66 – Wealth in America | MDMA | Hot VC Markets | Covid Lessons | NVIDIA’s Software Play

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. All right. Um, I have the rhino virus. Do you know what that is?

Vic: I do because I’m cheating. And we talked about it earlier, but no, I would have had no idea.

Vic: And it sounds scary. Uh, But I think it’s not as scary as it sounds. Yes,

Marcus: it’s one of the, uh, one of the viruses that is the common cold. Um, I’ve never known definitively what virus I had before, but my new doc has like this test that he can run where he does a swab like a, like COVID test and then like puts it in and they can tell like, I don’t know, like a hundred different viruses.

Marcus: You can have like COVID, the flu, blah, blah, blah. And so, yeah,

Vic: there’s several that will give you cold like symptoms.

Marcus: Yeah,

Vic: yeah,

Marcus: yeah. So he texted me and he was like, you have rhino virus, nothing [00:01:00] you can do over the counter, rest, blah, blah, blah. So I wasn’t feeling that good on Monday, um, when I went home after, after kind of our morning meetings.

Marcus: Yeah. And then, uh, thankfully I had a doctor’s appointment on Wednesday on the calendar. And my new doc is like, he’s the best, man. He has like all the like new fangled stuff, dude. He walked me through the, the clearly, um, cardiac test, which is like incredible. Yeah, dude. It’s, it’s like, I mean, he can drag with a mouse, like on the image.

Marcus: Down through all of the different arteries and can show you exactly where so you’re almost

Vic: like

Marcus: driving through your own Circulatory totally yeah, and you can see exactly where in your artery the plaque buildup is and then if it’s like calcified non calcified It’s it’s amazing. And so

Vic: there’s a density factor that they yeah their work they have made of it.

Vic: It makes a difference whether it’s stable, plaque or not stable. Exactly.

Marcus: Exactly. And, [00:02:00] and he can, because he can tell you like where in the artery it is, he can tell you this particular position in the artery is problematic versus like if it was here, not such a big deal, you know? So anyway, yeah, I think about all the test.

Marcus: I mean,

Vic: I do a lot of fishing in the river. You can see like where all of the, Logs and things get stuck and then if they break off and they’re going to go for a while. So in certain parts of your arteries and veins, like it’s probably okay. And then there’s another one that’s not going to be stable.

Vic: Exactly. It’s going to float somewhere else, which is the danger. Exactly.

Marcus: So it’s, it’s, uh, it’s, it’s kind of fun having a doc that is, you know, tapping into the future of healthcare. He’s also very much like, um, one of the things I love about him is he’ll be like, Cause I’ll talk to him about like Peter T and all this other kind of stuff and he’s super open to like any feedback I give him on stuff and he was, he’s always like, Hey, you know, like I’m going to come up with this like health [00:03:00] optimization plan for you, blah, blah, blah.

Marcus: But then like, when I give it to you, like, give me feedback on it. What do you think about it? Is it, is it viable? Am I, what am I missing? Yeah. It’s almost

Vic: like a collaborative partner on your health.

Marcus: Which,

Vic: which by the way, which by the

Marcus: way makes me trust him more. Yeah. You know what I mean? Because it’s like the fact that he’s open to feedback is like, Oh man, I know you, you know, this a million times better than I do, but you respect the fact that I’m actually investing time and energy into learning this.

Marcus: Yeah. So. You know, that makes you a better patient completely. Yeah, it’s fantastic. And I was the final thing and then we’ll jump into the show. Um, I was listening to, uh, a podcast that was talking about all the deficiencies that, that we have in the, in the healthcare system. And. It was so nice to hear somebody else say that the only answer is that patients are going to have to take more responsibility for themselves like that’s the it’s the only [00:04:00] scalable answer to this right and and of course we’re going to need.

Marcus: Um, more diagnostics to be able to do that, better technology, um, a different kind of paradigm in terms of our relationship with our primary care physician and, and the way that we navigate the rest, the, the, the larger healthcare system, we’re going to need more proactive education from the healthcare, you know, ecosystem on ourselves.

Marcus: Um,

Vic: but, but I mean, I think there’s other big decisions in your life. Like say saving for retirement that are already at that model, right? There are advisors and people that help you, but it’s your responsibility to learn that they will give you assistance and you can. You can talk about how much time you have left and how much risk you wanna take, and then they can help you with that.

Vic: But you, you have to be a active participant in it.

Marcus: Yeah. And, and for all the things that are going to save your life, whether it is adherence to regular diagnostic check-ins, or behavior [00:05:00] change, like who’s gonna know better? How to motivate you than you. Yeah. You know what I mean? Like it’s almost setting up the providers for.

Marcus: a job they can’t ever really be fully successful in. You know what I mean? Like they don’t see you enough. They don’t spend enough time with you. They don’t know you specifically. It’s like, how about we empower people, right. To actually, to actually motivate themselves to do the things that they need to do.

Vic: And give them options. That’s why I went to retirement. Like there might be some people that don’t want to make big changes in their lifestyle. Right. I would be more interested in making big changes. But that’s a personal decision, then the doc can empower you to take whatever course you want. Either if it’s going to be really lightweight, then they can still give you that kind of pathway.

Marcus: Yeah, one of my best friends who had a birthday today, I was talking to him yesterday, and he was talking about, you know, believing he was going to pass away at an age I would consider to be pretty early. Right. Um, let less than 70. Yeah. And his [00:06:00] view was just kind of like, ah, it’s enough time. It’s like, you know, if you haven’t done everything you want to do in your life by then, like, you know, what are you doing?

Marcus: And that’s his view. And, you know, it’s not a few I’m going to argue with. Right. Yeah. Um, obviously there’s people who believe you should, you know, die young, leave a beautiful body. Right. I mean, so there’s all sorts of views around. Yeah. What’s ideal from a living perspective?

Vic: Yeah. And I think the, um, the, is it called the, the well span or something?

Vic: Like I want to maximize where I can be fairly active and enjoying life, interacting with my family and friends and doing things I like to do. Yep. After I’m infirmed and not able to do those things, I’m not sure I want to drag it out much. So it kind of depends on how healthy and how much you can enjoy and experience.

Marcus: Really depends on your health span.

Vic: Yeah.

Marcus: All right, man. With that, let’s dig in.[00:07:00]

Marcus: Uh, starting out our first segment in this economy. All right. We are. Given the Fed a break, we’re just going to talk about how the American household turn back to them next week, but we’re taking a break this week. Yeah. So, so Vic, how is the American household doing?

Vic: You know, I think they’re doing okay. It was a good story in the Wall Street Journal talking about the wealth effect and how, how much wealthier really everyone is compared to 2020.

Vic: And so I wanted to dig into a couple of the charts in that, cause it, it was surprisingly optimistic. And I think we’ll talk about later, the economy is doing pretty well, but it doesn’t really feel emotionally doesn’t feel that well, maybe it’s the political fighting. Maybe it’s that it’s sort of stuck in a very small number of publicly traded companies.

Vic: Yeah, we’ll talk about that. Um, but the, but Americans have more investment income than they have in the history [00:08:00] of that we’ve been tracking this. And so maybe go to the next one because it’s, I think it’s useful to talk about it. By, um, by where you fall in the income percentage terms. So, um, we know the top one percent, the top 10 percent are doing well.

Vic: They’ve always been doing well for the last 50 years, but I think it, it has funneled down even more than I previously understood. So, so this chart is sort of the expectation that I always have that the, the top one percent or the top 20 percent Have a lot of assets in public markets. They have a lot of real estate.

Vic: They have done well Whereas the bottom half basically has been largely flat and this is in real estate Stocks and bombs pensions 401ks that that kind of so it’s it’s published by the fed So I think it’s seems like it’s pretty reliable, but then the next chart was really surprising And so this is the wealth [00:09:00] gains relative to 2020 So if you start at everyone the same and Q1 2020, how has our wealth increased over the last four, four years and the really surprise, of course, the top 1 percent of the top 20 percent have increased.

