106 – Tragic Assassination, Trump Picks & Anthem Anesthesia Coverage

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[00:00:17] Marcus: All right, Vic. It has been some week in the world. 

[00:00:20] Vic: Yeah. . 

[00:00:21] Marcus: Um, we're gonna change things up for this week, hopefully for this week only. Mm-hmm . Hopefully this is one, uh, terrible incident that we won't sort of relive in the, in the future. Mm-hmm . Uh, but the CEO of United Healthcare as just about everybody knows, uh, Brian Thompson was murdered, uh, yesterday morning.

[00:00:46] Marcus: This is, uh, Thursday, December 5th. So that happened Wednesday, December 4th, uh, before 7:00 AM. Outside of his hotel, United Health Group was preparing for its investor day. Um, [00:01:00] and he was targeted and murdered. Um, and I think throughout the day there were questions, uh, around it. Cause it was just so, just a shocking thing.

[00:01:11] Marcus: First of all, uh, the person was masked. Um, they used a silencer and apparently they got away on bike. Yeah, I think one of those 

[00:01:20] Vic: Rento e bikes. Yeah, hard to trace. 

[00:01:23] Marcus: Yeah, so, um, just, uh, obviously just a absolute shocking turn of events, a terrible turn of events. Um, and today, uh, as we are recording, They have a reward, uh, for the, uh, the killer.

[00:01:42] Marcus: Um, they have put up some, some pictures of, of this, uh, this person. And, uh, the industry is in, is in shock overall, you know, you and I, we both know people at United health group. [00:02:00] Can't possibly express how, how sad, uh, and upset I am. I don't want to speak for you, but how sad and upset I am, um, for them. Um, you know, I can't imagine what, what it must, what they must be going through.

[00:02:17] Marcus: Um, and you know, I, I think we have to at least briefly discuss. The response on social media, uh, to, to this, this murder, um, which, you know, for me has just been, uh, really disappointing and yet another sign of the ways that social media incentivizes, uh, sort of the worst, um, behavior from, from us in, in society, uh, You know, I feel like there was a [00:03:00] time where we knew

[00:03:05] Marcus: you can't try to justify murder, right? Um, political violence, for example, you may not like the policies that a politician is putting in place, but political violence, absolutely unacceptable. It's unacceptable, right? You can never normalize or justify political violence. Otherwise, society will become violent.

[00:03:29] Marcus: Right? Yes. You know, you can't say it's okay to do this. Um, nevermind that this person has a family and coworkers and a community that loves them. Right? And when you murder someone, you cannot take that back. Nevermind that. Um, just the understanding of what happens in society when you start doing things like justifying.

[00:03:55] Marcus: Um, it's, it's really sad and [00:04:00] disappointing to, to see that. Uh, I first saw it on Facebook, and I saw it coming from people that I know, um, and I was disgusted by what I, what I saw. Um, so, I don't know, I've been rambling a little bit here, maybe I'll just give you an opportunity to say something. 

[00:04:22] Vic: Um, I didn't know him, but I, I know a lot of, a decent number of people at United and in other payers and providers.

[00:04:35] Vic: He was for decades doing his best to help deliver health care to millions of people and Didn't deserve that no one deserves to be shot down in the street But by all accounts he was he was hard working family man seemed like really good [00:05:00] person And I'm just really sad. I'm sad for him and his family.

[00:05:04] Vic: I'm sad that social media is the way it is And it's sad that we're talking about this now and unfortunately I don't think we're headed in a good direction. It's also scary that in New York City someone can show up with a gun and murder someone else and get away. 

[00:05:31] Marcus: Yeah, I mean, it's, it's not quite broad daylight because it was before 7 a.

[00:05:36] Marcus: m. So maybe like, you know, it was still a little dark out. Uh, but this 

[00:05:41] Vic: wasn't like in an alley or no, this is right in the middle of Manhattan. Yeah, 

[00:05:45] Marcus: right in front of the hotel. Right. And, and we're talking about, you know, United Health Groups is the number one healthcare company in America. So, you know, the hotel that the CEO is staying in, this is a good place.

[00:05:55] Marcus: Right. I mean, yes. So, um. [00:06:00] Gosh, man, I mean, there's, uh, there's nothing good about this story, um, and we, we were discussing a little bit before we hit record that we have no idea how this will impact the future, but it is absolutely the kind of event that will impact the future. Um, I don't want to. Say how?

[00:06:26] Marcus: Right. But, uh, this is not, uh, this, this cannot be something that we, uh, collectively as society and certainly, uh, people in the healthcare industry won't respond to in some way, shape or form. 

[00:06:44] Vic: Yeah, I mean, I think what I believe to be true is violence does nothing except lead to more violence. And so there's no, there's no reason to take the action that was taken yesterday.[00:07:00] 

[00:07:01] Vic: And I don't know what will come after this, but it's, it's not going to be, I don't think it's going to be good. 

[00:07:10] Marcus: No. 

[00:07:12] Vic: And I do think that it is, it seems to me with the election, and the results from the election, and social media broadly, not necessarily around this story, but in, in general, there's a lot of people that are really suffering.

[00:07:31] Vic: We talk about the K shake economy in almost like academic, uh, statistical terms, but there are real people that are suffering and, and they don't have any hope or they don't have any way to get an education, get a job, live the American dream. And that is what makes me kind of scared and sad. It doesn't in any way.

[00:07:59] Vic: [00:08:00] excuse the action that was taken. It's not going to have any outcome that is going to help the killer's family. It's just going to be violence gets more violence and is bad. Yeah.

[00:08:14] Marcus: And as we were, as we were saying before, before we started recording, um, you know, anyone that views themselves to have, you know, empathy, character, integrity is going to be challenged. Now, to have sort of objective critique about UnitedHealthcare, because you don't want to look in any way, shape, or form like you're justifying murder, right?

[00:08:47] Marcus: I mean, like, like, there are levels to this and we have to, we have to deal with, with this level of premeditated murder. 

[00:08:55] Vic: Yeah. 

[00:08:56] Marcus: Is off the table. Worst thing you [00:09:00] can do. I don't want to talk about anything else. I won't talk about anything else. Like that's it. Right. So whatever the objective was,

[00:09:14] Marcus: it was misguided. Um,

[00:09:21] Vic: yeah, it's, I think it, I want to talk about healthcare broadly, not necessarily United. There are insurance companies and health systems and doctors and nurses 

[00:09:34] Marcus: and pharmaceutical 

[00:09:34] Vic: companies. Yeah. Yeah. All of these different, I mean, I think it's probably the biggest employer in the country. Yeah. And I can't think of one, I know a lot of people in the industry, I can't think of one person that didn't get into it really trying to help people and make a positive difference.

[00:09:55] Vic: And the healthcare industry accepts people like in their [00:10:00] most vulnerable, most difficult time in their life. And for the most part, I think in general. does a good job caring for them. Yep. And at the same time, when you take in a patient who is having a lot of health problems, there will be people that die.

[00:10:20] Vic: And that's just, that's just what happens when you accept people in their most difficult, vulnerable state. They're, they're, they need help and our industry, what I like about it is we exist to help people get back to living life with their family and doing what they want to do. There's going to be people that die and have bad outcomes.

[00:10:42] Vic: There's going to be well intentioned healthcare workers at all different levels that make a mistake or. Do the best they can, and then the end result, even though it was a mistake, just didn't turn out, and There's no excuse for [00:11:00] taking it out on the people that are trying to do the best they can. 

[00:11:04] Marcus: Yeah, I think maybe I'll just add on and say, it's such a big industry that there are also bad actors in our industry, right?

[00:11:11] Marcus: I mean, we know that there are some physicians out there that have become pill mills and have kind of become, you know, drug dealers in effect, right? I mean, And still everything you said is true. 

[00:11:24] Vic: Yeah. Right. You know, there's a, there's a accepted process in the legal system to try to work through that.

