142 – Why RFK Jr. Dismantled the Vaccine Committee & What Happens Next

Marcus: [00:00:00] 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. Uh, 

Vic: how's it going? It's going well. I, uh, I don't know. We had our selection committee this week, which always is like a ton of prep work. Yeah. But then, uh, we made some decisions.

I'm excited about once it's over, I I love the selection committee process. Yeah. The prep work is a lot of work. Getting ready for it. 

Marcus: Yes. Yes. A lot of work Good. A lot of work. Well, congratulations. Uh, I know. That's always I gotta 

Vic: land the companies. You gotta land. Yeah. 

Marcus: Yeah, yeah. But selecting them is, it's kind of half the job.

It's kind half the job. And 

Vic: every time, um, one of the selections, a friend of the pod actually pointed out something that we definitely, I didn't know. Like science-based thing. Yeah. That she is really good at. That saved us from. You know, not doing a good deal. Not doing a bad deal. Not doing a bad deal.

Marcus: Yeah. Not doing a bad deal. Well, that's, that's why you don't just trust your own judgment only. Right? That's, that's right. Uh, well, that's great. Uh, for me it has [00:01:00] been, uh, a. Good, but very busy week. Um, lots going on, uh, within a couple of the portfolio companies. That's good. And it's kept us sort of having lots of strategic conversations, so that's exciting stuff.

Mm-hmm. Um, and then, you know, just trying to keep track of everything that's, that's happening out there in the world. I mean, California is, uh, yeah, just really intense, you know, we've got, you know, I mean, Catherine's out there Yeah. You know, Natalie's out there. So we've got, you know, several colleagues that, that live there, which is really nice to kind of get like the, not like what's actually happening on the ground.

Right. Both of them great weekends. Yeah. Right. Uh, you know, like awesome brunches and all sorts of stuff. You know, it's kind of like, okay, good. So like the whole city is not on fire. Okay, great. That, that's, that's good to know, you know? Um, but, uh, but yeah, you know, just trying to, trying to. I'm trying to parse through it all.

It's, it's a, it's, it's a more complicated, um, news landscape than it, than it's really [00:02:00] ever been. I mean, one of the things I'm, I'm starting to, I dunno if, if you saw, but literally today, um, uh, the CEO of Uber was, uh, doing something where he was backing the big beautiful bill. You know? And, uh, you know, obviously that there's a whole bunch of backlash that that sort of came Yeah.

From that. And, and so, and, and it just got me thinking like, I don't think it was at all on my Bingo card, you know, five years ago Right. That there would be room for two of everything because the world would splinter politically Yeah. At the product level. Right. Like, like now I'm, I'm, I'm like, yeah. Like people are 

Vic: knocking, use Uber 'cause of whatever he says.

Marcus: This is gonna be huge for Lyft. Yeah. It's gonna be huge for Lyft, you know, and, and like, you know, X and blue sky, right? Yeah. I mean, you know, like we're just in this world where literally, you know, the, the whole [00:03:00] Tesla thing. Yeah. We're in this world where it's more than ever, you're, you're spending choices have some type of political edge to them, you know?

Uh, and, and it creates an opportunity for there to be multiple players in a market where typically it would sort of get consolidated down to one. 

Vic: Yeah. That's interesting that that's what you were thinking about. What I was thinking about is what, I don't know that it was on my Bengal card, that a tech executive's opinion about some legal, yeah, that's law.

New law would matter to me or, or anyone. I mean. That's not really what he's trained at. I don't see why it's important, but I know it is. I know it's, 

Marcus: yeah. So anyway, and, uh, y you know, today some, some really, uh, sort of unprecedented things happening at the, um, department of [00:04:00] Homeland Security event, you know, where mm-hmm.

Uh, Senator Padilla was, uh, was arrested. Um, and you know, it's by the time this show goes live, 40 more things will happen. Yeah. Because that's just the speed that we're, we're at at this point. Right. But, um, you know, thankfully we are gonna talk about boring healthcare stuff for the next hour. Yeah. 

Vic: Yeah. I think that, I'm looking forward to that.

And it is true that there's gonna be, I think unfortunately depressingly is gonna be unprecedented sort of destruction of social norms and, you know. Civil discourse every week. There's, there's like, maybe lows. Lows, new lows, 

Marcus: maybe. Yeah. Maybe every day. Right? Maybe every day. Right. Unfortunately. Um, okay. So look, we're gonna do our healthcare talks though.

Yeah. Yes. All right. So let's, uh, let's go ahead and dig in.[00:05:00] 

Uh, let's start with the economy. And we are seeing that hiring was slowed in May 139,000 new jobs, unemployment rate held steady at 4.2%. The market is happy that it's not worse. 

Vic: Yeah. So all the economic news is gonna be positive today. So, you know, some of the other news around the world is not so positive, but hiring slowed.

But, but we created 139,000 new jobs in the month of May, and the unemployment rate didn't change and that. That's pretty good. I mean, I was expecting worse. People were expecting worse. I think it's pretty clear we're having a slow down, but not a, not a bad recession, certainly maybe not a recession at all.

And so it's, it's really positive. I mean, what I like to have $200,000, 2000 jobs. Sure. But it's a, was a pretty good report, I think. 

Marcus: Yeah. Agree. Um, and, and also 30,000 

Vic: healthcare jobs. 

Marcus: Yeah. I, [00:06:00] I, I do think it you, the point you made about, um, what freaks out. The economy and the market versus what doesn't mm-hmm.

Is pretty important, right? Yeah. Like last week when Elon and Trump were fighting the market freaked out. Mm-hmm. Totally freaked out. Right? This week we're having all sorts of, you know, norms being broken. You know, the, the, the stuff that's happening in California is, you know, teetering on some really weird things.

Mm-hmm. And we look up at the ticker and it's all, it's all green, right. So it's, it's just, it's just interesting what, what moves the market, right? Yeah. And, and then almo and then, you know, almost like what does that say about the market, uh, as an indicator of the wellbeing of our society? Yeah. It's, it's, it is just, just an interesting, yeah.

Vic: Yeah. I don't 

Marcus: observation. 

Vic: I think the market's a really bad indicator of the wellbeing. Um, but it affects [00:07:00] healthcare policy, of course, in our portfolio, so we end up covering it, but of course, but yeah, I don't think they're. Yeah. That connected? 

Marcus: Yeah. Agree. Agree. Alright. Uh, muted may inflation defies tariff fears.

Consumer prices rose 2.4% over the year with a lower than expected month over month increase. This is the Wall Street Journal. 

Vic: Yeah, so this, I was expecting, 'cause we have really good policy people starting with Emily and around other, around hedge I mm-hmm. Um, inflation has bottomed so it, it ticked up slightly from, you know, like two three to two four, but it's not exploding to the upside.

Very minor increase and seems like a pretty good combination of reasonable job growth. Low inflation. It's not at two, but 2.4 is pretty good. It's fine. Um, so I think that's part of the reason the stock market is happy that we're getting this [00:08:00] like. Goldilocks, good combination of things. The, the fear about tariffs driving inflation has not, has not manifest yet.

Marcus: Yeah. And this, uh, this result, I, I think definitely boosts trump's, um, argument to Powell that he needs to cut rates. Right. You know, that, that, that what he's introducing from the tariff negotiation perspective is not material to inflation. And, um, to get more capital flowing and to get the economy a little bit more, liquid rates need to be lowered.

Agree. So this, this, this does support that argument. This does support that argument. 

Vic: There is, uh, there might be 15, uh, central banks around the world that are cutting. Yeah. Everyone's cutting. Yeah. Um, and I think the US is going to have that same sort of. [00:09:00] Deflationary fear if we don't get in front of it because I have that.

Um, but the Fed is always slow to act and Jerome Powell's that 

Marcus: in particular. 

Vic: Yeah. And you know, it's hard for me to criticize from the stance. Sure. It seems like a pretty good combination of, you know, we're not having job losses and so, um, I think it would be good for him to cut, but I think probably that's my bias always.

Yep. 

Marcus: Bonds rally stocks slip after inflation data, treasury yields drop after CPI Reports shows tariffs aren't making prices spiral. 

Vic: Yeah. So, um, we just sort of talked about this, but the 10 year yield is, um, what I have been really focused on. Mm-hmm. And so, you know, it coming down to 4 3 6, that, that's pretty good.

That's pretty good. Yeah. That's pretty good. So, I mean. Getting below 4.5, approaching, you know, 4, 2, 5 would be, when was 

Marcus: the last time we saw that kind of [00:10:00] drop? Because it's, it's been pretty stubborn here for months now. 

Vic: Yeah, it has. Um, it has been stubborn for, for months and it could be a short term thing, but I'm hopeful.