Vic: So the top 20 percent is increased by 45 percent of people that are listening on audio. But the really interesting thing is the bottom 20 percent and the next 20 percent that sort of lower tiers where normally. You expect to not see them making much gain that lower part of the K shaped economy that we talk about sometimes.

Vic: They have had significant wealth gains as well. The bottom 20 percent, and the last slide we saw was flat as far as the number of stocks in real estate and and retirement accounts they have, and yet their wealth has gone up. Gone up or the last since 2020. So I guess four years by about 36, 37%. So that seems really optimistic, really good.

Vic: And it’s not that, [00:10:00] um, other income groups are not doing well, but they’re keeping pace. It seems like they’re keeping pace.

Marcus: What’s interesting about this is this graph looks like all the cohorts by percentile are basically doing about the same. Okay. Right. That’s right. Yeah. Um, but of course, this is a percentage of gain and so the question is really what was your base, right?

Marcus: Because if

Vic: you start from a low, but you start from only. 100, you can go up a lot. If you start at a million, you can go up much more absolute terms, but same percentages.

Marcus: Right. So, so I think what’s, what’s really incredible is that the top 1 percent by percent gain Grew more in their household wealth than the bottom 20%.

Marcus: Now it’s the lines are very similar, right? The lines are very similar.

Vic: [00:11:00] The top 1 percent gained 40 percent or the last four years, whereas the bottom 20 percent gained 36%.

Marcus: Right. And we’re a much different base from a much different base. I mean, if we go back to the last chart, right. I mean, we’re talking about, if we go back to 2020, we’re talking about a base.

Marcus: Uh, for that percentile. And of course, because you’re talking about the top 1%, you’re actually not talking about that many people, right? So, the top 1%, base of assets, 120 trillion.

Vic: No, no, I think the top 1 percent is just that green, dark green line. So it’s 25 trillion, but still it’s 25 trillion. Okay. Okay.

Vic: The top 20 percent is 80 trillion.

Marcus: Okay.

Vic: All right. So, so either way, it’s a big number. Okay. So 25 trillion 25 trillion is the versus the bottom 20 percent is two, two, two, two or four. Okay. Like that. Yeah.

Marcus: Okay. And, and then going up another, let’s see here. 45 trillion. I don’t

Vic: know that the top changed that much.

Vic: I [00:12:00] mean, I think it, it’s still roughly 20 trillion. Okay. It’s like, how thick is that dark green line? The really big gainers were that top 20%, not the 1%.

Marcus: No, I’m not sure we’re reading this chart the exact right way. Yeah, I’m not sure we’re reading this chart the exact right way, because I actually think it’s probably the full band’s worth in terms of growth.

Marcus: That’s what I would imagine, is that it’s probably the full band’s worth of growth. I mean, there’s no way that they were flat. There’s no way that they were flat. So it’s at least 40 trillion worth of growth.

Vic: I’m not sure we can, we can look into it.

Marcus: Yeah. So, so, so anyway, the, the, the point is being like a very, very small percentage of the overall population.

Marcus: 1%, obviously it just, just by per capita is much, much smaller than zero to 20 percent that, that band, a number of people, right. Off of a much bigger base [00:13:00] growing by a higher percentage. Like, so that’s, that’s wealth inequality. Right, that’s, that’s it. And that’s wealth inequality growing.

Vic: Yes. That’s, there’s no question about that.

Vic: That is, at least to me, What I would expect now, whether it needs to be fixed or not. I think we do need to try to reconcile that. The surprising thing for me is that the bottom 20 percent did have some pretty meaningful wealth gains relative to relative to where they started. Now they started at a very low amount, but, but they grew over four years.

Vic: They grew 36%. So it wasn’t even, if you’re watching on YouTube, you can see the chart, but it’s It’s even enough to say they’re over four years. They’re getting something like 9 percent growth a year. Um,

Marcus: which, which is probably happening through some combination of, [00:14:00] um, wage increase and stimulus that was put into savings and they paid down

Vic: debt or they made savings.

Vic: Yeah. Yeah. Right. So, um, we have had wealth inequality for a long time and we need to work on that. But it seems like the bottom 20 percent and really everyone in the economy is growing their wealth. Yeah, your point is everyone’s growing. Yes, which I was surprised about. I did not expect that to be. And I think that’s because it feels like a K shaped economy.

Vic: Maybe it’s because I’ve told myself too much, but it seems like the, the people that have a lot of exposure to real estate and hard assets, stocks, things that are benefiting by inflation are doing very well. And if you don’t have a lot of assets, even though you’re paid, maybe it’s going up 9 percent a year.

Vic: It doesn’t feel like relative to the rest of the [00:15:00] world, you’re doing quite as well, but you’re not, you’re not doing as well on absolute terms.

Marcus: You’re not doing as well in relative terms, either. You’re not compounding the same way your asset base is flat while everyone else’s asset base is growing.

Vic: Yeah,

Marcus: I mean, you’re not doing as well.

Marcus: Now, the fact that you are not going in reverse or you’re not flat on your household wealth. Based on income and savings. That’s, that’s

Vic: like. That’s positive. It may not be enough, but it’s better than the alternative,

Marcus: I guess. It is better than the alternative and still like, I think you can understand why, and also like, let’s just talk about the, the, the, the vibes of it.

Marcus: Right. The vibes of it are not necessarily. How am I doing? It’s how am I doing comparatively, right? Like we, we can’t help but compare ourselves. That’s just, you know, you’re going to [00:16:00] be faced with comparisons every single day. If you got into the world, you get in your car, you’re in the street. You’re going to see other cars.

Marcus: You drive through neighborhoods. You’re going to see other homes. You, you go to eat. You’re going to see other restaurants. Like you walk on the street. You’re going to see other people’s clothing. Like it’s impossible to not be in some form of comparison, right? And by comparison.

Vic: Yeah, that’s right. And I’m interested in reconciling that. But it’s also an exponential curve, right? It’s gonna be always that there’s someone is doing better relatively. Okay. Well, let’s, let’s just look at inflation quickly because I was, I wanted to look at, okay, we have grown our wealth at somewhere between 30 and 40 percent depending on where you sit and what has the cumulative inflation been over that same period of time.

Vic: And it’s, it’s a decent story. Inflation has been 16 percent over that same period. Okay. And [00:17:00] so. Everyone is doing sl is growing their wealth, I think, slightly better than inflation. But, uh, yes, the rich people are doing better. This chart tells me that, that if human inflation is 16 percent over that same time period, but the thing that is surprising is, maybe not surprising, but the Fed’s 2 percent is, is also getting smoked, right?

Vic: It’s way, we’re not close to that. Even though we’ve come down, the, the speed of the curve has come down. It’s still not, it’s not near 2%.

Marcus: Yeah. I mean, we’ve, we’ve talked several times about how it’s becoming more clear that that 2 percent feels more like a relic of the past and, and a goal that’s not in line with what the future of the world is, is really shaping up to

Vic: be.

Vic: And so this is from the fed. They put in the, the fiat money printing, like the M2 rate of growth, which is 5%. [00:18:00] We’re still over that, but somewhere between 2 percent and 5 percent seem, I don’t think you can grow the money supply. at 5 percent and expect inflation to be 2%. Right. That works. Agree. All

Marcus: right.

Marcus: So this story in the Wall Street Journal about big tech companies that are detaching us from the reality of the, of the stock market, because as we’ve talked about for months now, the top 10 companies make up more than 50 percent of the value of the top two indexes for the stock market. Um, and the majority of the top 10 stocks are tech stocks, big tech stocks.

Marcus: It’s, it’s making the all time highs that we’re experiencing come with an asterisk. Because. That, that level of concentration does not reflect well for a broad economy, especially when let’s take one of those companies alphabet, right? Especially when that company basically has rolling layoffs. It’s like you’re in the top 10 stocks [00:19:00] in both.

