Jul 6, 2024

71 – What the Overturning of Chevron Doctrine Means for You!

Featuring: Vic Gatto, Marcus Whitney & Doug Edwards

Episode Notes

This episode reviews significant healthcare and financial news, including a Wall Street Journal article on the second quarter market performance, focusing on AI companies and their impact. They discuss key healthcare mergers and acquisitions, such as United Health Group’s deals and potential regulatory hurdles. The episode also covers the implications of the recent Supreme Court decisions, particularly the overturning of the Chevron deference doctrine, and explores the broader impact of these rulings on various sectors. Finally, the hosts reflect on their experiences and learnings from the Aspen Institute Health Innovators Fellowship, highlighting the importance of understanding historical context and striving for continuous improvement in healthcare and society.

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Episode Transcript

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, Vic, happy 4th.

Vic: Hey, yes, excited to be back on with you. It was fun to have a guest in town, but good to see you again.

Marcus: Man, be crushed it. Um, he is definitely a welcome, really job.

Marcus: He’s welcome back. You, you’ve picked some really great guest, uh, hosts. Paul Cappleman, Bo Barmy. These are really, really smart guys. Well, one of, one of

Vic: the, one of the great aspects of Nashville is there’s a lot of really, really experienced healthcare folks around.

Marcus: Yeah. Yeah. I I, I learned a lot in that episode.

Marcus: So, um, thank you Bo, for, for, uh, standing in and you’re definitely welcome back, brother. Um, so where are you, man? I’m in,

Vic: uh, Boulder, Colorado. So I was in Aspen a couple of weeks ago. So, uh, some friends of ours invited us here for the fourth.

Marcus: Nice.

Vic: So I haven’t been to Boulder in 25 years. So last night it’s, uh, it’s great.

Vic: I don’t know much about it, but a little hike this morning. [00:01:00]

Marcus: Yeah. Both

Vic: boulders,

Marcus: definitely cool weather

Vic: as opposed to national.

Marcus: Yeah. Yeah. Boulder’s boulders. Definitely. Nice. Um, I, uh, I I’ve only been there twice. I’ve been there twice, but I, but I’ve been there recently. I think 2021 was probably my last time there.

Marcus: It’s really nice.

Vic: You’re back in Nashville.

Marcus: Yeah. Yeah. I’m, I’m back in Nashville and, uh, having a really nice week back here. It’s hot. It’s super hot, but, uh, but it’s, but the weather’s nice. And you know, the week of the fourth is kind of like the last week of the year. It’s, you know, it’s a nice break.

Marcus: Everyone’s just kind of relaxing, thinking about. Taking some time off traveling, like you’re doing with friends, uh, hanging with family, spend some time at the pool. So it’s nice to get a little bit of a breather before next week, you know, which is kind of the real start of the, of the third quarter. And, uh, you know, I, I, I don’t know about you, but I definitely am getting.

Marcus: Myself prepared to [00:02:00] run the gauntlet between next week and the end of the year for sure.

Vic: Yeah, we got a lot We got a lot to accomplish For

Marcus: sure for sure. All right. So, um, we have a fair amount to talk about today, but I think you and I talked before Pressing record and our feeling is that you know, we did kind of a total Uh wrap up show at the end of last year trying to break down the big themes You And this week kind of feels like the last week of the, of the year, you know, but it’s more of like a halftime thing.

Marcus: So we’re going to, we’re going to cover some stories, but this will not be our typical round roundup, um, format. And we’ll, we’ll stick to stories we think are really, really important. Uh, not so much special interest stories. And then just kind of talk a little bit about how we think the last. Two months have gone and where we think the next, uh, last two quarters have gone and where we think the next two quarters are going to go.

Vic: Yeah, I think that’s right. There’s a ton of news. We’ll cover the [00:03:00] highlights, but I think it makes sense to sort of take a deep breath. We’re halfway through the year. It feels like a lot of change going on. So just kind of reveal that.

Marcus: Yeah. All right. All right. So with that, let’s dig in.

Marcus: The first story we’re going to cover is from the wall street journal, and it is a, uh, a bit of a review of the second quarter and, uh, it’s great article. The headline is the quarter that split the market in six charts. And we’ve been hearing so much, I mean, really driven by NVIDIA’s remarkable run up this year.

Marcus: Uh, becoming the most valuable company. Um, you know, at least in the known western world, uh, really on the back of artificial intelligence, very, very asset light business. Uh, and we’ve talked a lot about how artificial intelligence is being infused into every bit of software that we [00:04:00] use, but. Yet and still very few people, you know, from an end user perspective, are that proficient with it or, or really know that much how to, how to use it.

Marcus: But I think everyone has come to accept that LLMs are remarkable technology. And if they continue to advance at the rate that they have been advancing, We will inevitably be replacing humans with technology, um, in many specific, uh, functions in our economy. And that is going to lower the cost of delivering goods and services.

Marcus: And that’s going to create more margin. And so people are willing to, uh, give really, really strong future value to these AI companies. And this article does a good job of explaining how The AI companies have sucked so much of the oxygen, uh, out of the room that the rest of the S and P 500 hasn’t even remotely kept up.

Marcus: And in fact, in some ways has actually, uh, gone down. And [00:05:00] so, you know, when we’re talking about all time highs, that makes it even more remarkable what Nvidia and the magnificent seven have done because the healthcare industry, uh, as far as S and P 500 is down on the quarter.

Vic: I mean, we cover it every week that the, the pace of change in artificial intelligence is really impressive.

Vic: Very fast. It’s changing for the better. But I agree. The, the technology tools have not transitioned where, um, it every company out there is much more productive, where you can do a lot more with the people, people and resources you have. That’s the promise. I even think that will be the result in the long run.

Vic: Yeah, but we haven’t really seen it flow through yet so you’re getting the stock markets sort of giving valuation credit to the companies that are Building these tools and and and even monetizing the the [00:06:00] beginning of companies Experimenting and use and you know, you just need to spin up a lot of cloud services with the cloud providers Need to buy a lot of nvidia chips to even start using this stuff Um, and so I think I think the stock market is generally Reflecting the accurate the accurate valuations, but like you haven’t seen it be pulled through to Companies that are using these tools to do day to day services.

Vic: Uh, but there’s the size and extent of the, of the upside in NVIDIA and the, the, the Magnificent Seven, sometimes called the seven biggest stocks has like overwhelmed. The rest of the entire market, the other 940 90 companies that, in fact, are flat to, in some cases, even down,

Marcus: right? Yeah. And in NVIDIA’s case, uh, their rise is legitimate.

Marcus: They are [00:07:00] legitimately blowing out revenue numbers, right? Um, you know, exceeding analyst expectations quarter after quarter. And so for them, you know, they are actually moving the chips. Um, and then I think While, while we’re, while we can talk about the ramp up of the end user, uh, the, the large tech companies have for themselves figured out how to leverage artificial intelligence to improve their businesses.

Marcus: So, you know, meta is probably the poster child for that over the course of the last year. You know, everyone thought meta was just dead after apple turned on all their privacy, uh, stuff and really limited their ability to leverage. Uh, the apple ecosystem for targeting and they have figured out leveraging artificial intelligence How to deliver ads in an even better way than they did before when they were reliant Uh on apple tracking and so, you know, I think the large tech companies they have the wherewithal and the capabilities To really drive ai To improve their businesses, drive more [00:08:00] top line revenue as well as lower their cost of delivering goods and services in a way that, you know, the average non technology company cannot.

Marcus: And I think that’s where they’ve been able to see such such great growth, not necessarily because Gemini is changing the business world, right? Or meta is changing the business world, but metas use of AI on their ad engine and their auction is materially changing their business.

Vic: That’s right. And in general, if the.

