seems to be in our AI vc, uh, review.
Uh, I think one of the first AI deals really focusing on neurology.
Is that, is that right?
Yeah.
I haven't seen, it's the first one I've, I've can remember seeing.
Yeah.
Yeah, yeah, yeah.
Yeah.
So that, that's, that's interesting to me.
Um, what, what else, what else, uh, stuck out to you about this deal?
Yeah, I, I just thought it was a pretty good size deal.
I like the vettra, uh, crowd and Intermountain both so strong.
Mm-hmm.
Backing, and I think we're going to see a lot more virtual, uh, especially in specialty areas like this.
I just think it's gonna, we're gonna need to have.
Um, a consolidation and where you see specialists.
So, uh, virtual, I was more focused on the virtual than the ai.
Really.
Yeah.
Okay.
Um, okay.
Care Agility raised this 25 million in funding.
Um, so they're based in New Jersey.
Um, the Round was led by Star Mountain Capital, um, and they are focused on connecting care for patients and clinicians.
Yeah, so this is another Telehealth virtual.
They use a bunch of AI raises.
It's, you know, maybe crowded, but similar Time Care Lands, $97 million Series D backed by CVS Health, Humana, Morgan Health and Memorial Herman.
So, uh, this is a company with some strong Nashville ties.
Uh, uh, I've, I've met Robin Shaw, really, really bright guy.
Um, fresh Chrissy.
Uh, first Cressy was, was in on this deal pretty early.
Uh, but they've got kind of a who's who of, of, uh, VCs around the table here.
So we already said CVS Health ventures, but Foresite Capital a 16, the Concord Health Town Hall Ventures, Ali Corp. First Cressy, I mean, that's really strong.
And then they've also got Morgan Health, JP Morgan Chase's unit, uh, Humana, Texas Oncology.
So it's kind of like who's not in this deal, right?
Yeah.
Yeah.
And, and it's, um.
I mean, there's a theme of all, all these deals that this is also kind of a specialized virtual care, almost a, um, a way to find the right oncology specialist.
It's, they, they do other things besides cancer, I think is a heavy cancer, uh, theme to it too.
Yeah, yeah, for sure.
For sure.
Um, and you know, I think that it, it is interesting.
There have not been that many, uh, well-formed, well-funded, uh, new platforms on cancer.
Like, when people talk about time care, you know, they sort of harken back to Flatiron Health and, you know, lo and behold, Bobby Green and Robin Shaw both were at Flat Flatiron Health.
Right.
I mean, it's, it's, uh, it's one of these spaces that.
It doesn't seem like everyone gets a, gets a key to try to take it on, but like if you've got the right team in it, you can attract a ton of capital from kind of all parties.
Right.
Whether it's health systems, uh, insurers, uh, biggest VCs in the business, um, you can get a lot of capital if you can put the right team together.
Yeah, well, I mean it's, it's cancer and heart disease is sort of the two biggest markets with the most, um, existing treatments and also a bunch of change where for, for venture we need new, new treatments, new approaches, new things.
And so I, I think there's just cancer oncology, you know, unfortunately is a, is a really big growth market.
Yep.
Um, okay.
Uh, PBM capital RX Rebrands as Judy Health and Banks a $400 million funding round.
Yeah.
So this is another transparent, uh, PBM.
Which is, I think, uh, really the next phase of PBMs that the, the, the, uh, opaque complex PBMs, I think are sort of on the way out in general, though, they have a big market share now.
Um, and so this was a, you know, obviously a very large deal, 400 million.
And the rebranding is, is good, and I don't know if Judy is great or okay, but it's much better than whatever the capital RX cap.
Yeah, right.
Yeah, yeah, yeah.
I think it is better than Capital rx.
Uh, around the table on this one, the Round was led by Wellington Management and General Catalyst.
Um, Goldman Sachs was also at the table.
The company's valuation was $3.25 billion prior to this round, twice as much as last year.
So to me, this is, this could not possibly be all based on the progress of the company.
A lot of this has to be based on, uh, sort of the, the tailwinds around transparent PBMs.
And, and when Wellington comes in, Wellington and Fidelity, I I, when they start coming in, that's pre IPO times.
Yeah.
Yes.
They typically wanna get in like the last round before an IPO seven Starling races, $8 million to expand access to maternal mental health support.
So, uh, this round was led by Rethink Impact, uh, also included participation from peer vc, uh, our friends at Zeal Capital Partners, magnify Ventures, Ulu Ventures, uh, lot, lots of folks that we, we know, right?
Um, yeah.
Know well, uh, in, on this one, and this is, uh, yet another, we just had one last week, but yet another, um, women's behavioral health company focused on, uh, you know, perinatal mental healthcare.
Yeah.
And so, I mean, we talked about this last week.
It, it's a big space.
There's a lot of need and there's a lot of players.
And, you know, I think last week, uh, RO ro I wanna say Roku, that's not Ro Do or something raised.
Eight and a half million, seven Sterlings raising 8 million.
It's a lot of.
Sort of medium capitalized competitors in the space?
Yeah.
Yeah.
I mean, I, I think, I think it's a space that's emerging and so there's not, uh, you know, there's a belief that there's a market out there, but there's education, there's distribution.
Yeah.
There's, you know, working with payers, there's still a lot to be proven when you're sort of pioneering something that's, it's, it's patently obvious that it's needed, but it doesn't mean that the rails are all there.
And so I think that's why there hasn't been, you know, quite as much capital pouring into the space.
Yeah.
Not because it doesn't deserve as much capital, but there's a lot of groundwork these founders are gonna have to do to sort of prove that the market can, uh, you know, actually take care of, of, of these mother.
Expecting mothers definitely, uh, okay.
Until Labs raises 50, $58 million to Pioneer Organ cryo-preservation and medical hibernation.
So, uh, this is a Series A, the Round was led by Founders Fund, led with participation with Lux Capital and Field Venture.
So again, really strong VCs.
Yeah.
Um, founders Fund, uh, you know, getting into a sort of healthcare supply chain business.
Yeah.
Seems interesting to me.
Um, so, you know, it makes me think maybe somebody had some lived experience, uh, you know, one of the, the partners there, uh, that, that made them really interested in this space.
