30 – Cigna & Humana Merger while UHG Shows Reach & Scale | CMS Decreases Physician Payments, but adds New Programs | Global & Economic Power

Vic: [00:00:00] All right, here we are episode 30. Yes, sir. How you doing, man? I’m good. Ending. November about to start last month of the year. Yep. The year has gone by quickly. It has 30, 30 shows have gone by quickly.

Marcus: Yep. Uh, great responses from our last show. Yeah. Lots of good feedback. Um, we will definitely be doing more guests in, in 2020.

24 excited about getting them all booked, but we’ve reached out to a couple of really great guests already who have said, yeah, so we just gotta get them scheduled. I was looking at the show notes that you pulled together for today and what a week it’s been there in the world.

Vic: I mean, it’s usually over a holiday.

Thanksgiving is kind of quiet coming back, but it wasn’t quite this week. A lot’s going

Marcus: on. So we had the passing of, uh, Rosalynn Carter. Uh, first lady and with the passing of Charlie Munger now, and then we had the passing of Henry Kissinger. And I think what’s incredible about all [00:01:00] three is late nineties and then a hundred.

So no early passings there, but all three icons, um, two of those in the government and one, you know, uh, Potentially the, one of the greatest investors of all time that we don’t actually refer to as the greatest investor of all time. Right.

Vic: Yeah. I mean, I think all three really had a huge impact on the last century.

Especially America. Yeah. Yeah. And it’s just, um, I mean, it’s sad and it’s also kind of a change in the guard. Like they’re that whole class of. Really important people in the 70s, 80s, 90s, uh, where they were really kind of decided a lot for America. They’re no longer with us.

Marcus: Yeah. Yeah. I, I’ve been certainly reflecting a lot lately on, I think our generation generation X, um, the fact that [00:02:00] we are in that window where our giants are passing away.

And, uh, it’s, it’s the, it’s the weirdest thing to sort of realize that people aren’t just passing away, but like your generation of giants, you know, the ones that

Vic: you grew up looking up to,

Marcus: yeah, right. Um, are, are passing away. And I think this is the part of the, the midlife crisis. That doesn’t get talked about a whole lot, you know, people talk about, oh, you know, it’s on a motorcycle or he’s getting a convertible or, you know, um, you know, any, any one of those silly things that kind of is, is, uh, meant to say that you wish you were young again, and maybe that’s part of it, but I think it’s much more the, the inevitable, uh, sense of mortality that sort of just descends upon you.

Because your giants begin to [00:03:00] pass away.

Vic: Yeah, it’s, it’s definitely makes me. Realize my own mortality. It always also, I think, makes me realize that the, our generation X has to begin to step up and the role models that we all learned from, I don’t think that template works in today’s world. And one of the things I like about this podcast is that forces me to think through all of this news coming at me faster than I’m really aware of.

And I’m comfortable absorbing, but I have to figure it out. But the landscape is shifting. The geopolitical landscape is shifting. Technology world’s shifting. The healthcare environment’s shifting. And there’s not a good template just to pull out. We have to sort of invent it, uh, for ourselves, which is kind of daunting.

It’s maybe it’s exciting, but also there’s a lot of daunting aspects of it. [00:04:00] I

Marcus: agree. All right. So with that, let’s jump in.

All right. Starting with. Story about the Bureau of, uh, economic analysis that, uh, did a update to the GDP growth number for Q3 and found that it wasn’t in the high fours. It was actually in the low fives. Yeah.

Vic: Yeah. They revised, uh, GDP up.

Marcus: Yeah.

Vic: Which is great news. I mean, this entire story is great news.

GDP was up, and then the monthly inflation, um, thing, not CPI, but PCE, which is the personal consumption expenditure, it’s related to inflation, was down slightly. And so all, all good news. The story is written [00:05:00] as, Um, positive the Fed is likely done. Maybe we’re in a soft landing Goldilocks kind of, um, news article and I’m hopeful all the data seems really positive.

There’s something like in the back of my head that just makes me a little nervous to like call it over and say we’re, we’re in the clear. So yeah, I’m still a little bit cautious, but, but the news is all is all good.

Marcus: Yeah. I mean, um, the news that came out of the BA, uh, really showed the strength of corporate America, um, wall street stock market back.

Uh, we’re going to run through some numbers here shortly about some of the, the big healthcare companies. Um, but clearly, you know, our, our, you know, the, Our economy is doing great, but it’s because of certain shifts that it’s made. And there’s still [00:06:00] some dislocation that needs to bear out. I think in particular, we have not yet seen what is going to go down around core around corporate real estate.

Um, I’m still. I’m seeing people in the corporate real estate space look really stressed when I see them in person.

Vic: Yeah, just around, around town. Around town. Yeah.

Marcus: When I, when I talk to people in corporate real estate, they look really stressed. They don’t look like they’re having a good time. They don’t look like the economy is doing well for them.

And I’m now actually starting to hear them talk about the debt burden, um, how a lot of their terms are. Up for renewal and they’re going to be rewritten and the debt servicing numbers are really challenging and the capital markets are still closed. I think that’s one thing that if you’re in the private markets, you view the economy a little bit differently because you’re still looking at how the capital markets are moving.

And as we’ve been talking about for 29 plus episodes now, [00:07:00] uh, the private market capital is not. Flowing right yet. Um, so it’s nice that the stock market is starting to turn and rip, but it is not come down to the, to the private markets. And so there still might be some more bankruptcies, some more dislocation, uh, to come and, and we’ll see what those impacts are.

Vic: Yeah. And we were talking about this earlier in several episodes ago, the, the indexes S and P 500, for instance, it really is seven names. That are carrying the entire growth of the index for the whole year. So if you pull out those seven names, which are largely, I think they’re all tech, the big tech companies, except for Berkshire.

Yeah. It looks like the index is great. But then when you go below it, below that, I mean, there’s, there’s 493 other companies, they are all combined. They’re down for the year. So I [00:08:00] think the stock market is never the exact same as the main street economy. Because it’s it’s wealthy or people that have assets in the stock market, and I don’t know if the the regular folks paychecks are keeping up with inflation, even though inflation is coming down, it’s cumulative, so it doesn’t it hasn’t gone negative.

So you’re still getting slight price increases. And I don’t know that. Payrolls are keeping up with that, but it but it’s on the net. It’s good. And the Fed seems to be doing a good job Pulling it back fairly slowly. There hasn’t been anything that’s really broken yet I think real estate is a huge risk factor and we’re benefiting from the technology Which is great, and I’m glad we have it As a country, but it’s not evenly distributed.