[00:11:30] Vic: That's right. That's right. Um, 

[00:11:34] Marcus: yeah. Again, I, I feel like you and I are not just responding to this horrible act, but to the sentiment that we've seen on social media that has become normalized and is getting all sorts of engagement and support and things like that. And to me, it's, it's such a, it's such a disappointing view.

[00:11:55] Marcus: But also a sobering view because it is what it is. It's like, I can't make it [00:12:00] not, not happen. It is happening. And, you know, my, my commentary on it is. A it's really disappointing, but B it is also happening. And what, what are we going to learn from that? Right. What, what is it we as an industry are going to learn from the fact that that is the, that is the sentiment, you know, I haven't felt this way in a long time, but the last time I had this kind of, uh, just really bad feeling was during the pandemic, when there was.

[00:12:37] Marcus: All this negative energy, um, towards hospital staff, you know, when they were like risking their lives and their family's lives and, and, you know, they were being attacked and all sorts of crazy things. Um, and it's like, I understand the pressure that, that people were under during that time. Yeah, absolutely.

[00:12:54] Marcus: But taking it out on frontline workers was just so [00:13:00] Inappropriate, right? And inexcusable. Um, and this is, this is kind of the same thing, you know, it's just like

[00:13:12] Marcus: robbing children of their father, robbing a wife of her husband, robbing, you know, other family members of. of their loved one, robbing coworkers, robbing a community of obviously he's the CEO of United Healthcare. He was clearly a pillar in his community. How can you not be? How can you not be with that kind of position?

[00:13:33] Marcus: Right? How can you not be a pillar in your company? Um, You know, I've, I, I've been to UHG headquarters and I will tell you, like, it's a really big company, but these people, they act like a family, just like you and I, you know what I mean? Like, so it's just, and I 

[00:13:55] Vic: mean, I think I, I'll maybe, [00:14:00] I'll complain about, um, how the industry is structured, how it's regulated, how the incentives are designed.

[00:14:09] Vic: Yes. And that's because I think we as a society or as an industry could organize ourselves better. And I'm trying to argue for that case. That's being a citizen. That's being a good citizen. But there's a very big difference between arguing that the, the laws or the incentive structures or the reimbursement models need to be looked at and modified.

[00:14:36] Vic: That's very different than taking out aggression on an individual person or group of people that are doing what they're told to do and following the existing structure. Health means, sure there are some bad actors, but in general, people are trying to do the best they can and take care of themselves.

[00:14:59] Vic: Take [00:15:00] care of the their patients. So I think that's true on the provider the payer It's true on all sides and there's there's a healthy our system is set up between payers and providers with attention on purpose and We might debate how you could do it differently there are countries to do it differently, but we have to find some way to make decisions about how we're gonna allocate health care and Whatever we set up there's gonna be a patient that dies or someone that doesn't get some image that they should want to have, or they think they should have.

[00:15:34] Vic: There's no perfect healthcare system in the world. There's no way to do it where not one person is ever harmed. That's right. And the individuals, like Brian Thompson, I just feel really sad for him and his family that he got, he's being punished for something that's nothing to do with him. 

[00:15:54] Marcus: Well, he's no longer with us, so he's not in pain anymore, but everyone who's left in the wake [00:16:00] of his murder, you know, I want to explicitly use the word murder because he didn't die.

[00:16:06] Marcus: Right. He was killed. Right. Um, it's just tragic and terrible and so sad. Um, all right, let's try to compose ourselves and move on with the show. But we made a decision. We wanted to start with this. There's no way you could kind of roll into this later on in the show. Right. Um, You know, and, uh, and again, uh, deep, deep regrets and sympathies to anyone who is connected to Brian Thompson, um, for your loss.

[00:16:37] Marcus: Yes. All right. To the economy, Jerome Powell says that the economy is doing well enough that he can take his time with cuts. 

[00:16:49] Vic: Which is similar to what he was on stage in New York at the New York Times event. Um, and it, and said very similar to what he said, maybe a [00:17:00] week and a half ago. I think he is signaling that in the December meeting.

[00:17:05] Vic: No cut. Probably. No, cut my get, we're gonna get the inflation number next week. Yeah. I think it's gonna be higher than is expected. And if that happens, I think there won't be a cut. 

[00:17:16] Marcus: Mm-hmm . 

[00:17:16] Vic: But we'll see. Even, we haven't got the number yet, but I think it's likely that we, he will hold. But he left it open.

[00:17:23] Marcus: Let's move to VC markets. Clearly raises 106 million from insight partners for AI heart health, early detection. I am a clearly user. I love this company, so I'm thrilled that they are going to be around for much longer. Uh, I think this is the gold standard in, uh, cardiovascular scanning, um, and imaging.

[00:17:46] Marcus: And. If you've never experienced a clearly scan and sort of your doctor walking you through all of your arteries and actually like tunneling through them with you and showing you in 3D exactly where the plaque is. 

[00:17:59] Vic: Yeah. [00:18:00] Yeah. 

[00:18:00] Marcus: And here's is a stable. Is it not stable? It's Unbelievable. Um, you know, really not that expensive for the, for the clarity you get, um, which should then drive either an intervention or, or, or, or tell you, Hey, you're in great shape, but we're going to keep it this way.

[00:18:16] Marcus: Right. Um, I, this is fantastic. So, so kudos to insight partners for, you know, leading a, a really big, big round for this company. And I really hope this becomes a standard of care. Um, you know, the, the calcium scan is, is good. Yeah. But this is, this, this is what's possible right now. This is what's possible.

[00:18:38] Marcus: Yeah. 

[00:18:39] Vic: Yeah. To me, it's a, it's a question of who should get it. I mean, I, I, I think, Every adult over 30 years old should get a calcium scan. I wouldn't say that about clearly. I think it's much more like you get a calcium score that is not zero. Then you go to clearly, but, 

[00:18:58] Marcus: but yes, I [00:19:00] mean, or, or if you can afford it and you just want it and you want access to it.

[00:19:04] Marcus: Yeah, right. Yeah. What, what, what I've, what I've noticed is when I talked to, I have a concierge doc, when I talked to my friends who don't have concierge docs, they're, they're you know, their docs are not making it available. Right. And so I, I do think that's unfortunate, but like, if you don't have a concierge doc, it's probably not in the standard of care.

[00:19:24] Marcus: And so therefore you may not get access to it. So, um, my, my hope is that this becomes more of a standard of care. Yes. Sage, a senior living operating system raises 35 million in a series B from IVP. 

[00:19:38] Vic: Yeah. So senior living really should be. using some kind of operating system like Sage or something else to really manage all of their residents, know who's doing what, keep everything organized.

[00:19:52] Vic: Um, it's been slow. Um, it's been, I mean, Brookdale here in town that [00:20:00] they do good service to their residents, but it's financed and managed, you know, kind of like a hotel business almost. Like, how, what's your cost? Occupancy. Yeah. And then they don't really focus that much on the, the care like a hospital where it's very different than a hospital setting.

[00:20:18] Vic: Yes, it is very different. So I think it'd be great. It's, I'm happy that they got the raise done. Um, the end market has been challenging for me to invest in, but I hope they do well. Yeah. And they're, they're, they're already have decent, uh, customer lists that they're in. Maybe 50, uh, senior lives. Now it is 

[00:20:37] Marcus: a pretty fragmented market, 

[00:20:38] Vic: right?

[00:20:39] Vic: I mean, 

[00:20:39] Marcus: Bookdale is like the largest and they have 10%. 

[00:20:41] Vic: Yes. I think they 

[00:20:42] Marcus: don't 

[00:20:42] Vic: even 

[00:20:42] Marcus: have to sub 10%. So still very fragmented, still very mom and pop. I think that's part of why it's so difficult. There's not enough sort of like really big companies at scale that can make you an enterprise. So you got to kind of knock on a lot of different doors.