Marcus: Yeah, that's interesting. Let's, let's make sure next week we circle back and see if Yeah. If this drop has held because that's, that to me is more important. That's the most important thing. That's the most important thing. Yeah. The stock 

Vic: market will follow that. 

Marcus: That's right. That's right. Uh, alright. Moving into VC world, Axios Pro exclusive, right?

AI spelled R-Y-G-H-T raises c to shrink clinical trial timelines. I just, just talked about a company that was focused on, uh, shrinking clinical trial timelines. So I think there's a lot of, uh. Desires in the pharma world to kind of get the clinical trial world to be much more efficient than it currently.

Yeah. This is a, it's a hard space. Yeah. Clinical trials are really hard. 

Vic: Yeah. And especially this space, I mean, I think AI has a lot of promise. What they're trying [00:11:00] to do is, is work on the enrollment. Yeah. That, how can I find, that's the hard part. That's, that's the bottleneck always. But, but 

Marcus: it's, it's the, it's everything in there.

The identification, selection, activation, getting people to actually show Yes. After they show getting to follow up with the appropriate data. Right. Like, like it's just 

Vic: Yeah. People been working on, that's, I mean, I've been a VC 25 years. More than 25 years. It's hard. It's a hard space. 

Marcus: Yeah. Um, so anyway, they, uh, they raised $3 million seed round and, uh, they're planning a $20 million series A in the first half of next year.

So that's, that's pretty ambitious. Uh, Foothill Ventures led the seed round. Not familiar with them, but I will log them for future reference. Alright. Another Axios Pro exclusive ized ai, sorry. Yeah. Uh, gets 28 million for health agents. 

Vic: Yeah. So the agent, you know, trend is now healthcare. Uh, tres, uh, is the lead investor, you know, which I think I really like.

Yeah. We know Anna. Yeah. Yep. Um, 

Marcus: with Cigna [00:12:00] Ventures. Okay. 

Vic: Yeah. So it's a, it's promising, I think there's a lot of competitors in this space. Yep. Um, but virtuous 

Marcus: helps. 

Vic: Yeah. And they, they do have a human in the loop, which I think is valuable in healthcare, especially in the early, in the early phases. Yeah. I think it's gonna be important to have that.

Marcus: Yeah. I mean, there's, there's nothing that is not human in the loop that's functional today. Um, but as. Our conversation with Tarun pointed out like this, that's not long-term viable. Right. So, um, but this is the, this is the viable model today. So, uh, $28 million series A. That's a, that's a good size round.

Um, autonomize is, is what it is, how you say it, I would imagine, right? Yeah. I think that's I right. Autonomize ai. I want to make sure I get that right for the future. Probably a company we're gonna need to watch and we'll be hearing about just 'cause Anna doesn't play. Um, Emory Healthcare invests 10 million in Guide Health as it ramps up value-based care collaboration.

This is from Fierce Healthcare. 

Vic: Yeah. So this is a [00:13:00] population health, um, tool and Emory's getting stronger into that. Um, so I think good on both sides. Good. Good to see Emory get more active and happy for Guide Health. So. 

Marcus: Yep. Yep. Agree. Uh, good to see the investment. Uh, it'll, it'll be interesting to see how this actually does play out.

Um, it's good to see Emory, like leaning value-based coordination 

Vic: has been challenging. Yeah. But it's good to see them 

Marcus: still 

Vic: working on 

Marcus: it. 

Vic: Yep. 

Marcus: Agree. Uh, another Axios Pro exclusive Somnia raises 10 million for Smart sleep wearable. 

Vic: Yeah. IW I'm not sure we need another sleep wearable, but, but they're bringing one to market, so.

Okay. Didn't we have a company called Somnia? We have one. We have a better one called Sony. It's spelled better. I've invested in it. I was about to say, hold on. What's going on here? S-O-M-N-I. That's ours. That's ours. Okay. That's the better spelling. This is SOM. [00:14:00] And ee. Okay. Okay. Um, 

Marcus: and but ours is not a device company, right?

No, 

Vic: no, no. Because I, I think there are plenty of devices. Yeah. Our, ours is more the, the software software and sort of helping you understand what your device is saying and giving you coaching and other, that's other tools. Yeah. That was my understanding to improve it. Okay. We do take in data from a bunch of devices.

Yeah. But we're not trying to build our own proprietary device, mostly because I don't think that works and we don't have the same money Coastal Venture has. So 

Marcus: Yeah. But this, this is competing with Aura, but, but like, at, this is not like, like Aura is kind of a prosumer device. Right. This is $10 million seed extension.

So, you know, they're still definitely burning and also not quite at the place where they could justify Series A. That's what the round tells us. Yeah. And 

Vic: it's like a headband. It's a headband sort of, 

Marcus: yeah. 

Vic: Uh, form factor. 

Marcus: Yeah. Which I think is. I just think it's hard. Yeah. And then also, like I'm, I'm seeing here they've [00:15:00] got, you know, uh, they're in discussions with leagues.

I mean, you know, as someone who's got like pro sports stuff like that, that always worries me. You know, just 'cause everyone gets attracted by the leagues and Yeah. You know, that's, that's hard. That's hard. The league's got everybody coming to 'em. Yeah. You know what I mean? Yeah. So it's like you're, you're not in a strong position if you're trying to get any of the leaks to kind of do something with you.

Yeah. Alright. Uh, another Axios exclusive Eli Health raises 12 million for hormone tracking. So this is, uh, you know, continually growing interest in the hormone space. Peter Orilla just had a big sort of episode about, uh, women, uh, and, and sort of, you know, the lack of, of hormone therapy that has happened.

You know, for women there's a lot of talk about, you know, TRT for men. 

Vic: Yeah. 

Marcus: Um, but, you know, it's, it's been sort of outta for women. Premenopausal. Uh, yeah. 

Vic: Yeah. And, um. There's a human st, uh, podcast that came out a year ago really debunking the, the big announcement that [00:16:00] it caused cancer. Yeah. 30 years ago was not true.

Right, right. And, and, and so 

Marcus: you 

Vic: had a whole 

Marcus: generation of 

Vic: women who Yes. Are suffering for no reason. Yeah. 

Marcus: Yeah. So anyway, uh, this is focused on, uh, initially focused on cortisol measure measurements, saliva based hormone testing. So starting with cortisol, they can deliver results in minutes via the app.

That's, that's pretty interesting. $8 per test on a 12 month plan. That's the subscription. So seems pretty affordable if you're one of these like, you know, worried wealthy people who likes all the bio biohacking things and Yeah. You want to add, you know, in addition to your glucose tracking and your blood work that you're doing, you know, yeah.

You want to add in hormone tracking and guess what these people do. Yeah. Yeah. Um, $8 a month is pretty affordable, I think, to get that done. Alright. Uh, moving into policy. So Marty McCurry, um. Who is the head of the FDA wrote a article in jama, um, called Priorities for a New FDA. Uh, I think our biases on the table, we [00:17:00] both kind of like Marty, um, you know, we don't know him, but like, just, you know, our experiences with him.

He came to the healthcare fellows class. Mm-hmm. I just find him to be a pretty sharp guy, um, generally speaking and, uh, you know, skimming through this, I think you took a deeper dive on it, but like the skim that I did of it, uh, it's like more of the things I would sort of expect from him. Accelerating cures, removing bureaucracy, leveraging the AI that we've been talking about for, you know, so long.

And then obviously there will be the parts that are aligned with Maha, right? So the, you know, the healthier food for children. And that's, that's kind of a like, you know. That's that part. I feel 

Vic: like he put that at the end be nice to his boss. He literally in Yes. He stuck 

Marcus: that in there for RFK Junior.

Yeah. Um, but to me the, the, the big thing here is, um, you know, recognizing that the FDA has, you know, for a variety of reasons become a bottleneck and has, has actually, I mean we, we've talked about it like a lot of investors just won't even do anything that's got FDA risk because of the f FDA A. Right.

Right. [00:18:00] Not, not because they don't believe in the founder or the promise of the thing or the, or the potential future viability of the device or whatever the therapy is. Um, especially digital therapies. Right. Um, but it's more just, you know, you don't wanna deal with the fda. Yeah. Um, just is kind of a black box and you have to hire a consultant.

So making it more efficient is, is, is great. But also leveraging ai, you know, we've been talking. For well over a year now about all the advances that are happening in, in AI where we can now, you know, model out protein development. We can, you know, the synthetic data can replace lab tests. Yeah. I mean, there's all sorts of things we can do with AI now, um, that can advance drug development, therapeutic development, device development.

And right here, you know, Marty is saying, yes, let's leverage AI to do all those things. It's, it's proven, it's gonna work, and that's awesome. That's really exciting. 