Marcus: No, no. I mean, if the rates don’t come down, uh, there are going to be parts of the economy that are going [00:09:00] to be broken for, uh, for a sustainable amount of time. So this is all good news to me insofar as it actually leads to rates coming down. In the first half of 2025, 2024, then, then I would see it as good news.

I mean, otherwise it’s, it’s fine. But as you said, that concentration in the, in the stock market, that’s a real thing. Um, and you know, we’re about to move into a consolidation story right now. Right. Uh, you know, the big healthcare news of the week is the announcement that Cigna and Humana are working on a, on a merger.

Um, what was it, two weeks ago that. That the news about Cigna spinning off a health spring, their MA business. And we’re, we’re going to do a deep dive on MA here very shortly with Emily Evans from Hedgeye, because there’s a lot of stuff happening in the MA space and it really deserves its own entire episode to really dig into what’s going on, changes

Vic: in how CMS is running the MA program.

[00:10:00] Yeah.

Marcus: Big time, big time. But, but this, you know, this kind of makes sense. And, uh, Make sense of the health spring spinoff, right? Yeah, right. Um, because anytime this kind of merger is going to happen, the two parties, and they’re, and they’re as big as these two are one is in the 8 billion range. One’s in the 6 billion range from a market cap perspective.

Vic: Yeah.

Marcus: Um, you know. You got to start spinning stuff off. Right. You know, if you, if you want to get the deal done, you got to start spinning stuff off and obviously health spring would have been the, you know, the key assets to spin off, although there’s likely going to be other assets that, um, the two parties will have to consider spinning off probably, especially in the, in the drug space.

Vic: Yeah. I mean, you, you had an inkling of this when they spun it off. I don’t know if we did it on the air cause it wasn’t confirmed things, but yeah, but you, you knew this was maybe on the agenda. Yeah. It makes a lot of sense to me, like Cigna is really strong on the commercial book, ASO with businesses that are self insured, and Humana is almost a pure [00:11:00] play Medicare Advantage platform, so they’re very complementary together.

I’m sure the regulators will look at it because anything this size they’re going to look at. But it’s hard for me to see how with HealthSpring now spun off, there’s not a lot of overlap overlap. Yeah, there’s not much that I can see that you would have a problem with really. Um, and honestly,

Marcus: other than the pure size,

Vic: just the pure size.

Yeah. But then you have to say, okay,

Marcus: but there’s

Vic: other

Marcus: much bigger

Vic: groups. And so I think it’s actually healthy to have. Some, some consolidation so that we have a group of large insurance, large payers that are multidisciplinary. They start, they’re all doing, um, healthcare delivery too now. And I think it’s a good combination.

I’m excited about it. I

Marcus: think what’s really interesting about this is that Humana [00:12:00] is almost certainly the best. Ma. Yes. Business. Yes. Very well run period. Yeah, that’s right. And you can make a case. The Cigna is the strongest employer. I think they are based insurance company as well. So there’s a real, and Cigna has the ever north business line.

So they’ve got their health services data play in place. Yeah, they have a good sized PBM. Yep. Yeah, express scripts. Yep. And human has got the center. Well, asset in place. So this is actually a fairly high quality merger. I would say where I’m not sure that one plus one just equals to, you know, it, it really could be a, yeah, I think that’s right.

A very value creating merge. Yeah. Yeah. But just because of the quality of the assets, right. You know, it’s not just the size, but Humana being like the de facto ma. Business right out there. Right. Right. Um, yeah. So I at least want to give a shout out to the, to the advisory board. Um, you know, of all the data sources that [00:13:00] we look at, they’re one that we, we, we study.

And I thought they did a great review in a very short time on the, the Sigma and the Humana, um, merger. So we’ll, we’ll put this in the show notes. Don’t need to say too much about it other than, um, They do a good job of framing up, um, the overall health insurance business in America. You know, they basically say that there’s six players, uh, in the space and that, um, so the six players that they point to UnitedHealthcare, CVS, Aetna, Elevance, Cigna, Humana, and Centene.

Um, and so if you, obviously, if you merge Cigna and Humana, now you’re at five. Um, UHC far and away the, the leader, um, CVS sort of right behind it from a revenue perspective, at least. Um, and then Cigna Humana would, would be the third, then they would come in and they would be the third. And again, they’d be a pretty high quality third, um, in, in that game.

So this is, this is a big, it’s a big play.

Vic: Yeah, it’s a, it’s a [00:14:00] huge deal. And I think a really interesting combination. And then when I look at these remaining five platforms, right. I mean, UHG is its own thing. We’re gonna talk about that in a minute. It’s huge and really well run in a lot of areas. The winner.

I mean, look,

Marcus: until someone takes it from them, yeah, the winner

Vic: and humanity combining gives them a chance to compete. That’s right.

Marcus: That’s right.

Vic: CVS Aetna is they have their own strategy. They have a much bigger retail. Presence which has advantages has some negatives to elevance is really the blues. I mean They’re and not even right.

I mean not even all the blues. That’s right, but but that’s their Path or that’s their niche and centine is is really strong on the government side if you take humana and combine it They’re the they’re the last pure play medicare medicaid, I know but I do feel

Marcus: like A lot of [00:15:00] what I hear about Centene lately is just them getting dinged left and right with all the changes that are happening, uh, you know, at the CMS level.

So, um, and I’m not sure, does Centene have a, like a proper, uh, Optum, you know, health services business of scale and not

Vic: of scale. They may have something, but not, not even as big as like Evernorth, which is Cygnus. It’s not even, That developed,

Marcus: right? Right. Yeah. I mean, Elevance, at least as we covered a couple episodes ago, has Carillon and that’s developing pretty nicely.

And, you know, they need to add more of the, the, the state blues to the platform overall to get sort of the scale from a membership perspective. But you know, that’s what I meant. That’s pretty rapidly sort of.

Vic: Buy and partner with blues plans. That’s right. Yeah, that’s

Marcus: right. That’s right. So, uh, yeah, look, check this advisory board story out, uh, or their takes, not really a story, um, but their, their analysis of the deal.

I think they do a really good job of framing it all up. And of course, you know, the deal is going to have to get through the FTC. Right. So that’s, I mean, obviously this is sending [00:16:00] all sorts of bells off in Lena Khan’s office. And, you know, uh, I think their default stance is going to be no, but they’re going to have to, you know, The burden of proof is going to be on them.