Marcus: Both indexes. Yeah. And every quarter, you’re laying people off. Microsoft

Vic: laid off people yesterday. Same, I mean, not, not alphabet, but same story. Same story. They’re in the top, they’re in the top, they’re top five, probably.

Marcus: So, so, so, so what, like, what is that signaling about our economy? That our asset prices are continuing to grow.

Marcus: The top 1 percent that is flush with those assets, whether they be homes or stocks, are just continuing to get richer. But jobs are being lost if you’re in that, those lower two bands of the, of the percentiles, you know, you’re, you’re flat, um, on a really, really low base anyway. Like what does that, what does that say?

Marcus: What does that say for us? I mean, you know, we’re, we’re, we’re VCs, right? It’s like, we are, we’re not quite. Main street, you know, we’re not quite main street. I mean, we’re putting millions of dollars of [00:20:00] capital to work into technology companies. Um, but they’re tiny technology companies relative to these top giants.

Marcus: Right. And at no point in the history of, of VC, have we seen this kind of concentration of power, economic power amongst less than 10 technology companies. Right. So like. We’re not mainstream, but it affects us, obviously. Yeah.

Vic: Yeah. Yeah. I mean, I don’t think it’s sustainable. It is not going to change this quarter, but I don’t think it’s possible to have seven companies dominate the stock market.

Vic: As you say, lay off people. They’re concentrating their asset value. And that is leaving a lot of Americans Behind and I [00:21:00] mean we’ll talk about the the various agencies are trying to shift things Back somehow, but it’s not that easy to do and google alphabet apple Meta, they’re they’re they’re playing by the rule of law But the rule of law is set up for them to prosper for them They design they designed their business model to take advantage of it.

Vic: So I don’t think it’s gonna And soon, but you’re going to have a lot of people voting for someone. Now we don’t have any good choices, so there’s no one to really, whether beside you pick for, I don’t like either side, but there’s not, it’s not going to,

Marcus: and neither side is going to break these guys up.

Vic: Yeah, but I don’t think it is. I just don’t think it’s sustainable. I don’t know what’s going to tell you what’s going to happen, but it doesn’t. The reason there’s an asterisk is we can’t celebrate. I [00:22:00] mean, I remember when the Dow hit 10, 000, and everyone was, no matter who you were, you were celebrating.

Vic: Right. Just because you, you felt like the U. S. economy signified by the Dow was growing, and it just was a happy time, and it’s not. I mean, we’re 4X that. New records every week. Not a lot of people are celebrating. No,

Marcus: I like this story. This is a story about transportation, but not consumer transportation, but freight.

Vic: Yeah. And anytime we can, we can go to a publication called freight caviar. So everyone remembers at the end of the pandemic, as we’re opening up the cost of shipping, the cost of freight. Was very high. Yeah. Supply chain was broken. Supply chain was broken in general and That amongst other things drove inflation and we’re not back at those highs, but the volume is Growing pretty quickly this chart on the [00:23:00] screen right now is about volume and we are at Levels of volume that we haven’t seen in 20 years except for that one period where we had Nothing going on and then a huge spike.

Vic: And then if you go down a little bit, the rates for each container is also maybe not straight up, but, but up very quickly. It’s a sign of the economy is growing. We’re shipping a lot of stuff from Asia to the U S or from Asia to Europe. We ship stuff around too from the U S out way, but it’s all going up.

Vic: But it’s also going to flow through to inflation. Of course. I think, I mean, it just Of course. That’s what happens. We’ve seen that before, and it wasn’t that many years ago. So everyone, that’s why I, I was interested in this story. It’s going to make it really challenging, I think, for the Fed to, to be able to cut rates.

Vic: So as we talked about last week, I don’t see them cutting rates. I, I’m [00:24:00] hopeful the long end of the, of the curve will go up. So we have like a normal, uh, Curve, but we are going to be in a higher rate environment for longer. And even with that, we’re going to have high inflation.

Marcus: All right. So shifting into our VC deal review, a lot more deals happening in the healthcare space, um, sword health, rolling out a new AI tech they have raised around post series D they did a series D during the craziness of 2021 at a 1. 8 billion valuation, typically. We would have seen that value slashed in half or more, or maybe sold for parts, but no, not sword health, sword health raises a new round of 130 million.

Marcus: And now their valuation is 3 billion.

Vic: They, so, so it’s a, um, [00:25:00] it’s an orthopedic space, sort of helping people rehab and technology to assist with that. I think they have tripled their revenue the last year. And so I think it’s great. I mean, it’s difficult for me to know whether 3 billion is the right number or not, but you know, I’m a VC, so I’m happy for up rounds.

Vic: And if you’re growing revenue, 3x, able to get

Marcus: the markets to buy into it, that’s a win. I’m That’s a win because the market’s weren’t buying anything like that. Right. So that’s, that’s tremendous.

Vic: Yeah. And tripling revenue is a, is a, you know, obviously huge growth. A three X growth sign. That’s crazy. Right?

Vic: Yeah.

Marcus: Yeah. So anyway, sword Health, I mean, honestly a company I didn’t know. Yeah. Um, and now $3 billion, that means, you know, you’re on your path to considering an IPO or Oh yeah. Or a really big strategic acquisition, but That’s right. You know, $3 billion is, is massive. Massive. Uh, alright. Couple of, uh, VC deals, definitely smaller, but, but still, you know, [00:26:00] sizable, uh, acuity, EMD and Echo Health.

Vic: Yeah, so Acute EMD raised $45 million and it’s a bunch of good VCs, benchmark Capital, and several that, that we know of. Yeah, they’re in Boston and they are sort of a, uh, you know, medical data devices, wearables, technology, and they sort of, I think they sort of pull the data together, um, so that it’s more useful.

Vic: And then the second one is, is EcoHealth, which is, um, that ECG enables stethoscope that docs can use. They raised 41 million. So I think we’re, I’m at least starting to see a trend that we’re seeing bigger rounds and, you know, pretty, let’s say healthy valuations. Maybe, maybe they’re overly valued, but, but positive.

Marcus: Yeah. Also, um, a lot of AI. Yes. Yeah.

Vic: Everyone. Whether it was in it a year ago in your business model or [00:27:00] not, you have it now. You have it now.

Marcus: You have it now. Plentiful, uh, 17 million for automating administrative tasks for pharmacists. Again, another AI, artificial intelligence, workflow automation platform.

Vic: And pharmacies need help. And so I don’t know if this will solve all of the workforce challenges, but getting more efficient workflow tools into the pharmacy so that they can, um, Dispense medications. It’s great.

Marcus: Alright, and SoftBank, back to a company called Tempest AI, and they are considering an IPO, 6.

Marcus: 1 billion valuation. This is a company that is in the pharma space. Uh, they have customers, AstraZeneca and GSK.

Vic: Yeah, it’s oncology, diagnostic, genetic, genomics. Yep. And it’s the second, we had, we had Waystar last week, [00:28:00] we have Tempest AI this week. So two weeks in a row, IPO. So we’re starting to see the bigger VC rounds and now IPO is being announced.

Vic: So it’s all, I’m, I’m choosing to believe that it’s healthy and not yet overvalued. But it’s definitely heating up.

Marcus: Yeah, it’s, it’s a little of both, right? It’s, it’s on one hand, the markets can’t just hold forever. We have to bring new things onto the market. Um, especially when we’re looking for differentiated upside.

Marcus: I mean, yeah, the, the magnificent seven can’t be everything. Um, and at the same time, it’s a trend. Every single company we’ve mentioned here is an AI company. Yeah. So it’s like, All right. How much of this stuff is actually going to land? All right. So now getting into our healthcare review, we’re going to cover a policy.

Marcus: We’re going to cover payers. We’re going to cover health systems and we’re going to cover pharma. So starting out with unpacking policy, private equity, we we’ve talked about the, the [00:29:00] scrutiny that the FTC is putting on private equity and the. The, the rollup strategy that they have, the, the purchasing of health systems, physician groups, and how Lena Khan has, uh, been very clear that she’s putting a target on, on that type of deal making.