[00:20:57] Vic: Yeah, and I think the truth is, if you give [00:21:00] some great high touch automated service, it doesn't really translate to many more seniors living there. Yep. Because the market's just not set up that way. 

[00:21:11] Marcus: Uh, speaking of concierge medicine, Solus Health raises 33 million in the Series B. It's a NYC based concierge medicine provider.

[00:21:18] Marcus: 33 million Series B led by Foresight Capital. 

[00:21:21] Vic: Yeah, so I was a little surprised about this deal, honestly. It seems like it's five years later than a lot of the concierge, you know, VC growth rounds. Um, but at the same time that there's a lot of people, including me that are not already on concierge medicine.

[00:21:40] Vic: So there's plenty of market opportunity out there. 

[00:21:42] Marcus: I think it's a growing market. I mean, I think, I think if you, if you look at How Peter Atiyah and Andrew Huberman have become, you know, top 10 podcasts in the world, right, over the course of the last few years. Um, clearly more and more people are becoming aware of the concept of [00:22:00] concierge medicine.

[00:22:00] Marcus: And I think as that awareness grows, and people in the upper middle class band are kind of saying, Hey, you know, my health is directly related to my, you know, My economic performance, they can say to themselves, it's an investment that I actually can see an ROI on, you know, a peace of mind be convenience.

[00:22:21] Marcus: You know, I can text this person to them whenever I want to deal with standing in line and all this other kind of stuff, but then also I can go get it clearly, right? I mean, I can do some of these more advanced things that will make me feel like I'm. really taking care of my health so I can focus on making a lot of money.

[00:22:36] Marcus: Um, that at least that's the way I think about it, you know, quite frankly. And, and, uh, from, from that perspective, I think that market's growing. So, and of course they're in New York city. Well, I mean, do I think that the concierge medicine space is saturated in New York city? Probably not. 

[00:22:52] Vic: Yeah, well, and I thought it was interesting that they named the places they're going to grow into Silicon Valley, Miami and Texas.

[00:22:59] Vic: I mean, Dallas and [00:23:00] Houston, Austin 

[00:23:00] Marcus: growing markets, right? With a lot of wealth, a lot of wealth, a lot of wealth. Soda health gets 50 million to manage MA supplemental benefits. Uh, so this is a series B round and, uh, the usual suspects, general catalyst, former humana CEO, Bruce Broussard, Lightspeed, Define, uh, Quimming and, uh, SVB Capital.

[00:23:21] Vic: Yeah. So I think this is. Good to see there, there are benefits available to Medicare, Medicaid recipients that are not, there's not enough uptake that people, the members don't realize that. And so I think this will be good to get more. More adoption, more of the actual benefits out there. We saw Instacart, uh, doing the snap thing last week.

[00:23:43] Vic: So this is in the same vein, I think. 

[00:23:45] Marcus: Yeah. No, this, this is great. Morgan health. Another every week, general catalyst and Morgan health. Yeah. They're busy over there. Oh, they have a big team. I don't know. Uh, so Morgan health commits 25 million to meritive to enhance employer data capabilities. Uh, so this is [00:24:00] actually, you know, you know, 

[00:24:00] Vic: this space.

[00:24:01] Marcus: Well, yep. Yep. We've, we've got a company in this space. I. I told you, I think this is great because I think it's a validation of the opportunity. Um, but yeah, uh, Morgan health is investing in, in, in Merida of 25 million 

[00:24:14] Vic: health cost. IQ is the one that anyone listening should use. That's right. Big employer.

[00:24:19] Marcus: That's right. But this will be a good second. 

[00:24:21] Vic: This will be a good second. That's right. 

[00:24:22] Marcus: That's 

[00:24:22] Vic: right. 

[00:24:22] Marcus: No, look, this, this, this is good. Um, there's plenty of markets for everybody. Yeah, yeah, yeah. For sure. For sure. Uh, one thing that was interesting in this article was, was talking about Truven, um, Which I didn't know that Truven had, I guess, gotten rolled up into.

[00:24:38] Marcus: Yeah. Yeah, I didn't know that either until I read this. I heard about Truven a lot, you know, back when, when our buddy Jason was running Stratosan. Yeah. So, you know, I don't know. I think, I think I'm feeling pretty good about our, our chances to coexist. Let's call it, to coexist in the market. Amazon taps Hinge Health as an MSK care partner, expanding their digital health benefits program.

[00:24:59] Marcus: So [00:25:00] they've added on to, they've, they've have, uh, Omada, Talkspace, Rula Health, and now they're adding Hinge Health. 

[00:25:05] Vic: Yeah, so they're, they're kind of building out a digital health suite of services for, you know, a variety of disease states. I would imagine they'll keep going. I think it's going to be pretty interesting that, that they'll have a kind of a stitched together offering for whatever your needs are.

[00:25:22] Marcus: Yeah. And, I mean, and they really are picking, like, the top consumer brands, if you can call them. I mean, Talkspace is obviously a big consumer brand. Omada Health, not so much, but it is the brand in the, you know, in the chronic care management space. Um, and Hinge Health is, is, I think that's the biggest MSK brand that I can think of.

[00:25:40] Marcus: So, uh, so they're, you know, they're clearly going with, with, with the top dogs in each one of these categories. Uh, okay. Elon Musk's multi billion dollar. Pay package is rejected again by a judge. We were talking before we hit record that Elon has already moved the incorporation of Tesla from Delaware to Texas.

[00:25:59] Marcus: He's been [00:26:00] ranting about Delaware. He's been part of the movement to start a Texas stock exchange. Um, Texas, Texas, Texas. He, he very much dislikes what's going on in Delaware, but you and I read this article and we could not wrap our head around why this pay package hasn't just been approved. The shareholders voted for it.

[00:26:20] Marcus: The shareholders believe that. Elon needs to be incentivized to focus on Tesla. That seems pretty reasonable to me. I mean, if you are looking at all the things he's doing, you know, how else are you going to incentivize him to focus? Yeah. 

[00:26:37] Vic: I mean, well, a shareholder brought a lawsuit in Delaware claiming that it was an, an unfair pay package with the benefit of hindsight.

[00:26:51] Vic: 10 years after, I think 10 years, maybe it was eight years after they created it. And the, the goals that, that Elon [00:27:00] Musk had to hit were, were significant. Yeah. And the company almost went out of business. Yeah. And I think it was, um, maybe a 10 X, uh, increase in, in the enterprise value of the business. That was, that was one of the, of several thresholds he had to hit.

[00:27:17] Vic: And it was not at all clear when they put that in place that there was any chance. I mean, I think most of the board was concerned that. I mean, I just, I wasn't involved in, but just reading through things, Mr. was concerned that it was going to be so hard to hit that it would not be motivating because we're never going to get there.

[00:27:35] Vic: And with hindsight, this shareholder group is upset. They got, they, they got a huge financial return. In the stock never mind that that it was approved by the shareholders at the time And then when this first came out where they were appealing they put it to another shareholder vote this summer I think it was 75 maybe 76 [00:28:00] Approved it with all the facts and they put the entire court docket there I do not understand how the delaware court has any business getting the divorce.

[00:28:12] Vic: It's just The shareholders want to pay him to do A job and he's willing to do it I'm stop listening at that point. 

[00:28:21] Marcus: Look, there's a lot of things about Elon Musk that annoy me. Okay. But he is excellent at execution and stuff like this validates his, his points and his positions, and I just don't understand why, why are people giving him this kind of ammunition?

[00:28:49] Marcus: Like just give him a pay package. This is, this is crazy. 

[00:28:54] Vic: Yes. It's, and I don't think, I mean, he has moved it to Texas, but I don't think [00:29:00] you escape because it happened in when they were in Delaware. It is really unclear where Tesla goes next because he's, he's been the CEO. He's done this work. They're not allowed to pay him.