Vic: Yeah, I, I agree completely. There's two, two points I'll make sort of building on that. One is I thought it was really interesting [00:19:00] that he published this in, in jama, not in the Wall Street Journal, op-ed page or the New York Times op-ed page.

I like, I like that because he's going after the scientists. Yes. He wants the scientists to know that Please come to the FDA bring your new innovations and we are ready. 

Marcus: Yes. 

Vic: Um. And then yes, he is positioning as using AI to make the FDA process more efficient, more effective work through many more applications more quickly.

And then he put in there also to, to alleviate some of the anal testing that I think is really important. And there's no reason to torture animals when we can do it in silicon. Um, so anyway, I, I thought those are just the two points to add onto, but I was really, it was a, it was a good piece of work and, and, you know, he has to deliver on this, but it seems like a really good outline of where the FDA could go.

Marcus: Yeah. [00:20:00] Uh, moving from, uh, Marty to Bobby, uh, Bobby Kennedy Jr. Has, uh, continued his streak of, uh, public writing. Mm-hmm. So this time in the Wall Street Journal's opinion pages, um, I, I, I do have to just maybe call out, I hadn't really thought about this before, but I, this is a more star studded list of leaders, uh, of, from, from an HHS perspective, uh, than we, we've, than we've ever had we ever had.

It's, it's kind of ridiculous, right? Yeah. It's kind of ridiculous. And, uh, they are all using. Their brand and their pen in the right channels for them. Right. I mean, you know, even, even even Marty who's not as well known, he's a published author and a, and a, and a keynote speaker. So like, you know, if you're in the space like us, if you're a healthcare innovation wonk, you know who he is.

Yeah. You know, obviously RFK Juniors much, much bigger. Um, but I mean, is this, is this like [00:21:00] the third opinion piece that he's published that we've covered and health further? It least 

Vic: the third? It's at least the third, 

Marcus: right? 

Vic: There was one, there was one in Fox before Trump got elected. No, I'm talking about since, I'm talking about since he has been in the seat.

I think there have been three, one on Fox, two on the wall in the Wall Street Journal. Yes. Yeah, yeah, yeah. And I think part of, um, being a successful politician, I think whether I like it or not, I'm not sure I like it. You have to be able to communicate directly to the people Totally. On social media. In an op-ed piece or in jama, JAMA was not a peer reviewed.

Uh, maybe we should make that point. It was their, uh, discussion portal. Yeah. Whatever. Yeah. It's their, it's their analog to this. That's right. That's right. Um, 

Marcus: no, no. He, he wrote an articles, not, not a peer 

Vic: reviewed paper. Right. And I think that's part of what you have to be able to do to survive and get your message out in today's media landscape.

Yep. Yep. Alright, 

Marcus: so tell me [00:22:00] about this piece. 

Vic: So, RFK Junior, um, exited the entire advisory committee about vaccines. Yes. So 18, 17, 17 people, um, I can't say I was very surprised. He, he has been critical of this particular committee for years. Um, but he did move much more dramatically than I expected. So I thought he would, the more traditional thing is to replace one third of the committee each year.

Yeah. So you have kind of a rolling committee. Um, and it's, it's just much more aggressive, but in line with the whole Trump administration to not worry about, uh, what is traditional customs. And so he, he had everyone leave, um, shocked a lot of [00:23:00] people, and it certainly was not, uh, it was not traditional, wasn't, uh, sort of the norm.

Marcus: Yeah. I mean the, the part here that I would sort of call, um, hard to, hard to reconcile is the byline here. You know? Um. We're co, we're reconstituting an advisory committee to avoid conflicts of interest. I mean, I understand the conflicts of interest he is referring to. Right. I I, I I definitely get those.

Um, but there are multiple interests. There may be opposing interests. Yeah. There may be divergent interests. Right. And so to say you're fully trying to avoid conflict of interests is sort of an interesting way to to Yeah. To present it. First of all, um, you are ignoring that you have avoided all previous norms related to how [00:24:00] the selection of this committee happens.

You've taken a very hard line, unilateral, you know, use of power. It's, it's, it's certainly your power and authority to do so. Mm-hmm. Um, but you're, you're, you're, you're also clearly sort of saying, it's, it's all gonna be done my way and I don't care about incorporating anybody else's views into that process.

Right. So, 

Vic: yeah. I, I, I think I agree. Completely. I'm not going to be able to name the quote, but, uh, you know, you and I were talking about this a long time ago, and there's a good quote, like no conflicts, no interest. Right? Right. Like, everyone who has the right skillset and knowledge, it's conflicted to serve on this kind of committee is conflicting, has some kind of conflict, whether they're financial, emotional, political, they're friends, someone they went to school with, how else do you get the experience that validates your, your reason for being there?

Right. And so I think it's important. Disclosure's important. [00:25:00] Yes, of course. But I think that byline is not real. That that's a, that's a made up thing. He doesn't like how these people are doing the job of this committee. Totally. He has never, not never, but for many years he hasn't thought they did. Were doing a good job.

And he is replacing them. He's gonna bring in other people that have a different set of conflicts, maybe ones that he. Things are more aligned with where he thinks the committee should go, but there's no one that could serve that won't have any conflicts. 

Marcus: Right. And, and so, you know, when we go to this fierce healthcare piece, um, that lays out the new eight members that he announced today.

So yesterday was the news about the seventh, right? I mean, basically it was, it was a 48 hour window, right? 

Vic: I think it was Monday. He got rid of everybody. Was was Monday. Got rid of everybody. Wayne said he 

Marcus: named everyone. 

Vic: Okay. Okay. Although this story is today, but I think it, I think they came out 

Marcus: yesterday.

I, I, I saw it for the first time today, so it could have been yesterday, but basically very fast. [00:26:00] Within a week. Yeah. Everyone's gone. And now a whole new group of people are here. I mean, he, I 

Vic: think it's pretty, it was clear to me. I think he had the list. Ready. I mean, it wasn't like he was making it up on the fly 

Marcus: clearly.

So, so I mean, you know, the link is in the show notes. So for anyone who wants to, you know, get more detail, as you said when you were selecting this piece, fierce did a pretty good job of, you know, not going too deep into opinion or background and just sort of saying, 

Vic: yeah, I reviewed like 30 articles to try to get to one that was reasonably balanced, you know, not one way or the other.

Yeah, 

Marcus: yeah. Um, but stating the facts. This article does note that four of the eight people that are selected, uh, for this new group, for this, for this new committee, um, are all listed in the dedication of his book, the Real Anthony Fauci, which attempts to undermine the former health officials work and motivations before and during the pandemic.

Um, so avoiding conflicts of interest, [00:27:00] 

Vic: I, I don't think. We are avoiding conflicts of interest. I, I, I just don't think that that's, I think we are, that's just not real putting in, that's just not real. We're putting in a set of people that see the world in a, I don't know, complimentary way to how Robert and a JR sees the world.

And I am hopeful. I mean, they, they, they all do have, I think, uh, reasonable pedigrees of different expertise in different areas. Sure. And I'm hopeful they'll execute the job of the committee. But I, I don't think anyone could look at this and say, there are no conflicts. Maybe there are no financial conflicts, but there's, there's many ways to think about conflicts of interest.

Marcus: But, but I think the reality is that when you are looking to do the kind of, uh, [00:28:00] unilateral clean slate, you know. Reboot that he's done doesn't even really matter what words you use. I mean, you know, it, it doesn't really matter because the, the action speaks louder than any words that he could write, you know?

Yes. And, and, and the, you know, the, the president of the, the a MA, um, Bobby Mu Kamala, he, uh, his quote that's, that's listed here in the Fierce Healthcare article. I, I'll just read it. Yeah. 'cause I think it's, I think it's material. The a MA is deeply concerned to learn that new members have already been selected for the advisory committee on immunization practices without transparency and proper vetting to ensure that they have the expertise necessary to make vaccine recommendations to protect the health of Americans.

So he's not saying that they don't have that, he's saying they've been selected without transparency and proper vetting. Right. So he's not, not saying they don't have that ex expertise. Yeah. It's just like. Who got to make the call, right. Um, we urge the administration to re [00:29:00] reconsider the removal of the 17 ASIP members who have deep expertise in vaccines.

So physicians can continue to have confidence in asaps recommendations, which have for decades help them make recommendations to patients about vaccination. We will closely monitor the developments of ASIP and encourage the administration to recommit to maintaining vaccine access for all Americans. So it's pretty interesting, right, where you start to have like a divergence between HHS and, and the a MA, like in a, in a meaningful way where it's like, who is influencing what the docs are doing and saying, you know, uh, it's, it's kind of that point that Trun made in, in the, in our last conversation.