Vic: If, uh, Google’s suite of tools, or Microsoft’s suite of tools, or Apple’s, or Meta’s, get much more engaging, more powerful, they’ll have a stronger, uh, strong value proposition, and they’ll grow faster. So, I think it does make sense that a lot of the value would go to software companies first. We’re seeing it begin to be pulled through into other other groups like [00:09:00] communications even like power There’s a lot of discussion around powers is going to be in insignificant demand And that’s so you’re starting to see the stock market begin to look at these kind of adjacent areas And begin to increase the valuations there.

Marcus: Yeah. Uh, some, some other trends that this article highlights, uh, one is that higher for longer rates are now priced in. And so, you know, we’ve, we’ve talked over the course of the last few months, how, uh, it’s feeling less and less critical that the fed Delivers, uh, uh, a fed funds rate drop, um, because it feels like the market’s kind of priced it in.

Marcus: We’ve all rebalanced a bit. And quite frankly, if, if we don’t get that drop AI gives us at least a practical technology approach to how we can lower the cost of delivering goods and services. And so there’s just, um, less focus on, on the fed [00:10:00] at this point. People generally feel like, you know, 4. 5 is kind of where we’ll.

Marcus: And the year, and that’s fine. Um, so that’s a far cry from where we were last year at this time, uh, where everyone was just, you know, at the edge of their seat waiting for Jerome Powell to deliver first some relief from the constant rate hikes, but also when are we going to turn this thing around and deliver a cut?

Vic: Yeah, I think that’s right. And the transition like from zero interest rate environment to this higher for longer, I think actually has been as smooth as you could expect. That’s a hard transition and I think at least this article implies that overall people have moved on to We’re not going to get back to zero interest rate for a long time And we will have to figure out how to manage our businesses with administrative Three and a half to five.

Vic: Somewhere in [00:11:00] there for four and a half is what they talked about here.

Marcus: Um, another really interesting chart here is the way that the street is valuing, um, by market value, your balance sheet. Right. And so. You know, your, your large cap companies, uh, excluding AI, you know, if they are cash rich, uh, then they got a little bit of a premium, but if you were cash strapped or precarious, I mean, you went down anywhere from, you know, basically three to 7%, um, in your market value.

Marcus: And so, um, I think that is the way that the market has decided to recalibrate valuations. In this change fed fund rate environment where it’s harder to get access to capital, especially like risk capital, they they want to see stronger balance sheets. And I find that interesting because I think it reflects the mindset that you and I have when we think [00:12:00] about.

Marcus: Early stage venture, right? Like we have shifted away from, Hey, rah, rah, burn at all costs. You know, let’s graduate to, to series a let’s grow that top line. And we’re, you know, we’re much more like lower the burn, you know, get your revenue slow and steady. Um, you know, focus on the amount of revenue you’re getting per employee.

Marcus: Right. You know, how, how efficient are you? And what kind of steward are you of the capital? So it is interesting to see that that is the way that the market has shifted how they’re, they’re thinking about, um, how they’re going to value the public market companies, right? Is okay. It’s not as easy to get access to capital anymore, uh, you know, especially risk capital.

Marcus: So we want to see a really strong balance sheet. We want to know that you are here for the long run. And we want to see that you’re a good steward of that capital.

Vic: I think that’s right. And honestly, I think that probably is. A healthier place for the for the economy and the stock market to be if you have a [00:13:00] lot of cash on your balance sheet You can earn five percent four percent on that cash And it is expensive at least expensive to borrow money now, even if you have access you’re going to be paying higher interest rates And so companies that have, uh, business models where they’re using a lot of cash and they’re always borrowing and, uh, they’re highly leveraged, they have a lot more risk, uh, once we move out of the zero interest rate environment into a positive interest rate and overall, that’s probably healthier.

Vic: So we’re seeing that transition and I think, yeah, you and I are implementing it in venture markets. And I think it flows through the. The later stage markets too.

Marcus: Yeah. So, uh, I think it’s a great, great article kind of gives a great synopsis of where we’ve gone to, uh, over the last two quarters, but certainly the second quarter, um, NVIDIA and, and the many of us, the seven have really, you know, split the market into two [00:14:00] and, uh, and it’s interesting, you know, I feel that some of the more stable companies, you know, in, in healthcare, real estate, um, energy, industrials, materials, Uh, are all being, you know, punished a bit and and I wonder whether or not they’re being appropriately priced because I can’t see a world where comparison is not playing a role here, you know, obviously, when I is pulling away and you’re getting companies being valued at 3 trillion dollars, it’s hard to not look at some of these more steady as she goes companies and say, Uh, you know, your quarter over quarter returns are just not that impressive anymore, right?

Marcus: Um, and just apply a lower multiple to those. But to me, I still think that the steadiness and the lack of hype cycle in those industries from a long term investor perspective, um, does carry value. So I’m not overly concerned about that particular quarters, uh, result for those, those industry sectors.

Vic: Yeah, I mean, obviously, uh, [00:15:00] I’m somewhat biased because I’m a healthcare investor, but healthcare going down in the second quarter, uh, does not make sense to me.

Vic: I understand it’s not, it doesn’t have the benefit of the AI narrative, and I think it’s sort of as simple as that, that if it’s not involving AI, people are not buying it at all. But I think in general, we’ve gotten our workforce issues. At least manageable. We always need more people for a long time, but the cost of labor is more manageable.

Vic: And it seems to be like the, the, the healthcare system overall is bringing more patients through. And those patients are in need of higher acuity services. Um, and it’s a unique time when both payers, uh, now the star rating thing hasn’t has changed in a way that’s positive for the payers and providers.

Vic: Everyone is. Is kind of making more money and seems to be doing doing pretty well and [00:16:00] yet the stocks are down So I think it’s a little bit of a buying opportunity um, but because healthcare is going to be good over the next several years just may not be as uh, It’s not it doesn’t fit the ai narrative as cleanly as obviously as software Yeah, and

Marcus: I think you also have to look at Um, the run up that the AI companies have had and say, okay, did you, did you miss the run?

Marcus: Right. Um, it’s, it’s, it’s not entirely clear that it’s a buy today. Um, it’s not, it’s not entirely clear that it’s not a buy today. Right. But I mean, I think how much will it continue to repeat its performance over the first two quarters of this year? I think that remains to be seen.

Vic: Yeah, I mean because look if

Marcus: it does it’s going to end up being a four trillion dollar company next year Right.

Marcus: I mean like if it keeps repeating what it just did.

Vic: Yeah, i’ll say I mean I I thought I had missed nvidia [00:17:00] Gosh a year ago and didn’t buy it because I felt like it had already run up and then it’s doubled for me

Marcus: Yeah, and so

Vic: I I don’t i’m not sure i’m the best picker. What what I do think is that health care is uh more It’s running much more effectively than it was a year ago You I think both sides of payramp providers are both kind of working better And yet the stocks are down.

Vic: So I just would I think there’s something there but But financial markets are, are, you know, they move around very quickly. This is based on set.

Marcus: Um, all right, so let’s move into our, uh, healthcare stories for the week. We’re going to, we’re going to cover three stories. The first one is, uh, an update on the medicines and United health group deal.

Marcus: Uh, we haven’t heard anything about this deal. I mean, maybe for most of this year, obviously United health groups, you know, big storyline was the change healthcare, uh, cybersecurity attack [00:18:00] that they were managing. And so. Um, it makes sense that we didn’t sort of hear much, uh, other than that for most of the first half of the year.

Marcus: Um, but now that’s, that’s managed. It’s in the rear view mirror. And, um, you know, we’re now we’re starting to get back to hearing about UHG and deals and there’s a MEDICIS deal was a big one, uh, MEDICIS, uh, UHG had already successfully acquired LHC group. Um, a medicines was the other large home health company in what is outside of these two largely kind of a mom and pop industry.