[00:29:19] Vic: They, in order for them to give him a hundred billion dollars today. Would be really challenging. So, I mean, it was an option package. So like the option has, you know, appreciated and all the other shareholders have benefited alongside the options. That's easy. My view. That's easy. Now finding a hundred billion dollars some other way is not at all easy.

[00:29:47] Marcus: Should have done the math, you know, like who should have done the math, the shareholders, they signed up for this. They did the math. That's what I'm saying. So what is there to argue about? Now, [00:30:00] if the court has disallowed it, we are saying the same. Yeah, yeah. 

[00:30:05] Vic: We are saying the same thing. 

[00:30:05] Marcus: So, so it's 

[00:30:06] Vic: like not at all clear to me what happens next.

[00:30:11] Vic: It's not good for Delaware. No, I mean, like, I don't know if I want to organize in Delaware companies anymore. Yeah, no, we, 

[00:30:19] Marcus: we, we do a deal. Here's the incentive, right? You hit a 

[00:30:22] Vic: proper approval, right? 

[00:30:24] Marcus: You hit everything. And then, oh, look at that number. That number too big. 

[00:30:28] Vic: Yeah. I don't care. 

[00:30:30] Marcus: Yes. 

[00:30:31] Vic: I don't care.

[00:30:32] Marcus: This was, these were the 

[00:30:32] Vic: terms, right? Especially with an incentive package. I mean, maybe you could be upset about a salary, and, but This was very, very incentive. Like he couldn't make the money without shareholders doing well. 

[00:30:48] Marcus: Yeah. I, I don't, I don't know. I mean the, the, this is the kind of stuff that feeds the whole anti billionaire war on billionaires thing, and, and I, I just feel like what the, [00:31:00] what progressives don't understand about that positioning is that

[00:31:12] Marcus: core to the American dream is the idea that anybody. Can go from nothing to unlimited success. There's like, there's not supposed to be a cap on your success. The minute you put a cap on someone's success. It feels fundamentally un American and you open yourself up for all sorts of, you know, communism, Marxism, all this kind of stuff, you know, it's like, don't do that.

[00:31:42] Marcus: Don't do that. Yeah. Because, because there's, there's a lot of people, you know, is it half of America? Is it 60%? I don't know, but there's just a lot of people on probably on both sides of the aisle who don't think that is American to do. Yeah. [00:32:00] 

[00:32:00] Vic: I don't think it's American. I don't think it's American. And I also think it destroys.

[00:32:05] Vic: Destroy a sort of economic value. If, if you don't allow people to have the incentive to make a better life for themselves and take risk, and if they succeed, they make, they do really well. And if they fail, they don't. It betrays trust 

[00:32:19] Marcus: in the fundamentals of the market. Yeah. The contract doesn't mean anything.

[00:32:23] Marcus: Why did I, why did I kill myself to deliver a result that nobody else could have delivered? Right. Why did I kill myself to do that? Just to have the pay package that you agreed to. Be overturned by the court. 

[00:32:39] Vic: Right. When 76 percent of the shareholders are fine with it today, after the fact. And I think about our portfolio.

[00:32:47] Vic: I mean, we have every one of my CEOs has equity and options. Do we get 

[00:32:52] Marcus: to just take their equity back? Do we get to just say, ah, sorry. I know you hit every goal and we ha and we agree to this performance based [00:33:00] option. I think, I think 

[00:33:01] Vic: the answer is yes. Now, we wouldn't do venture deals very long, but after the fact, you can go, you can go to court.

[00:33:10] Vic: Yes. 

[00:33:11] Marcus: That's your point. When you say yes, you don't mean like it's like 

[00:33:14] Vic: we wouldn't do it, but someone, anyone in our portfolio companies that decides after five or 10 years that they now don't like it. See, 

[00:33:24] Marcus: and, and like, this is the long term and this goes to your point about Delaware and Texas. This is the longterm stuff where.

[00:33:31] Marcus: You might just see a whole bunch of VCs saying we're going to incorporate in Texas. Yeah. Instead of Delaware. Because like, that's crazy. 

[00:33:39] Vic: Yeah. We need to have a rule of law where if some percent, it's definitely under 76 percent of the shareholders agree, it's finished. Yeah. And I don't care what the contract is.

[00:33:52] Vic: If all the shareholders agree, That's why the business exists. 

[00:33:56] Marcus: The FDA issues final guidance on post market updates to AI [00:34:00] enabled devices. This is good news. Uh, the FDA is recognizing that AI updates are continuous. Models are constantly being trained and tuned and tweaked and whatever the right words are to talk about how AI models develop and evolve over time.

[00:34:14] Marcus: Um, and, There's no, there's, there's no reasonable way that the FDA can continue to sort of track that. And so you can continue to update your devices with the latest AI updates, uh, without having to run it back through for an FDA submission. This is good. Which is good. This is good. That 

[00:34:32] Vic: created a bunch of new acronyms that I can't remember.

[00:34:36] Vic: In order to moralize it, common sense, 

[00:34:38] Marcus: regulatory policy. Good. This is good. Um, Trump picks Paul Atkins to run the sec and Bitcoin goes to one Oh three. Yes. 

[00:34:47] Vic: I mean, he has a ton of Bitcoin and crypto holdings. He's consulting. Yeah. He loves crypto. Yeah. And he's now running the SEC. Dude, I mean, I've, [00:35:00] I've been listening to crypto podcasts like over the last week.

[00:35:04] Vic: Everyone is just like so to the moon excited. To the moon excited. 

[00:35:08] Marcus: They're all like. This is it. Like, cause they all thought it was going to take like 10 more years. Right? No, like no one, you gotta remember like the whole Trump aligning himself with Bitcoin happened this summer. 

[00:35:19] Vic: It happened in Nashville in July.

[00:35:21] Marcus: Happened this summer. This is, this is not like, you know, this was not the roadmap. Right. So to go from where we were at the beginning of the year, right, to where we are right now is just crazy. And I think as you and I have talked about, uh, the general public, and I think also a lot of business people and a lot of smart VCs.

[00:35:46] Marcus: It's if they haven't been dabbling and keeping at least a couple of toes in the crypto world. I think they're going to get real whiplash about how real this is about to be. How, how legitimate crypto is about to be as, as like a [00:36:00] means of doing finance. Yeah. Very quickly. This is going to become legitimate financing.

[00:36:07] Vic: Yeah. I mean, I think by next Thanksgiving. There's gonna be very competitive financial markets that are fully on Web3. Totally agree. Yeah, totally agree. I'm, I'm, I'm with you a hundred percent on that. And let's step back from that though. The US should be a leader in blockchain, crypto, Web3, whatever you wanna call it.

[00:36:31] Vic: The world is 

[00:36:31] Marcus: waiting for us to be the leader. 

[00:36:33] Vic: Right. And the reason we need to lead is we have the US dollar. Yes. And we have Silicon Valley. 

[00:36:40] Marcus: Yes. 

[00:36:41] Vic: And we used to have the court systems. All the stable coins 

[00:36:43] Marcus: are already denominated in USD. 

[00:36:45] Vic: Yes, right. So, all Paul Atkins has to do is state, Here are the rules of the road that you have to abide by.

[00:36:54] Vic: That's it. Just like there are in traditional securities markets. And then if someone doesn't [00:37:00] follow those rules, then fine. Throw the book at them. But, but dude. But it hasn't been any clarity. 

[00:37:05] Marcus: I mean, this is going to change so much. Like one of the, one of the dynamics that, that, uh, a couple of the podcasts I've been listening to have brought up is it's going to start attracting a bunch of the best engineers.