They have to show

Vic: how it is hurting, right? And I, it’s hard for me to see where that case comes.

Marcus: Yeah. And, and they have to show that on the heels of the news that didn’t really get covered this week because of the Cigna and Humana merger news, which is UHG had their investor day this week.

Vic: Yeah. So they had their investor day yesterday.

So this was the biggest story we’re going to cover until today. Uh, cause Cigna Humana came up today. I mean, I

Marcus: that timing, by the way, probably not an accident. Yeah, right. I think that’s right.

Vic: Listen, United health group is very strong on, they’re firing all cylinders. They’re, they’re just really good. [00:17:00] And.

I mean, they really have sort of built out all the different pieces. Optum is, I mean, everyone knows UnitedHealth Group insurance side is strong, but Optum has been the growth engine that’s just. Incredible, incredible scale. They have 90, 000 docs on salary. They already were the number one, probably the

Marcus: equivalent and tech workers.

Yeah, that’s right. I mean, I mean, that, that’s the part to me is like the docs is super impressive. Um, but my God, they, they are a tech company. Yeah. Optim is a tech and data company.

Vic: Yeah. That’s and, and it’s pretty well integrated together. I mean, it works and what I was impressed. I didn’t, I didn’t bring the stats, but Optum has a lot of payer clients that are not UHG.

They have selling services and also learning from all the other [00:18:00] payers. Totally. So it’s just a huge, they own advisory board. Yeah. They own an advisory board. They own Change Healthcare. They own Patients Like Me. They own a whole bunch of assets. They own NaviHealth. They own a bunch of things. That’s right.

Marcus: That’s right. Um, and, and it is worth just pointing out their, their revenue, uh, hit, uh, so Vic, you found this. So I’ll let you share. Well, I mean, they, they published it.

Vic: I had to do the math. I think I did it four different times. Yeah. Just to make sure. I didn’t believe it. They. Brought in 400 billion in revenue.

Last year. No, this is that look for next year. Yeah, we’re gonna be like for next year. And then the the profits are so earnings is 35 and a half billion. So the numbers are just staggering. It’s a huge and really well run Operation and they’re very transparent and they had their investor day on the internet I, I’m nothing [00:19:00] special.

I just want, went on and watched it. It’s just open.

Marcus: And, and I think, you know, if I’m chief legal for Sigmund Humana, I just sort of point to this exhibit one, I point to this and I point to change healthcare and I point to LHC and I just sort of say, I mean, we’re, we’re, we’re, we’re so small compared to the leader.

Like we’re so

Vic: small compared to the leader. Um, I think there’s a case for me that actually having a strong number two and number three is beneficial to market competition. Yeah, I would

Marcus: agree. I would agree. Um, and, and, and really. CVS is very, very, uh, comparable in terms of revenue size, but the makeup of their business is not that comparable.

Whereas what Cigna and Humana would combine, put together would actually be very analogous to what UHG has put together, like the, the design of the platform, you know, not really having [00:20:00] these retail drug stores, storefronts and stuff like that. Um, it’s just a much more similar business model. Um, and so they, I think you’re right.

I think they do become third overall in the, in the sort of payer landscape in the United States, but probably the close second competitor in terms of business model and approach to the market with two high quality insurance brands.

Vic: And I mean, I think CVS has done a really good job navigating from where they were five or ten years ago to where they are now.

No question. Oh, excellent navigation. I think the, um, future trajectory, even though the combination of Cigna and Humana would be slightly smaller, I think they’re positioned really well to be a good alternative.

Marcus: Agree.

Vic: Agree.

Marcus: So now that we’ve talked about the, the payers, we need to circle back to some provider stuff that we kind of got lost in because of all the AI stuff that popped up.

And we just kind of stopped talking about healthcare for a minute. Um, but something [00:21:00] really big was announced from CMS, uh, in early November, which was they finalized the physician payment rule. And, um, Why is it big? Well, it’s big because there is a decrease, uh, in the rates for physicians. Um, a decrease of 3.

4 percent from the last year.

Vic: Yeah. And it’s not clear to me how they calculate that, but I think it’s going to apply pressure to physicians, obviously. I mean, we’re in a high inflation environment and decreasing the physician payment schedule. It seems a challenge. And,

Marcus: and what’s, I mean, I think what’s. Of course, they’re not going to lead with a headline that says CMS finalizes physician payment rule and decreases the rates by 3.

4%. So they lead talking about that. They’re advancing health equity. And as you look further into the [00:22:00] press release, you see, you know, a lot of stuff around them, uh, creating codes. In the social determinants of health space, uh, adding payment models for community health workers, um, pretty big expansion around behavioral health.

Um, and just a lot of the things that, that fit into, you know, kind of community based care, uh, you know, value based care that could work in the maybe Medicare, uh, shared. Savings program and an ACO model in partnership with different community organizations, right? So still coordinated care, but not full risk capitation, right?

So it’s almost like CMS is pulling the reins back a little bit on giving so much opportunity through the Medicare Advantage model and saying, no, no, no, we’re going to dial in the codes. We’re going to be very, very. Thoughtful about the codes. And at the same time, we’re recognizing that, you know, we’re having an explosion of, of older people.

We need to start funding caregivers. So there’s a pretty big section in there around making sure that [00:23:00] caregivers, whether they be in the family or third party, that we have a way to fund the need we’re going to have for the growth of caregivers in America. Um, and then the behavioral health, including behavioral health and Medicare, I think for the first time ever.

Yeah,

Vic: I think that’s right.

Marcus: So, so it’s, it’s not simply. Taking the cash away from physicians. It’s sort of redistributing and rebalancing the scales and saying health care is not just going to be physician centric. We’re going to spread the love and make sure that all these other really important parts, um, of the care continuum are funded by the government.

Vic: Yeah, I think that’s right. They are. And we’ve talked about this a lot, the system has to move away from pure fee for service to more of a value based, capitated, shared savings model. And I think CMS, to their credit, is working on multiple, I mean, it’s four or five different initiatives that are [00:24:00] announced, not as much detail as I’d like.

But that’s definitely the trend they’re moving, uh, to be more aggressive on the fee for service price line item schedule, but they’re opening up several new initiatives to sort of encourage physicians. Yes, in a CEO models and but but also community workers and other. care people at different licensure levels that honestly is really needed.

And so there’s not enough detail, but I think it’s commendable that CMS is working towards this more holistic approach to whatever whole person care or lots of different providers providing care.