It's more of a tech play than healthcare really.
I mean, they have, yeah.
And I have no idea if it works, but new cryo-preservation techniques to be able to, um, preserve entire organs for much longer periods of time.
So right now we, we lose a lot of opportunity where you could do a. Transplant, heart transplant, lung transplant.
Um, but you have to, I think you have to do it between four or five, maybe up to 12 hours.
You have to do it pretty quickly.
So teams, I know there's a couple people from here in Nashville, they'll, they'll fly to wherever their car accident was, to get the organ and then bring it back to do the transplant.
But you gotta be rushing around to make it there.
And if we could preserve it, it would open up a lot more supply.
I think that's the, that's why I think Lux is in, when I saw Lux, I thought maybe it's a tech, tech innovation.
Yeah.
Well it's, it's a deep tech innovation.
Um, you know, they're, they're into heavy science.
Um, and, uh, and yeah.
Yeah.
Look, I, I, I agree.
I mean, I, I, I still think.
It makes me wanna look more closely at Founders Fund, uh, founders fund their portfolio.
Um, 'cause maybe I'm not giving them enough credit for work they've done in and around healthcare before.
And again, this is supply chain.
It's not like direct healthcare, right?
Um, but it's, uh, it's, it's, it's just an interesting fund name to see attached.
We, we rarely see them when we're doing our VC reviews, right?
So that, it just makes me interested, amplify MD snacks 20 million to help hospitals scale virtual specialty care.
So I thought this one was interesting.
Um, it's a series B, um, and they say they've got an AI driven virtual specialty care platform and physician network.
When I was reading through, uh, the article, um, and by the way, the round was led by four Runner Ventures.
Um, Memorial Herman is in the deal.
F Prime is in the deal.
Greylock is in the deal.
So again, really strong partners.
Um, when I was reading it, it felt like this was largely a, um, physician gap issue, right?
So there, there's gonna be shortages.
Um, more and more shortages are going to emerge for all the reasons we've been talking about forever on the show.
And, um, they've got this, uh, proprietary network that if you're part of the network you can participate in.
I, I guess both putting your physicians on it, but also finding physicians to fill gaps.
Um, probably as close to real time as, as you might need.
So that seems really important.
I'm just curious about the, the AI driven virtual specialty care piece.
I don't, I don't know that I fully get that.
Like, is it actually helping to deliver care in some way or is it that the AI technology is, is helping to do better matching and finding physicians and getting them, you know, um, engaged in, in episodes of care at the right time.
I don't know for sure.
My reading was that it's, it's much more using our physicians, uh, most effectively.
So like maybe Memorial Hermann has a bunch of cancer physicians that have a little bit of capacity free, they, they could, uh, work with rural Texan health systems that need that specialty.
I think the AI was added at the end.
Um.
'cause it, it helps market if you have AI something, I don't know how, I don't think they're really using like AI agents or anything like that in here.
I didn't get Yeah, it didn't, it didn't feel like that was the core value proposition.
But, you know, just, I I'm always interested in making sure I understand, you know, what new AI is emerging.
I mean, at some level AI is gonna be everything, but Yeah.
Yeah.
Yes.
Exactly.
Exactly.
Which is why it gets kind of annoying when you read it in a vc, you know, announcement.
You're like, eh, yeah.
How, how AI is it?
Uh, okay.
Moving on to policy, Trump issues warning based on unproven link between Tylenol and autism.
We didn't talk about at the beginning of the show, but, but big, uh, un week.
Um, yeah.
You know, we'll have to, we'll have to talk to Natalie and see how, how, how she enjoyed it.
She was bouncing around New York this week.
Yeah, yeah.
Um, but yeah, I mean, look, this Tylenol thing obviously blew up.
Um, and, and, and look, I mean, we we're, we're seeing, uh, we're, we're, we're seeing a, a group.
That has long held, that there are a variety of different, um, medications, um, and vaccines that are, uh, not being properly, um, regulated for, uh, their potential or some, some other stronger evidence that I've not seen, um, role in, in, uh, producing autism.
And it is, I think it's just the, there's no question that the growing rate of, uh, autism, um, in children in America is, is very, very serious and something that we need to be taking a real hard look at and, and making sure we understand.
Um, however, I do think that it's just getting to the point where we're, we're struggling to know who the authority is anymore, right.
Um, I think we're struggling to know who the authority is, and I don't know how a lack of.
Unity around who is an authority, gives us the best chance as a nation to advance our collective healthcare system.
Yeah.
We don't have a collective healthcare system anymore.
I don't think like the No.
The thing that was surprising about this is not that Robert Kennedy is digging up every possible autism study and, and looking into it, there, there were two studies on Tylenol autism.
I can't tell you if they were average or good or not good.
Um, but the former, um, head of HHS s had not chosen to act on them, and Robert Kennedy does.
So that, that's not surprising to me.
I think that's why he's been trying to work on this for a long time.
What was surprising is that Trump, you know, so they did this announcement at the White House and Trump.
Sort of went further and instead of allowing his, his cabinet member that he selected to do what, what he would do, presumably with some focus on finding the truth.
Instead of that, he went and made a bunch of other further claims kind of getting out in front of his own cabinet members.
To me, it's just sad.
I mean, we have lost kind of credibility to the point where not, I mean, nothing is taken at face value because a lot of things are not, are not what they appear, and that that's just bad overall.
I mean, whether Tylenol should be taken for if you're pregnant or not, to me isn't really the point.
The point is that we can't.
Can't rely, there's nothing to rely on anymore, which is, which has negative consequences all over the place.
Yeah.
I, I, I agree.
Uh, it's, it's, uh, I agree with you.
I find it to be highly destabilizing.
Yeah.
Nothing else to say.
Trump's $100,000 H one B Visa fee sets off scramble across corporate America.
You know, I tried to, to stay on top of this because, I mean, obviously on, on face value, the hike in, in, in the fee is like, you know, I mean, it's, it's actually a bigger hike than any of the tariffs, you know, now it's isolated to an individual.
But just if you, if you take what the previous fee was and, and then look at where we're moving to, you know, it's a, it's a radically huge jump.