Marcus: What are we seeing happening in the private equity space year over year?

Vic: I don’t think the FTC has. One, many or any significant cases in court, but LenaCon has been very vocal about pushing on to private equity and that has had a really a diminishing impact where there’s not as many private equity deals, not as many roll up transitions.

Vic: It’s kind of a chilling effect, right? Yeah. I think the Wall Street Journal had an article. I think it’s about. 50 percent as active as it was a year ago. So, I think it is right that we have a group that is trying to bar unfair competitive practices. We have to have that. [00:30:00] But I, But, She is, she’s sort of having the effect without actually preventing mergers, just, just by vocally kind of like pulling, uh, PE firms into the spotlight and delaying transactions and threatening that I think the overall effect is a, is a diminishing of the deal activity.

Marcus: Yeah. But to your point, um, not necessarily winning in court. Yeah. So in this article, it talks about the deal with Welsh Carson, which was kind of one of the first big high profile. Um, targets and a judge has already dismissed that case.

Vic: Yeah, that’s right. The, um, the portfolio company is still in process, but the judge threw out the Wells Carson side of it.

Vic: And so that’s the thing that’s interesting is that she’s having an effect or the agency that she manages is having an effect. Even though the, it hasn’t really been [00:31:00] meaningful in stopping deals, just the attention, the extra costs, the, the pain of it, the time and attention, it makes it such that you don’t do those tuck in roll ups and all those, um, acquisitions about half as many as last year.

Vic: So I think it’s pretty clear that it’s having an effect, whether that’s. I think it’s probably generally negative, but whether it’s positive or negative, it’s happening.

Marcus: Yeah. Uh, and in a similar, but not exactly the same kind of, uh, situation, uh, Chuck Grassley sent a letter to Ascension, Illinois, um, about their deal with SCP Health, which is one of the physician companies we talked about last week, um, which doesn’t have great credit rating.

Marcus: None of those, uh, groups have great credit ratings at the moment, but, but not. Targeting the credit rating of SCP Health, but more just targeting the fact that Ascension, which is a non profit health system, which is supposed to be, you know, Have a mission to take care of the [00:32:00] community, um, is partnering with a for profit private equity backed company.

Marcus: So again, you know, and Chuck Grassley is a Republican. So, you know, obviously we’re talking about the FTC. Yeah. We’re talking about, you know, a democratic led, um, FTC, but Chuck Grassley here, Republican from Iowa, um, focusing on, you whistleblowers saying, Hey, we’ve got this for profit company here and they may not have the best interests of the community.

Marcus: And how does that align With Ascension’s mission.

Vic: I mean, I think there’s a building consensus that is not there yet, but there’s a building process of politicians and, and regulators really questioning what does it mean to be a nonprofit health system. Mm-Hmm. at the scale. Ascension is, but they’re not alone.

Vic: That there’s common spirit. I mean, there’s, there’s several. Yep. And what should they be allowed to do? Is it everything that a for profit can do? And if [00:33:00] so, then why are they not paying state real estate taxes or metro real estate taxes or federal taxes? And if they are different, then how are they different?

Vic: And so I think that to me, that’s what’s underlying him, his push in this. And it’s going to be, I think, an aggregation over, over several probably years, but almost whoever wins the presidential race. Doesn’t matter which side this question of what does a non profit health system mean either side is going to pick it up.

Vic: It doesn’t matter who it is. That’s right. That’s right. I don’t have a good answer. I mean, I think there’s some, I mean, Ascension, the one that is, we got the letter written. I think they do a great job. They’re following the, the rules that are laid out, but, but they are, they’re not the same type of non profit as, Um, I don’t know my kids school little little school that like has one [00:34:00] location and doesn’t have any Um, resources, really,

Marcus: I mean, I hate to say it, but it really is complicated, right?

Marcus: I mean, um, nonprofits were the standard for health systems. And then, you know, 50 plus years ago, little HCA came out of Nashville and kind of invented a for profit model that has proven to be great for shareholders. And has been replicated by many others. Um, several of those are publicly traded companies.

Marcus: Many of them are private equity backed. And over the course of the last 50 plus years, five plus decades now, um, there’s been lots of for profit entities, not just health systems, but specialist groups, physician groups, um, You know, anesthesiologist, et cetera, et cetera. And it’s now all this whole kind of intertwined thing where some of the best parts of the industry are now for profit.

Marcus: And you have to ask yourself, how does a nonprofit, [00:35:00] you know, operate without interacting with and partnering with for profits? Right. I mean, so, um, It’s, it’s, it’s a complicated, long, windy road of how we got here, and my hope is that, uh, there’s not sort of a revisionist history that is overly punitive to the nonprofits in assessing their partnerships with for profits, as if to not say we opened up the healthcare industry to for profits, you know, 50, 60 years ago, right, and we, we, you know, We, we made it such that nonprofits had a harder time competing quite frankly, um, because for profits were able to pick and choose that, you know, bring external capital to the markets, be, you know, differentiated on how they, what, you know, who they provide services to, et cetera, et cetera, and, um, nonprofits in order to sustain have had to pick up more and more for profit, you know, models and characteristics.

Marcus: So it’s, it’s, [00:36:00] I just don’t like the idea of. characterizing the nonprofits as if they are just trying to use the nonprofit, you know, status as a shield. Yeah, no, I agree. They were here first. They were here first. That’s my point. They were here first. The for profit industry has invaded healthcare, you know, and now the nonprofit has to figure out how they work in a world where for profits have a lot of advantages, quite frankly.

Vic: I would argue there’s advantages to both models. Um, I think there were a lot of questions in the 60s and 70s of would a for profit Be able to deliver the same quality care at scale like a non profit could yep And to me that question has been answered that’s been answered. That’s been answered I think we now have to have a conversation around really what what is public health?

Vic: What is? required to keep our society functioning, especially in rural america or in places where for profits have not [00:37:00] chosen to go and what is kind of open game for You anyone to jump into. Um, I don’t know if you do. I got a lot of feedback. You know, we have a lot of listeners that are in the healthcare industry and our comments about the Medicaid rule and how it’s going to change the landscape.

Vic: There are a lot of health system executives that listen to us that, you know, that’s going to significantly change everything. And it’s just not clear if that will hold or not. Mm hmm. And I think it’s all rolled up in the same conversation. It was like, okay, we have Medicaid. If that is positioned as pain at the same rates as commercial, then there might be a lot of for profits that go, go into it.

Vic: And then what, why, why are we, subsidizing extra money when it’s really a non [00:38:00] profit type service. So, I don’t know, it seems like there are parts of health care that should be a public good, a public utility, and there are some parts that are certainly elective care, which is an easy one, should not be that.

Vic: But we don’t have any way to, or at least right now, I don’t know of a good way to have that discussion. At the industry level and then get regulations put in. It’s, it’s a pretty, that’s a pretty big question. Yeah. So anyway, they’re, they’re gonna push on this. And the biggest, uh, thing Chuck Raley sees, I think, is that there’s a lot of, there’s a lot of tax income in Illinois where they need, they need money that is.

Vic: paid by Ascension. Yeah. And that should not, it’s not fair because they were there first, but I think that’s why he’s attacking that because he’s looking for money. Right. Right. [00:39:00]

Marcus: I mean, he’s looking for money and also this is a now mainstream, um, political narrative, right? So it, it. Hey. It’s these kinds of complaints are going to come into his office.

Marcus: Yeah. You know, we, we, we talked about how, how the, the Massachusetts steward story is, is breaking through the zeitgeist and people are now starting to associate private equity with bad for communities when it comes to healthcare, right? Unfortunately. Right. And so,

Vic: and that’s, that’s the same way there. The Catholic church sold it to private equity.