[00:37:17] Marcus: Yeah. The best engineers have not done crypto because it's been like this rogue, like you got to leave the country to do it kind of thing. And 

[00:37:24] Vic: that guy with, uh, a turbo cash or whatever. Tornado cash 

[00:37:27] Marcus: jail. Oh, did you see that the Ofec, uh, that, that, that got overruled? Did you see that? No. So he's still in jail, but.

[00:37:35] Marcus: OFAC was, there's a whole Unchained Larsen podcast about this, um, the, the OFAC, whatever they, whatever they put the sanction, they have this sanction in place. A bunch of people's money is locked up in Tornado Cash for the listeners, but we're kind of going down a rabbit hole here. Tornado Cash is, is, uh, it's called a mixer.

[00:37:55] Marcus: And basically it's a way to have private transactions on the Ethereum. It's a way like you 

[00:37:59] Vic: and I both [00:38:00] put our, uh, are ETH coins in this thing and then someone buys something out of that and it's unclear who who did it was. Right. 

[00:38:09] Marcus: Yeah, exactly. So it's a way to have privacy like in, in, in, in blockchain transactions.

[00:38:14] Marcus: Right. So anyway, like, because North Korea was using it, no question, North Korea was using Tornado Cash. That's like known, known fact. Uh, oh, fact. Which does important work, put a sanction on the whole thing. So like consumers got hurt, their money's been locked up for years now, I think. Um, and that just got overturned in the courts.

[00:38:33] Marcus: So I think Tornado Cash in January gets unsanctioned, the money gets freed, everyone starts to use it again. I'm sure the new Trump regime is gonna be like, Tornado Cash is fine, do what you want with it. Just, it's just, it's gonna be a totally different world, Vic. I'm, I'm, I'm, I'm so glad you're, you're, you're a crypto literate.

[00:38:56] Marcus: Yeah. Yeah. If you're not, you're going to 

[00:38:58] Vic: catch up quick. 

[00:38:59] Marcus: Yeah. [00:39:00] Yeah. This would be hard if you, if, if either you or I was not crypto literate. So I'm, I'm happy you are. Uh, all right, let's, uh, let's keep moving. Uh, Trump taps Vance aid Gail Slater as top DOJ antitrust cop. 

[00:39:13] Vic: Yeah, so this is a break from the rest of the appointments in my mind.

[00:39:18] Vic: And it's not surprising Trump has been pretty vocal about, um, wanting to rein in big tech or crack down different, you know, adverbs. Um, so it's not going to change that much from the Biden administration. I hope they pick fights they can win. Because the last DOJ didn't win it very much. Um, Trump is going to continue, uh, you know, kind of looking at should we break up Google?

[00:39:51] Vic: What should we do with Google? Um, and then the rest of the Magnificent Seven, I think, are still going to be in, in review to make sure they're behaving [00:40:00] properly, which probably is fine. It's good. Yeah. And 

[00:40:02] Marcus: I'm in favor of that. I mean, this, this was kind of the, you know, we talked about RFK. Yeah. The Promise to RFK was really HHS.

[00:40:08] Marcus: This was the Promise to Vance. Yeah. Right? You know, Vance deeply cares about this issue. Um, he's kind of a Peter Thiel protege. Yeah. And uh, here we go. So let, let's watch this space. Gale Slater replaces the Head of DOJ, insurers collected billions from Medicare for veterans who cost them almost nothing.

[00:40:28] Marcus: So this is a story about how if you were a veteran, you're getting your care from the VA, but then you have this Medicare Advantage coverage that you don't need. because you've got your coverage from the va. Mm-hmm . Taxpayers we're, we're, we're paying for like an additional plan for you and there's no, there's no real cost.

[00:40:50] Marcus: So MLR is , you know. Great. Uh, and yeah. Great for the plans. Yeah. Great. Great for the plans and, and, and so they're making a lot of money. 

[00:40:59] Vic: Yeah. [00:41:00] And the plans call the veteran and they interviewed. This gentleman and a bunch of people, um, and they tell the truth, which is, well, the VA doesn't have everything you might need, you might need a specialist, you might want something else, um, and you're American, and you can get this, and it's your right as a over 65 retiree, I agree with all of that, the VA and Medicare and Medicare Advantage are all run by the federal government.

[00:41:34] Vic: Yeah. So like, we could get our act together and just say like, okay, let's have a different coverage plan for veterans because they don't need the same exact coverage. Yes. 

[00:41:45] Marcus: Yes. 

[00:41:45] Vic: I mean, I'm not trying to hurt veterans, but they don't, they don't need the whole thing because they have the VA. The VA is great.

[00:41:50] Vic: I mean, the VA is leading in a lot of places. 

[00:41:52] Marcus: No, no, of course. Of course. And look, I mean, There's a big question. I mean, in the last 24 hours, I saw Elon Musk tweeted talking about [00:42:00] all the inefficiencies in healthcare specifically. So he's starting to kind of put his eye of sorrow on, on, on, on healthcare.

[00:42:06] Marcus: Um, which it's only a trillion dollars a year we spend in infrastructure. Well, I mean, here's the thing, right? People keep talking about firing people. That's not where all the costs are, right? The costs are in our industry. Yeah. Okay. And so it's in government it's in government. Yeah. It's in defense and it's, and it's in healthcare.

[00:42:24] Marcus: And things like this, you know, it's like, are you gonna cut veterans, you know, spending, uh, no. But if you're double spending for veterans, then you should cut that. Right. You know? Um, or you should find a way to like, not have a full duplication and like maybe take the Medicare advantage and add it to add it to the 

[00:42:41] Vic: VA plan.

[00:42:42] Vic: Ask a thousand veterans, like, what do they use this for? And then give them a package that has that. 

[00:42:46] Marcus: Yeah. We're, we're not talking about giving veterans a substandard plan. Right. But if you're giving 'em two plans. Yeah, how about just combine it into one good plan, right? All right, this is a good interest story as it you know We're we're into [00:43:00] this interesting time in the world and different, you know Countries are taking different stances on things in the UK.

[00:43:06] Marcus: The lawmakers have approved medically assisted suicides. This is something that in America I think only in Vermont, and maybe in some situations, New Mexico. Yeah, it's Vermont, New Mexico. Vermont is, I think, more clear cut, like, period. If you're in Vermont, you can do it. I think in New Mexico, there's like certain situations.

[00:43:23] Marcus: You have to have 

[00:43:24] Vic: some number of months remaining. Yeah. Or something like that. There's some, there, there are guidelines. 

[00:43:30] Marcus: Right, right. But 

[00:43:31] Vic: in other 48 states, 

[00:43:32] Marcus: you cannot do this. Um, but in the UK, uh, They say apparently it's going to take two years to become law, but they have now approved it. 

[00:43:40] Vic: Yes, I just, um, our whole globe, but the U.

[00:43:46] Vic: S. particularly, and Europe, we have a lot of aging people, and the boomers are used to getting what they want. And [00:44:00] they don't know what they want, but they want the right to make their own decisions. And I think this is a trend that's going to continue to grow. I don't know what the right treatment is. Um, I think it actually is good in the United States that we have all these state experiments and it can bubble up.

[00:44:22] Vic: Um, To what's working well, you can go look at what's happening in Vermont and New Mexico and other states will try different things. Um, but it's something as health care industry folks, we have to monitor it because it's important. I mean, the last year of life is a huge source of spending, right? And it's a huge source of suffering and pain and really poor quality of life.

[00:44:49] Vic: And I think we, as an industry, could do better. Hospice is the easy place to go. But hospice often is, um, it's hard to know [00:45:00] when to go to hospice. And the physicians are not They're not trained on advising all the different family members of how to navigate this. It's just a different skill set. 

[00:45:11] Marcus: Uh, recently here in Nashville, one of our business giants, Bill Freeman, uh, took his life and I don't know why he took his life.

[00:45:22] Marcus: Uh, but it was known he, he was, he was over 70 and, uh, he had a stroke, um, at least one stroke. 