And, uh, then there was, okay, well what, what does this actually mean?
Like.
D are, is that true for all the existing ones?
Is it only new ones?
Are there particular countries?
From what, you know what I mean?
So, you know, again, totally intense rate of change and I don't think we know, I'm not sure we know that those answers.
Yeah.
Totally intense, uh, rate of change and, uh, you know, this much instability does not make a great foundation for, um, a burgeoning economy.
Meaning, like, why would you choose to do business in an environment that I just, just look at this year?
Right.
You know, between the tariff stuff and now this visa stuff and, and there's been other things.
I mean, it's just, it's just hard.
The whole point of the H one B process is to pull in people that have skills and abilities that Americans don't have or there aren't enough Americans that have it.
'cause we need those skills and abilities and.
Putting up barriers to that to make a little money does not make sense to me.
I mean, I don't, I don't, I don't see how that makes sense in any, in any world.
I mean, we, I, I have the number.
I guess my point was just like the jump in the number is designed in a way that, you know, people are not just going to swallow that.
Right.
You, you know it, so, so when you do it, it's even more than make a little money.
It's the, it's deterring applicants is what it's doing.
It's, it's a deterrent.
It's a deterrent.
And I mean, I, I used to have an investment in a nurse staffing business and we don't have enough nurses.
And we used H one, we used several different plans.
H one B was one of 'em.
And we weren't taking jobs from US nurses there, there aren't enough US nurses.
We, we were bringing in new talent to fill.
Chronically open positions that cannot be filled.
And so I, I do not think it makes sense.
I, I'd rather see the, I mean, I don't care what the application fee is, the number of H one B visas should be increased dramatically.
Um, but we're headed in the wrong direction apparently.
So.
Okay.
Um, so I found this story to be very interesting.
Uh, this is, um, yeah.
So I pulled this story not knowing your, um, understanding that you're following this particular doctor.
Uh, but this is, yeah, I pulled it because there's a, there's a continuing trend of other groups kind of feeling like we have been talking about on this show that there's a lack of scientific rigor or credible sources.
Giving the public guidance and trying to step up to that.
So last week, I think there were a couple different state groups that got together, um, blue States in California and the West Coast and also New England.
And then this was a story of, you know, kind of a doctor creating a new platform to try to give people advice.
Uh, but you, but you know him from a long time ago.
Yeah.
So Dr. Michael, um, uh, also home.
I did not know him until, uh, COVID.
And we, you know, we were all in our homes and I was listening to Joe Rogan podcast.
I think at that time I was watching,'cause I don't think he had quite moved full-time to Spotify yet.
So I think I was like watching it on YouTube.
Yeah.
Um, and uh, he had this guy on, and this was the first person I heard say that COVID was airborne and then it was not on little drops.
On, um, railings, right?
Mm-hmm.
Yeah.
Um, that it was airborne and, uh, that, because you remember, like, we didn't know that in the beginning.
Yeah.
Right.
At first it was surface.
Yeah.
Surfaces.
It was surface.
Right.
It was all on surfaces.
Right.
And so, um, I remember hearing this from him and being like, I believe that guy.
And, and I think like this was, I, I, I feel like this guy was actually part of the beginning of Joe Rogan kind of becoming very distrustful of, um, the information that was coming out of the US government's, uh, you know, health agencies.
Yeah.
Because they weren't, right, right.
Yeah.
Well, of course.
Once, once this guy became proven, correct.
Yeah.
Um, yeah, I think Rogan just kind of really went down a, a, a rabbit hole after that.
Right.
And, um.
You know, because this was obviously way before vaccines, right?
Mm-hmm.
Yeah.
This was way before vaccines.
This was, this, was this even predated masks because we weren't yet even allowing people to have masks at this point.
This was early.
Well, you don't need a mask mask if it's not airborne.
You don't need a mask.
It's not, it wasn't airborne.
Right, right, right.
So anyway, long story short, I just found it interesting that he's the guy heading up this independent vaccine research and recommendation entity sort of saying, we need this information because probably unfairly, I anchored him in my own personal narrative, right.
As maybe someone who was fully, you know, because of where I first saw him, you know, that hey, this is a guy who, you know is, is totally against that particular party.
Right?
Um, but no, he's just an epidemiologist and Yeah, and, and he's, and he and his, his vision is to get the information out.
I would, I would just urge people to pay attention to this agency.
He's starting.
I think we're, it's gonna be really important to have independent agencies now.
Um, it just, it just is.
Yeah.
It just is.
And, uh, and, and this with the science, this, hopefully the science takes them wherever the science takes them.
And there'll be mistakes that scientists makes.
There'll be learnings that they find, but we need to trust that the people that we are listening to are, are really just pursuing the science as best they can and not thinking about all these other politically minded or cultural fights.
So I look, I, I, I plan on trying to see if they have a newsletter or something like that and signing up.
'cause Yeah.
Uh, actually I have deep respect for the guy.
I just, you know, I, I just hadn't really heard from him since COVID.
Um, you know, he, he, he's popped on a couple of shows here and there, but, you know, for me, he was the guy who informed me that, you know, COVID was airborne.
So, yeah.
Um, so, so I, I definitely think it's, it's, uh, it's interesting.
Uh, okay, moving on.
Regional, nonprofit health insurers are falling behind competitors.
This is moving into industry, talking about the payers, and this report basically says that, uh, there's a big difference between the nationals, um, and the regionals and the not-for-profits and the regionals and the notfor, not-for-profits, many of whom are blues, um, are really, really, uh, you know, struggling and losing operating margins, um, at a pretty fast rate.
Yeah.
And it's.
It's worrisome.
I mean, we're gonna have regional health systems and regional payers all underwater and in negative margin territory.
There's a lot of people that have coverage.
Through there, get their treatment at health systems, get insured, and then a lot of people that work in all these facilities and, and institutions.
So the whole thing is, is scary worrisome, uh, United Healthcare unveils direct to consumer tool for to shop for health and wellness programs.
So this is, uh, UHC leveraging their brand and their strong distribution specifically for employers.
Um, and they've built a health and wellness, uh, store basically.
