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We Built Our Own Salesforce in Months. Here's Why We're Cancelling the $600K Contract | Curative CEO

1:29:27EnglishTranscribed Jul 22, 2026
0:00

Lockdowns had just started. Everybody

0:01

[music] was starting to freak out. There

0:03

was basically nowhere to get a test. So,

0:05

our chief scientific officer had in his

0:07

spare time developed a COVID test. I

0:09

think our peak day was 26,000 people

0:11

tested in a single day. I'm so excited

0:14

for a freaking wild story today. Fred

0:16

Turner, co-founder and CEO of Curative.

0:18

This is an English founder in the valley

0:21

who scaled a COVID testing business to

0:23

$5 billion in revenue. Then he had to

0:27

scale it all back. [music] It did not

0:29

last postcoid for obvious reasons.

0:31

Today, he turned it into a health

0:33

insurance provider that's worth $1.3

0:35

[music]

0:36

billion. And in the show, he says some

0:38

pretty wild stuff. And the company went

0:40

from about 7 to 7,000 employees in those

0:43

first 9 months. We did 2.5 million

0:44

[music] vaccinations. That was another

0:45

service we did. We also lost a ton of

0:46

money on that. That was a terrible

0:48

business. We're cutting about 80% of our

0:50

SAS spend this year. What's the single

0:52

largest contract you signed?

0:54

>> Ready to go.

0:57

>> [music]

1:07

>> Brad, I'm so excited for this. Dude, you

1:09

have the most wild story and I heard it

1:11

from Justin first uh and then from Anil.

1:14

So, thank you so much for joining me,

1:15

man.

1:15

>> Yeah, thanks for having me.

1:16

>> Now, I always find it very telling

1:18

entrepreneurs often kind of compelled

1:20

either by the fear of losing or by the

1:22

thrill of winning. If I were to ask you

1:25

which one drives you more, what would

1:27

you say it is?

1:28

>> Uh, thrill of winning. I feel like

1:30

during um certainly during co with what

1:33

some of what we built at curative, I got

1:35

kind of a taste for the the speed at

1:37

which you can move when everything is

1:39

like is behind you and all the momentum

1:40

is behind you and uh I've been chasing

1:43

that ever since.

1:44

>> I mean that is the biggest tailwind that

1:46

one could have ever expected. We're

1:48

going to get to that. You actually grew

1:50

up in the UK and then you moved to

1:52

Silicon Valley very young. 17.

1:54

>> Uh 19.

1:55

>> 19. Okay. Could you have built the

1:58

business that you did in the UK?

2:00

>> No, definitely not.

2:01

>> Why is that?

2:02

>> I just think the UK doesn't have like

2:05

some of the the kind of infrastructure

2:07

for um for startups and investing of

2:10

like that many people that have kind of

2:12

done a startup before and then are

2:14

willing to invest in the next

2:15

generation. Particularly investing in

2:16

younger people. like when I found I

2:18

tried to raise a venture round in the

2:20

UK. Um, and I couldn't even get

2:22

meetings. This was when I was like I was

2:24

18. I was in like first year of college

2:26

and I was doing this startup on the side

2:28

and I couldn't even get meetings with I

2:30

think I got like one fund to take an

2:33

associate meeting with me. [laughter]

2:36

>> Naturally, it went very far.

2:38

>> Yes. And and so it just it seemed like

2:40

people were more investing like purely

2:41

on credentials. And this was a while

2:43

ago, right? This was this was, you know,

2:44

more than 10 years ago. But it seemed

2:46

like people were investing just on, oh

2:48

well, you came out of this university.

2:49

Um, so if you, you know, you're an

2:51

undergrad, like, how could we possibly

2:53

look at this? This doesn't make any

2:54

sense. Whereas you go to Silicon Valley

2:56

and it was like, well, what's the

2:58

possibility here? What could you

2:59

envision in 10 years if if everything

3:01

succeeds? Like, how big a company could

3:03

this be? And it it just it was a very

3:05

different mindset that they were

3:07

optimizing for how to get the best

3:10

outcome rather than I always felt like

3:12

in the UK it was sort of optimizing for

3:13

like mitigating the the worst downstream

3:16

outcome.

3:17

>> Yes. How do I not get fired,

3:18

>> right?

3:19

>> Yeah, I totally get that. Um [laughter]

3:22

that's pretty funny. Um okay. And so we

3:24

decide to move to the valley. Great. Um

3:27

>> how does because we go from sepsis

3:31

detection. No. Well, cows to sepsis to

3:35

>> Can you just walk me through how we go

3:36

from cows to sepsis to co just so I

3:39

understand this?

3:40

>> Yeah. So, my first company that

3:42

>> I've never said that statement before in

3:43

a 20 VC episode, by the way.