Vic: And, and the company transitioned from for profit, from non profit to for profit, and then did a whole bunch of things. I don’t want to characterize the details because I don’t know, but there’s, there’s definitely a lot of accusations of what was done. The other thing that I think is going to be pulled into this is, uh, OpenAI started as a non profit.

Vic: There were [00:40:00] several hundred million dollars of tax deductions donated to it. And then it just transitioned to a for profit. Yeah. And you didn’t get those tax deductions back. The government didn’t get those back. So I don’t know. There’s a lot of, there’s going to be a lot of discussion around this, no matter who wins the election, I think it’s going to be a big topic.

Marcus: All right. Let’s, uh, let’s take a break here and let Doug share a little bit about Jumpstart Foundry when we come back. We’re going to talk about, uh, Thanks

Doug Edwards: 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.

Doug Edwards: 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 of 4 healthcare with suboptimal outcomes. Jumpstart Foundry exists to help us [00:41:00] find and identify and invest in innovative companies that are going to make a difference in healthcare in our country.

Doug Edwards: 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.

Doug Edwards: We find the best and brightest, typically around single digit percentage of companies that apply for funding from Dumpstart. And we invest in the most incredible, robust. Innovative solutions and founders in the United States. Over the last nine years, Jumpstart Foundry has invested in nearly 200 early stage, pre seed stage companies in the country.

Doug Edwards: Through those most innovative solutions that Jumpstart Foundry invests in, we also provide great returns and a great experience for our limited partners. We partner with AngelList to administer the fund, making [00:42:00] that ease of access, not only with low minimums, but the ease of investing in venture much better.

Doug Edwards: 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: And

Doug Edwards: we’re back.

Marcus: Um, so Dr. Anthony Fauci appeared in front of the House Select Subcommittee on Coronavirus Pandemic on Monday.

Marcus: Fireworks, for sure. Yeah. For sure. I mean, we’re going to put the Marjorie Taylor Greene stuff to the side because she’s just kind of always, uh,

Vic: Yes,

Marcus: right. She’s just a circus.

Vic: She’s such a circus that I can’t interact

Marcus: with. Yeah, it’s it’s not worth talking about but but but there were there was a lot here to talk about and it really seems like There are two main issues that were credible issues to [00:43:00] discuss.

Marcus: The first is just the fact that we were doing gain of function work in collaboration with the Wuhan lab. And the second one being the lack of protocol, which led to a lot of questionable actions and judgments in the wake of the pandemic, where An abundance of caution made sense, but then over time that started to sort of spin out into, um, questionable protocols, questionable communications, um, whether or not things were being withheld, uh, from FOIA requests, or just generally speaking, things that were known and should have been communicated to the general public that were not communicated to the general public.

Marcus: Um, and I want, I want to highlight those two things because. I think those two things kind of stand the [00:44:00] test of time and don’t get into, okay. You know, Monday morning quarterbacking, right. You know what I mean? Where we’re going to say, Oh, here’s what you should have done when in the middle of the thing, it was like, this is crazy.

Marcus: Right. Um, but the gain of function research that that’s one thing that was probably always questionable, always carried considerable risk and, um, needs to be scrutinized and potentially needs to. You know, have some resulting consequences, and then there were aspects of the lack of protocol that we should think about for the future.

Marcus: Like, how do we fill in those gaps so we don’t have those those failures in the future, but then also there were some questionable ethical. Decisions made when it comes to communication and the protocols that were rolled out for the general public. Are there any, before we dig into the conversation, is there a third topic that you see from this?

Marcus: Because I want to try to frame it up before we start going, you know, point for point.

Vic: [00:45:00] No, no, I think, I think those are two. Let’s try to keep it to those two topics. I think that’s plenty. If you have a third, I’m No, no, I, I don’t, I always get started on something I might go into. I don’t know, I can’t, I can’t exactly say what I’ll, what I’ll end up saying.

Vic: But I think those are two very good topics that does, and it’s a healthcare issue. So we should talk through those issues.

Marcus: Yeah. Yeah. All right. So why don’t we start with gain of function? Yeah. There are so many things that we do in the world.

Marcus: Um, that have good reasons for wanting to do them, but have serious risks if things go wrong. Um, nuclear power. Yeah, sure. It’s kind of a good example of that. Um, AI. AI is another example of that. There are, um, many, many military technologies that fall into that, you know, um, into that category. [00:46:00] Gain of function, it’s a military technology, I

Vic: think.

Marcus: Yeah. Yeah. And so I think it’s just hard for people to wrap their head around. What are we doing collaborating in a lab in China on gain of function in what can only now be thought of as potential biological weapons? Like, like, what the

Vic: hell are we doing? The fact that it leaked out of our lab and killed all the people that it killed, let’s leave that to the side.

Vic: 20 plus million. Yeah, but look, but I think the question is, should the U. S., or any government, but we’re in the U. S., should the U. S. be creating very dangerous, more [00:47:00] transmissible, more deadly viruses? On purpose to learn right that’s that is one thing should we do it for military reasons. We have lots of military weapons, and I would say that I would prefer to live in a country that doesn’t use biological weapons.

Vic: Maybe there are military reasons, maybe there are scientific reasons. We should have a, some kind of discussion about that. And it seems to me, I’ve been trying to follow the facts, it seems to me that Dr. Fauci requested to do this research while he was head of NIH to either President Obama or his administration, and it was denied.[00:48:00]

Vic: And he, I think he did not pursue it because he was told directly he couldn’t do it. But then our president only can be in office for eight years. And so then there was a new administration, Dr. Fauci doesn’t leave one of the things that is coming to light is the, the bureaucracy, the administrative group of people at some level, they have, they have a different kind of power, but they have in some ways more power than the elected officials because they are there much longer.

Vic: Every bureaucracy is that way. It’s there much longer. And, and Dr. Fauci waited. And then when the new president came in, he tried again and Trump allowed it. And whether that was smart or not,[00:49:00]

Vic: that dynamic of you ask mom and and she says, no, you ask dad. And he says yes. Like that. That’s not, I wouldn’t, I get mad at my kids when they do that. Mm-Hmm. like that seems something wrong with that. Mm-Hmm. that the unelected administrator who I, I mean, I think he has good intentions. I, I don’t, I don’t think anyone has.

Vic: I don’t see malicious intent. at that time. I think he was talking to scientists, he has intellectual curiosity, he’s a believer that the lab can contain it. But then it gets put into a non profit and it’s not done, the Wuhan lab is not set up for this, it’s not a It’s not the highest level security lab.

Vic: And then why are we doing a biological weapon with China? Our, our arch enemy.

Marcus: [00:50:00] Gosh, there’s so much there. Um, so I think the thing that you just said about bureaucracy there, there’s, there’s obviously a good and a bad to that, right? So the good is the idea that the head of an agency can work under both the democratic or Republican administration.

Marcus: Right. So that, you know, there’s some indication there that that person is, you know, at least somewhat nonpartisan if they’re able to work under both administrations. That’s so that that’s a plus. Another plus would be the continuation of intellectual of institutional knowledge. Yeah, that’s good. And also, um, especially in something like the NIH.

Marcus: Um, some of the projects can be much longer than eight years. Right? Right. And, and so having someone be able to work over the course of [00:51:00] maybe 16 years, you know, could be beneficial. So no question about that. It’s, it, you know, it’s not a hundred percent bad that these people can work across. You know, administrations, having said that, you are right, there is an incentive of power and, and their own agendas that individuals in these agencies seem to, um, seem to have, seem to have.

Marcus: Yes,

Vic: and, and I am, I said I wasn’t going to change topics, but I hope this is not a shunt. I am suspicious, but I don’t have proof. I’m suspicious that there is a defense or. Other three letter agency influence probably behind the scenes, encouraging the scientific work through NIH because more weapons is always better in [00:52:00] defense.