Um, and, you know, uh, UHC has a, has a strong, uh, ambition to continue to take their brand into a more kind of consumer, um, direct to consumer, uh, place.
And so this, this to me feels in line with, with their strategic ambitions as far as I understand them.
Yeah, I mean, I, I think it is, uh, I mean, Lilly really led with this.
I think it's great that United is, is bringing out an offering.
It's a little confusing where UHC.
Um, consumer ends and where Optum begins.
But o over time, I think I'll probably figure that out as they, as they roll it out, but good to see.
Yep.
So this is an interesting one.
Humana is ending commissions for some Medicare Advantage plans, and I think if Humana was almost any other payer, um, where Medicare Advantage was a part of their business, you know, we might read into that.
Oh, that means they are planning on downsizing their MA business.
Right?
Because, um, third party marketers, uh, have for a long time been a really big part of growing Medicare advantage roles for insurers.
Uh, but now given the pressures, given the focus on fraud, waste and abuse, given the margin compression, um, and given the fact that Medicare Advantage is Humana's business, it's not just a portion of the business, it is the business, the ending of commission signals something much different.
Right.
It signals a strategic shift and maybe a serious end, uh, for third party marketers in, in terms of them having a viable business to drive, uh, more enrollment.
Yeah, that's right.
And I don't know if I fully understand it, and Humana didn't really comment on the story.
So Modern Healthcare broke the story.
I think they, through investigative journalism or whatever, founded out, um, there's something between the PPO plans and the HMO plans.
So 80% of the plans that they're not paying commissions on are PPO, uh, what you need to pair a a, a part D drug plan with it.
I can't totally recall.
Emily was talking about a trend around that, that I can't fully recall.
But there's something here to, to dig into more around the, the types of plans as well as how they go to market.
But, um, I don't, I'm not knowledgeable enough to know the details, but yeah, Humana is not gonna, I mean, Medicare Advantage is a huge part of their business, so they're gonna keep doing that, but not in the same way.
Not with these agents.
The agents also caused a lot of trouble trying to sign up more health.
I think they got paid more to sign up healthier younger participants.
Mm-hmm.
And so it may be that Humana is, is building their own sales network so they can control those.
Those shenanigans and not have that, have the exposure.
I don't know.
Since you brought up shenanigans, it could also be that Humana see the writing on the wall and that there could be regulatory actions coming out.
Around these third party marketers.
Yeah.
So they get in front of that and human And they may be getting in, out in front of it.
Yeah.
Be, yeah.
They may be getting in front of it.
Uh, okay.
Moving to health systems, Ascension, return to profitability in 2025.
Huge turnaround story.
Congratulations to everyone at Ascension.
We know it was a lot of work for them.
Um, a lot of movement in their network, selling things off, engaging in joint ventures, um, you know, overcoming a serious cyber attack.
Uh, but they've returned to profitability.
So, you know, they were one of the, when we first started the podcast, and we were talking about them in common Spirit in particular with really, really serious, um, operating income, you know, uh, holes that it needed to dig out of.
This is a, this is a big plus, right?
I mean, yeah.
Especially knowing the headwinds that, um, all health systems are going to face over the course of the next five years.
At least they enter into this next window, um, in a, in a pretty strong position.
So that's good.
Yeah.
Yeah.
That's right.
We, we need.
We need the big platforms like Ascension to be as strong as possible, um, because the, the smaller groups are gonna face headwinds, but, um, it's great to see Ascension, turn it around, it's well run.
Uh, but to see them actually hit the numbers is great.
Yeah.
And, and look, they had a billion dollar loss last year, so Right, right.
Um, it's like almost a $2 billion swing.
Yeah.
Yeah.
And, and, and when we first started covering it, they worked $2 billion down.
Right.
Right.
So, uh, so yeah, no, it's, it's, it's, it's great news.
Uh, Privia acquires evolent's value-based primary care unit, $400 million.
So Privia definitely one of the best operated, uh, you know, value-based primary care businesses out there.
Um, you know, we know several people in leadership over there, strong, strong leadership team, um, and, uh, that I think, I think this is great, uh, that they're continuing to grow in a really smart way.
And, you know, a hundred million is like not a crazy number.
Like it's a, it's a good size number, but it's not a crazy number.
And that, to me just, just, um, smells more like, uh, pri being very, very sharp and they're deal making here.
Yeah, that's right.
I mean, I, I think they're, they're a great operator.
We'll see.
Value-based care is challenging with all the different incentives needed, but Privia is running, running it really well, so we'll see.
Yeah, so just, uh, by the numbers, this deal adds, uh, a hundred more than 120,000 lives, um, in the Medicare Shared Service Savings program, um, uh, various commercial programs and Medicare Advantage.
So, uh, it's a significant growth in, in, uh, lives for them.
And, uh, you know, just congratulations to Yeah, Privia, you know, great, great leadership team over there.
Uh, more than 46,000 Kaiser Permanente workers have authorized strikes as contract expirations loom.
Again, this is another one of those stories that just seems to kind of be pretty cyclical pop up.
Mm-hmm.
You know, pretty regularly.
Every, every fall I feel like it comes around.
Yeah, yeah.
And, and we see Kaiser at the, you know, sort of, uh, as, as a, as a big part of these, but they end up getting resolved.
Right.
And, and, and we, maybe it was just a few weeks ago, we covered Kaiser having incredible.
Um, you know, uh, operating income, uh, relative to almost all the other health systems out there.
And so I'm certain that, uh, that news being public, uh, you know, didn't help their, their argument as, uh, you know, their negotiations fell apart and, and led to, you know, um, you know, the, this, this impending strike.
Yeah.
I hope they resolve it.
I mean, I, I don't, I don't, I don't know.
I hope they resolve it.
I, I don't, it's hard to say.
I mean, I think the, the unions have learned, um, how to negotiate much stronger than previously, so we'll see.
Um, yeah.
Yeah.
I, I mean, I guess my, my view is, uh, Kaiser will end up paying something, right?
Right.
And Kaiser will still operate well, and Kaiser will still deliver an operating margin, but like, you know what I mean?