[00:45:31] Vic: Yeah. I don't know the, I mean, I know rumors and things, but I can't, I don't know the details more than you do. 

[00:45:36] Marcus: So I'm, I'm gonna, I'm gonna throw a big caveat in here. Um, I don't know why Bill took his life. Okay.

[00:45:42] Marcus: But

[00:45:48] Marcus: when I, when I read this story, it makes me think if someone like Bill decided [00:46:00] his health was failing in a way that he didn't want to, you know, um, you know, he, he did, he didn't, he didn't want to suffer any longer. Right. This kind of law could allow. That to happen in a way that could have been collaborative with the family and could have had, you know, could have brought peace to everybody.

[00:46:24] Marcus: Um, and wouldn't be something where someone would feel they need to do something desperate by themselves, you know, and that that's where I feel like there is, there's some, some real kindness. And in this kind of legislation, because it's like, if people, if, you know, it's, it's, it's almost the same as like, if people want to take their life, there's not a whole lot you can do to stop them.

[00:46:56] Marcus: Right, but can you frame it in a way [00:47:00] that allows it to be a choice that is about the end of suffering because their health is deteriorated to a place where they don't feel that their life is worth living and that is something they can do in collaboration with their family and I don't know, I mean, I just, I just think that there's

[00:47:24] Marcus: There's some pragmatic kindness in this kind of lawmaking. Does that make sense at all? Yeah, yeah. Yeah. So 

[00:47:30] Vic: I mean, my wife and my wife's really driving it. Wendy, we are looking at buying a second place in New Mexico really for this, for this reason. Exact issue for this reason. And she likes Cine Fe No, but for this, she, she researched where it is possible.

[00:47:47] Vic: Wow. Wow. And now we haven't done it yet. And I'm 54. She's 52. We have time. But it matters enough to you guys that you're really looking at it. And I draw a very big distinction between [00:48:00] end of life, I don't want to go through the next 6, 12, 18 months of treatments and pain and suffering. I'm 80, I'm 90, I'm whatever, whatever.

[00:48:17] Vic: I'm at the end of my life. Sure. Whatever. And I'm deciding that I've had a good life and I'd like to end it on my own terms. I think that's very different than a suicide in the middle of the life, where I would say like, we need to intervene and they're not thinking straight. I completely agree. I completely agree.

[00:48:37] Vic: And yet we treat it like it's a good life. Legally, we treat it kind of the same. 

[00:48:41] Marcus: And no, it's not the same. It's not the same. It's not the same. That's, that's kind of the point. Right. Uh, that, that I'm trying to bring up here, right? Is, is it's not the same when we, you know, it, it's, I mean, Vic, I got, I got to say, man, you know, spending as much time [00:49:00] as I have with, With my parents at this point in their life, it is, it's daunting to see, you know, what happens to us, you know, when we really, really get to those advanced stages and, you know, I, I'm very thankful that my parents have great attitudes and that mentally they're all, they're all there and, and they, they have a, you know, You know, a zest for life.

[00:49:27] Marcus: They, they're very happy to be alive and they want, they still want to see things. They still want to do things, you know, and these are their words, right? I'm happy with that, but it's not for the faint of heart, man. Yeah, it's really not. It's, you know, it's like, wow. I mean, I remember my dad, you know, when I was a teenager and he, you know, he was probably 50 something at that point.

[00:49:47] Marcus: Cause you know, He's, he's significantly older than me. Right. And he would like beat me in a race down the street. Yeah. You know what I mean? Like, like again, it's fifties and to see where he is now. It's like, it's amazing. I'm so grateful [00:50:00] for where he is now. It's, you know, it, it's great, but it's not for the faint of heart.

[00:50:04] Marcus: Yeah. It is not for the faint of heart. Right. 

[00:50:06] Vic: Yeah. And to me, it's about, um, the value of this story and us talking about the podcast. My wife and I talking about it is, um, when we are not at the decision point, right? There's a lot of details to talk about. Like, okay, well, when, when do I want my wife to pull, pull the plug, you know?

[00:50:27] Vic: Um, and under one circumstances, what, what do I want to live for? What would I not want to suffer through? Yeah. And these are not easy to understand choices, and there are a lot of nuance behind it, so it takes talking about it over many years, I think, and then being honest with your other family members.

[00:50:49] Vic: And if we just don't talk about it, and then wait until, uh, someone's in a coma, and, you know, who knows? It's, [00:51:00] it's At that point, it's too late. That's right. 

[00:51:02] Marcus: All right. Let's, uh, let's keep moving on that. That one took us a little bit longer than I thought it was going to. Uh, okay. This is an old story, but you, you want, you want to bring this back up?

[00:51:11] Vic: Yeah. So I found this, uh, in, in a blog post it's Robert Kennedy Jr's, uh, op ed in the wall street journal from September 5th, uh, which of course, uh, Was a few months ago before Trump won the election and he lays out. I think it's 12 Points that he thinks would make a big difference in the health of America.

[00:51:37] Vic: Mm hmm, and they're very tactical And I wanted to bring it back up. We'll put it in the show notes. Um, it's not that there's that much different from what he has signaled or we've talked about here before. He's interested in food, getting people healthy, uh, kind of aligning incentives around scientific research, but it is very different.

[00:51:57] Vic: Tactical and detailed. Yeah. And so I think it's [00:52:00] likely he's going to do something very similar to what the list he put in the Wall Street Journal in September. 

[00:52:04] Marcus: Yeah, so we'll avoid talking through it all, but we'll link in the show notes because I agree. It is good now that he is the head of HHS to see what he was talking about back in September.

[00:52:13] Marcus: Important story here. U. S. officials urge Americans to use encrypted apps. A 

[00:52:19] Vic: Chinese government affiliated hacker group called Salt Typhoon infiltrated U. S. telecommunications companies like Verizon, AT& T, all the big ones, um, and established a presence in their network systems. And the FBI is telling us now that they have not been able to get them out of the system.

[00:52:49] Vic: And furthermore, they don't have a, cannot predict a timeframe when they will be able to get them out. So their advice is that we should use [00:53:00] encrypted phones and encrypted text messages. Um, because the Chinese government can see whatever, whatever we're saying back and forth. And so they, they can see who you're calling.

[00:53:13] Vic: They can listen in. They can read your text messages. Um, now I'm not sure the Chinese government cares who I'm calling, but it's just an interesting, I, I was not aware that our government could not, Beat them like this. 

[00:53:32] Marcus: Yeah. I mean, listen, signal by default, right. Uh, which by the way, signal is an app, uh, that I'm starting to use by default.

[00:53:40] Marcus: Yeah. People, you know, just cause yeah. I still trust any of this stuff, man. It's just, everything is. It's insane. It's insane. So, so just protect yourself. Yeah. WhatsApp signal. Uh, you can't get into an encryption with Google messages and iMessage, but you need to turn it on. Uh, but just understand like the, these things, these things have been compromised at the [00:54:00] root network level and yeah, it's not going back now.

[00:54:05] Marcus: Anthem reverses plans to put time limits on anesthesia coverage. This has been a hot story over the last 24 hours because of everything that's gone down with Brian Thompson's murder. But, um, Yeah. 

[00:54:16] Vic: Yeah. So Anthem is trying to get control of their anesthesia costs and they put in time limits for surgeries based on sort of what they have seen as the average or normal time limits for various surgeries.

[00:54:36] Vic: Um, and it got huge, um, public opinion. Against it, because it's scary, like I go get a surgery on my hip or whatever, and if my surgeon and my anesthesiologist need to keep me under for half an hour longer, they're going to do that. [00:55:00] And so Anthem not just not reimbursing that the patient's going to get a bill or it just doesn't make sense.

[00:55:06] Vic: Yeah. 

[00:55:07] Marcus: Yeah. And you know, this, this feels like, you know, this, this feels like one of those stories that like nobody would have even. 