Vic: And I don’t have any proof for that, but, but it is true. There aren’t checks and balances in the same way in these agencies. And I was trying to figure out, what is NIH’s mission? What are they trying to do? What is, what is Dr. Falchi, as the head of it, supposed to do? And it’s not clear. There’s like five or six aspects of the mission, and they’re so vague and general.

Vic: I think you could be sitting there, Dr. Falchi could say he did everything in the NIH mission, even though he approved gain of function research through several non profits over into China.

Vic: Somehow, we want to keep the institutional knowledge. We don’t want to change the entire agency every four years. It would be good to try to learn from this and put some check and balance in. [00:53:00] So, I don’t know. I mean, I don’t think we should have done gain of function research. function research. I don’t see how the scientific knowledge is beneficial.

Vic: And unlike nuclear power or AI or, I don’t know, airplane, I don’t see a benefit other than scientific learning, where like nuclear power, if it goes badly, could be really bad, but also it could be very sustainable, less expensive power. And so there’s a, there’s a cost and benefit With gain of function, maybe we would learn something, but, but when you have the, the new, very deadly virus, you can’t use it for anything.

Marcus: Yeah, I mean, maybe because it is the first of its kind, um, it was very [00:54:00] difficult for, The proponents of gain of function to appropriately weigh the potential downside, um, you know, I’m sure now knowing that 20 plus million people died, um, they would have different calculus. Yeah, yeah, with

Vic: hindsight, you always have different calculus.

Marcus: Yeah, they have different calculus. Um, but yes, the gain of function issue was, was a real one and deserved some serious scrutiny. The second one gets into school closures, gets into, you know, what we were told about masks, gets into a whole bunch of other sort of communication protocol gaffes that were questionable.

Marcus: And. Allowed different state politicians to basically like tear the the NIH is, you know, and the CDC’s [00:55:00] credibility to pieces, right? Um, well, which didn’t help. We, you know, it’s it really kind of tore us apart as a nation because the communication was done so poorly. Um, what, what, what do you, what do you think?

Marcus: Like, what do you think about that? I mean, I, I, uh, I very much dislike the, uh, the way that people have gone back and looked at the vaccines and sort of acted like we were not desperate for some, you know, for some answer. We were, we needed something. I, I very much dislike that, but I do think, um, the measures that we took in society, uh, around.

Marcus: Children in school and, um, the closures of businesses and things of that nature. That’s kind of a different [00:56:00] category. Um, because a it’s, it’s, it’s people deciding what they want to do with their, with their own lives. Um, and B it’s not like, you know, learning challenges or economic impact. What isn’t also a real, you know, healthcare issue as well.

Vic: So, well, I think there’s, Two sides to this that I feel differently about. Okay. So the um, Freedom of Information Act, FOIA. Yeah. I think has to be respected. Always. The press. Always. Must be able to request our government that we pay taxes for, And they have to deliver that. Period. I mean, the point of the act I don’t care what the ulterior motive is.

Vic: The point of the act is to give press opportunity.

Marcus: And specifically for moments like this. Yes. Yes. Like, we actually really needed it in moments like this. So that

Vic: is unacceptable. Right. I agree with that. And I don’t care [00:57:00] the rest of the story. If you get a FOIA request, you don’t have to like it, but you have to provide the documents.

Vic: That’s right. And I think that’s the end of that. And then I also think it is unacceptable for behind, not in the press, behind closed doors for the head of NIH or CDC talking to the president or talking to government officials, not on TV, to say, well, we funded this gain of, this gain of function research and here’s what we think about it.

Vic: Let’s get all the information on the table that people know, and I don’t think that happened. So, to me, those are acts that are not acceptable for government officials to do. They’re just not. But then I think there’s a whole [00:58:00] separate thing, which is public health, by its nature, Is managing the public perception and trying to save as many lives as you can.

Vic: And I think there’s a difference between what Dr. Fauci says to the president or to someone else behind closed doors. I think you should tell the whole truth and just like say everything, you know, and let’s get to the bottom of it. But then when you come out and say something about public health, there’s a lot of people listening.

Vic: And so I think it was right. It would be in my opinion, right to be cautious about how you say to the world. We did this gain of function research because there were times during the pandemic when the whole world might have turned on the U. S. And [00:59:00] And that would have meant more people would have died.

Vic: And so I think there are hard choices that elected officials have to say in all public health. It’s just, it’s just what happens that this vaccine is not that well tested, but it’s better than not being vaccinated. And we need to get people to take it. So public health is always a dance of perception and trying to save as many lives and do The best we can with limited information so I think that’s a whole nother category, but the the foyer requests the Like the punishing scientists that were trying to do research.

Vic: Oh, man When they were actually trying to get the the actual research, correct Yeah, yeah protecting his own ass Dr. Felchie tried to squash that, so those things are not acceptable, but then the decision of what to tell the public, when to tell them, how to phrase [01:00:00] Whether it’s six feet or eight feet or three feet, we don’t have any idea what it is.

Vic: Those messages, I think that’s a hard choice and there’s no right answer, right? If you say you don’t know anything, you just have people scared and chaos, you have other ways that people die. So, I don’t know. I think the public messaging is a different thing.

Marcus: You know, this would have been so much different if it were just in the television era, you know, but it’s the internet era, right?

Marcus: You’re playing by different rules now, you know what I mean? Yeah, like everybody can broadcast. Everybody can fact check everybody, you know, and there’s a lot of experts out there. That’s the other thing. Yeah, there’s a lot of experts out there. Like I still remember. Let me just say this. Because maybe you’ll remember this.

Marcus: Do you remember when the infectious disease guy from, I think it was [01:01:00] University of, oh man, was it Wisconsin? Went on Joe Rogan? Oh no, I don’t know. And way before the CDC said it, or way before it was on Real News, This guy was like, this thing’s airborne, it’s not on droplets, it’s not, you know, like, he was, he was on Joe Rogan, and I remember, like, being like, Vic, uh, I just heard on Joe Rogan this thing is airborne, that was where I heard it, so then when you hear Joe Rogan talking about Ivermectin, yeah, dude, Ivermectin.

Marcus: Ivermectin. The first place I heard it was airborne was on the fricking Joe Rogan podcast, not CNBC dot right. You know what I mean? Like I didn’t hear about it on mainstream media and I didn’t hear about it from our government agencies. I heard about it from an infectious disease expert who went to alternative media that has millions of [01:02:00] viewers and listeners.

Marcus: We were all home doing nothing. We had nothing better to do but listen to Joe Rogan, you know? And so it’s just, right. Recognizing that you don’t have control of the narrative anymore, right? The best you can do is put forth the truth because you’re going to get called on it. Like, to me, I think that’s the, the original sin was doing the gain of function.

Marcus: But then the secondary sin was thinking you actually had the ability to control the narrative, right? You don’t have the ability to control the narrative anymore. Well,

Vic: I think

Marcus: the,

Vic: the,

Vic: if. You are honestly responding to FOIA requests and you are telling your superiors, the president. everything you know, then you have to have a discussion of, okay, what is the message that we can control? How long can we control it? [01:03:00] I think there are a lot of other examples. I mean, I’ll give you this. Like, so I think in a U S flight, I don’t know how important it is to take off my shoes and go through security.

Vic: And like, am I really like smuggling something through my shoes? Right. Right. But after nine 11, People were scared to fly. Oh, yeah. And their perception that the flights are safe is more important than how safe they are. And that’s an example where, like, I think, I hope that TSA and FBI and everyone NSA are really digging into Where there are exposures or not, and I don’t want them to publish that like I don’t need that now Maybe Joe Rogan can find it.

Vic: That’s an example where the public safety and the need to sort of keep things going I don’t need to know that there’s an opening in [01:04:00] LaGuardia, that they haven’t been able to figure out who’s the leak. But they need to talk to each other and fix it. So like, there’s a difference between the officials being honest with each other and getting to the bottom and really trying to solve it.