Marcus: Right now, of course, uh, this is a blow. Yeah, to blow to the physician. Yeah, to the physician groups and the physician business model.

Right? Uh, and that combined with the, uh, no surprises act, uh, [00:25:00] which at a dinner a couple of nights ago. Uh, a friend of mine referred to as the one piece that you pull out of the gender stack Jenga stack that makes the whole thing fall down. Um, this, uh, this no surprises act, uh, has really been a massive blow.

And in particular, this is the story is a, it’s a wall street journal pro story in their bankruptcy. Category, but it’s really sort of focusing on the private equity, um, markets and all of the different, um, PE backed, you know, physician groups, um, and related sort of ambulatory services and things like that, that have been pushed to bankruptcy, um, really as a result of the no surprises act, which forced the payers and the providers to sort of renegotiate and how really the providers, even though they have a method for, uh, Um, going back and arguing and appealing, um, overall, they’re losing the, the claims denial battle, you know, and it, and it’s pushing a lot of them to, um, to, to either downsize or totally go [00:26:00] out of business.

Vic: Yeah, I think it is really hard on many private equity, but lots of companies in this space that sort of relied on a certain reimbursement payment structure. Sure. And then the government has changed that with this, with this rule. And I, you know, in general, I’m not for Government sort of stepping in and pushing new things out, but it’s hard to argue with not sort of somehow making it much more difficult for no patient choice.

I mean, I, I get in a car wreck and I’m airlifted somewhere. If that airlift group is not in my network, I have no choice over that. And then I get hit three months later with a huge bill. That’s why it’s called no surprises. And it’s. It’s it seems roughly good for the overall system, [00:27:00] although it’s really painful for these largely private equity groups that have invested around a certain reimbursement structure that then changed midstream.

So it’s in the bankruptcy area because a lot of these companies are going to. They’re going to be in risk of bankruptcy.

Marcus: Yeah, for sure. And look, I mean, we, we’ve experienced it here in Nashville. I think envision was probably the first big one. American position partners came, came tumbling down after that.

Um, so this is

Vic: affecting HCA. I mean,

Marcus: yeah, yeah. Yeah. The, I mean, talk about it. The, you know, the, the, the JV and they,

Vic: they were basically forced to buy the other side of the partnership that they had. And it’s. It’s really unprofitable. It’s a drag on earnings.

Marcus: Yeah. A hundred million dollars in that in the quarter it was stated.

Yeah. And then I think it’s, and then 50 million million per quarter for, for a year, right? Yeah, that’s right. Basically for a year. Yeah. Yeah. So I mean, you know, not anything that they won’t work out. Yeah. It’s not that

Vic: they can’t sustain it, [00:28:00] but $50 million is $50 million. Yeah. It’s, that’s, that’s directly out of earnings.

That’s

Marcus: right. And, and, and the fact that you can really kind of point to this, no surprises act as the, the one piece of legislation that. And regulation that really created the problem, right? Right. Yes. The inability to bill a patient when things don’t work out between you and the insurer. Um, all right. So we will stop there and take a break from all of our healthcare talk to dive into the tech world and, uh, talk about the, the balance of power that is shifting.

And we’ll let Doug share a little bit about Jumpstart Foundry and we will be right back.

Doug Edwards: Thanks guys for the opportunity to talk about our pre seed fund Jumpstart Foundry. My name is Doug Edwards, CEO of Jumpstart Health Investors, the parent company of Jumpstart Foundry. We’re so excited to be able to talk about, uh, early stage venture investing.

Certainly the need for us to change the crazy world of healthcare in the United States. We are spending 20 percent of our GDP, north [00:29:00] of 4 trillion a year on healthcare with suboptimal outcomes. Jumpstart Foundry exists to help us find and identify and invest in innovative companies that are going to make a difference in healthcare in our country.

Every year, Jumpstart Foundry invests a fund, raises a fund, and deploys that across 30, 40, 50 assets every year, allowing ease of access for our limited partners. To invest to help us make something better in healthcare. Some of the benefits of Jumpstart Foundry is there’s no management fees. We deploy all the capital that’s raised every year in the fund.

We find the best and brightest, typically around single digit percentage of companies that apply for funding from Jumpstart, and we invest in the most incredible, robust, innovative solutions and founders in the United States over the last nine years. Jumpstart Foundry invested in nearly 200 early stage pre-seed stage companies in the country.

Through those most innovative solutions, the Jumpstart Foundry invests in, we [00:30:00] also provide great returns and a great experience for our limited partners. We partner with AngelList to administer the fund, making that ease of access, not only with low minimums, but the ease of investing in venture much better.

We all know that healthcare is broken. Everyone deserves better. Come alongside us with Jumpstart Foundry, invest in making the future of healthcare better and make something better in healthcare. Thank you guys. Now back to the show.

Marcus: All right. So we, I feel like we were relatively on top of the open AI, um, stuff, you know, we, we, we talked about the dev day before the implosion, right?

Vic: Oh yeah. Yeah. Right. Yeah. Yeah. That we were talking about the dev day and how powerful the tools were and how we need to focus on AI and the next week, um, Sam Altman was, was, was, uh, Let go and we can talk about why, but all of that, I think [00:31:00] it was that, it was that Friday

Marcus: we recorded the show On Thursday.

Yes, on Thursday. And

Vic: then he was go Friday and then on Friday he was let go, right? Yes. Right.

Marcus: That’s right.

Vic: And now, and so that then over Thanksgiving, so we recorded the next week and, and de debriefed all of that. He was still out when we requested for Thanksgiving, we recorded a little bit early and then you got reinstated, basically the employees.

Exerted their power over the board, which was really interesting. The board is sort of the governance authority of every company. And yet, when 720 of the 780 employees threatened to walk out, all of a sudden, the employees have a lot of say, and so he he’s been reinstated. They’ve redone the board, whole new board, and so we’re kind of back to where we were a couple weeks ago.

Marcus: Yeah, except, uh, there’s now. A lot of questions around what actually happened, right? [00:32:00] And there’s a lot of questions about what will happen in the future. So we’re back, we’re back to where we were, except for we’re not back to where we were. Right. I mean, where we were when you and I were recording the episode two days after dev day was This stuff is incredible.

They’re going to like knock over everyone. They’re going to run down everything. Right. And I can tell you, I’ve talked to, you know, several people who are at relatively big tech companies that are, you know, looking at integrating and they were almost entirely focused on open AI and chat GPT. And in the week that followed.