3:45

>> There we go. It's a new a new phrase for

3:46

you. Yes. So, um I went from initially

3:50

cattle testing uh through sepsis to to

3:52

co. So it started off my first company

3:55

in the UK which was called TL Biolabs at

3:57

the time basically sequencing dairy and

4:00

beef cows to predict various traits

4:02

about the animal from an early age. So

4:04

it started off with beef you can predict

4:05

that certain cows are going to have more

4:07

musculature um from an early age and

4:10

some cows can have too much musculature

4:12

and then they have trouble giving birth

4:13

and so there's like an optimum that

4:14

you're shooting for um and I found this

4:17

like completely by chance. I won uh the

4:20

UK National Science Engineering

4:21

Competition and um like was on TV a

4:25

little bit and this farmer reached out

4:26

to me because he wanted help testing his

4:28

cows and he was sending his samples to

4:30

the Netherlands and it was taking weeks

4:32

and it was terrible. And I initially

4:34

told him like I'm not interested in

4:35

cows. I was interested in human genetics

4:37

at the time. Um like no thank you. Um

4:40

and then he kind of kept pressing and he

4:42

like sent me samples with a check

4:43

attached to the front and I was like oh

4:45

okay like this is interesting. And so I

4:48

did the first batch of samples for him

4:49

and then all of his friends started

4:51

sending me samples. And so it kind of

4:52

grew from there. And this was all still

4:54

in the north of England. I was in the

4:55

first year of of college at the time. Um

4:58

and uh we started branching out into

5:00

dairy and predicting how much milk

5:02

animals would make. And I tried to raise

5:04

uh the first venture round for the

5:06

company in the UK. Didn't get very far

5:09

and so ended up uh going to the US for

5:11

the US ACT investing conference in San

5:15

Francisco. It's my first time in the

5:16

States, never been before. Um, and I was

5:19

like my last ditch attempt to try and

5:21

raise some money. And I met a bunch of

5:23

VCs. Didn't raise any money, but I did

5:25

meet a guy who had just finished doing Y

5:28

Combinator. And he was like, "Oh, you

5:31

need to apply to YC. That's like that's

5:33

what you need to do. You need to move

5:34

the company to the US. You need to apply

5:36

to YC. Like that's the only thing you

5:38

can do here." Um, and I was like

5:40

familiar with YC uh but had never

5:42

applied.

5:42

>> What year was this? This was like the

5:45

end of 2015.

5:46

>> Okay.

5:46

>> Yeah. So, I went back to the hotel room

5:48

and it turned out like the application

5:49

deadline was 6 days away. So, I was

5:51

like, "All right, it's meant to be." So,

5:53

did the application, you know, got the

5:55

interview, came back for the interview,

5:57

uh, and then moved to to Silicon Valley

6:00

for the summer 16 batch.

6:01

>> Paul, so how was the interview? Who was

6:03

it with?

6:04

>> Tim, Jeff, and somebody else. Yeah, it

6:08

was I mean, it was all a bit of a blur.

6:09

It's very fast.

6:10

>> And then you found out you get in.

6:11

>> Yes.

6:12

>> You moved to the valley. moved to the

6:13

valley and then it was the same, you

6:15

know, pitch the same company. We were

6:17

doing uh mostly dairy testing at that

6:19

point. So testing dairy cows to try and

6:21

predict uh their milk yield, which for

6:23

farmers is actually very valuable

6:25

because they don't make milk until

6:26

they're 18 months old. And so from day

6:29

one, all your animals have to have a

6:31

cough every year to keep making milk. So

6:33

your herd doubles every year.

6:34

>> Is this still the same curative company?

6:36

>> No, this is a completely different

6:38

company.

6:38

>> Okay. I was about to say, god my this is

6:40

where investing is so difficult because

6:41

like if you hear a founder pitching milk

6:44

yield optimization [laughter] and I'm

6:46

sure it is like logistically a big town

6:48

I'm sure

6:49

>> well not big enough that was the

6:50

problem.

6:51

>> Okay.

6:51

>> Yeah. So so we did this went to YC and

6:54

we raised a seed round from Andre

6:57

>> a seed round from Andre. Yeah, their

6:59

their bio uh fund uh did our seed round

7:02

right out of YC. Um and I don't think

7:06

they did the TAM calculation.

7:09

>> Um

7:09

>> they backfound us.

7:11

>> Credit to you.

7:12

>> Yeah, they they were like, "Oh, this

7:13

sounds interesting." And they did the

7:14

round. It was a small round. It was like

7:16

1.65 million. So

7:18

>> chum change.

7:18

>> It was for the coffee.

7:20

>> It was, you know, for for Andreason, it

7:22

was like a smaller round.

7:23

>> Sure.

7:23

>> Um and so we kept developing the

7:25

technology. We had customers. Uh, and

7:28

then we went to go raise an A. And then

7:30

people did do the TAM calculation and

7:32

there's about 100 million cows in the

7:34

US. If you're doing well, you could

7:36

charge 15 to $20 per test. So even if

7:38

you assume you could test every cow

7:40

every year, you'd be at 1.5 billion like

7:43

total market, which is not enough to do

7:45

a series A off of. And so what we end up

7:47

doing is taking some of the core DNA

7:49

testing technology that we had developed

7:51

and pivoting and using that for human

7:53

diagnostics. And so that was my kind of

7:55

first foray into healthcare. Uh we

7:58

actually first launched a high

7:59

throughput STD testing lab. Um yeah,

8:02

which was and we launched an at home STD

8:04

test. It was that was tons of fun.