You know, it was, it was a weird reminder for me, but the Joint Commission is not a federal. Yeah. Agency, it's not a federal body, you know, it's an industry body and healthcare is made up of a lot of industry bodies, you know, um, that, that create a lot of the regulations and the rules and that, that the industry abides by.

And so there is this interesting question that, that starts to [00:30:00] get laid down. Where is this advisory committee going to lose credibility amongst, you know, the body physician of America? 

Vic: Yes. I mean, there's no question about that. Yes. The, the, the question I think is so without proper vetting with my view, which is, you know, just my view is that Trump and then Robert Kennedy Jr.

Believe that they won the election and they then get to put whoever they want on this committee. They did their own vetting. Yep. Now, the a MA is an independent body. It. Is not subject to elections or not the same kind of elections and it can make its own decisions. I'm hopeful that the committee will behave in a way that engenders respect and credibility.

[00:31:00] But, but we won't know until they start, until they start having meetings and start behaving. Um, there's no question that it was not done according to custom. And that just that by itself would make groups like the a MA Very nervous Yes. And then throwing things around like, uh, removing people 'cause they had conflict interest and then having a bunch of people that Kennedy clearly has known for a long, long time.

Um, it's just, is just not, I. A hundred percent transparent. So the transparency thing, this, this is not transparent at all. Yeah, that's right. It Kennedy did not run a transparent process. Yeah. Subjectively not transparent. Now he maybe has the right to do that, but it doesn't engender trust and credibility.

And so hopefully they will behave in a way that [00:32:00] keeps our vaccine policy producing positive public health. But we won't know until they start executing it. Yeah, that's right. 

Marcus: Alright, moving on. Hospitals rail against inadequate pay bump mandatory team participation in IPPS comments. Fierce healthcare.

Vic: Yeah. So, um, there's a comment period after CMS puts out their payment rules. Mm-hmm. Um, it was a pretty low 2.4 pay raise, you know. Maybe inflation is 2.4 this month, but it's higher than that in general. Yeah. It's pretty, pretty difficult, uh, set of, you know, payments and so it's not surprising that the, you know, hospital and physicians Sure.

A HA are upset about it, but, but they, they have the chance to comment and they have provided a lot of comments. Yep. 

Marcus: Yep. So both the a HA and the, uh, [00:33:00] fed of American hospitals are basically aligned on that and the essential hospitals, all of 'em. Yeah, of course. The essential hospitals. Yeah. I mean they're, they're in a world of hurt right now.

Um, alright. Wall Street Journal, moving on to payers, Humana to back curbs to Medicare Advantage billing practices. So Humana may be trying to get on the good side of, uh, all the attacks against, uh, Medicare Advantage billing practices. 

Vic: Yes. Humana is trying to get in front of the criticisms about upcoding.

Yeah. Or aggress, maybe aggressively. Diagnosing things. Yeah. I mean, I mean, whether that will work or not, I don't know. I don't know if, if they have a track record of doing that or not, but they're, they're saying that they're supportive. Curbing that. 

Marcus: Yeah. Well, it's, it's interesting, right? I mean, I the kind of knock that, that, uh, that came to United's door around Upcoding, and we're gonna talk in a little bit here about cvs.

Mm-hmm. You know, now [00:34:00] being, you know, accused of the same thing, uh, in both of those enterprises is a part of the, of the business, but it's not the business. Right. You know, it's a meaningful part of the business, but it's not the business. Medicare advantage you mean. Correct. Yeah. Right. Sorry. Right. Um, for Humana, it is the business.

Yeah. Right. And, uh, they are somewhat new to the game with, with what they've been doing with Center Well, but they've got the same Payvider platform Yeah. In place. Right. And so I, I think I. You, you've already seen the kind of damage that can happen to this. And I mean, I, I think it, this would be like a lights out moment for Humana if, if they were to, um, you know, get railed for, uh, for upcoding.

So this seems like the exact right positioning to them. Yeah. I don't even see it as competitive. I see it as like defensive and, and, um, sort of trying to survive. 

Vic: Yeah, I agree. It's smart that no one supports those kind of practices. Um, and [00:35:00] Humana getting out our front and saying that they are in support of curbing that kind of practice is an easy, an easy win for them.

Marcus: Yeah. Yeah. And, and necessary. Yeah, necessary. Right. Um, all right. Cigna rolling out new tech tools to simplify the member experience. This is Fierce Healthcare. 

Vic: Yeah. So, so Cigna is rolling out tools, AI based kind of your. You're a coach, help, help you navigate the system. Um, I think it is also smart. They have a very different business than Humana, but um, they are trying to make the mostly employer based plans.

They're trying to help them with navigation and members, you know, if they are happy or with the tools. Cigna, I think could maybe gain market share against other, other groups that are, let's say, distracted with their other lines of business. Sure, sure. 

Marcus: Healthcare dive. HHS Watchdog Accuses CVS Medicare [00:36:00] Advantage Plan of Upcoding.

So this is what we were just referring to. Uh, the vast majority of diagnosis codes that CVS subsidiary Coventry submitted to the CMS between 2018 and 2019 weren't supported by patient documentation, the H-H-S-O-I-G found. 

Vic: Yeah. And. This is an accusation, so we will see how it plays out. But this is even a step further than United was accused for because, um, United was accused about going to the patient's home and sort of interview them very carefully to document every possible thing that they could have.

This charge is that CVS up charged without the documentation, which is I think even a step worse. Uh, but it's all, it's all negative. 

Marcus: Yeah. And, and is an audit now. Now we'll go through the whole Yeah. Yes. You know, but there's no 

Vic: good result for CVS, I [00:37:00] mean, this is a bad. Going through this process is not what you wanna be.

Marcus: Yeah. And I mean, again, it, it gets to what we were saying when, when the first story came out about United th that this is a payvider issue, not a united issue, almost certainly. Mm-hmm. Right. Because it's, it's, it's that closed loop ability that you have when, when you've got both the provider and the payer sort of, you know, on two sides of the same balance sheet.

Right. Um, and, uh. It, it gets back to why Humana is saying, Hey, we're, we're all curbing this. Right. You know? Yeah. 

Vic: And 

Marcus: Cigna, 

Vic: I mean, Cigna has ever north, but it's not the 

Marcus: same scale. It's not, it's not the same. Yeah. And, and they're, they're kind of out of the government pay business anyway, so. Yeah. Um, alright.

Fierce Healthcare, the layoff tracker two key, uh, additions, um, both on the health plan side, blue Cross Blue Shield of Michigan. Uh, they eliminated 600 positions that included 220 layoffs. There were a bunch of open positions. They just shut those down. And then they actually also laid off 220 people. They have a goal of, uh, lowering [00:38:00] administrative expenses by 600 million over the next three years.

And so this was the next step in that process. And then Molina also laid off basically their, their Virginia Health Plan employees. They're exiting the market. We've talked about the government pay groups, looking at the economics and, and just exiting markets. And that creating. Less competition, which is less good for, um, you know, the government pay, uh, based, uh, you know, residents of, of certain states.

Yeah. And this is, this is one less payer in the state of Virginia. 

Vic: Yeah. Yeah. They lost the Medicaid contract and so they're, they're, they still have some business but not significant enough to, to keep it open. Yep. So they're, which is not good for coverage, but, but it just 

Marcus: is what it is. Yep, yep. So hopefully those employees can find work with mm-hmm.

You know, another plan that, that Yeah. You know, was able to pick up where Melina lost, but, uh, in the meantime, hopefully, yeah. Hundreds, hundreds of, uh, folks in the health payer world lost, [00:39:00] lost, uh, lost their jobs. Alright. Uh, for patients with rare blood cancer, new drug offers relief. People with polycythemia vera often need regular blood draws to keep the disease in check.

So this is, uh, a new. Treatment for very rare type of blood cancer where people, uh, they're, they're just generating too many red blood cells. Yeah. Um, uh, from their bone marrow and, uh, you know, rare, the, these rare diseases, uh, are often great targets for coming up with therapies. They're, they're hard.

They're hard, but because they're rare, you get, you know, some, um, some leniency from the fda. Yeah. Um, especially if they're rare and deadly Right. Then, then you get some leniency from the fda. A and you have this captive audience. It's like all sitting there waiting for it and is gonna lobby with their insurance company to like, please save my life.

Life. And I 

Vic: think, and I think CMS is friendlier about reimbursement. Yes, yes, yes, 

Marcus: yes. Especially if it, if it's a breakthrough. Yeah. And, you know, you can now [00:40:00] sort of take a daily disease off the list of daily diseases. Right. Yeah. So, um, so this is, uh, yeah. 