Sam being displaced, uh, they started looking hard at Bard. They started looking hard at heart at Claude. Yeah. Um, I think you have to, yes. Cause they realize the concentration risk and the instability, uh, you know, no pun on, on, uh, uh, on the AI tools, but the instability that could be present there. Right. I mean, cause honestly, this was.

This was kind of a shit show. I mean, really, I mean, you know, there’s no

Vic: question. There’s no any kind of anything. It was a complete shit show, you

Marcus: know, [00:33:00] I mean, in terms of like something that’s, that’s valued at billions of dollars. I mean, the way it all went down was definitely junior varsity. I mean,

Vic: yeah.

And it, it, it causes me and I’m not everyone, you, we have. Other people to comment on something, something caught their attention. They felt like they had to make a change with the most successful CEO who has raised billions of dollars and launched the best Ruth received product in the history of tech products.

And they have not disclosed really anything about why that was. And so it just creates a lot of speculation about, what, is there something that we should be nervous about, that society should be nervous about? [00:34:00] That we don’t know. And I think we’re, we may never know.

Marcus: So let’s just walk down this open AI path a little bit, because everything happens so fast.

So just 10 days ago, which I think was like two days after Sam was let go or something, Ted published a Ted talk of the chief scientist, Ilya Sutskever, who was. At first on team, kick Sam out and then apologized on X and was thankfully allowed to remain at open AI as Sam came back in and took back over.

Yeah, he was

Vic: the credible tech lead. Advising the board when they let him go. Yeah. And he’s a co founder of

Marcus: the company. He’s a co founder and the chief scientist. Like, let’s, let’s be clear. Sam is not a like AI scientist, right? Right. He was a [00:35:00] VC, right? Exactly. Exactly. You know, Sam, like he’s not doing any

Vic: coding.

Marcus: No. For people who don’t know Sam Altman, Sam Altman was, uh, Paul Graham’s successor. For Y Combinator. Right. So he’s a VC tech entrepreneur. He’s an entrepreneur. Yes. But he’s not like a deep AI guy. Um, this guy, Ilya, this guy is a deep, deep AI guy, right? You can look three years ago and see Lex Freeman at interviewing him, talking about where AI is and where it’s going.

So this guy is a, is a. Deep AI guy. And he, and the title of his Ted talk is the exciting perilous journey toward AGI. Again, AGI means artificial general intelligence. Right now we’re in specific, uh, artificial intelligence, which is, it’s got a very specific domain. It’s only as smart as the data that you feed it.

It can’t sort of think like humans do broadly and about all things that it encounters from a place of consciousness. Whereas AGI is basically. Human consciousness in computer, [00:36:00] in computer form.

Vic: It’s human consciousness with extendable memory and power and reach. Yes. So the ability and the ability to learn 24 hours a day and grow exponentially.

Marcus: Yeah. That’s the point at which the computer is better than us in everything and everything and everything,

Vic: including at building its own code for the next release. Right. And first of all, Ted. Ted Talks, they had perfect timing to drop this video. Um, it, it was, it was the ideal time. Because one of the four most important names in the biggest story ever.

of the year. They had a TED talk. It was about 30 days ago, but recent enough. And they hadn’t published it yet and they dropped it. And, and it’s a, it’s a [00:37:00] well done talk. It’s, it’s 12 minutes. It’s not that long. Yep. And he does a really good job explaining it where, you know, my mom can understand. It’s, it’s not super technical.

And it, and it’s really well done.

Marcus: And at about the five minute Mark, he basically says about healthcare is one example, one example, he uses healthcare. And basically he says what Dr. Tarun Kapoor said on our show last week, which is the medical knowledge is going to double in such a way that. It’s you’re going to need to have, I mean, honestly, it was so shocking to me when I watched it.

And then I was, you know, rewinding back to, to turn it. And I was like, yeah, did to ruin, like watch this. And like, is that where he got that example? I mean,

Vic: because

Marcus: yeah, because he’s, he’s making the point that at some point, we’re going to look back at the way that we currently deliver care. And. And we’re going to think it’s like, [00:38:00] you know, back when they put leeches on George Washington, right?

You know, it’s, it’s going to seem crude and barbaric, um, in the face of this computer that is going to be, you know, exponentially better than the human.

Vic: Yeah. So just to just people, everyone listening should watch take 12 minutes and watch it. But I think it’s worthwhile to. Just emphasize one of the top five AI scientists in the world chose one example to demonstrate how AGI could be beneficial.

And he chose a medical doctor interaction to illustrate it. He did not choose

Marcus: revenue cycle management. No,

Vic: he did not choose back office anything. And he is giving an optimistic view. I mean, I also, I, [00:39:00] I, we have a lot of friends that are doctors and nurses and administrators and leaders and health care is, is not as good as it needs to be.

And having a computer that knows every part of my medical record and all of the research and can bring in different things that we should look at together. Is really compelling.

Marcus: So go watch the video, but then one final note on this, before we move on to, uh, to Elon is on X Mark Andreessen, who just as a reminder, we’ve, we’ve covered Mark in the past.

He’s co founder of injuries and Horowitz, the creator of the Netscape browser. So he’s been in the internet as long as there’s been an, you know, a worldwide web, his

Vic: profile is a tech optimist. He, he is an investor and. He’s a developer. He’s very tech friendly.

Marcus: He wrote that whole manifesto, you know, the techno, the tech optimist manifesto.

We covered it. I don’t know, probably five or six [00:40:00] episodes back. So this is a guy who’s a hundred percent like. Accelerate. It’s all in on tech. Yeah, yeah. Tech, tech, tech, tech is all good. Anyone who says it’s not good is lying. And, uh, he tweets, seriously though, what did Ilya see?

Vic: That’s the question everyone is asking.

Right. And as usual, Mark is exactly on the sort of zeitgeist.

Marcus: Yeah,

Vic: I mean, he clearly

Marcus: saw he saw something. Okay. Moving to Elon. Elon was, uh, one of several really high profile guests on, uh, the deal book summit, by the way, I think, um, we’re not quite acknowledging who might be the biggest star of this whole deal book summit.

Elon Musk using the F word fiasco, which is. In my book, Andrew Ross Sorkin. I mean, this guy was able to get Elon Musk and Kamala Harris on stage at his event. Like pretty good. That’s ridiculous. Okay. Anyway, back to the story. Um, so Andrew Ross Sorkin is interviewing Elon Musk and he gets to a point where he’s talking about [00:41:00] the advertisers fleeing the platform, uh, in, in the face of the recent antisemitism, uh, issues.