Marcus: There are some other larger platforms, but, um, these were definitely the two big ones. Um, and so I think there were some concerns about the, uh, what will happen to the industry afterwards. Obviously, there’s always different mechanics that have to go into making these deals palatable for regulators, and it looks like some of those mechanics are starting to bear out where a medicines and U.

Marcus: H. G. R. divesting of certain assets to a company called vital caring, and that’s kind of [00:19:00] clearing the way for for this acquisition to happen.

Vic: Yeah, and I think it’s, uh, it’s really the way that Acquisition should be managed by the FTC. I think, I mean, I’m not parting to the detailed conversations, but the government looking into this and then forcing the merger to not occur until there’s some, some number of locations that are spun off because it would be too in the local market, a Metasys slash.

Vic: UHG slash LHC would have too much control. They might own the whole market. Um, in those cases They’ve asked them to to find other buyers for these assets. So that that seems like the way it should work Um, and I don’t know vital caring group Uh, but presumably they’ll they’ll be a healthy competitor And they get to buy these assets that otherwise they wouldn’t have been able to

Marcus: Yeah, [00:20:00] so, so an interesting, uh, note in this article here from Fierce Healthcare is that in October, uh, Senator Elizabeth Warren and, uh, Rep.

Marcus: Pramila Jayapal, um, from Massachusetts and Washington respectively urged federal officials to take a closer look at the proposed merger, citing concerns about vertical integration, uh, and that kind of plays into our next story about UHG slash Optum, uh, which is their backing out of the deal, uh, to buy the steward physician group.

Marcus: And so the steward physician group is part of the infamous steward health system from, uh, from Massachusetts that has had, uh, a terrible outcome insofar as they’ve gone bankrupt and communities in that area are being left without, um, any Community health system to care for them. Elizabeth Warren has been on a war path around this.

Marcus: And this is a story we’ve talked about in previous weeks as it pertains to the focus [00:21:00] of the regulators on private equity. Uh, firms and, you know, how this this steward health deal has really been a bad story for the entire private equity industry. It unfairly, you know, paints all private equity as sort of acting from a single position of being just financial engineers and not caring about the communities.

Marcus: But this is a really bad story. And so, uh, not to say that, you know, That the reason why optimum backed out of the steward health deal is, you know, because maybe they really see the amethyst steel being close to being executed, and they don’t want to create any risk there. Uh, but certainly the steward deal had a lot of hair on it, and, um, I think.

Marcus: Optum swooping in to potentially buy that physician group. Probably it felt to me, just reading that story, like a good thing for that community, um, to have the backing of, you know, the biggest healthcare company in America, uh, stepping in to, to support, but who knows, maybe Optum looked under the hood and just said, uh, this, this deal is not, not [00:22:00] viable.

Vic: Yeah. I don’t know the details other than, um, I don’t think Optum is going to buy a physician group that is, that’s not viable. Okay. I think, I think in general, they would rather just recruit the docs away themselves. And so either they got a lot of information and when they looked at it, it’s not really what they were sold.

Vic: Um, or they didn’t have much information and it was really a tentative deal that was promoted, um, by Stewart and their attorneys in the bankruptcy to get the bankruptcy. Approved when the deal was really shaky either way. It’s hard to know which is true, but either way That’s

Marcus: right. Yeah. Yeah, so I mean we’re we’re just speculating all the different circumstances that are surrounding these two stories happening at the same time um, but uh, obviously more tough news for um for [00:23:00] for those communities and and look, you know, it’s like We are just consistently seeing Elizabeth Warren’s name whenever it comes to any acquisitions in healthcare, you know, her and Lena Kahn, uh, and are, are out there as much as the state AGs, uh, when it comes to evaluating and scrutinizing, uh, healthcare mergers and healthcare deals.

Marcus: But as you and I’ve talked about, it’s like when those deals don’t happen, what’s the alternative, right? Is the government going to step in and provide the care? I mean, they’re not. Yeah.

Vic: I mean, I think with the emeticist deal, Elizabeth Warren complained about it last October. FTC and justice looked at it in their normal process and they’ve requested that these hundred ish Locations get sold off that that feels like the process working pretty pretty like it should be Senators upset about it.

Vic: They look into it where there are Competitive issues meaning that there’s no second option in that market in that local [00:24:00] market It can’t include those locations and there were a hundred or so That’s a, that’s a critical thing. I think for Optum, for UnitedHealth Group and Optum to, to integrate a Metasys and get that acquisition done.

Vic: That is really important. The Stuart acquisition, opportunistically they might buy, but it doesn’t, it doesn’t matter to UnitedHealth Group really. And I think that is going to be a hard thing to get worked through. There’s a lot of, lot of challenges, a lot of skeletons in that process. Some of which maybe there were bad actors in private equity, but there’s, There’s lots of things that haven’t come out yet.

Vic: And unfortunately we need to think about the patients and the doctors and the caregivers, the people in this situation with Stuart, how we put it. back on solid footing to take care of the patients and the caregivers. I don’t know, but that’s what we need to try to work.

Marcus: Uh, and then our final story on the [00:25:00] healthcare side of things, Arden health right here in Nashville, Tennessee, our friend, uh, Marty Bonick CEO, uh, they have filed for an IPO, um, estimated 500 million IPO, uh, previously.

Marcus: They were owned by Sam Zell’s private equity firm, and Sam Zell passed away, unfortunately, uh, within the last six months. Um, and so maybe the timing of that, uh, is, is related, but, uh, but regardless, um, Arden going public. So, uh, another Nashville health system, uh, going back on the public market.

Vic: Yeah, I think it’ll be great.

Vic: I mean, um, EGI Sam’s group is a pretty big operation. I mean, it, um, I think they’ve done a good job building up art and taking it, taking it private work, building on it. Um, the plan was always to bring it back public. I think the time is more related to the public markets being open and interested [00:26:00] than Sam passing away.

Vic: But it’d be great to get them out again And have another for profit company. We’re here in Nashville.

Marcus: Yeah. Yeah. So, uh, best of luck to Marty and the team over there, a bunch of good people. And, um, as, as, uh, as mentioned previously, Paul Kappelman, uh, used to be the COO over there at Arden. So a bunch of great people have, uh, have, have walked through those hallways and it’s a really solid company.

Marcus: So best of luck to them on getting the IPO done. We’d love to have a Nashville IPO, uh, take place this year. That’d be awesome. All right. So that is kind of what we’re going to talk about just in terms of general stories. Uh, let’s take a break, let Doug share a little bit about Jumpstart Foundry. And then when we come back, we’re going to talk about president Biden and the Supreme court of the United States.

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 [00:27:00] talk about, uh, early stage venture investing, certainly the need for us to change the crazy world of healthcare in the United States.

Doug Edwards: We are spending 20 percent of our GDP north 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.

Doug Edwards: To invest to help us make something better in health care. 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.

Doug Edwards: Innovative solutions [00:28:00] 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. Through those most innovative solutions that Jumpstart Foundry invests in, we also provide great returns and a great experience for our limited partners.

Doug Edwards: 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.

Doug Edwards: Thank you guys. Now back to the show.

Marcus: All right. So Vic, I listened to your episode with Bo last week. And, uh, I listened to your prediction. I’m not going to beat you up because I think it’s, I think it’s great that you were optimistic and positive, [00:29:00] uh, in what, in what I think what you were really saying was less of a prediction and more of a hope let’s, let’s, let’s frame it that way.

Marcus: Um, I had, I’ve been on the show, I would have been. Parroting what Bo said, which is

Vic: right, right, which I would have been

Marcus: much more cynical, you know, unfortunately, I think now everyone is saying the quiet part out loud, but, you know, in the weeks prior to the debate, uh, Unfortunately, President Biden was not showing well.