Vic: And then figuring out what do we tell 300 million Americans when we don’t, we don’t exactly know if a mask is going to help or not. We don’t know what the side effects of these vaccines are going to be because we’ve never done an mRNA vaccine before, but we need to get something out there to begin getting herd immunity.

Vic: I’m okay with officials making those kinds of decisions, but what I’m not okay with is Dr. Fauci knowing that he had done gain of function research and not telling the president. He reported to both Biden and Trump, so it’s not a political thing, and he did not give the leadership Everything he knew, [01:05:00] and worse, he was like sending out confusing things and pushing down scientific research.

Vic: So, that’s not acceptable. Now, when you go into public health, I think it gets more nuanced and, and, like, I mean, I, I knew there was going to be a really bad pandemic before everything was shut down. One of our listeners was talking to me about it. I remember that. I said to him at dinner, We need to tell people about this and that he said well public health is confusing because if we tell people And they all they all run to the to the woods and start shooting each other and buy all the food like that’s not going to necessarily save lives, right?

Vic: And so if you don’t actually trust that the leaders are telling the truth, even to each other. I think everything falls apart.

Marcus: Yeah, [01:06:00] again, like I said, it’s, it’s just a more challenging time, and we definitely need to keep moving on. Yeah, yeah, yeah. But like, it’s a more challenging time, but you have to understand, you have to understand the media landscape.

Marcus: You have to understand that you are just better off I agree with that. saying what you know. Yes. You know, you’re just better off saying what you know, because you’re going to get found out. Like you can’t control it. You can’t hide it.

Vic: Changing the S in someone’s name to a dollar sign. That, I mean, that’s like junior high crap that like, it’s embarrassing that our NIH is doing that to avoid a FOIA request.

Vic: That’s not acceptable.

Marcus: All right, Vic, I’m going to have to make an executive decision here and like, we’re going to cut some stuff because we are, we’re going too long. We are, we are behind. All right. So, um, I’m gonna. Get us,

Marcus: I’m going to send us, okay, we’re going to get through policy. Cause I think the policy stuff is the most [01:07:00] exciting stuff. And then we’re going to go to AI. We’re just going to skip the, the, the payer and the, and the provider stuff. It’s just not that exciting. Um, all right. We talked about this. All this Fauci stuff.

Marcus: We got a bunch of links for you guys. Um, we’re putting a link in the show notes about the New York times, a guest essay around, uh, the bird flu. It’s people are starting to pay more attention because we are having more cases. So, um, I don’t think there’s much more to say other than like, you know, worth reading, but I do want to talk about this MDMA, therapy issue with the FDA where We had so much Zeitgeist momentum around, uh, psychedelics, um, and their efficacy, uh, in depression and PTSD, um, and then, bam, the FDA just knocks down MDMA, uh, for PTSD, um, saying that it’s, it’s not clear that MDMA, um, is, uh, [01:08:00] Effective or that the benefits outweigh the risks and the panel voted nine to two.

Vic: Yeah, like wow. Yeah, I was shocked I mean, I I thought and I think a lot of people thought not effective ten ninety

Marcus: two not effective, right? Ten to one the benefits don’t outweigh the risks Like that was not what I was expecting based on all the you know, hype we’ve been hearing about.

Vic: Yeah, and and probably purported results.

Vic: Yeah. Now the FDA presumably looked at data that we haven’t seen in, in sort of the, on, on X or something. Right, right, right. But there was a lot of momentum that it was a, almost a cure for PTSD. It was really

Marcus: touted

Vic: as

Marcus: very

Vic: beneficial.

Marcus: But I guess it’s interesting, right? It’s like. Were we, were we seeing studies or were we hearing advocacy?

Marcus: Right. Like now, I’m kind of wondering, because 9 2, I mean, that’s a pretty [01:09:00] overwhelming vote.

Vic: Yeah, yeah, I think, I mean, this just came out yesterday, so we might find more information about it. But John Hopkins, I mean, there was serious places that were doing studies for years. leading up to this, but it was, it’s not a close vote, man.

Vic: So anyway,

Marcus: you know, to me, this is more like the opening of a storyline that I want to dig into more. It’s going

Vic: to be over the next couple of years. I think there’d be a lot more research into MDMA and figure out what is it good for, if, if anything.

Marcus: Yeah, yeah, for sure. Um, all right. And I think that kind of covers it.

Marcus: Yeah, that covers it. We’re gonna, we’re gonna, we’re gonna go all the way down to AI. All right. So, uh, doing our AI tracker. Yeah. Uh, so first story is around NVIDIA. Um, NVIDIA is partnering with Meta on, uh, Metaslama 3. To create a new [01:10:00] integrated model that’s going to be part of the NVIDIA AI enterprise stack.

Marcus: They’ve got this new thing that they call NIM, which is an inference, um, uh, an inference, uh, microservice. So basically, NVIDIA is getting in the API game. Yeah, which means they’re getting in the cloud computing game, um, but not necessarily opening up their own cloud, but selling to people who are managing clouds, you know, you could see a world in which Google cloud and Azure by these chips and offer this service.

Marcus: You could also see a world in which corporations that are managing their own private clouds will buy these chips and now be able to out of the box have the same kind of packaged microservice support that hosted clouds provide today. It’s pretty powerful.

Vic: That’s right. So it is, um, they, they have great technologists.

Vic: Jason Wang is a good leader. They have 80, [01:11:00] 85 percent market share. So there’s really nowhere to grow left in, in the chips on the hardware side. And they know, and I know everyone knows that they, all the other chip manufacturers are coming and trying to. Replicate what they have done and they’ll be they’ll be somewhat successful at that.

Vic: I mean and it’s a lot right like google Amazon and microsoft everyone everyone is doing their own chips And so I think they are sort of playing offense and moving up the stack into the software layer. Yes And I think it’s gonna be great for consumers I mean the bottom line is there’s going to be more options and it’s going to be less expensive and everyone You They’re going to compete with open, open AI and Google and Microsoft,

Marcus: you know, one, one of the bit, so Jensen really does feel like a [01:12:00] business genius.

Marcus: And one of the genius moves here is if you’re selling more chips than anybody has in the history of computing, why not leverage your chips as a distribution channel for software? Yeah, right. And I’m trying to think, has anyone done that before? Yeah.

Vic: I don’t think so. I don’t think anyone’s done that before.

Vic: No. I mean, the, the, um, Microsoft Intel partnership was the closest to that. But they were two separate companies that just aligned.

Marcus: Yeah, and it was more the reverse.

Vic: Yeah.

Marcus: Right? It was more like, you would have Intel inside the PC maker, kind of bundled with Microsoft software, but I don’t think Microsoft was embedded in the microprocessor.

Marcus: No, no, no. Right? It was just more, everything is designed to work really well. That’s not what this is, right? This is like, you’re going to buy the, you’re going to buy the chip. And you’re going to get this microservice [01:13:00] embedded in the, in the chip. I mean, that’s, yeah. And

Vic: there’s a lot, there’s a lot of banks and companies that have their own data, other healthcare systems that have their own data service systems, data centers.

Vic: And this is now going to open up an entire market where they don’t need to go to one of, you know, Amazon, Azure, Google cloud. They can use the existing centers they have. And it’s, it’s brilliant. It’s also going to, I think, create. A very competitive pricing environment, even more so than there is now. And so I think that’s good for us.

Vic: It’s good for anyone who’s not. I mean,

Marcus: you’re starting to connect developers to Nvidia, right? Whereas before that wasn’t what was going on.

Vic: Yeah. Before they were selling chips into a cloud provider and then you had to buy Google cloud or Amazon PC three. And it was

Marcus: abstracted away from the [01:14:00] developer.

Marcus: Like I didn’t really care. All I knew was that you have powerful chips. Right. That’s all I knew. But now I’m like, Oh, I can optimize for developing on the, the Nvidia spec. And I’m probably going to get not just tuned performance, but maybe some other little utilities that are built in there. Right. That are like specific and advantageous to the applications I want to build.