And of course, you know, Elon is on stage, you know, days after meeting with Benjamin Netanyahu, uh, you know, um, on the matter. And so Elon, and, and what I think is at this point becoming typical Elon fashion, uh, basically says like, you know, you’re going to boycott me with advertising. You’re going to boycott me with money, go F yourself.

Right. And then if, if anyone wasn’t clear that he said that he then repeated, go F yourself. And then he said. Hi, Bob, uh, you know, talking about, uh, the CEO of,

Vic: uh, of Disney. I mean, there’s so many things to talk about, but I think, uh, I want to get to the power dynamic in a minute, but I think I’ve never spoken to Elon, but I, you know, obviously followed a bunch of stuff.

I think he bought Twitter now X to try to protect free [00:42:00] speech. And well, that’s what he says. So that’s what he claims. That’s what he claims. And the wonderful thing about free speech is people can say whatever they want to say. And the terrible thing about free speech is people will say whatever they want to say.

I think of the choice of free speech or sort of, uh, some, someone sitting in a dark room deciding who gets to say what free speech is better.

Marcus: No, no question.

Vic: Now, is there a lot of Damaging hate, shitty stuff on social media. Yes, but the alternative is, is worse. And so I think that’s sort of the basic ethos that Elon goes with, but he also has, More money than I have.

So he, he has enough power then to say like, you can’t hold me hostage with advertising revenue, go fuck yourself. And [00:43:00] I don’t think he’s really bluffing. I think he’s

Marcus: definitely not bluffing. He’s definitely not bluffing. And I think that, you know, the reason he’s not bluffing is because he doesn’t just have more money than everyone else.

He’s putting all the satellites in space. Right. He’s he’s powering the internet connectivity. In wars, right? He’s deciding what drones can. Fight the war and what drones can’t, who cares about X, like this guy has legitimate geo political power. He’s not just a rich guy. He’s not Warren Buffett. Like it’s, it’s, we’re, we’re talking about something entirely different with him and he is demonstrating that difference, right?

Vic: So I think this next, the next couple of stories are really about the shifting power dynamic in our society. And Elon is symbolic, I think, of The [00:44:00] technology entrepreneurial power side, and he’s been really successful in, I can’t tell you how many there are, maybe six or seven different high growth startups that he, there was a founder in or early the first investor, including open AI that now he’s gotten sideways with, but he is one of maybe 10 people that is sort of is driving the future of our economy and society.

And I think that’s I don’t know if it’s good or bad. There’s probably some aspects of both, but but just it kind of is.

Marcus: Yeah, I mean, I mean, it is is the point. And I think your point about the power dynamic is, is what we should focus on. And this even goes back to when you were talking about how the You know, the S and P and the NASDAQ indexes are so stacked with eight or nine companies, right?

That, that make [00:45:00] up 50, 60, 70 percent of the index consolidated into five, six, seven companies. And they all are really tech companies. You know, this goes back to, uh, you know, the Sigma Humana merger, right? This goes back to UHG. And what really makes UHG powerful? Optum. What is Optum? A tech and data company, right?

Um, and now we’re accelerating all of, we’re accelerating what was already tech dominance with AI.

Vic: Yeah. And advertisers are used to, for, I don’t know, 20 years, pushing media around. That is fraying. It’s not over, but it’s beginning to fray. I think, I think it’s over. It’s ending. It’s ending. The power has peaked.

But now it’s still

Marcus: seems like it ended yesterday. Seems like it ended when Elon said, go F yourself to the advertisers of X. I mean, literally

Vic: [00:46:00] X X is independent, but there’s a lot of TV that I see that is, is. Not fully independent, so there is other media that is still pushed around by advertising, but I think that’s declining.

Marcus: Yeah, yeah, yeah. I mean, we’re watching that die. Yeah, that’s right. That’s the point. We’re watching that die. And especially if you stratify across generations. Yes, it’s already dead with Gen Z.

Vic: Yes.

Marcus: There is no advertising media business model that is powered by Gen Z. It’s powered by us. It’s powered by Gen X and the boomers.

But yeah, I think stratified across generations, you go

Vic: younger.

Marcus: Yes. Yes. It’s over already. Right. Um, okay. So then let’s just talk about Elon’s influence as a. An icon and as a cult of personality, right? So he does this, this gets everyone ginned up. I think I, I think maybe when I sent it to you, it wasn’t like an official media news.

[00:47:00] It was a tweet, right? Or next post or whatever you call these things, right? It was next post. And, and the, the post was celebrating him. And celebrating him in language, by the way, calling him based, which is something, I think most Gen Xers don’t even know what that is. Yeah. I don’t know what that is. Yeah.

So it’s hard to actually articulate what, what based is. It kind of came out of hip hip hop. There was a guy named, it was a little something, uh, but he was the base God. And, and it, it basically is like, you’re, you’re so. On your own individual, like, like cool is, is more like what’s accepted with all, with other people.

It’s more like you make cool, you make cool, you, you know, you create cool in ways that other people couldn’t possibly. Even think about doing right.

Vic: Yeah. Like you’re rebasing what is, what it means to be cool.

Marcus: Yes, exactly. Exactly. That, that’s the way to think about it. So, so, so Elon was being called like, you know, the most based person of the day by what he was doing there.

Right.

Vic: And then, [00:48:00] I don’t know if we explained to people that are just listening. So people were posting on X canceling Disney plus,

Marcus: we were about to get there. Oh, okay. Sorry. Sorry. Yeah. So, so, so. Elon being celebrated on X for the way that he told all the advertisers to go F themselves. So what are the X loyalists to Elon?

How do they

Vic: show their loyalty

Marcus: and their appreciation for him doing that? They start canceling their Disney plus subscriptions and putting screenshots. So now that’s going to trend on X. So it sounds like it’s a feedback loop. It’s self reinforcing too. And it’s fast, right? I mean, remember we just watched the bank run of SVB happen in record time because it all happened in group chats, right?

The speed, again, the speed with which things are changing or with which, you can totally drop. The market cap of a company, because we have a mass wave of subscriptions that [00:49:00] just go away all over what this guy says on stage, you know, at a wall street journal event. Yeah. How did tell me, I think, tell me, tell me how as an analyst.