Vic: So it's 50 out of a hundred thousand, so small population.

Mm-hmm. But. But really very valuable for, for those patients. 

Marcus: Yeah. Yeah. So this is a new drug from Protagonist Therapeutics and Takeda Takeda's, the, the distributor. Um, and, you know, good news, good news. So, you know, let's, let's see how this continues to progress, but, uh, this, uh, this is not yet out in market, but everyone seems to be very, very optimistic about it.

Yeah. 

Vic: Yes. 

Marcus: Alright. And then in the, in the continuing, uh, expansion of chronic disease drugs, finding new use cases that are passing clinical trials. Mm-hmm. And, and, uh, you know, getting sort of more economic viability. We normally talk about Glip ones, but, uh, SGLT two inhibitors, it's, so everyone may not know what those are, but you've certainly seen c commercials for Jardiance and Farxiga.

Um, those drugs are, [00:41:00] are now sort of being, uh, embraced as longevity drugs, uh, as well as just, um, glucose management drugs. 

Vic: Yeah. So. Glucose, um, causes diabetes and kidney disease. And, and so this drug, I think helps the body expel glucose more efficiently through the kidneys. Um, and so people that are wanting to live longer and be healthier, ha and think metformin was the first thing to, okay, right?

Managing your glucose more carefully, not having swings at all, or very limited movement, I think has been shown to, I think it sort of replicates the, um, calorie restriction benefits, um, without having to fully go on a, a fasting diet. That's my belief. Uh, so anyway, yes, uh, [00:42:00] longevity folks are. Now utilizing these SGLT two 

Marcus: drugs.

Yeah. It's old, is new again, you talked about Metformin. I, and I feel like that was what I knew Peter Atia for. Yeah. When the beginning, that was like 15 years ago. Yeah. Right. Yeah. And, and now he doesn't talk about Metformin at all anymore. Right. He's, he's a hundred percent just like exercise, just like, just exercise.

So I just think it's, it's, it's, it's interesting how this stuff just kind of keeps cycling back and forth, forth. People 

Vic: want an easy solution. Exercise is hard, so, yes. Um, I'm not sure that the easy solutions work as well as exercise. Right. But 

Marcus: Right. For, for many, many reasons. Right. Yeah. Um, alright. Into the AI rundown, starting with the Wall Street Journal's coverage of IBM who has a roadmap to a fault tolerant quantum computer by 2029 IBM back in the computer game.

Vic: Yeah. I mean, I think IBM is good at what they are mapping out here, which is building a, you know, computer the size of an entire building. Um, [00:43:00] but instead of it being a mainframe computer, now it's gonna be a quantum computer. Yep. And they have ways to make it fall tolerant, where I think the, the quantum bits affect each other and you have to somehow shield them and have redundancy.

So 2029 having a, a working, you know, enterprise scale quantum computer is pretty fast. So that's also what caught my attention, the timing of it. 

Marcus: Yeah. I don't know. I mean, I guess given all of the, you know, chips that, that have, uh, sort of hit the scene over the course of this year, this is becoming less, uh, less shocking.

Yeah, yeah, yeah. Yeah. Less, less shocking. So, um, but, you know, good to see IBM. Yeah. Putting a stake in the game. Yeah. It's, it's a, you know, quantum is, is is one of those step change revolutions in, in computing. Mm-hmm. And so if IBM wanted to sort of get back to their glory days, yeah. This is probably the right place for them to focus.

Yes. Um, I bet that's, you know, four years out. Right. Um, but might get them some work. Back close to where they were in the [00:44:00] past. Uh, okay. The next story is also Wall Street Journal and it is referring to something in East Tennessee. So it's talking about Oak Ridge. Yeah. Um, which, if you're not from Tennessee, you probably, you may have heard of the Oak Ridge boys or, you know, no, but you may not know that.

Oak Ridge is a, is a huge, um, you know, technology hub, chemistry, nuclear power. Yeah. Especially anything energy, anything energy. You know, Oak Ridge is, is really sort of known for. Yeah, that's, that's right. Solar, wind is all, all sort of, you know, um, being worked out of Oak Ridge. Um, but this is a cool story about a company, um, that was sort of backed by a single founder, not, not a single founder, but single benefactor.

Yeah. Um, who really sort of believed in, in this evolution in nuclear as sort of the future mm-hmm. Uh, important that this is very against the grain because, you know, America's been anti-nuclear in sentiment for a very long time. Yeah. It feels like just in the last five years, we've sort of turned that around.

Um, and AI is now supercharging this whole belief that we need to get nuclear back online in America in a meaningful way. Um, [00:45:00] but this little itty bitty company that was being backed by the single person, uh, he died, their checks ran out, and just a real story of resilience, um mm-hmm. Of the team Yeah.

Where the money wasn't coming in and these people started making all these crazy personal sacrifices Yeah. To keep the company going. I mean, you know, you just never hear that happen anymore. Right. Um, and, and then boom. In comes a VC drops 40 plus million on 'em, and, and now they, they also have the tailwinds of nuclear being, you know, yeah.

Highly desirable. And they may be sitting on, you know, a massive, massive company. 

Vic: Yeah. It's a, it's a great story in Oak Ridge that, that needs a wind. I mean, Oak Ridge was incredible in the, you know, atomic age when, when the Manhattan Project sixties. Yeah, yeah, yeah, yeah. Um, but this company, standard Nuclear, they make the, the fuel, it's like little pellets.

I think the size of a poppy sea is [00:46:00] what they said, um, that are uranium kernels that go into the small molecule reactors, um, that are much safer. Um, it's a much safer way to do nuclear. So, um. I'd like to see, I think we need the small molecule reactors to begin getting regulatory approval and getting produced.

One of the companies that's doing that is also in Oak Ridge. Um, but there's other ones around the country and when they get produced, this is, this is the company that's making all the fuel. Right. They're gonna do well, they went without pay for a while, but they'll do very well in the next few years.

Marcus: Yeah. I mean, they had to know they were, they were onto something. Yeah. If they could just kind of make it to the other side. Yeah. Um, yeah. 

Vic: But without AI coming up the way it has Right. The, the nuclear like impetus, it's just, it wasn't there. It's not there. We needed to get desperate enough. We're lazy, we have oil and gas.

It's [00:47:00] easy to get it there. There 

Marcus: needed to be a new consumption driver. Yes. Right. Of, of power. Yes. Right. And, and that's what AI is. It's, it's a new consumption driver. Yeah. Alright, uh, Google is extending employee buyout offers in a push to raise AI spending. So this is more proof that Google is getting super, super focused on AI and going around to other departments that may be a little bit more in a mature state, um, where, you know, maybe the market has been largely saturated and it's mostly like a small increment, you know, kind of a Netflix theme, right?

Yeah. You're not gonna grow your, your user base by very much, but you can increase pricing, add on some extra products, et cetera, et cetera. Whereas AI, it has, you know, from the ground floor to go up for them. And also search is being cannibalized by AI simultaneously, right? And so the imperative here for Google is to get their AI game supercharged so they can compete with Sam.

Vic: Yeah. And, and, um. [00:48:00] VCs know the story, but not everyone will know it. The innovative dilemma has been studied for, I mean, since the nineties, Clayton Christensen and Harv at Harvard Business School created it, where like when you are the dominant player in industry, it's really difficult to disrupt yourself and move as quickly as the innovators do.

And so VCs like you and I back a small startup and they move much more quickly. And it has been traditionally, I mean, I think the, the startups are undefeated in the long run. Google is doing things to try to buck that trend. I mean, laying off or giving employees buyouts is essentially like helping them move on in Chrome and Android and search in the, these are significant cash flow positive cash cow businesses.

Moving them on in order to reinvest in [00:49:00] AI where they are one of five companies, but they're not the dominant 90% share. I don't remember a company doing that this aggressively, and I give them a lot of credit. I mean, it's clear from the outside that they need to make these kind of changes, but it's really hard on the inside culturally to say to your friend who's at search that you know is running a team there.

You gotta give your entire team a buyout option. 

Marcus: I think the unique thing about Google, which, which I would love to see the Innovator's dilemma, you know, sort of model, analyze the Google Open AI story from a case study perspective, right? Yeah. Yeah. Because the unique thing about Google is Google invented the tech that is cannibalizing it.

Yeah. Yes. And it, and it was behind in getting it to market. 

Vic: Yeah. 

Marcus: Right. So it, so it was a completely self-inflicted 

Vic: wound. I mean, that is the textbook story of the innovative dilemma, [00:50:00] right? Like, uh, I'm not gonna get, right. Polaroid invented the technology, but then, uh, Kodak destroyed there. I might have that backwards.