Marcus: Um, and on, uh, on numerous occasions, he was, he was not showing well. And he sort of had intermittent periods of not showing well. Um, and so he does seem to rebound and then have a bit of a spell where he’s speaking in publicly and everything is just fine, but when he’s in, but when he’s that close to the debate and he’s having two to three referenceable Bad [00:30:00] spells in public speaking or public presentation.

Marcus: Uh, I, I don’t think we were in for a good night and, and, and, and we got just that right, which was, uh, a presentation of, of a person who if not for his incumbency and the belief of some. In the democratic party that he is the only one who can beat donald trump Um shouldn’t have been on stage right should not have been in that debate at all.

Marcus: Um, And you know, look it’s father time is undefeated You know,

Vic: right.

Marcus: Um and We’re health care guys I mean we all know that the stress of the job of being the president of the united states of america ages people right and It’s a hell [00:31:00] of a thing to age someone in their fifties or sixties. This guy’s, you know, got, came into office in the late seventies,

Marcus: you know, it’s like, of course he has aged tremendously over the course of the last four years. And of course he’s struggling to keep it together. He’s not super bad, you know? Um, so I, I am, look at this point, The likelihood that he is not going to be the candidate for the democratic party is very, very low.

Marcus: Um, barring something significant happening to him from a health perspective, which obviously I don’t wish on anybody. So I don’t wish that on him. Uh, I think it’s full steam ahead. He does not seem like he is willing to step aside. Um, and quite frankly, It echoes, um, Ruth Bader Ginsburg. [00:32:00] It echoes, um, Dianne Feinstein.

Marcus: Um, this is, this feels like history rhyming in a really bad and tragic way. And, uh, look, it’s, it’s, it’s tremendously disappointing for me, uh, to see the Democratic party unwilling to face reality in, in this situation. Um, it’s just, it’s just, it’s just really frustrating.

Vic: Yeah. I mean, I, I agree. I mean, I was watching the debate with my wife and one of my sons and two of his friends. So they’re a bunch of us, three teenagers, three 17 year olds. And I agree with you, Joe Biden, you know, I’m not sure I agree with every policy, but he’s been, he’s been 50 years plus public servant doing the best he can do [00:33:00] every day for, for his constituents.

Vic: And I respect that. I think everyone should respect that. Um, and my son and his two friends left after the, we saved Medicare, uh, gaffed, or I don’t know what it was. It wasn’t a coherent statement. They left. Like, the debate was over, and I think, I mean, they said something to the effect of these old people don’t represent us, and we’re, we’re not watching anymore.

Vic: It’s ridiculous. It’s just, it’s just, it’s ridiculous, and it’s sad. I mean, we, we should have better people running the country. You know, on both sides, and, um, I don’t know, it’s, it’s, it’s sad, and I agree with you, I, I don’t think the odds are that Biden will step down, although I think he, I think he should, I don’t think [00:34:00] he, it’s not clear to me that he’s qualified to be president today, like, I, I don’t know if we had a real, uh, international emergency, if I think Joe Biden could actually be negotiating with other world leaders, Right now I don’t I don’t know that I feel confident with that

Marcus: We don’t know the truth of his cognitive abilities.

Marcus: We’re not close enough to it But we can certainly say what is required of a candidate who has a strong chance of winning Um, is they have to be sharp on their feet. You know, what we have seen out of president Biden in, in, in recent weeks, and, and I want to be clear, it has not been isolated to recent weeks over the course of his presidency.

Marcus: He has had these moments now, again, not consistently the state of the union was quite good, right? So I was

Vic: thinking the [00:35:00] state of union was, was a reason to think he could do well with the debate. Right. But that was, that was a scripted speech, which is a different thing than on your live on your feet reacting.

Marcus: That’s right. That’s right. Um, and he hasn’t been looking that great the last two or three weeks, right? And and that’s that’s just the part of it that I think is uh, it just comes off to the american public as being very uh Disingenuous disingenuous and selfish, you know, that’s what it comes off as it’s like, you know Are you so

Marcus: in love with the idea that you are the only one that can defeat Donald Trump, that you cannot recognize, uh, that your ability to hold this office, uh, is, is fleeting. And, and, Oh, by the way, like we’re not even just talking about this election. If he wins, there’s gotta be another four years. [00:36:00] Yeah. You know, how many people really are looking at where he is today and thinking he’s going to be just totally solid.

Marcus: For the next four years in this role, knowing how much stress. The presidency of the United States brings on a person. So it’s just frustrating, right? I mean, it’s just, it’s just like we’re, we’re, we’re not allowed to. I mean, we, we are doing it. Everyone’s doing it, right? Like the, the gloves are off in households and on and on.

Marcus: Social media. The gloves are off. We’re, we’re all having the conversation. He’s had to acknowledge it. You know, Jake Tapper’s, uh, got got a tweet out there talking about all the Democratic governors are all circling around and saying. Hey, we’re concerned. We need to hear from the White House. What’s going on here.

Marcus: You know, none of that means he’s not going to be the candidate, but it means we’re all talking about it. America is having the conversation right now. Okay. And it, it, like I said, it reminds me of Ruth Bader [00:37:00] Ginsburg, you know, you know, had she stepped down during Obama’s term, the Supreme court would be five to four, not 63.

Marcus: And we’re, and we’re going to, we’re going to shift into talking about SCOTUS here in a second, but like, You know, it’s like, what are we doing?

Vic: Yeah. I mean, it has to be true that the strength of our country is in the systems and all of the, all of the many people that are running for office and voting for people and supporting and doing the, their administrative work, all of those people together, it’s not one person.

Vic: And so whenever, whenever

Vic: justice Ginsburg or president Biden or, or anyone, there’s certainly Republicans also that are, that have been in there forever, that, um, [00:38:00] Mitch McConnell, you know, it’s not necessarily as sharp as he once was, let’s say, but

Marcus: he’s stepping down, he’s stepping down. Yeah.

Vic: Right. And it’s, it can’t be about you personally.

Vic: It has to be about the overall, the overall process, the whole, the whole, the whole structure. And I don’t know, I just think people around Biden are trying to prop him up for their own selfish reason to stay in power for a while longer. And whether he has the best chance to beat Trump or not, I’m not sure he has the best chance to beat Trump right now.

Vic: But whether he is or not, it doesn’t feel like the American people are being given a real choice.

Marcus: No, definitely not. Um, look, yeah, I, I think that one of the truly, [00:39:00] um, damning things about all of this is You know, love him or hate him point out his flaws during COVID and just for sort of what’s going on in California.

Marcus: Um, but Gavin Newsom went on Fox news and was a superstar. He was an absolute superstar, right?

Vic: The democratic side has lots of talent. There’s

Marcus: talented people there, right? I mean, it’s not like. We don’t have any potential options. Yes, there are options, you know, and I, and I think one of the, one of the saddest things is that I think the democratic party, you know, it’s, it’s much, it’s much like for us as leaders of companies, right.

Marcus: When there’s that person who they’ve, they’ve had a history of doing great things for the company, [00:40:00] right. And they’re also pretty good. But they’re kind of toxic, right? They’re toxic. And the, it’s, it’s, there’s a trade off, but the right thing to do is let that person go. The right thing to do for the culture and for all the other people in the company is to let that person go and, and you in leadership, you wrestle with this.

Marcus: You’re wrestling, you’re wrestling, you’re wrestling. And then you finally get the courage to let that person go. And when it’s done, you go to like share the news with the company and you’re kind of like hanging your head and everyone goes, what took you so long?

Vic: Right, right. , yes.

Marcus: You know. What took you so long?

Marcus: Did you have so little faith in all of us that you thought it was okay to continue to subject us to this one person? This one person was that important, [00:41:00] right?