8:06

[laughter]

8:08

>> I don't I used to run a lot when I was

8:11

young and my knees were wonderful. Uh,

8:12

and I used to love how I built this cuz

8:14

they would ask the questions like this,

8:16

which is like, how do you go from like

8:19

cows and musculature on cows and milk

8:22

yield optimization to at home STD

8:24

testing? [laughter] Like, it doesn't

8:26

feel that natural a jump.

8:28

>> Yeah. On the back end, it's more

8:29

natural, right? All of these things have

8:31

DNA in them. And so, if you're if you're

8:33

looking to do better DNA testing, you're

8:36

just looking for markets where people

8:38

care more about that. and anything human

8:41

people obviously care a lot more about

8:43

are more willing to pay for and are much

8:44

larger markets. And so we sort of did

8:47

like a market first approach of, you

8:48

know, where where could there be

8:50

interesting things and we narrowed in on

8:53

uh antibiotic resistance in STDs as

8:56

being like a particularly interesting

8:58

area where they're getting harder and

8:59

harder to treat because you get more and

9:01

more antibiotic resistance. And if

9:02

you're doing the DNA testing, you can

9:04

predict what the best drug is going to

9:06

be early, treat with that drug, and then

9:08

you're not using the most aggressive

9:10

antibiotics.

9:11

>> Do we have more STDs than ever?

9:13

>> Yeah. Yeah.

9:16

>> [laughter]

9:17

>> This conversation's pivoting somewhere.

9:19

I didn't expect but I thought we were

9:22

having less sex than ever.

9:23

>> Yeah, but more STDs.

9:25

>> Wow.

9:26

>> Yeah,

9:26

>> that's worrying.

9:28

>> Yeah, it is. And and well, it's a while

9:30

since I looked at the statistics because

9:32

I've not been doing this for a while

9:34

now. Um but when I was like last in this

9:37

Yeah. The statistics were just kind of a

9:39

like steady increase and then an

9:41

increase in resistance. And so it's

9:42

getting to the point where certain STDs

9:44

are like harder and harder to treat and

9:46

some of them might eventually become

9:47

untreatable or like you have to be

9:49

hospitalized to get a certain really

9:51

powerful antibiotic to treat it which is

9:53

crazy. Um and so antibiotic stewardship

9:56

was a whole thing. And so we did that

9:57

with STDs [snorts] and then [laughter]

10:00

I love this conversation keep. And then

10:02

[clears throat] and then we found a

10:04

fascinating market in sepsis. Um and so

10:06

sepsis is a disease that kills hundreds

10:08

of thousands of people a year. It's

10:10

basically where you get bacteria in your

10:11

bloodstream. And what kills you is not

10:14

actually the bacteria. It's your own

10:15

immune system. So, you're not supposed

10:17

to have bacteria in your blood, right?

10:19

Your blood is supposed to be sterile.

10:20

And when bacteria get in there, your

10:22

immune system kind of freaks out and it

10:24

triggers this whole downstream cascade

10:27

where your blood vessels start to leak

10:28

and all of your organs start failing and

10:31

it's basically really bad. And that's

10:32

what kills you is your own uh immune

10:34

reaction to the bacteria rather than the

10:38

bacteria. And so this is, you know, one

10:41

of the leading causes of death in the

10:43

US. Often if you're dying from something

10:45

else, like if you know, you have serious

10:47

cancer, it'll be sepsis that ultimately

10:49

ends up being what kills you. Um because

10:51

you get more susceptible to it uh with

10:53

other diseases. And so it's leading

10:55

cause of death, like increasing

10:57

mortality. It's incredibly expensive.

10:59

Outcomes are terrible. Um and so we were

11:02

working on basically a better testing

11:04

technology where from the earliest date

11:07

uh you could detect these bacteria and

11:10

what antibiotic they are going to be

11:12

susceptible to and treat people faster

11:14

because with sepsis basically every hour

11:16

that you don't treat somebody is about a

11:18

12% increase in mortality. So you want

11:20

to get the treatment as soon as

11:21

possible.

11:22

>> Every hour you don't treat someone is a

11:24

12% increase mortality.

11:26

>> Yeah.

11:26

>> Okay. And so we start the sepsis

11:28

testing.

11:28

>> So start the sepsis testing. And so this

11:31

>> does it instantly go well?

11:33

>> No. So this company died at the end of

11:34

2019.

11:35

>> Oh, I'm sorry.

11:36

>> Yes. So, uh, we went to the testing was

11:39

working great. Prototypes were, you

11:41

know, pursuing the FDA approval process.

11:43

We went to do a series B round, uh, with

11:48

ended up being a strategic.

11:49

>> Sorry, just so I understand. So, we

11:50

raised the A from A and it's still the

11:52

same company as this milky.

11:54

>> Same company. Yeah. It changed its name

11:55

from TL BABs to Shield.

11:57

>> Oh, love it. Good. It's a good single

11:59

name. Okay. So, we go to raise the

12:00

series B, bigger TAM, sepsis, death,

12:03

more bigger

12:03

>> TAM gravitas. Yeah. Many many billions

12:05

of dollars TAM uh for testing for this

12:08

and ended up getting a term sheet from a

12:09

strategic uh large public diagnostic

12:12

company. Signed the term sheet, did

12:15

three weeks of of work on docs. We were

12:17

in the second round of docs and then

12:19

their CEO killed it because it was too

12:20

competitive with their core products.