Vic: Yeah. And if you’re down the street at HCA dinner center. Why do you want to give up all that control and host it with Azure? Well, you can do yourself and so like for the individual person, it’s incentivized and for the company is and for Nvidia it is

Marcus: well, well, we already know that it’s not best practices to be 100 percent um, public cloud, like you use public call for some things, but basically most corporations are hybrid cloud, right?

Marcus: Some public cloud and then some. Internal private cloud that they manage.

Vic: Yeah, but if AI starts to be integrated into all the [01:15:00] core aspects of the business, you got to get into the private cloud or it’s been beneficial to be beneficial. It’s beneficial,

Marcus: right? You can, you can manage your budget and your dollars probably better in the, in the private cloud than in the public cloud and energy consumption, right?

Marcus: You know, as much as

Vic: the cloud providers tell me they won’t train on my data. Ah, yes, yes, yes, yes, yes. I’m capital one. Or epic or someone that has like, I mean, not necessarily the jumpstart algorithms. I’m proud of them, but they’re not that valuable. But, but there are companies that have really valuable data.

Vic: They’re just paranoid, even though they have a contract that says they won’t trade. They’re going to be more comfortable with like in my data center. I can walk up to it and see it.

Marcus: So, uh, you’ve got a clip of, uh, Jensen’s, uh, keynote at Computex. 2024, we’ll just kind of play this, it’s only half a minute here, but it goes into the [01:16:00] breadth of what they’re building.

Marcus: And he is focused on healthcare.

Vic: The reason it’s really interesting is healthcare is one of the big, big issues. Of course.

Jensen Huang: We now have the ability to create large language models and pre trained models of all kinds. And we have all of these various versions, whether it’s language based or vision based or imaging based, or we have versions that are available for healthcare.

Jensen Huang: digital biology. We have versions that are digital humans that I’ll talk to you about. And the way you use this, just come to ai. nvidia. com. And today we.

Marcus: So we went to a dot com and that’s when we started to kind of understand about these inference microservices. So if you’re not like a real techie, it’s going to be a little bit hard for you to like fully understand what’s going on here.

Marcus: Uh, but, but just, just be aware they are not asleep at the, at the wheel. They understand that they’re, they are ultimately getting into competition with, with the Googles of the world. I mean, Look, they already are by market [01:17:00] cap. There’s no question about that. They’re, they’re more valuable than those companies.

Marcus: And now

Vic: all those companies are trying to build their own chip.

Marcus: Yeah, exactly. Of course. Cause they don’t want to be, if they don’t want to be, you know, buying from an NVIDIA as a vendor and NVIDIA realizes that as a B2B vendor, they are, you know, always going to be taken out. So they have to get more verticalized themselves.

Marcus: So,

Vic: and healthcare is one of the top. It’s probably the top thing, if you include biotech, that they’re all looking at.

Marcus: Yep, yep. Alright, final story, uh, The Great AI Challenge. So the Wall Street Journal did a test of the top five bots that are out there. So they did, uh, ChatGPT, Microsoft’s Copilot, Google’s Gemini, Perplexity, and Anthropic’s Clawed.

Marcus: And, uh, pretty nice, you know, little, little article here that breaks down different use cases. Yeah. And their assessment of, you know, which bot was best for, you know, which use case. Yeah, I

Vic: hadn’t seen an easy to understand place where they test for How is it at creative writing? How is it in health? How is it in coding?[01:18:00]

Vic: So yeah, so it was good to, to see the different, uh, the different use cases.

Marcus: Yeah. And, and we’ll just kind of go to the end and say that the winner was actually perplexity, um, which is, is one of my favorite, um, bots, but, but it’s not, I don’t know how much staying power it has. I mean, yeah, I mean, I, I, I like it because to me it feels like the best, um, transitional replacement for search.

Marcus: Yeah, you know what I mean? Definitely is that right? Like, like it’s it’s better than than Google’s AI results today, right? So if I’m trying to aify my search, my searching complexities, the way to go. No question. Um, fifth place was co pilot, which I think tells you a little bit about why Microsoft is probably working with chat.

Marcus: GPT, um, open AI. GPT was second, Gemini was third, Claude was fourth, Co Pilot was fifth. So, um, I, to me, the big surprise here is probably perplexity being in first overall, although not necessarily like the best at much. Um, but. [01:19:00] Avoid it being fourth or fifth in any category, which is, which is pretty, that’s probably how they won.

Marcus: Um, check GPT, you know, really good at health, really good at cooking and also the fastest, which I think makes sense. Um, Gemini only best in finance, um, and outside of that definitely struggled in summarization, uh, current events and, uh, you know, And coding it was third. That was kind of interesting. Third to perplexity.

Marcus: So anyway, if, if you’re, if you want us to be able to trying to like figure out which one should I use, this article is a, is a really nice breakdown, at least as a starting place for you. And to realize like, they’re not all tuned for the same things. Yeah.

Vic: Yeah. That’s right. I think, um, there definitely are differences and in general, they all are getting much better very quickly.

Marcus: Yeah.

Vic: So I’ve decided just to. Get all my stuff in Gemini so I don’t have to keep learning new interfaces and mess with it, but [01:20:00] But over time, there may be a reason to do, for particular use cases, other things. Yep, absolutely. The GPT 4. 0 is pretty cool. I was playing with the image thing. Oh, really? This weekend.

Vic: But, but in general, I think it’s better to pick one and sort of get used to it.

Marcus: All right, final note before we get out of here, um, did you see any of the, uh, SpaceX launch this morning?

Vic: No, I did not see it. So Boeing had one too. They both

Marcus: were Boeing or SpaceX. SpaceX was this morning. Okay. Starship. Boeing was made yesterday.

Marcus: Yeah. Starship. Okay. Yeah. I mean, get off dude. A hundred percent success. It’s crazy. It’s crazy. So fourth attempt, um, you know, the first one blew up.

Vic: Yeah, yeah, yeah.

Marcus: Um, and then the last two had malfunctions, but they were able to reuse a lot of the components. And so I didn’t even know what’s happening. And Jason Moore reached out to the ring of five.

Marcus: It was like, you know, you know, That the SpaceX launch has happened this morning, I was like, Oh, that’s cool. So put it on TV and it was, I got to say, man, it was amazing. It was amazing. Um, you know, massive rocket. I mean, you could look at it. It’s huge, [01:21:00] huge, it’s huge. And just watching it go from like step to step to step and, and everything, you know, I, I would say they probably will rate it as like an A minus.

Marcus: You know, launch, because it was like, you know, 19 boosters, you know, fired on the way on the reentry for the rocket. Like the wing, I mean, it, as it was going back through the atmosphere, the, the heat was like tearing the wing, uh, like to pieces and the camera was able to like, continue to focus on the cameras cracking, but you can still like watch it.

Marcus: And then in the last minute, it was like, it was time for the wing to like shift its positioning. And even after all that damage, it still was able to do that. And it was like, Oh my, like everybody watching, you can feel it was like, Oh my God, I can’t believe that happened. So anyway, like there’s a lot of cool shit happening now in the world, man.

Marcus: And, um, you know, we’re going to be multi planetary. Clearly, clearly. I mean, like, it’s, it’s like not a joke. Yeah. You know what I mean? If you think about life expectancy, if you think about AI, if you think about genomics, and then you [01:22:00] add in like where we’re going from a space travel perspective, we’re headed there.

Marcus: Yeah. We are headed there.

Vic: Yeah. I mean, I’m super optimistic about all of the innovation and it always, um, it’s all building on, on its, on each other. Right? So the AI systems are going to help SpaceX. All that data is going to be fed in and then all the biotech is in, you know, sort of supercharged by alpha fold and it’s all integrated together.

Vic: It’s just great. If we can get our politics and our, all of our human stuff figured out, we’ll be off to Mars.

Marcus: That’s the key people. We got to take care of each other. All right. Until next week.