Like, yeah, that's, I mean, if you're not in California, I mean, being in California and.
It just, it's a highly unionized medical workforce, so you're gonna have to navigate that.
Epic preview is new interoperability features for patients, providers, and developers.
Um, I don't know if I could be less excited by an announcement than this one.
Um, I just feel like every time I see an epic, epic headline, I'm happy.
Just, I'm happy.
It's, it's good that they're opening up the data and you know, they should, if they're should actually doing that.
Should've done it 10 years ago, but, but yeah.
But yeah, hopefully it will be true.
Yeah, yeah, yeah.
If they're actually doing it, uh, nothing else be said there.
Alright.
Moving into pharma, Pfizer to buy weight loss.
Drug developer met Sarah for up to $7.3 billion, so this is a pretty big deal.
And also it's Pfizer.
Stepping up their position in weight loss because they, they had to scrap an experimental weight loss pill, so clearly, you know, their own pipeline wasn't working.
So they've, they've bought, you know, probably one of the biggest independent ones.
Uh, and their pipeline is really set to hit in 2028.
Um, you know, it won't help Pfizer's operating, you know, revenue issues for the next three years, but at least from the long game perspective, it gets them in the game that is currently winning.
Uh, and it, it diversifies them away from the game that has been losing.
Yeah, yeah, that's right.
It is a, it is a big move, I think a pretty, pretty healthy price.
And at the same time, Pfizer needed something they, they need, they need to get in this game, so, yes.
Yeah.
Yeah.
And, and I think it at least puts them more in line with Maha as well, so, you know, hopefully, you know, they, they can stop being the, the poster child for.
Yeah.
Um, bad behavior in pharma and constantly being beat up.
Uh, okay.
Uh, Roche to by maker of fatty liver treatment 89 Bio for up to 3.5 billion.
Uh, so this is, you know, another player in the, uh, liver disease, obesity, kidney, you know, space.
Um, I would say three, 3.5.
That's a, that's a pretty big, you know, pretty big purchase as well.
Um, and again, we're, we're just seeing all the pharma players realizing, uh, that the Novos and, and the lilies of the world were ahead and now they have to really catch up with their pipelines.
Yeah, I think, I think Roach has a decent portfolio of, of assets, but, but you're right.
It's definitely strengthening them.
So, uh, and then also Roche is, uh, launching late stage trial of an experimental obesity drug in 2026.
The phase one results showed the participants lost an average of 18.8% of their body weight over 24 weeks.
Yeah.
So it's a little bit, I mean, it's an early phase one, so.
We need to see more, but a little bit higher in results than either Lilly or Novo pills, but they're all in the teens.
But, uh, but yeah, it was a good result.
Yep.
Uh, okay.
And then Novo says that Wegovy weight loss pill matches the shot as it eyes landmark approval.
And so, uh, this is, you know, Novo taking the Wegovy brand, um, taking it from a shot to a pill and looking to get approval and, and sort of get back on the right foot with, uh, you know, advancing their, their Glip one into a pill form.
Yeah, the pill, I mean, as we've talked about in the show before, the pill is gonna be, I think, much more, just a much bigger market that will take a pill.
Um, and it has a, it's a longer shelf life and harder to copy.
So it is a lot of benefits of the pill.
And so everyone's moving in that direction and it's gonna be interesting to watch.
There's lots of, lots of competition.
Yeah.
Um, and, and we'll, we'll put one more story in, in the show notes for those who, who happen to be interested.
You know, we've, we've been covering for months now, sort of Novo's missteps and decline change in leadership.
Uh, it does appear that they may have hit the bottom of that, uh, of that down slide and could be on their way back up.
So, um, I, I don't know if this is much for us to discuss here, but, uh, an interesting story for those who may be interested in, in seeing how Novo might be turning it around.
Uh, this, I think this Wall Street Journal story does a good job.
Yeah.
Yeah, I agree.
Uh, okay.
And then Eli Lilly to boost, uh, to build a $6.5 billion Texas facility to boost US ingredient manufacturing.
Feels like every two to three weeks there's an announcement about Lilly investing in, uh, yeah.
Manufacturing in the United States.
It's a Midwestern brand at, you know, Lin from Indianapolis.
Um, it, it is, you know, sort of the pride of, of Indianapolis.
Um, and I think they are a great corporate citizen in the cities, uh, that they're in.
And the idea that they're continuing to expand a little brand across America, um, is.
You know, it, it feels both in line with their, with their brand, but also just really, really smart based on, you know, where the political winds are are blowing.
So, um, I don't know.
It, I, I'm struggling to see where we've seen Lily make like a bad step against all the other pharma companies out there.
Right.
You know, it's like, I feel like Lily and j and j really have kind of gone, come through most of this pretty unscathed.
Um, yeah.
Continuing to perform well, continuing to have a unique position in the market, uh, and then, you know, making investments that are continuing to align them well with, uh, with the current political leadership.
Yeah.
Yeah, no question.
The only thing I have to add is, um, this week it seems like a lot going to Texas.
Texas is getting a lot of, uh, new investment.
We see that ai Yeah.
We talk about stuff on the AI side, right?
Yeah.
Yeah.
No, no point.
All gonna Texas.
Good point there.
Good point there.
Uh, okay.
Quickly we've got, I think, just one story, uh, from Web3, uh, but it's a pretty, pretty big one.
Uh, Vivek Swami's Strive is going to buy similar scientific in an all stock deal boosting the combined Bitcoin treasury above 10,900 BTC.
So Strive is, you know, I would say probably the, the latest, you know, um, big Bitcoin holding company to come out on the market.
You could probably tie them and, and David Riley's, um, Nakamoto, um, as sort of the two latest big ones to emerge with, with, you know.
Um, prescient leaders, uh, that, that have big brands, um, and, and can, you know, aggregate more and more political and, uh, financial capital.
Um, but this, this is a, this is a big, big, big deal.
I mean, it's, it's, uh, it's, it's worth over $1.2 billion when it's finalized.
And I think Strive is, is really looking to make a, you know, a, uh.
A, a strong financial platform that, uh, that tradify and maybe more traditional businesses will be able to, um, you know, work with where Bitcoin is the underlying collateral.