Vic: Or you didn’t have faith in all these other people.

Marcus: Right. And that’s, that’s the analogy I’m trying to make big,

Vic: right?

Marcus: Like the, I think the democratic party really underestimates the swell of support that would come if they would make the change.

Vic: Yes.

Marcus: Like how proud we would be that they made the decision to make the change.

Vic: And it’s also a little bit of a longer game. I think like, yeah, I don’t know. I mean, I was watching with my 17 year old son. He doesn’t really care if it’s Trump or Biden, he thinks they both are out of touch with his generation’s needs. And. The Democratic Party should be the party that is sort of like empowering a whole bunch of young people that want to change the world and do great things.

Vic: And they [00:42:00] have that opportunity and whether they win this election or not, it would field up all these strong people to run in elections for, for years. And instead they maybe are going to prop up Biden. And unfortunately, literally, it seems like prop them up and one that’s not good for the country. It’s, it’s not good for our safety day to day.

Vic: But it’s a really bad signal to, to all the young people that might, they want, they want to vote. They want to run for office. They want to volunteer somewhere and they’re not going to.

Marcus: You know, I really wish, I really wish that in America, we’re, we’re very bad at, at how we treat our elders. I really wish we had some form of like elder counsel [00:43:00] in American, in the American politic body, right?

Marcus: That like was official. Maybe it’s even an elected set of roles, right? But it’s not an executive management role. It’s not an executive administrative role. It’s a role of wisdom, you know, and it still can do a lot of important ambassadorial things. It can do coaching for, for, for the active president, you know, cause it’s almost like we don’t have a place for these wise people.

Marcus: When they’ve, you know, I don’t want to throw Joe Biden away. I don’t want to throw Dianne Feinstein away, but I also don’t want Dianne Feinstein voting on Tuesday and passing away on Sunday. You know what I mean? Like that’s ridiculous. That is ridiculous. So anyway, um, let’s, let’s, let’s segue.

Vic: It empowers the, um, the [00:44:00] bureaucratic like staffers.

Vic: I mean, I don’t think Diane Feinstein was reading those bills and evaluate them and debating it with colleagues before she voted when she died a week later. It’s, it’s her staff. And so I don’t know, like we, we don’t vote for it. The chief of staff, I can’t even name who Biden’s chief of staff is, but,

Marcus: but

Vic: he clearly is, is very important.

Marcus: But, but, but I guess what I’m saying is because we do not, you know, look The private market is not favorable to older people, right? Like what you, what we have going on in politics does not happen anywhere in the private market. Right. I mean, so it’s, it’s a pretty ruthless world out there for, for, you know, elders.

Marcus: Um, and I feel like because we don’t have a, a role of wisdom and coaching and, um, and being ambassadors, right. Uh, for elders, they don’t [00:45:00] have incentive. To build succession into their career. You know what I mean? And so, so they just keep doing it. They just keep, they just stay and they stay and, you know, somehow Joe things because I can do two terms, I should do two terms

Vic: and there’s no place for him to go.

Vic: Or anyone to go that would be respected where he actually would contribute the perspective in, in the important decisions that we’ve made in the next 10 years. He’s seen a lot of things happen. And so has George W or, you know, all, all the presidents that aren’t that, that’s right, that are, that now are finished.

Vic: Um, and there’s something around, uh, they no longer are trying to build their personal ego or their personal. Uh, next step in their career. So they’re able to be much more, I think there’d be much more [00:46:00] willing to talk to the other, other party and willing to think about other alternatives. Yeah. I think that would be a great addition to bring wisdom to the, to the people that are doing the day to day decision making.

Marcus: Yeah. I mean, I mean, find a way to not just gracefully, but, but like practically. Put the elders to work in an appropriate role, right? Being the president is not appropriate in what might be the last three years of your life. Like, I’m sorry. Okay, let’s, let’s, let’s move on to the Supreme Court. Um, a couple of things.

Marcus: First, Vic, just a, uh, just a pat on the shoulder to you and to myself. The second episode of the Health Further podcast over a year ago, Was a complete focus on the Chevron deference doctrine. [00:47:00] And now everybody in podcast is talking about the Chevron deference doctrine. Nobody was talking about it a year ago, buddy.

Vic: Right.

Marcus: Yeah. High five for you.

Vic: And it’s, uh, it’s important in every industry and it’s really important in healthcare where we’re over. I think over half of the spending is coming from the federal government. Therefore the agencies have a lot of power and therefore Chevron is going to be such a, it’s going to be an important change.

Vic: Yeah. Yes. I’ve been thinking about it for a long time. It’s still, even though we’ve been talking about it and thinking about it, it’s still not clear what the impact is going to be. It’s going to be a lot of change.

Marcus: No, no, no. Uh, it’s, it’s, it’s not clear at all. And you know, all these things are all chess moves right on the [00:48:00] board.

Marcus: Um, I was listening to, uh, a recent bankless podcast where they were digging into it because I don’t know if you know this, but crypto was actually referenced in the Supreme Court’s opinion on Chevron because they didn’t name him by name. But, uh, by historical attributes, they referenced Gary Gensler, um, as, as someone who formerly was at MIT, uh, now was a regulator and was establishing law by default, um, you know, Without going to Congress and asking for law, um, on crypto and, and basically like, you know, be being judged jury and executioner.

Marcus: So, so crypto was actually referenced in, um, in, in this decision, which to me is, uh, another example of the Democrats shooting themselves in the foot. You know, that was stupid. I like, it’s just stupid. [00:49:00] Um, but

Vic: they’re still, the dems are still, I don’t know what they’re doing with crypto, but not the right thing.

Vic: It’s just insanity. It’s just inanity. They’re, they’re losing votes for no reason.

Marcus: Crypto, no reason this, this is, there is no reason to do this. The, the, the only thing I will say is, you know, there, there was a whole narrative. That had been emerging over the last year that the Dems are a party that is losing touch with young men.

Marcus: Right. Um, and, and crypto is largely a young man thing. I mean, I don’t want to say that young women are not engaged, but if you’ve ever been to a crypto conference, it’s dominated,

Vic: it’s eight, 80%.

Marcus: Yeah. And young men and young. Yeah. Right. It’s very, very much young men. Um, and I think that that is that real, that is a very real blind spot.

Marcus: You know, [00:50:00] James Carville, did you see James Carville talking at Aspen ideas? Did you, did you,

Vic: I missed it. I missed it, but, but he’s, he’s great. Yeah. So he,

Marcus: so, so, so he w he was at Aspen ideas and he, you know, he, he, his talk has been memed now. Yeah. Because he was saying that basically the Democrats, you know, are telling people, they shouldn’t watch football and it shouldn’t eat burgers.

Marcus: Right. And like, you know, you know, and they’re waving their finger at people and, and that, and that’s why they’re losing, you know, young men. And it really is such an unnecessary position for the, for the Democrats to take, it’s like, I don’t understand why I just don’t get it. I just don’t get it. Uh, Well,

Vic: they, uh, There was like two weeks in April or May where there was a There was some crypto bill that Biden was gonna veto and fight about.

Vic: And, and all the, all the Bankless and other, other crypto were upset about it. And [00:51:00] Trump came out and started accepting donations at Bitcoin, which, what the hell, that’s an easy thing to do. And all of a sudden, just because he’s accepting donations in Bitcoin, that’s, that means he’s procr. But, but it was brilliant.

Vic: I mean, Trump is a lot of things. One thing he is is really good at reading the room and, and, and doing something to pull people to his side for a, for a minute or two, the Dems seem to be okay with it. Like they, they sort of walked back the, the Biden vetoing, whatever. Uh, but then it just didn’t filter through and, and they haven’t.