12:24

Meanwhile, we told all the investors

12:25

that, oh yeah, we've got the lead. We're

12:27

good to go. Oh, here's the paperwork.

12:29

And so, uh, that was the death of the

12:32

company. It had, we had about 3 weeks

12:33

worth of cash.

12:35

>> Would you be where you are today,

12:36

though, if that round had come together?

12:38

>> No. No. Cuz I don't think we would have

12:40

pivoted as hard into CO when CO hit. Um,

12:43

I mean, it would have probably been

12:44

easier cuz we had at that point, we

12:46

actually had a lab license. So, you

12:49

know, in the US, you need this thing

12:50

called a clear license to run these kind

12:52

of tests. And we had got one of these

12:54

licenses over like a painstaking

12:55

two-year process. Uh, and then in

12:59

December of 2019, as part of the

13:03

windown, I sold that license to a

13:05

company in San Diego for $150,000

13:08

uh to pay some of the creditors and then

13:12

5 months later acquired a company in

13:14

Southern California to get the same

13:16

license for 27 million.

13:19

So, timing is everything.

13:21

>> Whoa, whoa, whoa, wait, wait. So, we're

13:23

winding down the company and we sell

13:25

this license for $150,000,

13:27

>> which is it roughly its market value if

13:29

there is not a pandemic.

13:30

>> Totally get that. Cool. Okay. And so,

13:32

we're winding down the company. I want

13:34

to go chronologically cuz that's like a

13:36

wild [laughter] number like flies in

13:38

shutting down the company in 20 now 20 I

13:40

guess.

13:41

>> Uh it was Yeah. kind of right at the end

13:43

of 2019.

13:43

>> Okay. End of 2019. Shutting down the

13:45

company strategic alle [ __ ] that.

13:49

[snorts] Um

13:50

>> and then what happens then? So then I

13:53

was kind of looking at what to do next.

13:55

Um, and

13:55

>> were you like personally devastated?

13:58

This is five years of your life. Yes.

14:00

Any lessons for founders? Reflections on

14:02

that?

14:03

>> I think it's a lot easier to build a

14:05

company the second time around. Like

14:07

there's so many mistakes the first time

14:09

where you just you don't know how to do

14:10

like thing X, like the first time you

14:12

fire somebody, like how to build a good

14:14

interview process, how to build a

14:15

pipeline. Like there's so many things

14:17

that it's really easy to screw up the

14:18

first time around. And then when you've

14:19

seen them go wrong, it's so much easier

14:21

to build it the second time around. And

14:23

so like, yes, it's the worst thing in

14:25

the world to go, you know, to go through

14:27

is having something you poured all that

14:29

time and energy into and like, you know,

14:31

the 7-day work weeks and the late nights

14:34

basically go to zero. But you learn as

14:37

long as through that you you learn and

14:39

you take those lessons and you go solve

14:42

an even bigger problem, I think, you

14:43

know, you got something out of it.

14:45

>> Okay. And so this company is like

14:47

winding down,

14:49

>> need to find something else. What

14:50

happens now?

14:51

>> Yeah. So originally the pitch behind

14:53

curative uh was we were going to also

14:57

solve sepsis but in a completely

14:59

different way. [laughter]

15:01

>> You really focused on really. [snorts]

15:05

Yeah. So

15:07

when we were going through all of this

15:08

work with the sepsis diagnostics, one of

15:10

the things that kept jumping out in the

15:12

data was when you look at other

15:14

companies that had tried to do sepsis

15:16

diagnostics because we were not the

15:17

first. A bunch of big pharma companies

15:19

like Ro spent a couple hundred million.

15:21

Um Seaman spent a hundred million. A

15:23

bunch of companies spent a lot of money

15:25

trying to make better sepsis

15:26

diagnostics. So it's kind of this like

15:28

graveyard of dead sepsis companies. And

15:30

when you dig into the data, you find

15:32

this really interesting thing that in

15:34

academic medical centers when you try

15:35

out these new sepsis tests, they work

15:37

great and you see much better outcomes

15:40

and you see, you know, people live

15:41

longer and it's saving lives. And then

15:44

you try to replicate that in bigger

15:46

studies and they fail. And when you dig

15:48

in and look why, it's when you expand

15:50

that aperture of who's in the trial out

15:52

of the academic medical center and into

15:54

community hospitals. What's happening in

15:57

a community hospital is they're so

15:59

understaffed, they're so overwhelmed

16:01

with the volume, particularly in the

16:02

emergency room, they don't suspect

16:04

sepsis fast enough and as I said

16:07

earlier, it's every hour is 12% increase

16:09

in mortality. And the intervention that

16:11

they have to do is actually pretty

16:13

severe. They basically put a big IV line

16:15

usually in your femoral artery. They're

16:17

pumping you full of fluids. They're

16:18

pumping you full of nasty antibiotics

16:20

that have bad side effects. So, it's a

16:22

pretty aggressive treatment. But if they

16:24

don't suspect sepsis early enough and

16:26

jump to that treatment, by the time they

16:28

get there, it's already too late. And so

16:30

if you're in a community hospital and

16:32

it's 2 a.m. on a Saturday, is there

16:34

someone on staff that actually suspects

16:36

sepsis early enough or does it wait

16:37

until Monday morning?