Yeah. I, I mean, I, but what's different about Google, I think, is that they still have founders with, that are, well, one of the founders is still there. Yeah. Sorry. Is still there. And he has either the special preferred chair or enough ownership that he's very influential in the company. Yes, yes. And I think that he's not doing it for the money.

He, he wants to make the world better. Right. That is a different mindset than a lot of incumbents companies have. 

Marcus: Okay. So, so. I don't wanna take too long, but I I Where I thought you were gonna go, I thought you were gonna go to, to Xerox and Apple and, okay. That's a, that's a better story because I, we 

Vic: know that one very well.

Yeah. In, in the graphical user interface. Right? Yeah. 

Marcus: That's where I thought you were gonna go. Yeah. And, and I guess [00:51:00] the, the difference is Xerox was not in the gooey business, you know, like Google was in the AI business. Yeah. They just were not in the unleash AI to the world business, I don't think they believed it was 

Vic: safe and 

Marcus: ready.

And also they didn't have a good answer for how they were gonna manage the cannibalization of Yeah. Of search themselves. 

Vic: So, I mean, I, I mean, I think at Xerox Park, they, they invented the Windows gooey interface and the mouse, and they thought it was small and cute. And a toy, a toy toy. And didn't bother with it.

They didn't believe in 

Marcus: personal computing. 

Vic: Yeah. Yeah. And I think it's pretty analogous in, in that set of facts, Google invented the, um, [00:52:00] TPU, the, the processor and they invented the, and the transformer. Yeah. And the, the attention is all you need Paper came out of Google. Yes. Um, but they, and they bought Deep Mind, so they understood how important it was, but they didn't go to market quickly until Sam Altman and OpenAI did.

That's right. That, um, and so it is different in the sense that they have, I mean, they probably have the best depth of, they definitely have the best depth of AI research team, uh, in the world, but they hadn't unleashed it yet until they saw it turned on by this upstart competitor, open ai. And then it took them a little while to get their act together and figure out how they were gonna turn the ship.

But, but they have turned it now. 

Marcus: Yeah. Yeah. I, I, I think that's right. I mean, I'm, look, I'm still, there are still issues, uh, with, with Gemini that [00:53:00] I'm waiting to get worked out, right? Mm-hmm. Um, but it's, it's clear they're very much in the game. It's just they're not, they're not Google in the game. They're just a player 

Vic: Yeah.

In the game. 

Marcus: Yeah, that's right. You know, they're, they're not, they're not who they are in search in, in this particular game. Right. They're who they are in cloud Yeah. In this game. Yeah. You know? Yeah. And that's not good enough. That's not gonna be good enough, right? Yeah. 

Vic: I mean, I, um, I mean it is, it's any person's game to win right now, but I, I would bet on Google if I was gonna.

Pick one, but they're not the brand. I don't have to pick one right now. But they're not the brand. They're not the brand. No, they're not the brand. No. T is by far the brand. That's the brand. That's the brand, yes. 

Marcus: Yes. Yep. That's the brand. Alright. Oracle shares jump as the CEO targets dramatically higher revenue growth.

So this is about the cloud business at Oracle, which mm-hmm. Um, you know, the revenue growth, [00:54:00] we gotta remember it's on a small base, right? They are, they're definitely way behind. They're forth by a long way. By a long way. Yeah. So they're gonna be able to, you know, clock a bunch of multiples because they're now putting a lot of attention and focus on their cloud, um, which is good.

And I think they also can make some discounts and be attractive and all sorts of other things. And also they probably have more, um, they probably have more capacity to, to offer people, you know, because, you know, Azure has gotta be awful to try to get capacity on right now. Yeah. Right. Yeah. They. Like real, not, not you and I doing a little pet project.

Right. I'm talking about real capacity on the cloud. 

Vic: Yeah. Google's the only one that has capacity. Yeah. Um, of the three top ones. Right. Um, so two reasons to, to include this. One, it's, I think it's an AI story because Yeah, I agree. The growth is ai and secondly, I believe that they're really [00:55:00] focused on healthcare in the corporate suite.

Agree. And so they're the one to watch. Like, are they going to, what are they gonna do in healthcare ai and what's that gonna mean for us, if anything? 

Marcus: Very much agree. Uh, alright. This was, this was kind of my story of the week. Mm-hmm. Um, 'cause I, I, I did, I had not seen a chart that actually laid out how bad Google's AI rollout, um, on search was impacting.

But I, but I have to admit, like when I use Google now. I kind of stop at the AI overview. Yeah. Right. Yeah. So Wall Street Journal, uh, has this article here. News sites are getting crushed by Google's new AI tools, and it's not all the sites because many of them have their own or organic traffic sources that are not just Google, but the whole idea of the The blue links.

The 10 blue links, like that's effectively dead now. Yeah. Like even if you go on Google and you look at the real estate, the AI overview takes up like two thirds of the page. Yeah. You only get like one link [00:56:00] on on the na. You have to scroll to get more than one link. That's not an ad paid from Link. 

Vic: Right, right.

Marcus: Because the AI overview just takes up all of it, you know? It's crazy. Yeah. I mean, it's crazy. 

Vic: That is the right thing for Google to cannibalize search and move people to start using ai, but it is really having. Bad downstream effects to to news journalism agencies. Yeah. So this chart here, people that are listening, uh, since 2022, business Insider went from 110 million visitors, um, to now monthly, monthly to now 50 million.

Marcus: I mean, that kind of crater cannot survive that. No, no, no, no years. First of all, the trend line is just brutal. Yeah, just brutal. Now, to be fair, it is ticking up a little bit here, but like the overall trend line is a 50 plus percent haircut. 

Vic: Yeah. Brutal. Brutal. [00:57:00] Yeah. And so the, the, the question that I have is not, I mean, this is over, I mean, the news publications, unless they have a strong subscriber base, so like the Wall Street Journal has a strong subscriber.

They're they're flat. They're flat. Yeah. Um. But most newspapers and websites do not have that. They're not gonna exist in five years. And so what will the inputs to AI be like, who is going to be doing the reviews of some new TV that then the AI can ingest if we don't have a revenue model for, for journalists to do it?

I, I don't know that we have that answer right now. 

Marcus: No. I, no. Look, I, I, I think we don't. Um, I also think it's worth noting here, wall Street Journal was flat. And to me, one of the things that says is Wall Street Journal had an iconic brand [00:58:00] for a very long time, has had a very strong subscriber base for a very long time, and did not feel the need to get into the SEO game.

They just kept publishing high quality articles. And so they, yeah, 

Vic: they, they, they were, they didn't monetize. The SEO, uh, traffic. Right. And now they don't have that exposure. 

Marcus: Right. Whereas Business Insider was an SEO farm. 

Vic: Yeah, 

Marcus: that's right. Right. And now that SEO is basically dead. They're dead. Yes. Right.

So that's, that's kind of another aspect of this, right? Yeah. Um, but that, but you know, here's the deal. You can't make another Wall Street Journal. Yeah. Right. Like, like that, that brand cannot be replicated quickly by some innovative new company. Can't be replicated at all. Right. I mean, I don't know how you would put it.

Yeah. So, so, so your, your ultimate point is the media business is gonna be something completely different, and we don't understand what it, what it is actually gonna be, but whatever it is, it's gonna be very, very different than what it has been for the last 15 years. [00:59:00] I mean, S-P-S-E-O has been a really legitimate thing.

I mean, since I, I kind of remember, I I just kind of mark it here. You know, our, our, our city's current Mayor m do you remember when him and Scott Holden created sighting. No. So it was, and and then they created Raven, the SEO tool. Yeah, yeah. Um, but that, that was 2006 I think was was when they did, yeah. So, so 2020 years of SEO being like a meaningful thing and it's pretty much over, man.

Yeah, that's right. SE o's pretty much over. Alright. Disney and Universal. Sue Midjourney over AI generated princesses and minions. That's a good headline. Uh, wall Street Journal. So you, you know, Hollywood continues to, uh, leverage the courts to try to manage their innovation challenge here with, uh, AI engines.

Vic: Yeah. And I think, um, maybe it, I [01:00:00] mean it's related to the last story, like Hollywood has, has these fears because they've seen other publications. Yes. Um, it's interesting. They sued in Midjourney and they didn't sue other. Groups because Midjourney, uh, didn't respond to them, didn't engage, didn't admit that they were causing any problem.

Other groups, uh, that also are doing image generation at least made an attempt to interact with them. Um, and so I, I think we're gonna have more lawsuits and still win some, but, but it's a, you can't put the horseback in the barn. Like it's, it's already, it's already over For this. I, I do. Dominions are, 

Marcus: are 

Vic: out.