Vic: They haven’t followed up. And so I don’t know,

Marcus: it was, well, listen, Gary Gensler has been a true, um, antagonist to that industry for years. You can’t fix it by, by greenlighting the, the Ethereum ETF. Like that’s not, that’s insufficient. Anyway, I don’t want to go down the crypto rabbit. That’s an

Vic: example. I think of [00:52:00] where Chevron has been used.

Vic: I mean, that’s why it was, it was carried out where Chevron was used to extreme.

Marcus: That’s right. And,

Vic: and inappropriately.

Marcus: That’s right.

Vic: And the Supreme Court now has made it clear that that’s, that’s not legal. They can’t do that.

Marcus: Right. Right.

Vic: Um,

Marcus: so, so we could, we could go down a rabbit hole of Chevron, but I would like to zoom out a little bit because in, in a little than more than a year, this Supreme Court that when each of the new justices Specifically, Kavanaugh and Comey Barrett went in front of Congress.

Marcus: They said, of course, stare decisis is a real thing. Precedent is a real thing. You know, they claimed that they would [00:53:00] be humble and they would be judges that would, um, level opinions of humility with respect to previous decisions that had taken place to the court. And the last. Year plus has been anything but that

Vic: yeah, they have not been I would say there’s been a lot of humility there

Marcus: There’s zero humility This this is a court.

Marcus: This is a court That is not looking over their shoulder at all.

Vic: Yeah, that’s right. They are,

Marcus: they are untouchable. They are acting like they are untouchable, right? They are acting like they are untouchable. They, I mean, what do we have besides ProPublica? to actually watchdog them. There’s nothing. There’s nothing. So, I mean, Congress is not doing it. Congress has the power to do it.

Marcus: You know, I think I saw AOC is going to introduce articles of [00:54:00] impeachment of the Supreme Court. Obviously, it’s not going to happen. It’s AOC. Um, but, I’m only saying that to demonstrate that the Congress does have The ability to check this court, but are they in a position to do that? We’re in the middle of an election cycle, you know?

Marcus: Um,

Vic: yeah. So Rovers Rovers is

Marcus: Wade affirmative action, bump stocks, Chevron doctrine, presidential immunity. I know I’ve missed something, but those five, my God,

Marcus: they have changed America. More in the last year, anything that has happened in either of our lives, and that’s saying a lot because we lived during 9 11,

Marcus: but they have changed America more in the last year than anything in [00:55:00] our lives.

Vic: And it was a 20 year, really well thought out plan by social conservatives to try to change the landscape that was that was implemented over a long time. And it’s going to take another 20 years to reverse it. If, if even we decide we want to reverse it, but let’s just stay on Chevron for a minute. Like, I haven’t, I think I agree with the court that, um, administrative authorities like the SEC, but we know healthcare, let’s take HHS or FDA or CDC, they should have very limited latitude to go make up their own.

Vic: Uh, [00:56:00] policy, and should have to follow, you know, laws that are passed by elected officials. I agree with that. The problem comes that our elected officials, as we talked about previously, I don’t have a lot of confidence that Congress, the House, and the Senate, or any of them, are going to actually produce legislation that is meaningful, and so we get this like, um, stasis, or inability to do anything.

Vic: I agree.

Marcus: No, we don’t. We get the courts.

Marcus: We

Vic: get the courts, and the courts will be, uh, conservatively They’ll rule conservative, because they’re stacked with conservative judges. For the I mean, there’s a mix, of course. Anytime there’s thousands of judges, but But more judges are conservative than not.

Marcus: Yes. Um

Vic: And the agencies are staffed with More liberal [00:57:00] career, uh, government officials, but that’s, that’s completely dependent on

Marcus: what that completely that’s completely dependent on what administration is, is in the white house.

Marcus: So,

Vic: yes, but then the, um, let’s just say it was, That the courts now have the power through, through Chevron. The the courts are gonna be more powerful than the agencies by,

Marcus: they are

Vic: by policy. They just

Marcus: are, they’re, they’re, so I think the thing that you and I need to start to, um, understand better is we need to start to understand the administrative procedure act better.

Marcus: Um, because Chevron really kind of stacked on top of that act. This act is from 1946, and this was the act that basically laid out the rules for how the regulatory, uh, agencies can regulate, like how it works. Right. Um, and I, [00:58:00] My understanding, I’m not a lawyer. I’m just trying to study this stuff. My understanding is that removing Chevron rolls us back to the Administrative Procedure Act or the A.

Marcus: P. A. And I don’t think we understand what those rules are, but I think that’s going to be the standard that the regulatory Bodies are held to now on bankless. Um, the guy who they were interviewing, uh, he was a former, uh, he was a former, uh, I can’t remember what position he had, but he was a director, I think in the sec, um, and also the CFTC.

Marcus: Now he works at Paradigm, I think, in the crypto industry. So he formerly worked in the agencies. And what he said is, look, you know, one tactic that they might take, uh, is, okay, we can’t do regulation, um, but we can do enforcement actions, right? So one [00:59:00] thing we might see is sort of much more aggressive enforcement actions that are getting rolled out.

Marcus: Um, which at a minimum, Make it expensive and, uh, unattractive to do certain types of businesses, right? Because, okay, you got to fight the enforcement action in court. You got to get the lawyers, blah, blah, blah. You got to do all this stuff. Now, as we’ve talked about in previous episodes, the track record, unfortunately, for the regulatory agencies recently in the courts has not been that great, right?

Marcus: Um, you know, Medicare advantage rolled back, right? Um, we’re, we’re seeing a lot of this stuff. Just not actually take place. Uh, but, um, enforcement actions are a lever that the regulatory agencies can still pull, even with Chevron being repealed by the Supreme court. So, um, I think we’re, we’re, we’re going to see actions driving.

Marcus: You know, new actions and, and we’ll see how this whole thing will play out. But I, I don’t expect, uh, the democratic led [01:00:00] agencies to totally lay down in the face of this. I don’t expect that.

Vic: Yeah. Well, I think that’s, that’s definitely true. And so I think we’re going to be in a kind of a wait and see period where the election is six months away, roughly six months away, and there’s going to be more clarity, certainly about the president, but there’s And then about the Senate and House.

Vic: And if it is a, if it’s Biden or another Democratic president, there won’t be that much change at the top of the agencies. And if it’s a Trump presidency, there’ll be significant change at the top. And then the, the Congress will be split or it won’t be split. And, and we’re going to have to sort of move into a new administration under this new, uh, This new set of policies that I think are going to be quite [01:01:00] different and how that, how they’re different exactly.

Vic: I don’t know, but it’s going to be, it’s going to be less authority to do things from the administrative agency, executive, uh, authority, um, kind of thing where the president just says, we’re going to do this, um, new initiative, um, and we’ll adjust to that, but it’s going to be a significant change and, and not.

Vic: I don’t have a lot of confidence that Congress is going to be cranking out a lot of bills to clarify everything.

Marcus: Yeah.

Marcus: Well, look, um, I think that the Supreme court has, uh, made it clear they are going to be an active player. Um, started decisive is, um, I mean, it’s basically out, [01:02:00] it’s basically done. I, I, I don’t know that. You know, it’s, it’s, it’s so interesting, right? There are, there are rules to games and then there are customs to games.

Marcus: And for long periods of time, uh, when everyone agrees to customs, you sort of have this, modicum of what you would call good sportsmanship, right? You know what I mean? We, this doesn’t actually fall into the rules, but this is the custom. And if we both agree to it, the way that we, um, engage here will be seen as, as a sportsmanlike affair, right?