16:40

And so it doesn't matter if you have a

16:42

better test if no one ever runs it. And

16:44

so the original pitch behind curative is

16:46

let's take the learnings from an

16:48

academic medical center and go out to

16:51

community hospitals and basically build

16:53

mini hospital in a hospital uh that just

16:56

manages their sepsis patients. So

16:58

whenever they get somebody you know we

16:59

will diagnose them as having sepsis out

17:02

of the emergency room. We will then take

17:04

on that patient. They would pay as a

17:05

fixed fee. So no matter what happens

17:07

we're on the hook. If we can drive a

17:09

better outcome by applying mostly just

17:11

getting doctors to follow the

17:12

instructions but at scale then you could

17:15

drive better outcomes um by getting

17:18

those academic medical center type um

17:21

like clinical results but helping a

17:23

community hospital actually do that.

17:24

>> So what happens then we we start that

17:26

business

17:27

>> start that business we raised uh a

17:30

million dollars of seed money. Uh Justin

17:32

was the first investor you mentioned at

17:34

the beginning Justin Matine. Uh he came

17:36

in uh right as I was shutting down

17:38

Shield. He was an investor in Shield. Um

17:40

and he wanted to put more money into

17:43

Shield. And I said, "No, I I don't think

17:44

you should do that. I think that company

17:46

is is, you know, is not going to make it

17:49

unfortunately, but I'm thinking of

17:51

starting this new thing." And he was

17:53

like, "Yes, I'm in." And he didn't even

17:54

know what it was.

17:55

>> How much did he put in? He

17:56

>> put in, I think, $125,000

17:58

uh at a $3 million valuation. Wow.

18:01

>> So, he was the first

18:02

>> Okay.

18:03

>> First money in.

18:04

>> First money in. Love it.

18:05

>> Um and and so we had a pilot set up with

18:08

a first hospital in Wisconsin. This was

18:11

a clinician that we'd worked with

18:12

before. He was really enthusiastic. And

18:15

then we got a call from his assistant

18:17

saying this is all on hold and I can't

18:19

speak to you for at least 3 months.

18:21

>> Huh.

18:21

>> And we were like, that's really out of

18:23

character that he wouldn't at least call

18:25

us or text us or that he's having his

18:27

assistant. And when we dug in, they were

18:30

getting ready for this thing called CO

18:31

19 that they were expecting to see the

18:33

first patient in their hospital. And so

18:35

that was the first inkling for me of

18:37

like, oh crap, this is going to be a big

18:39

thing. This is going to be bigger than

18:41

people think it is. And so they were

18:43

shutting down the entire hospital. And

18:44

so it started off for us as like, okay,

18:46

well, we can't run our clinical studies.

18:49

We can't actually launch this product

18:50

because all the hospitals are on

18:52

lockdown. maybe we can go help out with

18:54

this testing thing for a couple of weeks

18:56

until all of this blows over um and then

18:58

we'll go back to sepsis.

19:00

>> And so at that point we're like we've

19:02

move into CO 19 testing.

19:04

>> Yes. Yes. And so it all happened quite

19:06

quickly from like a lot of me saying no

19:08

no no this is not going to be a thing

19:09

like don't worry about it like just it's

19:11

>> What was the moment where you realized

19:13

like where were you like this is

19:14

substantially going to be a real thing?

19:17

So, I was like in my apartment in San

19:19

Francisco looking at some data that I

19:21

think was on Twitter. Um, and and I was

19:24

like, "Oh crap, if that if this

19:27

continues at this rate, like this is

19:29

going to be way more substantial than

19:31

people realize." And so this was

19:34

probably midFebruary. Um, and so then I

19:36

started to reach out about sort of

19:38

setting up testing capacity uh to well,

19:41

first of all, we had the problem of

19:42

finding a lab license cuz I just sold

19:44

the lab license. [gasps] This was the

19:46

150 grand you just sold.

19:48

>> So just sold the lab license and so we

19:50

didn't have a lab anymore that was

19:52

capable of running these kind of tests.

19:53

We had a test. Um so our chief

19:55

scientific officer at at Curative had in

19:58

his spare time developed a COVID test.

20:01

And one of the things they' done at a

20:03

previous company is they developed one

20:05

of these flu tests and just offered it

20:06

to employees to make them feel better.

20:09

And so he said, "Hey, can I develop a

20:12

COVID test? I don't think it'll be very

20:13

useful, but it might make our employees

20:15

feel good, and it's like a good training

20:17

exercise for the team. And so, they had

20:19

worked on through January and the early

20:22

part of February a COVID test that

20:24

they'd been developing uh basically in

20:26

their like spare time in evenings and in

20:28

weekends. And so then when everything

20:31

started to really take off, we actually

20:32

already had the test. What we didn't

20:34

have was a lab to deploy it in.

20:36

>> And so at that point, you then go back

20:38

to the old one and buy it for 27

20:39

million.

20:40

>> No. So I bought a different lab license.