Marcus: Yes. Yes. I, I, I agree. I, I do wonder. If on the corporate side, this does create a nice opportunity for Adobe because they have been very thoughtful in their [01:01:00] copywriting licensing strategies. And you know, they're not gonna be the same. They have an image 

Vic: generating tool that is so far 

Marcus: Yeah, that is fully Yeah.

Copyright protected. Yes, exactly. Exactly. So it, it just, you know, they're not like the sexy name out there. You're not gonna hear about them versus Midjourney or some of these other ones. 

Vic: Yeah. But yeah, but if you're doing an AI generated TV ad, you, you might want to use them. Yeah. Yeah. Cool. Because it would be better, I mean, wouldn't be better, but it would be as good, a little more expensive and, and safer protected from 

Marcus: I, I think, I think, I think the safety, right?

Yeah. I think, I think the, the trust that what you've created is not gonna be, you know, content Id taken down later on is kind of, yeah. You know, kind of nice to have. Right. Uh, okay. Onto Mark Zuckerberg. He, uh, cannot buy companies outright. They're already trying to pull companies out from mm-hmm. The meta ecosystem.

Right. Um, but he can make very, very large minority investments and acquihires, and that is what he has done. He has [01:02:00] made a, a significant multi-billion dollar Right. Investment. Oh yeah. I think it's 14 billion. Yeah. Multi-billion dollar investment in scale AI basically to buy the founder and CEO Alexander Wang, um, to come lead AI at meta.

Vic: Yeah. So Alexander Wang is, if this goes through, going to lead the super intelligence dedicated team at Meta, um, I don't know if that would cover all of it. I think it's only the super intelligence piece. Okay. Um, but it's a really interesting deal because I, I totally agree with you. Meta would not be allowed to buy scale ai.

That's my opinion, but I think that's pretty apparent it wouldn't go through. And yet they are buying 49% and hiring the CEO. Look, 

Marcus: they're not the first people 

Vic: to do this. No, [01:03:00] it's the second time I've seen it. Yes. But, but it is, um, I mean I guess it is, it's Microsoft. 

Marcus: Microsoft did this with, uh, Suleman.

Vic: Yeah, yeah. And there's nothing that prevents it, but it is quite similar to them buying scale AI in Yes. In, I mean in all, in all in all spirit, in all 

Marcus: effectiveness. 

Vic: That's right. 

Marcus: So it is, and, and, and probably the investment serves as, as liquidity. I know it does for the investors. Right? I know it does.

Vic: They're distributing the whole thing. Yeah, right. They just, they just raised $2 billion last year. Yeah. They don't need money for operations didn't, 

Marcus: yeah, no, that's it, Chris. That that's great. That's a seven x. 

Vic: Yeah. So a sale and the other VCs are getting liquidity and they keep their ownership, but it's, it's half as big.

Right. Um, I guess what, what I'm struggling with is that if the, let's just say the FTC, it could be the Justice Department. If they [01:04:00] would block meta acquiring scale AI because it would impair competition or something similar to that, why would they let this transaction go through, wouldn't it? Isn't it always, is it gonna do the same thing?

Well, you, I mean,

Marcus: I think you know the answer to this because I know your view, which is the government tries and tries, and tries to. Create certain outcomes in the, in, uh, the free market via regulation, but the incentives drive creativity, and that's what we have here. Right. A creative deal structure that does not quite trip the trip.

The wire, 

Vic: I mean, I'm in favor of, of acquisitions happening. It, it doesn't, it doesn't quite trip the wire. I'm not trying to stop it. I just think it's, it's not an 

Marcus: acquisition. It's not an acquisition. It's a minority investment. Yeah. You know, these, these things, these things have technical terms, right? Yeah.

It's a minority investment. The CEO wants to go, so it's, it doesn't, if the CEO wants to go work [01:05:00] for Meta, the CEO can go work for meta. He's not, he's not. Yeah. That's forced to deal. That's the 

Vic: beautiful creative loophole is that it's not under their purview of the FTC of justice problem. 'cause there is no, there's no change of ownership.

Yeah. 

Marcus: And, and can control, and here's what we're not doing. I, I, at least I don't think we are, unless we're doing personal vendettas, which this administration will do. But, you know, I, I don't, I don't think we're gonna expand. The remit of these agencies from a regulatory, I don't perspective, I don't want, I hope we don't, well, I don't think that's on brand for, I don't think that's on brand from a business perspective.

It's not on 

Vic: brand for the Republicans. 

Marcus: It's not brandand for Trump specifically. Yeah. 

Vic: Yeah. Yeah. It makes, I mean, I, I am, I think there might be people that are in government that are frustrated with the loophole, and I guess it's fine. But it seems like, you know, the first time it happened, it was the first time.

Now it's, it seems like it's [01:06:00] a playbook now. It's playbook now it's, it's a playbook. Yes. 

Marcus: Now it's a playbook. So, well, the first time it, 

Vic: it, it, it's a playbook. Yeah. It's, it's just, you know, yeah. 

Marcus: It's just, 

Vic: I hope that it's precedent. I hope I have a company big enough to have 

Marcus: to use that playbook. Uh, RSM plans $1 billion investment in AI agents and other services.

So this is a very, very large, but not a big four accounting firm. And, uh, you know, yeah, I. These big accounting firms are all in on ai. Yeah. You know, look, they, and, and they should be, I mean, they offer a service. The service largely follows a set of very predictable rules. Um, it's a lot of data parsing. You wanna talk about a business that really can leverage AI and also has significantly struggled with labor.

Um, you know, getting, getting new accountants to join these firms. And, and the, the downstream effects of that for us, for, for businesses is prices keep getting jacked up. Yeah. You can't get an auditor. I mean, it's, it's really pretty problematic. So this [01:07:00] is one of those spaces where I feel like, um, the market was starting to break down and AI is actually going to allow for an increase in productivity where the labor force was actually diminishing productivity, um, and also creating higher prices.

Vic: Yeah, I think that's right. Internally, they will use AI extensively. And then another thing that RSM is doing is they're gonna. They really have a middle market customer base. They're gonna bring AI solutions with a credible kind of partner, um, level of trust mm-hmm. To Middle America and help them implement some of these things.

And I think we're gonna need trusted groups like auditors and accountants to figure out what are the tools that are not on the bleeding edge, but are, you know, we, we've been using this. RSM has been using it, they've tested it, and then they bring it to their clients and, and that would be good. All round.

Marcus: Yeah. And also like firms like this, doing this kind of work is where AI gets [01:08:00] real. Yes. Right? Because they're not making this kind of investment if they can't operationalize it. That's right. Yeah. So this will be AI agents for real doing real work. Yeah. Nvidia climbing in a bottle opens a view into Earth's future.

What will we do with it? 

Vic: Yeah, I don't know what we're gonna do with it, but it's cool. So we put, I wanted to talk about, put the link in the show notes. They have used their tools to model the entire planet, including all the weather patterns and so they can predict what the hurricane season is gonna be like this year, but also what the sea level rise will be 50 years from now.

Yep. And it looks really, it looks really good. I don't know that we have an ability to see how accurate it is. Um, but it's a showcase thing for Nvidia to show off and 

Marcus: Yeah, look, Nvidia is cool. NVIDIA's [01:09:00] cool. That's right. They do cool stuff. Nvidia might be the coolest company right now in the world. I mean, honestly, you know, they're not a consumer company.

Right. So they lack some of that kind of playing. Yeah. 

Vic: People can't really understand them, but they do a good job. Yeah. With things like this Yes. Given 

Marcus: yes, yes. 

Vic: Illustrations of how, 

Marcus: yes. And, and, and I think they paint a much better picture of the future than any of the LLM companies. Like they, they just seem confused and we're gonna talk at the end, we're gonna end the show.

But they, they're just out there saying all this like weird stuff, whereas like, they're delivering the actual picks at this, at this gold rush, right? Yes. And so when Jan, when, when Jensen speaks, I'm like, I believe what he's saying, right? Yeah. It's, it's much more about the demand and what, uh, organizations are gonna do with this demand.

Like what RCM is doing. Yeah. It's just much more grounded. You know, the stuff he says is much more grounded. Okay. Musk says the Tesla Robo Taxii launched, tentatively planned for June 22nd. So Elon stopped fighting with Trump. Yeah. He's [01:10:00] apologized 'cause he realized he has to get this damn robo taxi done or else Tesla is in a fuck ton of problems.

Yes. So yeah. Robo Robo Taxi in Austin. 

Vic: Yeah. And hopefully it works. I mean, they, they're claiming to be very concerned with safety. Um, and I hope they are. I, I, I mean, I've ridden in Tesla. I don't own a Tesla, but I've ridden in a bunch of Teslas. It's really good. And going from really good to letting it be a taxi just on the streets of Austin is, is a significant change.