[00:55:14] Vic: Well, this, the next two stories, this one and the next one are really about the payers and the health system sort of, uh, sparring back and forth. Yeah. Which is, uh, How we do health care in America, but, but is messy.

[00:55:29] Marcus: Yeah. Yeah. And particularly messy around Medicare Advantage. So, this is a story in, in the state of Minnesota, um, where health providers are dropping Medicare Advantage and it could affect coverage for 60, 000 Minnesotans. Um, I'm, I'm, I'm dealing with this right now. I'm helping my parents to kind of figure out the, uh, What plan they need to go on because things are shifting underneath them right now, like, you know, the system that they're in, the plan they're in was compatible a year ago, not compatible today.

[00:55:56] Marcus: They don't know anything about that. People just feel like, you know, the plans are [00:56:00] screwing with them, but it's, it's, it's not exactly that. It's, it's this, this, you know, negotiation, uh, between these folks. And I think the craziest thing about it is just like,

[00:56:13] Marcus: if someone's in their eighties, this is very hard to navigate, Vic. Yeah. Like, I don't know how seniors who don't have somebody that's advocating and has access to all their stuff and has power of attorney and I don't wanna change my health 

[00:56:25] Vic: plan now. Now. Right. And changing it, I mean it advantage seniors.

[00:56:31] Vic: You basically change every year. Yeah. 

[00:56:33] Marcus: It's mostly affecting seniors. 

[00:56:34] Vic: Right. So one of our listeners, I just want to put predict. Quick plug, one of our listeners sent this story in, so, uh, which is great. So, Pete, if you're listening now and you have a story we should cover, let, let me know. Send me a text or email.

[00:56:45] Vic: Um, but then the next one is, um, Becker's hospital report. So, that was from this week in Minnesota. Right. But I wanted to see if it was going on nationwide. So, About three weeks ago, so a little bit, there's [00:57:00] 32 health systems that have dropped some or all of their Medicare Advantage contracts. Yeah. And Vanderbilt is one of them.

[00:57:09] Vic: Yeah. But there's 32. Listed here. And there are big ones here. Yeah, big ones. 

[00:57:15] Marcus: I mean, Memorial Hermann, uh, Christianic Care, I mean, Baptist Health. 

[00:57:20] Vic: Yeah, so there's a systematic issue going on where Medicare Advantage, is not paying at a level that health systems feel that they can agree to. I mean, it 

[00:57:35] Marcus: got broken, right?

[00:57:39] Marcus: Like, last year, this time, we were doing all the deep dives with Emily and everything, and here we are a year later, and it's just broken. You know? It just doesn't work. It doesn't work for the, it doesn't work for the plans, the plans, the plans are losing money. 

[00:57:55] Vic: So they're leaving markets, right? They're leaving [00:58:00] markets.

[00:58:00] Vic: Yes. And then in markets where they want to stay, they're not able to sign contracts. The 

[00:58:04] Marcus: health plans are dropping them. 

[00:58:05] Vic: Yeah. 

[00:58:06] Marcus: I mean, it's broken. 

[00:58:07] Vic: Yes. Yeah. So this, the whole concept of Medicare Advantage being a capitated, Uh, incentives aligned thing can work, but it, but it needs to be enough money in the system that it's functional.

[00:58:22] Marcus: Yeah. And right now we don't have that. BMS is the latest pharmaceutical company to sue HHS over the 340B rebate model. I mean, I don't know what more there is to say other than like 

[00:58:33] Vic: 340B has got to change. 

[00:58:34] Marcus: 340B is clearly going to be a hot Yeah. a hot topic. For a while, we were just hearing about how the AHA won, but now the, the pharma industry is kind of lining up and saying, uh, you know, this has got to change.

[00:58:47] Vic: You guys talk about this. Yeah. Yeah. 

[00:58:49] Marcus: I mean, you pull together a slew of stories around transgender care for young people here in Tennessee. Yeah. We have a, uh, a big [00:59:00] case going on between the, um, ACLU. And the state of Tennessee, um, and it's, it's basically around the ban. The Tennessee is putting in place for gender affirming care for transgender adolescents.

[00:59:14] Marcus: Um, and the ACLU is sort of lined up and said, this is, you know, dangerous. And in fact, you don't have constitutional right to, to block this. They're, 14th amendment, but, um, apparently SCOTUS blog and others are saying that the Supreme court has heard the arguments and Predictably, um, is going to side with the states here.

[00:59:37] Vic: Yeah. So we'll put in the, in the show notes that there's, uh, op eds from each side because they're well written and there, there are good arguments on both sides. And then the SCOTUS blog, it is pretty predictable, right? It's a conservative court. They are, they haven't announced it yet, they won't announce the decision until next year.

[00:59:59] Vic: Right. [01:00:00] But from the QA and this blog, it seems like they're trending towards, you know, supporting the state of Tennessee. Um, I, I, I kind of think if the parents and the child make a decision, the state of Tennessee has no business getting involved. That is, um, maybe going to get me some, some hate mail, but, but I don't know.

[01:00:28] Vic: I just think I don't want any state in between myself and my sons. Or my daughters or my, my transgender confused kid that needs to figure out what to do. I think the parents are best suited. When the parents and the doctor and the child, 

[01:00:46] Marcus: I mean, this is entirely predictable, um, and all the way through to the likelihood of the Supreme Court agreeing that that is, it's just the error we're in and this will be, [01:01:00] there'll be many more of these kinds of situations that will, there'll be popping up, um, starting at the state level, going up to the Supreme Court, Supreme Court, You know, backing the state and the state will be a southern state like state of Tennessee.

[01:01:12] Marcus: Yeah, but I think state Tennessee is going to lead in a lot of them just because of how, how deep the red supermajority is here in the state of Tennessee, definitely a leader in many of these conservative policies. 

[01:01:25] Vic: Yeah, and the, the American system, so I was talking to my son about this, the American system with the states doing 50 different experiments around these social questions.

[01:01:38] Vic: I think it's probably the least bad way to run a country. Yeah, but it's really slow. Yeah, it's so like maybe eventually people will vote and make decisions and there'll be other states to try other things, but Meanwhile, parents and kids are not able to get care in Tennessee. Yeah. [01:02:00] 

[01:02:01] Marcus: Long AI rundown. Uh, let's start with Intel CEO Pat Gelsinger resigning after struggling to turn around the chipmaker.

[01:02:08] Marcus: So, um, he's been there four years. It's been a pretty bad four years when you compare how Intel has performed versus Nvidia. And Intel was just flat footed when it came to everything in the AI world. 

[01:02:22] Vic: It's, um, it's really sad to see what was, I mean, really one of the best American companies. The chip brand.

[01:02:31] Vic: Yeah. The chip brand and very powerful. And they kind of lost their way. They lost the culture of innovation and inventing new things. And it's hard to get that back. Like once you lose that, it's, I don't know if it's over, but it's hard to get hard. It's really hard to get back. 

[01:02:53] Marcus: Um, I have heard Boeing, 

[01:02:54] Vic: Boeing, similar Boeing.

[01:02:56] Marcus: It's the same. Well, Boeing is kind of in a duopoly. [01:03:00] So, I mean, they've, once they get their P and L together, I think they'll be fine. Uh, Intel. Uh, now they have incredible manufacturing capabilities and they do have really smart people. I have heard people say that, um, they've been really, really beat up, uh, from a stock market perspective because they're not NVIDIA and that actually they're going to come back and kind of get it together.

[01:03:21] Marcus: Um, but yeah, just pretty rough. Yeah. Pretty rough. Uh, all right. Let's see if we can run through because Amazon had, uh, the reinvent conference this week. And yeah, we can just sort of touch the basis. Yeah. 

[01:03:33] Vic: Yeah. Amazon came out with four models, uh, for different, different use cases. Like they have a really small one, a light one, a pro one, different levels.