Marcus: And then, and I think about this in martial arts, right? But then, you know, there are those who read the rules to the letter and play the game by the rules and say, conduct be damned. I’m not actually engaging in an agreement. with you. [01:03:00] Right? Um, and

Marcus: And breaking conduct, but those wins are rarely celebrated. Sometimes they, they illustrate to people where conduct actually held the game back, right? And you kind of realize, Oh, wow. Like that, you know, conduct here actually didn’t really help us advance the athleticism of the sport or something like that.

Marcus: And sometimes it’s great. You know, the father is an example of that.

Vic: That’s right. Sometimes the, the challenging to the custom. And designing a new way to play the game is liberating, liberating, and And people start adopting that as a better way to play. Um, [01:04:00] and sometimes people then change the rules to, to say, well, that, well, that was technically inside the rules.

Vic: That’s not how we want to, that’s not how the game really should be done.

Marcus: That’s right. That’s right. And story decisions is a custom. It’s not a rule. It’s a custom. It’s not a rule. And, uh, I think. What has been such an affront to people in the legal world, right? I mean, think about it this way. Um, law schools all over this country have to teach constitutional law.

Marcus: And the foundation of that class has been decades of precedent law, right? That that is wrapped in this decisis. And Supreme, the Supreme Court has blown that away. Over the last year, right? Um, next year’s law students are going to have to learn a whole [01:05:00] new form of constitutional law. Um, and, uh,

Vic: we haven’t really talked about it, but, uh, In the Delaware business, corporate law law system, though, the whole Elon

Marcus: Musk,

Vic: Tesla comp thing, again, the, the customs were, are being challenged.

Vic: And I think that, uh, what is best for the shareholders should, should be what’s best, what, what is, what is corporate law and the fact that with hindsight, Elon Musk made a bunch of money when he also increased the shareholder value by, I think by a hundred percent. Um, We maybe shouldn’t or don’t want to take that incentive away now that those kind of [01:06:00] precedents also, it’s just, everything is changing the entire system is going through kind of a generational change and it’s going to be really challenging.

Vic: I think,

Marcus: yes, I, I very much agree. We healthcare’s at the center

Vic: of that. Cause there’s a lot of, there’s a lot of rules in healthcare and there’s a lot of customs that human life is at stake. And so therefore. Customarily, we don’t do this thing, and everyone kind of agrees that, yeah, of course, we don’t, we don’t clone embryo, embryos and grow organs, because there’s, there’s downsides to the humans that would be producing those organs.

Vic: But I’m not sure we have laws around that. That’s just a custom thing. And all of this needs is going to be challenged and debated and thought through and [01:07:00] our society is not good at talking about hard things in any long form, more than a 10 second soundbite. That’s

Marcus: a, that’s a really good way to maybe wrap this, uh, this, this conversation on, on, on SCOTUS.

Marcus: So I think, look, I think you and I are committed to paying more attention to SCOTUS, right? We, we, we started this podcast with a, with a focus on a really important Supreme court case that we knew because we work in the healthcare industry, that it would have really significant impact to our industry. Um, But I think it’s now even broader than that.

Marcus: It’s here

Vic: now.

Marcus: Yeah. Yeah. We knew

Vic: it was coming. We thought it was going to come, and now it’s here.

Marcus: Yeah, that’s right. And so, A, what’s next? And B, what does it mean now that it’s here? Right? These are things we’re going to have to wrestle with in the future. And, uh, [01:08:00] the weeks to come. So listen, um, I wanted to share a little bit about my week last week.

Marcus: Wow. Let’s talk about

Vic: that’s yeah. Let’s talk about where you were and, and review that.

Marcus: Yeah. So I had my, um, I’m a fourth and final seminar with the Aspen Institute health innovators fellowship in. Alabama said

Vic: over two years, it’s over two years. Yeah.

Marcus: Yeah. Four weeks over two years. Uh, a group of 21, uh, professionals in the healthcare industry in a variety of roles.

Marcus: I think we have maybe eight doctors of the 21, uh, folks. And then, you know, some BCs, some people from politics and people in, in, in city leadership, uh, some scholars it’s, it’s just a phenomenal group. Phenomenal group. And, uh, we’ve all gotten very close over the course of the last two years. You know, [01:09:00] um, disclosure will do that.

Marcus: And also, you know, reading the classics. I mean, I think one of the most valuable things I will take away, uh, from the Saskatoon Institute experience is, you know, On my own, I’m going to be much more motivated to read the Declaration of Independence and the Bill of Rights and, uh, you know, important, uh, you know, chapters and psalms and Aristotle and Plato and the art of war from a Birmingham

Vic: jail or, yeah, and, and reading those, uh, really like some of the best pieces of writing in human culture

Marcus: ever.

Vic: Ever. Ever. In the history of human culture and then debating it or talking about it.

Marcus: Yes.

Vic: And compare and contrasting with 20 other healthcare people from all different, uh, parts of the industry. One, I think, uh, [01:10:00] you learn a lot about yourself and about those documents, but, but two, it’s, it’s an incredible sort of, uh, Perspective to see like what other people think about from across all kinds of healthcare.

Marcus: Yeah So one of the things we read, um is a famous speech made by Frederick Douglass in 1852 in Corinthian Hall in New York, um, that is called, What to the Slave is the Fourth of July? Um, and, you know, Frederick Douglass was a remarkable person, um, was born a slave, was born a slave, Uh, became free, taught himself how to read, became one of the greatest orators and writers of, uh, his, his time and, um, and many other things.

Marcus: Um, but this speech is, is famous because it [01:11:00] does, it, it does a job. Of

Marcus: communicating to America. And what’s really interesting is, you know, he’s, he’s talking in a, in a, in a famous hall to a group of, of antislavery people, uh, it was, it was an antislavery group, a women’s group pulled together, uh, and asked him to make this, this speech. I think it was the day after the, the, the 4th of July.

Marcus: Um, and it, it does in New

Vic: York. So it’s, it’s, it’s in, it’s in the North

Marcus: talking to abolitionists. Right. You know what I mean? Um, but it does an incredible job. of highlighting what, what a work of art, the Declaration of Independence is, um, and what a tremendous feat the founding fathers of the United States of [01:12:00] America did by, uh, breaking free, uh, from the, what they saw as, You know, unjust, um, tyranny from the crown.

Marcus: And at the same time that the words in that declaration of independence, um, the right of every man to have life, liberty and the pursuit of happiness. Um, clearly we’re not for all people. Um, and it’s a very difficult thing to square because the only way you could really square it was to somehow create this quasi man, this three fifths of a man, right?

Marcus: Man enough to be punished man enough to, uh, be jailed man enough to have a, you know, a litany of laws written about them of things they can and cannot do. That you would never write for [01:13:00] beasts, right? So clear man enough to be punished, um, but not man enough to have rights. Not, not, not,

Vic: not, not five cents of a white man.

Vic: That’s right.

Marcus: Of a man, of a man, not a white man, a man.

Vic: Yeah.

Marcus: Right. Um, and look, I did not grow up a slave. Thank God. Um, you know, and thanks to, uh, the unbelievable sacrifices of many of My ancestors and many allies that that, you know, um, black people have had this country to sort of fight and put themselves in harm’s way.

Marcus: You know, we live in a, in a city that has a tremendous history of civil rights, the freedom writers, um, you know, the work that John Lewis and John Seigenthaler, you know, a black man and a white man did in this city. are powerful and largely contributed to, um, the freedom that I’ve had, um, to be your partner and to be in a VC fund.

Marcus: But we spent the week in Alabama, man. And, [01:14:00] um, you know, Alabama is different from Tennessee. I gotta tell you. Um, and we, we spent a lot of our time in Birmingham, but we did spend one day Driving to Selma, and we walked across the Edmund Pettus Bridge.

Vic: Oh, yeah. That must be powerful.

Marcus: Yeah, it was incredibly powerful, where Bloody Sunday occurred.