20:41

you bought a different lab.

20:42

>> So, we reached out I reached out to a

20:43

bunch of people I knew in the Bay Area

20:45

that had facilities with this kind of

20:46

license. Nobody wanted anything COVID

20:49

related on site. Nobody wanted, you

20:51

know, anything to do with it. And so we

20:55

um I like put it out I just put out an

20:57

email to like everybody I know. Um, and

20:59

there's actually a guy who uh was in the

21:02

same YC batch as me um who had become a

21:04

VC and he uh connected me to a group in

21:08

LA and they had this license and they

21:10

were using it for like uh sports doping

21:13

testing and they were in what I thought

21:15

was LA. I remember telling Justin, "Oh,

21:17

Justin, I'm going to to LA. I'll be in

21:19

Sand Deas." And he was like, "Where the

21:21

hell is Sand Deas?" It's like basically

21:24

very far east of actual LA. It's still

21:27

in LA County. It's a little city uh best

21:30

known for uh Bill and Ted. It's a little

21:33

town of like 30,000 people.

21:35

>> And that's where the lab test

21:36

>> and that's where the lab was. And so I

21:38

flew out there to look at that lab. Uh

21:40

this was from uh from San Francisco. And

21:43

to look at one other lab license that

21:45

was I think affiliated with um with one

21:48

of the universities and you know they

21:50

had a good space, they had this license

21:52

and they were doing pretty minimal

21:54

testing. So they just kind of like a

21:56

blank slate. And so it started off as a

21:58

50/50 JV between Curative and this

22:01

company that had the lab license. And we

22:04

would bring the test, we would bring the

22:05

expertise, they would bring the license.

22:08

And it became pretty clear quite quickly

22:10

that they didn't have the expertise to

22:13

scale it up. Like they were actively

22:16

getting in the way of scaling it up. Um

22:18

and so we

22:19

>> What did you do?

22:20

>> We bought them out

22:21

>> and that was that was the 27 million.

22:22

Where did you get 27 million from?

22:25

>> Uh forward revenue from customers. So we

22:27

were getting paid. We had our first

22:29

testing contract. We were doing the uh

22:33

police and the fire department.

22:35

>> And so how do you do you have the chief

22:38

science officer who's created this

22:39

brilliant task kit?

22:40

>> Yep.

22:40

>> And you go to like San Francisco state

22:44

or government.

22:45

>> So this is mostly Yeah. And so actually

22:46

our very first customer was the sheriff

22:48

department in Sand Demos. Well, we did

22:50

some like private testing for

22:51

individuals that were paying for the

22:53

tests. But our first, you know,

22:54

government customer was the sheriff's

22:56

department in Sand Demus and that came

22:58

about because they got wind that we were

23:01

setting up a CO lab because people were

23:03

freaking out about it in the town. And

23:05

so one of their sheriffs reached out to

23:07

me on LinkedIn and was like, "Hey, what

23:10

are you guys doing?" Um, and so I

23:12

connected with him and I explained what

23:13

we're doing and how it was very safe and

23:15

how we had this way of deactivating the

23:17

COVID as soon as it went into the sample

23:19

and so there was no live virus on site

23:21

and we were not presenting a risk to the

23:23

community and actually this was going to

23:24

be a good thing and we're going to be

23:25

hiring a lot of people and kind of got

23:27

him on board that you know we're doing

23:29

we knew what we're doing and we're doing

23:30

this in a safe way. And then he was

23:32

like, "Well, well, we really need

23:33

testing." And then the fire department

23:35

wanted testing. And then our first

23:37

really big contract was the city of LA.

23:39

And that came about from a tweet. Um, so

23:42

we had uh Laura Deming

23:44

>> who was a

23:45

>> Yeah, I remember she's YC uh longevity.

23:49

Yeah, exactly. So she um you know was

23:52

was a friend and would trying to

23:54

basically help with the pandemic. And so

23:56

she actually drove me down to LA with a

23:59

car full of PCR machines um so I could

24:02

like work on a laptop and she helped

24:05

with a lot of the early development work

24:07

and she tweeted, "Hey, we've got CO

24:09

testing capacity. Does anybody want some

24:13

deputy mayor of LA slid into her DMs

24:17

and was like, "Yes, please. We would

24:18

like to talk about that."

24:20

>> Wow.

24:21

>> So that was how our first big contract

24:23

came about. And so you speak to

24:25

[laughter] the deputy mayor of LA.

24:27

>> Yeah. And then so they were doing a

24:29

pilot. They said, "Look, we got a couple

24:30

of labs. You know, you're going to have

24:32

to demonstrate this." Because we were

24:33

complete unknown, right? We' done

24:35

>> And co wasn't peak ramps now, was it?

24:37

This was

24:38

>> This was like early March. So people

24:40

lockdowns had just started. Everybody

24:42

was starting to freak out. There was

24:44

basically nowhere to get a test. Like

24:46

you unless you were ultra high risk and

24:49

in a hospital, there was pretty much no

24:51

chance you were getting a test. So

24:52

everybody was freaking out. This is when

24:54

everybody was still like cleaning their

24:56

um you know supermarket bags with wipes

24:59

and nobody knows what's going on.