But there are many other different types of, uh, financial products that they offer.
Um, you know, if Vive is a respective business person, you know, successful entrepreneur, um, and when I, you know, I look at the team he's building, I've, I've got a friend KU who, uh, you know, very, very connected politically, very smart guy.
He, he's always been, you know, um, big on Bitcoin and he's actually, you know, leaving healthcare to go work over strive.
And so I think strive's gonna be, you know, one of those firms that we need to keep, keep a good eye on.
Yeah.
Yeah.
No question.
And, and.
Similar Scientific was one of the early Bitcoin treasury companies.
Uh, of course, strategy with Mega Sailor is the first one, but they were, they were in the first five, I think, early on.
Yeah.
Um, and I think we're gonna start seeing some consolidation.
I mean, this was a pretty big one for strive to take down, but, um, I think there's gonna be consolidation in the Bitcoin Treasury.
There's just too many, uh, fairly little ones, not so much similar being little, but lots of little ones.
Agree, agree.
Uh, okay.
The VA plans to rule out abridge and no techs, AI tech across its health system.
This is our first story on the AI rundown, and it's a pretty big deal for Abridge and Noex because, uh, this was a bake off, uh, against other companies and they were selected.
So, um, the VA is, is kind of a closed market.
When you win, it can literally keep your business going.
Just ask Cerner and, uh, you know, congrats to both Abridge and Noex.
Really, really strong outcome.
And like you said, at Bakeoff, they, they ran a full competition.
Um, and these were the two winners, so seems like a good process too.
Yep.
Uh, unity AI rolls out scheduling agents for outpatient clinics.
This is covered by Fierce Healthcare and I'm just happy we're covered it.
'cause A, it's Nashville based and b it's our friend Edmond Jackson who we probably should have on the show at some at some point.
Um, but you know, Edmond's been a friend of health further from the days when Health Further was a conference.
I think he was a be in our first or second year or something like that.
Um, and just a great guy and it's been cool to see.
You know, for people who don't know, Edmond was the, um, uh, the chief, uh, data scientist at HCA, their first ever chief data scientist.
And, um, you know, recently launched his, his own AI company called Unity ai.
And, uh, when he started, I think he had a much more broad view of the things that they would take on inside of a, a hospital.
Um, but now, you know, he's, he's really focused on outpatient clinics.
He's really focused on scheduling and, you know, I, I think he's, he's found it's really, really important to not get caught up in just the broad AI hype, but like, find a very specific program that you can lights out solve with ai, uh, because there'll be plenty of money to be made there, or at least you can, you know, build a really strong foundation to your business and then, then start to layer on either, um, complimentary business lines or more features selling into those same businesses to build out a platform.
So, um, I'm, I'm happy to see sort of the, the growth here with him.
Um, and they have not raised a lot of money.
They've only raised $6.5 million so far.
That's right.
I, I think Edmond's a smart guy.
I agree.
He's been navigating this well, that, um, you know, we had two guest shows over the last month, uh, talking about this exact same sort of use case using AI for phones, text messages, reaching out to pa, to patients, uh, so that the humans don't have to do that kind of work.
Um, and this is the first one I've seen in outpatient clinic.
So, you know, now broadening to not an inpatient health system, but more a clinic, uh, physician group, uh, or ambulatory surgery center.
So, uh, pretty interesting.
We, we should have entered on to talk about it.
Uh, okay.
Now going to pure ai Nvidia to invest up to 100 billion in open ai.
Yeah, this was the big investment story this week.
They have, over the last couple years, they've made 106 billion in net income.
And they're investing a hundred billion in OpenAI, and it is gonna be in 10 different $10 billion tranches.
Um, and then I think OpenAI will turn around and use the money to buy Nvidia chips.
And so it's an interesting, uh, very connected investment.
Yeah, I mean, look, Nvidia, OpenAI and Oracle, there's a lot of sort of circular investing money going from one hand to another between these three companies.
Um, and so I, I think I was more impressed with the first announcement, but now that they've sort of come out in succession over the course of the last three, four weeks, um, you know, may, may, maybe, maybe not as much, may, may, maybe not as, but I think it is gonna keep, whether it's a bubble or it's real, doesn't matter.
It's, it's gonna keep.
The energy going in in AI for the next several years.
I think this goes of course.
Go to this story.
Thanks.
Yeah, of course.
Uh, so open AI unveils plans for seemingly limitless expansion of computing power.
Uh, and Texas Prairie and Startup showcases ground zero of ai boom, and its plans to shepherd $1 trillion in infrastructure spending.
Yeah, a tri, it's hard for me to envision a trillion dollars in data center, um, investment in Texas.
Just a lot of huge buildings, a lot of compute power.
Um, but I, it's sort of an all or nothing play.
Like if you, if if open air can get to a GI and then, you know, a GI gets smarter and smarter.
It doesn't matter what you spend, I guess.
Um, but trillion dollars is a lot of money.
Yeah.
I mean, look, what, what, I know you, you know, but you're just not.
Saying, um, is the reason why these numbers are coming out is because they're, they're talking about the replacement of vast numbers of humans from the economy, right?
Yeah, yeah.
And standardizing it through electricity and compute, right?
Right.
And that's going to, that's gonna cause significant social and political upheaval.
And so how that ends, we don't know, which is why I didn't want to get too much into it, but, but yes, I mean, you can.
It's a 20 $20 trillion economy, right?
So if you replace 5% of the people with compute and electricity, you could have a trillion dollars every year out into the future.
The leaders of these big AI systems, not all of 'em, certainly Sam Altman, is talking about replacing more than 5% of the people.
So it, it could turn out that way.
It also could turn out that it's slower and harder.
But either way, there's a lot of money, a lot of energy, a lot of people.
Um, I think it's gonna, it's almost self-fulfilling when you put this much cash behind it.
Yep.
AI agents arrive at Citi.
So, so the financial firms said it would run a 5,000 person pilot to find out how helpful the new agent tech technology is to staff in areas like research and client profiling.
Um, I mean, I think the notable thing here is Citi is a really big bank and, uh, them talking about starting to really roll out AI agents, uh, probably signals many other banks are already doing the same, um, or will be making those announcements very soon as well.