Marcus: Um, and then we drove to Montgomery. And I had one of the most powerful experiences I’ve ever had. Uh, at the legacy sites, which are three sites established by the equal justice initiative, which was founded by Brian Stevenson. Um, so anyone who knows the just mercy story has seen the movie, read the book, um, but knows about the man who was on death row in Alabama for crime.

Marcus: He did not commit, uh, spent way too much [01:15:00] time there, uh, because people wouldn’t, Do a DNA analysis, uh, he ended up losing decades of his life, missed the passing of his mother, um, but eventually was freed and was spared his life, uh, by the work that Brian Stevenson and many other people in the, um, equal justice initiative did.

Marcus: And so he formed this nonprofit. And then realized over time, like he, he needed to change hearts to help them, people to understand how mass incarceration had become an insidious continuation of slavery. And so he created the legacy sites and there, there are three sites. One of them just opened in the last like 30 days, I think.

Marcus: Um, but the first site is the legacy museum, which is incredible, super well done museum that tracks the path of African Americans from the transatlantic slave trade. So from slavery, um, through to modern day [01:16:00] mass, um, incarceration. Um, the second location is a monument and a memorial to, um, The thousands of people who were lynched, uh, during the lynching era in the South.

Marcus: And then the third, uh, site is a freedom monument and sculpture garden which is breathtaking. The quality Of the art in this sculpture garden is unlike anything I’ve ever seen in a sculpture garden. It’s just magnificent and, and it all leads to this, um, this monument that is like an open book, bronze book with black trim, um, that’s got the thousands of names, I believe, uh, from the census of the freed slaves.

Marcus: Um, and the 1800s and, and my, my dad’s last name, I was, it was so hot. I couldn’t like stay out there all day. Um, but I was able to find [01:17:00] my, my, my father’s last name and take a picture of it, um, uh, to bring home for him. And, and, uh, You know, he wants to, he wants to go, he’s doing much better by the way. And he wants to go and my mom wants to go.

Marcus: So, you know,

Vic: yeah, I’ve, I’ve heard about these sites and read about them. I really want to take a weekend trip down there with my family. And see, it’s the kind of thing that when you, I think you have to sort of be there to experience. It’s, it’s an in person experiential thing. Would you agree with that?

Marcus: Uh, absolutely. Absolutely. It’s, it’s, you know, the, the, the historical work they’ve done, the work to aggregate all this information. Is tremendous, but the presentation is so visceral, right? It’s one thing to read this stuff on the internet. It’s another thing to be in an immersive, beautiful, awe inspiring, horrible experience.

Marcus: Yeah. It’s

Vic: in Montgomery, which you [01:18:00] know, is, has a lot of hard history.

Marcus: Yeah.

Vic: It’s almost like, I’m not going to get it right, but like kind of black people taking some of that ownership of the. The city back and trying to control it. The legacy

Marcus: museum is in a building that was once a cotton mill. Right. I mean, like, it’s like, I mean, you can’t get any more.

Marcus: So, so anyway, I, I, I, I think what I want to share is that all of that is America’s history. That’s not black history. That’s America’s history that like, there were some things in there, Vic there, there are. There are companies, incredibly prominent companies today. Like these names roll off the tongue.

Marcus: These are especially financial companies, especially financial companies [01:19:00] that had collateral for loans of slaves on their books. So it’s, so it’s, it’s important to, to, to understand that, um, the creation of Juneteenth as an additional day of independence, national day of independence, uh, really was necessary.

Marcus: It really was necessary because the 4th of July. As Frederick Douglass, so aptly put was not a day of independence for the black people in this country. Um, it was, it was largely the beginning of really difficult journey to where we are today. Right. Which is being in a place where. We now can look at the Declaration of Independence and we can now look at the flag of the United States of America and we can now look [01:20:00] at our monuments with hope that we can continue to do the work that will allow this country to live out the words that were in those founding documents.

Marcus: Um, but we need to be really clear. The country didn’t start out living out the words. In those documents, they’re incredible words. The writing is brilliant. Um, but what happened to millions of people throughout the founding of this country was not, um, yeah, and I think, and it’s material, you know,

Vic: well, I was gonna say, I think it is.

Vic: Um, I agree with that. And it’s, it’s not that

Vic: we don’t expect the founding fathers to be perfect. I don’t expect them to be perfect. They, they were, they were trying to make the world [01:21:00] better from the perspective that they had. And I don’t expect Biden and Trump to be perfect, but like doing, doing the best you can, trying to live up to these ideals and recognizing the history that we all share and how it’s affected all of us.

Vic: And in different ways, we can learn from that and try to be. better next year and better and teach our kids how to make it better. And, uh, you and I will make mistakes. I’m sure our elected officials make mistakes, but, but those ideals, we need to keep kind of striving towards that. And I think our country has a lot of problems.

Marcus: It does,

Vic: but if we try to make it better and you and those 20 other people talked about healthcare and you walked through those sites, and then you now have a network of people that can make it better. None of you [01:22:00] are perfect, but you can try to make it better along the way. And I think that’s all we can.

Vic: That’s all we can kind of do.

Marcus: And, and we can, we can, we can look an awful history in the face so we can understand how awful it was so we can be sure that we don’t repeat it because there is no guarantee we won’t repeat it. I think people really take things for granted, but the Supreme court of the United States has made it clear.

Marcus: Don’t take anything for granted. Right.

Vic: Yeah.

Marcus: Don’t take anything for granted. Right.

Vic: Yeah, I think that’s right. I mean, I mean, just a simple thing. Our life expectancy in the United States has been going down, but we’re not, we’re not getting, [01:23:00] overall, we’re not helping our population live longer, more productive. Now everyone is trying to help the patient in front of them, but systematically we’re, we’re not, we’re just not doing all the things we, we could do better.

Vic: So that, that’s just one example, kind of bringing it back to healthcare. There’s a hundred ways that we could regress and, and take setbacks. And I don’t know, I think that the 4th of July is a good halfway mark through the year to sort of take stock in where we are and, and what we should do in the second half.

Vic: And healthcare innovation is a place that I mean, obviously I’m biased, but I, I think it’s a fun place to, there’s a lot that can be done to make, make healthcare better and to make life better.

Marcus: Yeah, I, I, I, I agree with you. I think, I think we’re, we’re very fortunate to be in a space where, um, We get the fun of [01:24:00] innovation, but we get the meaningfulness of health care, right?

Marcus: Um, so that’s a, that’s a privilege. I would say, you know, we have the privilege of being able to manage and allocate capital in that way. And I think it’s important for us. And I think we do. an okay job, but I’m kind of holding us to task here. Um, I think it’s important for us to be students, be students, right.

Marcus: And, and, um, so, so that we don’t unwittingly, uh, repeat an unnecessary tragedy.

Vic: Yeah. There’s a lot to learn from, from history, from those, from those 30 most important written documents and from Frederick Douglass’s speech and from those. Historic [01:25:00] sites where they called what sites in Montgomery, the legacy sites legacy sites.

Vic: Yeah. I mean, that’s a Five hour drive. I need to get down there and see it Yeah, I mean, I think it’s a there’s a lot that I am frustrated with but I think there’s plenty that I can do Personally in the work. We do at jumpstart or in learning myself and so instead of pointing fingers at other people, maybe it’s This week.

Vic: Think about how, well, how can I learn from what’s come before and try to do something better for the next six months?

Marcus: That’s it, man. That’s it. It’s 4th of July. Let’s, let’s, uh, let’s see, what are we doing to help this country to continue to live out its, um, it’s incredible ideals. All right. Good show, man.

Marcus: Good.

Vic: Yeah. And

Marcus: enjoy Boulder.

Vic: And, uh, I’ll see you on Monday.

Marcus: Indeed. Take [01:26:00] care.

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