[01:03:46] Vic: I think they are competitive with the other frontier model. So before this, Amazon didn't really have its own. Yeah. We anthropic was kind of what we thought for about for Amazon. Right. Um, and then go to the next one that they, uh, the really [01:04:00] thing is that they're, they're undercutting the market from price, which makes sense.

[01:04:03] Vic: Amazon is known for. Driving prices lower and they're doing that here and just like it benefits me when I buy a book on Kindle or a present for my wife on, on Amazon, it's going to benefit me here too. Absolutely. So it's good for everyone. 

[01:04:19] Marcus: And you've already got all the developers on Amazon, right? I mean, not all, but I mean, they are the number one cloud.

[01:04:24] Marcus: I 

[01:04:24] Vic: mean, there's no one that's a good developer who doesn't know how to build today. That's right. That's right. 

[01:04:29] Marcus: And Amazon has announced that they are doing their own homegrown chips. 

[01:04:33] Vic: Yeah. They bought an Israeli company. And moved it to Texas again, Texas, and they're not competing with Nvidia, but they're sort of taking the, um, cheap replaceable, there's going to be a lot of use cases where you don't need the Cadillac, you know, really high performing GPU, right?

[01:04:52] Vic: And I think that makes sense. Yeah. There's going to be times like that. 

[01:04:54] Marcus: Yep. Okay. Over to Google. Um, Google has rolled out a new AI video model. Uh, it's called Veo [01:05:00] or Veo. I think it's a Veo. Veo. Okay. 

[01:05:02] Vic: Okay. 

[01:05:03] Marcus: Um, 

[01:05:04] Vic: it's pretty cool. Yeah. Yeah. And it, all these video models, it's very short. Yeah. And like when, when you, when you mentioned video, I was thinking like a TV show or something.

[01:05:13] Vic: This is like three to four seconds. Yeah. Um, but it's pretty, pretty cool technology. 

[01:05:19] Marcus: Yeah, and you know, it'll get longer, it'll start, it'll start getting more and more. Yeah, exactly. And then kind of in the same vein, uh, DeepMind, which is, you know, Google, uh, they, they've also unveiled a model that can create playable 3D worlds.

[01:05:32] Marcus: So think, you know, if you're old like me, Doom, uh, if you're sort of Minecraft, Minecraft, yeah, exactly. Yeah. 

[01:05:40] Vic: Absolutely. It spins up this entire world or universe from scratch. Um, and they're, they're using it for research and it's, it's just gonna, the whole world 

[01:05:54] Marcus: is going to change. Yeah. It's just crazy that, you know, you can start to generate these things.

[01:05:58] Marcus: I mean, of course, video game [01:06:00] studios are going to, Compressed to nothing. Of course, of course, movie studios are going to compress to nothing. I mean, like, just get ready. Uh, Gencast predicts weather and the risk of extreme conditions with state of the art accuracy. So they've now got an AI model that is the best at predicting the weather.

[01:06:15] Vic: And this actually, I think, can be impactful. By the way, this is Google DeepMind again. Yeah, yes. Um, I think this is going to be impactful pretty quickly. Because being able to predict where a hurricane is going to hit more accurately is better all around. Um, and it's incredible technology, it's, it's better than what we have.

[01:06:38] Vic: With all the government based weather things today. Agree. Uh, and 

[01:06:43] Marcus: open AI not to be left out 12 days of open AI. So they are today's day one, uh, Wednesday, December 5th, and they're releasing a new product every day. 

[01:06:52] Vic: That's right. So, um, pretty interesting marketing gimmick. Um, [01:07:00] I don't know how they're going to find 12 new products.

[01:07:06] Vic: The product today is not all that new, and so I think several of them will be what today was, which is the not preview release of 01, which had already been previewed and what people testing and then another tier of chat GPT pro, where for 200, you don't have to pay by the token anymore. You just get all you can eat.

[01:07:29] Vic: Yeah, 

[01:07:30] Marcus: I think it's really smart. Right. I mean, because I think, I think if you deconstruct an Apple keynote, there's probably 12 products in there. Right. You know what I mean? Some of them are a new iPhone. Some of them are a new feature in the iPhone. Right. And so this is a nice, and it's a seasonal, obviously, 12 days of Christmas, 12 days of open air.

[01:07:52] Vic: If, if nothing else, he's very good at marketing. Yeah. And you know what? I would love to know 

[01:07:56] Marcus: if a chat GPT came up with this marketing campaign. [01:08:00] Uh, okay. You found this post, uh, on, on Twitter and we were, we were talking, there's a lot of stuff happening at the intersection of AI and crypto, like a lot. Um, but tell, tell me about this.

[01:08:10] Marcus: Yeah, I thought this 

[01:08:11] Vic: one was. easy for someone who's not like on base, you know, making their own meme coins, uh, to understand. And so you go on to Twitter, it's called Otco and it is an AI agent that automatically for you will create a Delaware LLC, put it on base, which is one blockchain that, that is. Um, and then it can start doing activities in the world.

[01:08:44] Vic: So one of the things that has been difficult in, in the blockchain web three spaces, um, liability, right? So like, if you sign a contract, if I sign a contract and then I don't live up to my side and there are [01:09:00] damages and I signed it with you, you could come after me and I'm liable for that. Yep. In the web three crypto space, there was no way to really have that easily done.

[01:09:13] Vic: Um, and so they've solved that now, but the create an LLC structure and you can fund it with, you know, any, any, any token, any token you want, Bitcoin or ether, whatever you want. Yeah. Um, and it, they, they do it live. And it's about a, you know, 30 seconds. Um, this came out yesterday. I know it came out a while ago.

[01:09:40] Vic: Okay. Yeah. So there's been 1600, um, LLCs that have been created. Um, and so there's going to be this intersection of web three, crypto and AI. Where as AI gets stronger and [01:10:00] needs to have money and a wallet and be able to, say, buy something on Amazon Web Services, because it needs compute, it is going to do that with crypto.

[01:10:13] Vic: Absolutely. And of course, that is obvious to you and I, but this is the first time I've seen it like, Okay. illustrated and up and live and running. You had a couple other examples, but, um, it's going to really, it's going to accelerate everything. 

[01:10:31] Marcus: Yeah. I mean, crypto is the obvious financial system for AI.

[01:10:33] Marcus: Yeah. Obvious. Yeah. Right. It's free. Permissionless. Right. Click of a button. You have a wallet. Yeah. Start throwing some, some coins in there. Go to town. Right. And final story, uh, Waymo to expand to Miami aims to launch RoboTaxi service there in 2026. Waymo is really capturing this whole autonomous car space by storm.

[01:10:56] Vic: Yeah. Yeah. I'm excited about this. I mean, it is [01:11:00] going to, they're in two, they're in LA and Phoenix, maybe, maybe San Francisco. Uh, and coming to Florida now, I think it's exciting. They're going to start rolling out to more and more cities. And again, this isn't exactly in the AI category, but it's, it's pretty much AI.

[01:11:24] Vic: Yeah. And you're going to then have. The ability just to call Uber or call Waymo app. And there won't be a driver that I have to have a fake conversation with that just automated. 

[01:11:38] Marcus: Well, let's, let's see if, uh, in the Trump administration, Alphabet can hold on to Waymo. Yeah. Uh, yeah, it's, it's, it's going to be an interesting year.

[01:11:48] Marcus: It's going to be a really interesting year. Anyway, uh, thanks for pulling together a great show. Um, sorry we had to start it the way we did, but I think at the end, you know, we covered a lot of great stuff. And, um, [01:12:00] Yeah, exciting times on the, on the innovation front, for sure. 

[01:12:03] Vic: Yeah, hopefully we'll have, uh, some more positive news to talk about next week.

[01:12:07] Marcus: Yeah, from, from your mouth. All right, man, see you next week.