Um, you know, Citi probably struggled a little bit more than, than, uh, you know.
The, the, the bigger banks.
Your, your Goldmans and your, your JP Morgans.
But you know, they're in the middle of a turnaround and I think obviously they're gonna have to look at how they can cut expenses.
And so it makes sense that they would be a little bit on the bleeding edge with this.
But, um, anything else notable that you, you found in the article?
Well, I mean, the, the title says, it says correctly 5,000 people in a pilot.
What I thought was really surprising is the pilot is four to five weeks long weeks.
And so they're gonna, they are gonna run this pilot in the fourth quarter, like right now, Uhhuh, and then presumably learn from it and, and iterate.
And so that, that was pretty surprising to me at the pace.
Like Citi is a pretty big bank, running a pilot in five weeks and then learning from it and growing from there.
Um, things are moving very quickly.
I wanted to note that.
'cause if you don't read the whole article, like I kind of assumed it might be a year long pilot or even, you know.
Right, right.
Other in healthcare, we might even have a two year pilot, but a five week pilot's a different different animal.
No, thank you for pointing that out.
I missed that.
Uh, okay.
That's our last two stories.
Neon.
The number two social app on the Apple App Store.
Pays users to record their phone calls and sells data to AI firms.
We are cooked.
Vic, we're so cooked.
It's the number two app, no social app.
I don't know if that's a subcategory, but the number two app implies a ton of people are downloading it.
Well, hold on, hold on.
Social apps are the top apps.
Okay.
So, so it's the, it's.
It means that huge numbers of people are using this on their phone to send all of their voice conversations to the big AI platforms.
And the story does a good job sort of explaining.
It's a very broad terms of agreement, right?
So basically they can use your data to sell to AI companies in however form they want.
It's only one side.
So you opt in for your voice.
They don't, supposedly, they don't take the other person you're talking to, which is important.
I think it's scary that people are opting in like this.
I mean, I don't know how a couple dollars makes sense to give your voice and all the stuff you're talking about, but apparently people are doing it.
K Shape economy, man.
They don't have a choice K shape economy.
And, and on that note of the K shape economy, PWC rolled out a report on healthcare last week, and they call it from breaking point to breakthrough the $1 trillion opportunity to reinvent healthcare.
Now, Sam Altman would say 1 trillion, who cares for spending that on infrastructure?
But, uh, you know, to those of us in healthcare, trillion dollars is a, is a big deal.
Um, and, and they're talking about trillion annually.
So I, so Sam is talking about trillion annually too.
Yeah.
Yeah.
Um, you know, look, I, I, uh, I like the positive, uh, slant, which is, hey, the healthcare system can't get any worse than it is right now.
Right.
You know what I mean?
And, uh, we're gonna leverage innovation and we're gonna make a much better healthcare system for the future.
And you, you know, I'm all for that.
I'm all for that, but, and I think this is a pretty big, but, um, if you're on the inside of the healthcare industry, when you hear a trillion dollars, right, that is usually associated with the, the future revenue losses that the industry is going to take as a result of HR one, the one big, beautiful bill, right?
So I'm left to think that this is somehow, uh, implying that the trillion dollars that are going to be lost are somehow going to be refound, reinvested, redeveloped on this tech enabled version of, of healthcare in the future.
You know, all the pictures here are, to me, are of people in really nice houses.
You know, you got a picture here of a guy with a drone coming, uh, you know, we have like one of those mirror, um, yeah.
You know, workout systems.
Uh, so, so all the imagery, you know, really hearkens to, uh, you know, a world that there's, there's the woman there, uh, with, with the mirror.
Uh, these are all people who are pretty well todo.
Like if we were to look at the K shape economy, these are people who would be on the, on the top part of the K. At least that's what it looks like to me.
Yeah.
And the bottom part of the KI, I don't, I, you know, I don't necessarily think it's, it's addressed in this report.
Um, now I think we've come to a similar conclusion from an investment thesis perspective.
You and I talked about it this week that Yes, like.
This is the sector's going to need to adapt and it's gonna be, you know, companies of the future and we're going to be leveraging technology and all these, these different types of things.
These are very, very important.
But they end the story talking about the inno or they end this paper or this report talking about the innovation divide, right?
And they admit even the most advanced transformation won't automatically close healthcare gaps.
58% of Americans believe access to quality healthcare depends on income or societal status.
And then they kind of say, as a result, three customer consumer profiles will merch empowered consumers.
We talk about those all the time.
You and I are those mainstream America and then the underserved consumers and, and what they say about the underserved consumers at the end is that digitally disconnected.
They continue to receive episodic crisis driven care resulting in worsening outcomes in higher costs.
And so there's not really, you know, when, when they talk about building an equity from the start, I, I'm just kind of like, but who pay?
Who is gonna pay for this new technology driven world for people on the bottom part of the cap?
Like, who, who's, who's gonna pay for that?
Right?
And they do not answer that question.
And then what I thought you were gonna go, like right below it, like they end the whole thing with, uh, this picture of a amputee who's working on something on the floor, which is kind of a weird image.
But this headline is how the future could play out, lead, follow, or fall, fall behind.
And I think that's fairly, um, insulting and.
Kind of tone deaf to the underserved commun consumers.
Right.
Like they're gonna fall behind.
Yeah.
And it's not because they don't want to have this future for themselves.
They, they just have no, they have no ability to access it.
No.
No.
And so, I mean, I think PWC is doing a great job sort of painting.
Um, how the, how healthcare could evolve for the wealthier maybe half that might be generous, half of the country.
It might be less than half.
Um, but we're gonna have to figure out, I mean, the thing about healthcare that, that I think is important, part of the reason that you and I are in it is we, we have to provide health for all of our citizens in, in some form or fashion.
Now, of course, it's not quite as good.
Um, as if you get concierge care, whatever, but, but there needs to be some basic level of health for all, all Americans, for all citizens.
For all people.
Yeah.
I'd say for all humans and, and yeah.
And we don't have nationalized healthcare, right.
I mean Right.
We, we, we, we have CMS, right.