25:02

Everything's shutting down. Um it wasn't

25:04

so bad on the West Coast, but New York

25:06

was like was really bad already by this

25:09

point.

25:09

>> And so they're paying ahead of time. So

25:12

the best thing we could get with the

25:14

city of LA because they have obviously

25:16

their city there are certain

25:17

restrictions is that they would pay

25:19

after delivery but they would pay net

25:22

one on the invoice. And so we would

25:24

deliver the tests for a day and then we

25:26

would send somebody to city hall the

25:29

next morning to pick up a check for

25:30

those tests.

25:31

>> Wow.

25:32

>> So the tests had been done. They were

25:33

paying after we delivered them. Um but

25:35

which was not you know your standard

25:37

like net 30 [laughter] or net 60 for a

25:40

government contract. They were having we

25:42

were invoicing them every day for the

25:43

number of tests they did and they were

25:45

having somebody in their finance

25:46

department like get us the check because

25:48

we needed that to pay for supplies to

25:51

basically grow out that testing capacity

25:53

for where they wanted to be.

25:55

>> What's the single largest contract you

25:57

signed?

25:57

>> Probably one of the Florida contracts

25:59

was maybe the largest. So we did a

26:01

contract with the state of Florida for

26:02

all of their nursing home testing. Um I

26:05

forget what the dollar figure was, but

26:06

it was, you know, in the hundreds of

26:08

millions of dollars. And so we were the

26:11

they put it out out to bid and we won

26:13

it.

26:13

>> Hundreds of millions.

26:14

>> Yeah. They tested every employee at

26:17

every nursing home across the state once

26:20

a week for a 3-month period. And so they

26:24

did a great job of basically keeping

26:26

things open, keeping these nursing homes

26:28

open, keeping visitation, but making

26:31

sure that the employees of those nursing

26:32

homes were not spreading COVID to the

26:35

people in the nursing homes. Um, and so

26:37

they wanted to test every single

26:39

employee that was working at those

26:41

nursing homes and then exclude the

26:42

people that weren't uh that that had

26:44

COVID so they weren't exposing the uh

26:46

the residents there. And so we ran this

26:49

big program, a bunch of labs or they put

26:51

it out to bid and everybody said, "No,

26:53

that's too crazy. Like that's

26:54

impossible. We cannot possibly test that

26:57

many facilities with that tight a

26:59

turnaround time. Like this is

27:01

impossible." And we bid. We're like,

27:02

"Yeah, we can we can do that. We'll make

27:03

that work." Um, and we delivered it.

27:06

What did you see that others didn't?

27:08

>> That you have to kind of scale like

27:10

something like that up from scratch that

27:12

the existing labs like the lab industry

27:15

in general is a very low margin industry

27:16

and it's built on efficiency. You look

27:18

at the big labs, the Quest and Lab

27:20

Corpse and they are ultra efficient

27:22

machines. Like they're some of what they

27:23

do with automation is incredible. But if

27:26

you're asking them to 10x capacity,

27:28

that's literally the opposite of what

27:30

they're built for. they are built for we

27:33

will get 1% extra margin by optimizing

27:36

this bit of the process over here so

27:38

that it is perfectly efficient and they

27:39

are really good at that but if you ask

27:42

them to 10x that it really doesn't work

27:45

and the mindset isn't there the people

27:47

don't know how to scale those kind of

27:48

things up all of the supply chain broke

27:50

down and so we basically said okay start

27:52

from scratch throw all of that away

27:54

imagine that you're going to have to

27:55

scale this up to hundreds of thousands

27:57

of tests a day where do you start and so

28:00

we built what we called an orthogonal

28:02

supply chain which is just basically a

28:04

fancy way of saying we don't use the

28:06

things other people use

28:09

>> sound like a Mackenzie consultant

28:10

specializing in innovation an orthogonal

28:12

supply chain yeah great

28:13

>> well I found that was like a good fancy

28:15

word that like you know was helpful from

28:17

a sales

28:17

>> stand

28:19

what it basically means is everybody was

28:20

chasing the same uh consumables the same

28:23

supplies everybody was trying to use the

28:25

same stuff and if if you know you can

28:28

make 1x of that maybe they can increase

28:30

to make 1.2x. If everybody's trying to

28:32

buy that, us also trying to buy that

28:35

doesn't help. That doesn't net increase

28:37

the number of tests being done, right?

28:38

It just makes us all squabble over it.

28:40

>> So that's pointless. So you got to find

28:42

other ways of doing the testing using

28:45

supplies that maybe wouldn't

28:46

traditionally be used for this kind of

28:47

testing. Um, so we were sourcing swabs,

28:50

you know, from other types of vendors

28:52

that were being used for, you know,

28:54

electronic testing and then sterilizing

28:56

them. we were sourcing. There's this

28:58

kind of extraction material that you

29:00

usually use and magnetic beads is kind

29:02

of the default standard, but there's

29:05

this other way of doing it with filter

29:06

plates which is more scalable because

29:08

it's basically just glass and plastic

29:10

and you can scale that up faster than

29:11

you can scale up magnetic beads where

29:14

they all come from basically two

29:15

factories in China. And so we're like,

29:17

okay, we should never use magnetic beads

29:19

because that's not going to scale as a

29:21

technology. we need to go find vendors

29:22

who can scale up the plastic and glass

29:24

manufacturing and partner with them to

29:26

basically 10x it. And so you kind of

29:28

approach every single bit of the supply

29:29

chain that way. You end up with this

29:32

massive scale. Now, outside of a

29:34

pandemic, that doesn't work because

29:35

people don't want 10x more testing than

29:37

they wanted yesterday. But within a

29:39

pandemic, you got to approach it

29:40

differently. And so we peaked, I think

29:42

our peak day was 26,000 people tested in

29:45

a single day.