You, you model the future when that is, you know, when that’s, what’s, what’s happening, you know, when one day open AI has a dev day, three days later, the CEO is fired by the board a week later, he’s reinstated Microsoft is kind of in the mix four days later, Elon goes on stage Wall Street Journal and says, go F yourself to advertisers the next day, a bunch of people on X dart.

Quitting Disney plus and turning it into a meme. Like what world is this dude? You know, and I’m not saying like, Oh, it’s so crazy. Blah, blah, blah. I’m just saying if you’re not doing what we’re doing tracking this every single week. It goes by too quickly. It’s going too fast. It’s going too fast.

Vic: That’s right.

And, and [00:50:00] I mean, I think the advertisers made the first aggressive move, but they, they poked a bear that they shouldn’t have poked.

Marcus: Well, they, they did what they felt they needed to do. In the moment, based on the playbook that sort of was in place before, but we’re now seeing like, there’s a response to that playbook now that didn’t previously exist, you know, before, if that happened to you, you would just have to like, get on your knees and grovel and say, Oh, I’m sorry.

And we’re not talking right or wrong here, by the way, we’re not litigating. We’re not the judge and jury of this. We’re just, we’re observing and we’re retelling here, you know? And previously, if you were called an anti Semite. And then all the advertisers left, you have to get on your knees and kind of grovel and say, I’m sorry, here’s my apology letter, you know, and then they probably make you like, like, wait, you know, three to six months.

And then, and then this guy got on stage [00:51:00] and said, go F yourself, you know, I mean, that’s a new response to the playbook. And that is, I don’t know how you can get a clearer sense of the shifting power dynamics than that.

Vic: Yeah, I think I think that’s right, and I think podcasts and social media and acts, honestly, are empowering individuals to have a voice.

And if you begin to have smart things to say, or you say things that make me think differently, or I’ll listen to the podcast, I don’t necessarily need my media. Sort of curated by someone in Madison Avenue or whatever that’s sort of issuing, uh, news articles and then putting banner ads around it. And that’s Started maybe with Facebook, but now it’s just proliferated and huge.

And, and Elon is probably the biggest profile like [00:52:00] that.

Marcus: So shifting to Google, um, there was a, there was a long running story about Google and Canada, um, around the, around the links to Canadian news and whether or not, you know, Google was profiting on them and, you know, there’s the whole summaries that they were showing on the homepage and so they were fighting, fighting, fighting, and Google said, we’re just going to.

Pull the news from Canadian searches. That’s what we’re going to do. Like, you know, I think, I think, I think maybe Zuckerberg started this whole, like, we’ll just pull the news. Yeah, exactly. Exactly. His, his response to like these different, you know, um, countries and continents saying, you know, uh, you know, you need to do this.

You need to do that. He’s just going to, I’ll just pull it,

Vic: you know?

Marcus: And again, this is a show of the, of the, of the power.

Vic: It’s power of tech. And the, the social media or digital search as compared to a newspaper in Ottawa or [00:53:00] whatever. Yeah. And the, the news media is losing.

Marcus: Well, is it? Well, the news media is losing, but I think the bigger thing is I think the nation states are losing.

That’s the bigger thing. The nation states are losing.

Vic: Yes, the nat Canada, the nation state of Canada, which I don’t know, it’s a top 20 country. Yeah. They tried to protect their, their homegrown news organizations. And they don’t have the ability to do that. They can’t protect them. They don’t have the ability to do that.

The Magnificent Seven, Google and Microsoft, Apple, whatever.

Marcus: Amazon. They

Vic: have more power than nation states, except the United States. Yep. And China. And China. And the thing that they don’t have is military. And what’s interesting about X, [00:54:00] Is XX? Well, not X musk has, um, the satellites. Yep. And so a lot of nation states are gonna need the satellites and you can’t really get internet service in some places.

It, it just, um, the balance of power is shifting.

Marcus: They’re they’re running their military on their networks. Right,

Vic: exactly. So you, you can just like unplug it and then the military drones don’t work, so don’t work. So the. It’s a balance of power thing. Um, that is interesting.

Marcus: Yeah. And then, and then the final story we want to just tell around, around all this tech stuff is that, uh, the tech giants are finishing the year, how they started the year, which is with layoffs.

They did a big ones, right? 7 percent across the board. Every big tech company did 7 percent in Q1. Uh, But even as they have readied [00:55:00] and steadied the ship and they’re profitable and they’re growing and the stock is performing well,

Vic: record highs,

Marcus: unbelievable, right? They’re still cutting. They’re still cutting.

Vic: Right. So it is tech. And leaders in tech gaining power over nation states over their customers, advertisers, but even the workers at these technology companies are losing power because these companies now have automation and AI and technology and they, they rely on the, the broad based team less than they have in the past.

That’s counterbalanced a little bit with the open AI Employee walkout. Well, what kind of

Marcus: employees, I mean, let’s, let’s be clear. If you’re on the AI team, I think you’re okay. [00:56:00]

Vic: If you’re a large language model, AI developer, you’re worth like 30

Marcus: regular employees.

Vic: Yes, but they don’t need as many people. I mean, so I was at Thanksgiving and, and someone asked me like what the effect AI is going to have, and I need to be careful because it’s, it’s a Thanksgiving dinner, but, uh, but I think.

Something like half the jobs that exist today aren’t going to be here in 10 years. Oh, dude.

Marcus: I know.

Vic: Listen. And like, we have to figure out what else

Marcus: people are going to do. It is so hard to have that perspective and try to have conversations about it. It’s really hard to do it. You know, and we’re not driving it.

So we’re just trying to, I’m just trying to like keep up myself and invest

Vic: in the right things in healthcare.

Marcus: Yeah. All right. So just to kind of change topics for the end of the show, uh, a positive story in the wall street journal, talking about how CRISPR is, [00:57:00] uh, poised to win FDA approval, uh, next month, not, not, not CRISPR itself, but a treatment that’s based on CRISPR.

Um, you know, this is going to, It’s a health equity story, actually, because, you know, we’re going to finally be addressing, um, sickle cell, uh, disease, which is something that has forever been underinvested in, um, you know, misunderstood for, for a million reasons. And, uh, you know, we’re, we’re about to leverage DNA editing, uh, technology to cure it.

Now, of course the parallel. Sort of problem with that is going to be the cost and also who is going to qualify for this, right? So, you know, just for anyone who doesn’t understand how sickle cell works, um, you know, it’s basically a mutation of the, of the cell, the red blood cell that was designed to protect against malaria, um, in Africa.