And we have HHS, but that's not the same thing as nationalized healthcare.
Right, right, right.
And so, and so we don't have that, we don't have that baseline of care for every single citizen.
And we're painting a future of the healthcare industry that is for the wealthy.
Yeah.
And that's fine.
And it might sell a lot of consulting projects to, for pwc, but there needs to be solutions where we spread this abundance, spread the wealth, spread the capabilities to, to everybody, or at least to a broader set of people.
Yeah.
And, and, and I think, I think I would just say in advance, like for any of our listeners who are.
Techno optimists and, and maybe like, you know, oh, you know, the stop thinking in, in, in limited ways.
Think abundantly, blah, blah, blah.
Vic and I, we, we, we take in as much, if not more of this content than you do.
Um, you know, uh, and, and, uh, you know, nobody's got a good answer for how we're gonna take care of the poor people, right?
They, they, they, they've got shallow theories at best, but no working plan.
Like, not even actually close to a good working plan for how we're gonna do it.
Um, meanwhile, they are accelerating AI at unbelievable rates.
That's only going to cause more unemployment, right?
Like, I, like, I, I think we just got, we, we just gotta sort of say this on a regular basis that this, those are the things that are true now.
Then there were also people saying, we don't know what the future holds.
That I can, I can admit to, we, we don't know what the future holds, but we know we're running towards a future that is going to, um, bring near zero cost intelligence to market.
It will radically replace, um, human professions.
We do not have a good answer for what we will do for those humans who are replaced.
Uh, so you could presume if we don't have a good answer, there is at least a reasonable chance that they will go down in their socioeconomic status.
Right.
And their ability to take care of themselves.
And so we, it appears we are increasing the number of people who we need to be thinking about how we're gonna take care of.
And we have no plan on how we're gonna take care of them.
But we're talking about like drones and, you know.
Fun exercise mirrors, which, which by the way, like you and I can afford.
Yeah.
Which is fine.
Like I have no problem with that.
But we need to come up with a plan that's coherent for the rest of the people.
And I wasn't gonna talk about it, but I feel so strongly that mean, I, I wrote a book about this.
'cause I think it, it's a, it's a really important thing to begin thinking about how do we take care of the population?
How do we take care of the humans that are gonna invent the next, the next internet, the next thing.
They're, they're 10 years old today, but we need to take care of them.
And yeah, that is probably even broader than the US but, but at least in the US we need a solution.
And it's a complicated, uh, story that it took me five years to put together a potential, uh.
Concept and there's lots of exciting aspects, but you have to think through the, the rest of the population too.
Or, or you, I think you don't get the exciting stuff because there's a revolution or people start throwing, you know, both of cocktails around 'cause they're just frustrated and have no way out.
Yeah.
L let me, lemme just say this and, and, and I, uh, I I still need to like digest your book.
Um, yeah, yeah.
I don't, I wasn't, we didn't get into the book, but we need a solution.
No, no, no, no, no, no, no, no.
Listen, I, I I, I, I actually think we should do a show with you talking about the book.
Yeah.
I mean, because I, you know, I, I wanna dig into it more with you.
Um, and I, I also wanna say I've never been one of these like super gung-ho America needs, uh, national.
Healthcare systems, single payer, like I've never been that way because I've always sort of looked at, at the trade-offs, right?
Yeah.
With other countries.
Right.
And, and like you don't always get, you know, quick access to care.
Like there's a million problems, right.
With nationalized healthcare.
And I've always thought, hey, we need to sort of look at, there are models in the world that, that work with, you know, have very high outcomes, very low cost.
They have, they don't have, you know, nationalized healthcare.
Right?
Right.
So, and have a system more like what we have, but, but based on where we're headed, based on where we're headed.
I mean, the countries that have nationalized healthcare in place right now are in a far, far better place than, than America is far better place.
You know, because, because we're, we're at a cliff with, with our general population, um, with a, with a weakening healthcare system.
It's weakening, it's gonna get less capital.
We are gonna have less providers in it.
Um, it's freeing.
It's freeing.
Yeah.
And, and I mean, you, you said it Well, I think we study this very, I mean, in depth and the, the universal bank income and people that say the tax base will increase and will then be, have subsidized it, that they're wrong.
I mean, the, those plans I agree with your terminology, do, they're shallow.
Like, not that they can't work, but the current ones that are being thrown around are, are not Right.
They're too shallow and they don't work.
Yeah.
They, they're either not politically viable or they don't really take into account the truth of ho human sociology.
Like they're just, they're just not, they're not real.
They're not real yet.
We don't have anything that's real yet.
Right.
Um, so in the meantime, we, we ha we are headed to a pretty dangerous situation.
Yes.
That's, you know, that, that's the reality.
And, and oh, by the way, like.
You're not gonna have that many investors or innovators going into this space because they're not viable.
That's why PWC is not writing about it.
I mean, there's no, there's no clients.
There's no way to, there's not a market go to consulting business.
Right, exactly.
Right.
Right.
Yeah.
They, they're not viable.
Yeah.
To invest in Yeah, that's right.
Which is, uh, scary or sad, I don't know.
Yeah.
They did a good job.
I've been a little fired up at this point lately.
Yeah.
Yeah.
Well, I mean, I think all we can do is cover where we are in healthcare right now, and then, um, maybe we can invest in some new innovations that are gonna make a difference.
Well, let's, let's, let's make sure in the future we book a show, you know, one of our guest shows.
Yeah.
We should do a show.
Shows You'll be the guest.
Yeah, yeah.
I can be the guest.
Yeah.
And, and we'll focus on, you know, elevate Health, you know.
Yeah.
By the way, when, when is, when is the book dropping?
October 6th.
So we should do it after it comes up.
Oh, it's around the corner.
Yeah.
Yeah, it's, yeah, it's around the corner.
We could do away.
Awesome, awesome, awesome man.
Uh, alright man.
Look, I will see you next week at, uh, sessions.
Okay.
And then we'll be in the studio and, uh, yeah, exactly.
Then we'll be in the studio next Thursday.
Thanks for everything.
Yeah.
Alright.
Alright.
Bye.
Thanks.