Marcus: Yes. Well, look, the, the thing we know is Waymo has an advantage on the technology. Tesla has a significant advantage on the data. Yes. Nobody's got better data that Right. Than Tesla's. That's right. So we're gonna, so now we're, now we're [01:11:00] gonna see, right? Yeah. Now we're gonna see, 

Vic: and it'll, I hope it works and it'll be great for you and I for all the, all everyone who does it.

Own one of these things, to have robo taxis from two companies that are both really growing quickly 

Marcus: and just like we started the show talking about if you're on the left, get in a Waymo. If you're on the right, get in a Tesla. Yeah, yeah, that's right. I mean, seriously. Yeah, that's right. I didn't think about that.

Right now, the politics are gonna allow for both companies to, to, to make it, you know, uh, okay. Open AI releases O three Pro, a souped up version of its O three AI reasoning model. So, uh, interesting. It feels like, so who came out with Pro First? Does Gemini, was Gemini the first to come out with, with Pro in the naming convention?

Vic: Uh, I think that's right. They have, or was it Claude? Claude Pro and Ultra, I think at Gemini. [01:12:00] Claude, no, Claude has, so Claude has a different, their artistic Sonet Sonet. Uh, Opus something in the middle. Yeah. Yeah. I dunno what the middle one is. Um, I don't know that open. I don't think they, I think they're late to the party with Pro.

Yeah. Okay. Their naming convention is the most confusing to me. It's all I, but I also don't use it as much as the other ones. Yeah. 

Marcus: Right. Yeah. So anyway, look, I mean, I don't think it's anything more to say other than it's very, it's very good. 

Vic: It's very cost. It's, it's very expensive to run. Um, and I don't know this mixed reviews, some people love it, some people think it's not that different than, yeah.

A one, I 

Marcus: guess, I guess maybe the thing to say here is that, you know, these deep reasoning models are getting more into analyst replacers, right? Like, you use these when you're trying to replace a consultant or an analyst that you would hire

Vic: [01:13:00] y Yeah. 

Marcus: Yeah. 

Vic: I, and I think I have a lot of. Biases is gonna take too long to scuff, but I think you need more tools than OpenAI is offering. Sure. I I'm just, but yes, you need a reasoning model. Yes. Um, but the, that's less important than the, than the tooling, I think. Yeah. You, well, you're, you're talking about workflow, I think I'm talking about getting, getting things done.

Marcus: Yeah, 

Vic: yeah, yeah. You're talking about, 

Marcus: you're talking about workflow. Yeah. Right. You're talking about workflow interfaces. How does it plug into Slack and things like that. Yeah. 

Vic: Yeah. I haven't found, and, and actually, uh, uh, I can't remember who it was. Someone came out, maybe Apple, someone came out recently saying they had bad, bad results with reasoning models when they push them to, to sort of create new concepts.

So like be a Oh, yeah. No, it's all 

Marcus: derivative. 

Vic: Yes. Yeah. So if it's seen it, you know, before it can Yeah. Regurgitate it out. And so [01:14:00] there's value there, but I, I have, um. I am having more success using AI without the reasoning just to do particular tasks Yeah. That I want to do. Yeah. I don't need the reasoning.

Marcus: Yeah. Piece of it. Yep. Alright. And finally, Sam Altman trying to get into the Dario. I'm a day game. Um, I guess Dario keeps coming off as like the philosopher king right. Of, of AI CEOs and, and Sam wants to get more credit for that. So he did a Ted Talk and now he's wr he's written this piece here called The Gentle Singularity.

Yeah. Which is, which, which to me feels like a bite off of Robots of Loving Grace, which was Dario's thing last year. But anyway, let's, yeah, it's a bizarre, 

Vic: uh, essay. It's sort of simultaneously trying to claim that Open Knight has already created what I would say, super intelligence. Uh, he doesn't use that particular word, [01:15:00] but he says like.

For instance, I'm quoting in some big sense Chachi PT has, is already more powerful than any human who has ever lived. So that's, and that, that's true. That's a, it's true. It's also approaching claims that it is super intelligence rate. A GI, it's not exactly saying that. So anyway, he, he's taking credit or saying that they have achieved incredible, uh, gains and intelligence.

They certainly have. And then he's saying that trust him, it's gonna be wonderful for all of us and we will all enjoy it. And so the first one I think is, uh, kind of self-congratulatory. And although it's true, I don't know that I need Sam Altman's blog to tell me that. And the second part, I don't trust him at all.

I mean, of all the platforms. I, hopefully it will be wonderful for all of us. I [01:16:00] don't trust Sam Altman to be the gatekeeper to that. 

Marcus: Yeah. I mean, uh, I can't quite put my finger on it. He, um, it's, it's not that I've seen him carry himself in any kind of, uh, you know, just in any kind of manner that, that makes me feel that I don't trust him.

I think it's the magnitude of the responsibility, right? The, the magnitude of the responsibility of the CEO of open ai, right? Like this is just, it's such a big job. Yeah. It's such a huge responsibility and I just find the way that he communicates about it to be wanting of a sense of humility. And I just, and that is, I think what, what concerns me, right?

Like yes, generally speaking, [01:17:00] you are looking for CEOs to be very confident and you know, you're, you're not necessarily looking for humility, right? But this is not a drill man. This is not a joke. This is, uh, it's intelligence. It's the power. That is intelligence. I think he's right. I think he, he is accurately describing chat, GPT when he says, in some big sense it's more powerful than any human who has ever lived in some sense.

Like not in all senses. Yeah. But there is a way in which it already has done that. It already has achieved this level of power, um, that's greater than any of us. And. That is a huge responsibility. And when we see the board departures, the team departures the spinoffs, the people who are saying that this thing is already at a GI internally, and they're just not telling you, you know, [01:18:00] the, the, the worries that we hear about it rewriting its code and not, when I say it now, I'm talking more broadly about LLMs, you know?

Yeah. Rewriting their code, trying to deceive people, you know? Yeah. The, the, all of these things, the whole 

Vic: nonprofit, uh, we wanna make it for profit, raise money around going for profit, then, oh, we can't do that now, so we're not gonna do that. It's, yeah. It's, there's just, it's not that I have any evidence, it's just, I, I don't trust him with this level of responsibility.

Marcus: It's the, it's the level of responsibility. Yeah. If he was running a normal company. I'd be like, the dude's a badass. Right. He's smart. He, he attracts great developers. He's got strong vision. He ran YC for a while. Yeah. So he's been under Paul Graham, you know, like there's a million things to respect about Sam Alman, you know, but the level of responsibility and, and the other thing is like, he's sneakily like Elon in that everyone who, I'm not trying to say this in a pejorative way, but [01:19:00] like, normies only know about him doing open ai.

Yeah. They don't know about world coin, you know? Yes. Where he's freaking scanning people's eyes into an orb because he believes like, we're gonna need proof of humanity. 'cause Theis are gonna be like, you know what? So yeah. It's just like, like, and that's a real, this is like a legitimate, real thing right now that's, that's happening.

Yeah. But if you're not crypto, you don't know that. You don't. Right. You know, you have no idea that's even happening. Yeah. So he's, he's not running one company, he's running multiple companies, 

Vic: right? Yeah. And. Going back to Dario. Um, he is, he also has the same level of responsibility. And the way he frames it is we need to be transparent about what the models are doing.

Yes. And you should, and you reader should hold me accountable. Yes. And that's very different than someone, than Sam saying, trust me, it's gonna be wonderful. You'll have a great life. Okay, but [01:20:00] you'll, but you'll be the trillionaire and I'm going to be just like at your, you know Yeah. That doing, 

Marcus: playing with whatever toy you give me.

Yeah. That sounds like the architect in the Matrix. Yes. 

Vic: And so, you know what I mean? It's just a, it's a, 

Marcus: I don't know, it 

Vic: might be a style thing, but I think the, uh, yeah, there's not a lot of humility. He didn't come up through a humility filled No dude, you know, process. So, no, 

Marcus: no. You know, it's not his fault.

He's not on, he's not on earth. Right. You know, he's not on earth. Yeah. Um, anyway, read it if you want to. I mean, the Gentle Singularity by Sam Altman. Yeah. We'll have a link. Yeah. Uh, anyway, I gotta get the heck outta here. I'm, I'm gonna be late for, for, uh, an event tonight at the, at the Parthenon. Oh, nice. Um, yeah.

Uh, but okay. Another good show. Are, are you back next week? 

Vic: Yeah. 

Marcus: Yeah, I'm here next week. Alright, cool. Alright. See you next [01:21:00] week.