Um, but then sort of. Had an extra adaptation [00:58:00] that results in blood clots and all sorts of other really, you know, negative, uh, uh, it’s, it’s just comorbid with a lot of things. And it was

Vic: selected for by evolution.

Marcus: Yes. For protect Africa. Yes. To protect against malaria. But. It, it has, it has adapted to become sort of a, um, just, just a really, really devastating disease.

People do die from it, and, and even when they’re not dying, they have chronic diseases, just like, you know, your, your typical, um, autoimmune diseases.

Vic: Yeah.

Marcus: Um, so

Vic: Just because of DNA heritage, it affects black populations. That’s right. Almost exclusively. I,

Marcus: I’ve never heard of a white person having sickle cell.

So, um, so say all that to say it’s, it’s, it’s been one of those areas in the black community where, you know, we have felt just. Unattended to, you know, as here’s a black disease that nobody wants to do anything about. And now we have, you know, this state of the art technology, this CRISPR technology is, is coming in [00:59:00] with finally a solution for it.

But again, the cost, right? Um, you know, this, this, this is likely going to be, you know, a million dollar, um, solution. Cause it’s going to cure you.

Vic: It is a one time change. genes such that your red blood cells do not have this mutation anymore. Right. And then thereafter you formerly had sickle cell, but you no longer have sickle cell.

That’s right. And first of all, that’s just incredibly positive for, for people that get the treatment. It’s amazing. I think we have to fund it, period. We have to fund it. Now, our healthcare system is not designed for I mean, cures are hard to finance, because it’s a one time thing, and whatever insurance group I’m on today I guess has to bear all that cost, but then I’m much less expensive for all the insurance companies later.

So the [01:00:00] basic structure of how we provision care is not well designed for this. But I don’t think that matters. We have to figure out a way to get it done.

Marcus: But again, I mean, you want to talk about An entire business model that on one end is flanked by AI and on the other end is flanked by gene editing. I mean, the physician, this to me is really becoming the nexus of disruption, right?

Whether it’s the No Surprises Act, whether it’s the decrease in the physician fees. Whether it’s the advent of new AI that everyone is predicting is going to end up being better than a physician in five, 10 years. Um, when it comes to, you know, understanding all the medical knowledge and being able to actually diagnose, or whether it’s, should we have you, the physician caring for this person for five, 10, 15, 20 years and prescribing all sorts of small molecule, you know, solutions that really are only just somewhat mitigating, uh, you know, the [01:01:00] issue, but not actually curing it versus gene editing.

And just cure them period done. It’s over. You’re not sick anymore. I mean, on all ends, it feels to me like the physician is really being flanked.

Vic: Well, I mean, I guess, so I have a more optimistic view of it. I think that there’s going to be a long time where I still will value having a human with empathy, help me navigate this.

But that doctor or nurse or caregiver should have all of these AI tools and be able to sort of help me navigate it with, empowered by those things, including gene editing. And I, I think if I cure some aspect of my health, The normal human reaction, in my mind, is what’s the next thing that I should work on?

It’s not like I’m going to say I don’t have sickle cell anemia anymore, so I’d never have a word about my health. I take [01:02:00] an optimistic view that there’ll be a role for empathetic caregivers to advise and help people live healthier lives. But they have to adopt and learn all of these Technologies and our industry is not designed that way right now.

So there’s a big change, big change and, and doctors are right there at the forefront of it.

Marcus: Right. And don’t doctors love to change?

Vic: Yeah, they’re not going to, they’re not going to like

Marcus: changing. So that’s my point. That’s my point. Like I can, I can agree with you in a line with you on the optimistic take for the doctor or the future for the, for the doc, for the doc.

I talked to an MD MBA today, like he is going to love this new world. You know what I mean? He’s going to love to, to provide care in this new world. Yeah. If you’ve been practicing for no

Vic: time or less than five years, you [01:03:00] can change easily. Totally. It’s value

Marcus: based. You’re leveraging technology. You’re able to actually, you

Vic: know,

Marcus: yeah, I can help people for real hundred people now, not 50.

I don’t have to worry about my own dumb brain. Cause the AI is going to make a better decision than I am, you know, nine out of 10 times, like he’s going to love it. But 50 year old doc

Vic: with A lot of debt and they did everything right

Marcus: and identity wrapped up in how they deliver things, you know, like I, I just think again, dislocation and disruption, it doesn’t mean physicians are going away.

I’m just saying they are the nexus of a lot of disruption. That’s, that’s what I’m, that’s the point I’m making.

Vic: That’s right. And they’re going to go from, you know, in the seventies and eighties. The top of the social status, smartest, wealthiest, most well regarded profession in the world. And they’re going to [01:04:00] have to change every way they practice medicine.

And that, that is going to be very difficult. I

Marcus: think that’s

Vic: right. But, but we’re not going backwards. No, no. And I think net, there’s going to be a lot of disruption, a lot of, you know, change, but it’s going to be better to cure sickle cell. So it’s better. It’s better. It’s amazing. And I think, um, this is the first CRISPR related cure.

It’s not quite approved yet, but it’s about to be approved in UK. Um, but I think there’s a lot of other things that are in the pipeline. And, uh, we talked about alpha fold and the protein folding. And so you, we’re now sort of building all of these tools that are going to Allow us to see what needs to be changed.

And then we have the technology to go in and, and, okay, let’s change those three base pairs and, and all of a sudden you’re cured now, which is, which is great and positive [01:05:00] and there’ll be massive disruption, but. I think that it will also be good.

Marcus: By the way, um, Walter Isaacson, who wrote the Steve jobs book and Elon Musk book, I believe he also wrote a book on Jennifer Doudna.

Yes. Um, and so, you know, we just want to kind of give a shout out to Jennifer Doudna, whose, whose name does not get enough recognition for the unbelievable Nobel prize winning breakthrough of CRISPR. Um, but that’s a, that’s an audio book that I have in my queue.

Vic: Yeah. And I haven’t read it yet either, but she’s a, Very successful woman in science that won the Nobel prize and a great role model for everyone, but for women, especially to see you can succeed.

And she’s making a huge impact on the

Marcus: world, changing the world. Yes. I mean, CRISPR is going to change the world. So, um, all right, that’s it. Another show in the books. Uh, anything else to, to cover? No, I don’t think so. We’ll see what happens next week.

Vic: A lot going on

Marcus: in the world. Look forward to it. Talk to you [01:06:00] then.