29:47

>> 206,000 people tested in a single day.

29:49

And that was December of 2020. So that

29:52

was within

29:54

eight months from zero zero to 26,000.

29:57

So and the company went from about 7 to

30:00

7,000 employees in in those first nine

30:03

months.

30:04

>> 7,000 employees in 9 months.

30:06

>> Yeah. [laughter]

30:08

>> Yeah. It was it was a little crazy.

30:10

>> Do you sleep at all? I mean

30:12

>> I don't sleep very much now.

30:14

>> But like in that time, what was the

30:15

craziest thing that you did?

30:18

Um, I mean some of the hiring, you know,

30:20

you have to get licensed people for

30:22

certain roles, but other like more

30:23

administrative roles, you don't need

30:25

licensed people. And so we would

30:26

literally a lot of people wanted to work

30:28

on the pandemic, which is very helpful.

30:29

We'd have people like line up in the

30:31

parking lot um, socially distanced like

30:33

down the street and then give them five

30:35

minute interview slots and just have

30:37

somebody sit there with a clipboard and

30:38

it's like 5 minutes and next just to get

30:41

the volume of people um, in the door.

30:44

>> How much money did you make from co

30:46

testing? I think the total revenue ended

30:49

up being about five billion over a

30:51

three-year period.

30:54

>> Five billion. Is that the largest

30:56

private provider?

30:58

>> We were Yeah, we were the largest like

31:00

non-labcest

31:02

testing company.

31:03

>> That is extraordinary. What is the

31:06

margin profile on a co test?

31:08

>> So really good during surges and then

31:11

really bad not during surges. [laughter]

31:15

Um, so what we found was when when there

31:17

was a peak, right, so we get a new

31:19

variant or, you know, this usually

31:22

winter was the biggest peak, but then we

31:24

started having these summer peaks, which

31:25

was kind of weird. Um, everybody would

31:26

run to get tested. Um, and these were

31:29

all public testing sites. So these were

31:30

in parking lots. These were the

31:31

drive-through tests. That was what we

31:33

were doing. So if you went to a

31:34

drive-through testing site, like the

31:35

biggest one was the uh Dodger Stadium

31:38

site in LA. It was seven lanes of

31:40

traffic, 7:00 a.m. to 7:00 p.m. 7 days a

31:42

week.

31:43

So they were testing at the peak about

31:45

10,000 people a day coming through their

31:46

cars getting tested and coming back to

31:49

the lab. So when you're at peak capacity

31:52

and you're filling all of the labs

31:54

volume,

31:55

it's very profitable. Then those uh

31:58

basically surges subside, right, and you

32:00

end up back at testing, you know, using

32:04

20 or 30% of your capacity. All your

32:06

fixed costs the same. You're still

32:08

paying 7,000 to people. Now you don't

32:11

have to buy as many consumables, but all

32:13

of that infrastructure has to be

32:15

maintained for the surge. And so this is

32:17

again where it's like the opposite of

32:18

the traditional lab industry where they

32:20

have a very flat volume. Every year

32:22

people do roughly the same amount of

32:24

blood work as they did last year or

32:26

maybe do like predictably slightly more,

32:29

but it's it's within a couple of

32:30

percentage points. here you're kind of

32:32

building it for that peak capacity

32:37

and then during the lulls like

32:39

maintaining that capacity is incredibly

32:41

expensive and so it was kind of

32:43

necessary and this was part of the way

32:45

it was set up they increased the price

32:47

the reimbursement price uh that they

32:49

were paying for these tests because they

32:51

needed to incentivize the capacity to be

32:53

built because if you don't build that

32:54

peak capacity then when you have a surge

32:56

it all goes horribly wrong and no one

32:58

can get a test but that means you

32:59

basically have to pay to overbuild

33:01

Because during the dips you have to have

33:04

that capacity. You can't just shut it

33:05

down, right?

33:06

>> And you can't build up 7,000 in 24 hours

33:09

in

33:09

>> and so you need to maintain that. And so

33:12

we would lose a lot of money in every

33:14

one of the dips basically.

33:15

>> Well, you would actually lose money.

33:17

>> Yeah. Yeah. Yeah. We would lose money on

33:18

every test during the dips.

33:20

>> Oh wow.

33:20

>> Yeah.

33:21

>> So of the five billion, how much is

33:23

profit? So after all was said and done,

33:26

the money that we basically put forward

33:28

into the uh insurance business, the

33:30

health insurance company was about 500

33:31

million that we invested into the health

33:33

insurance business.

33:34

>> It's absolutely astonishing.

33:35

>> Yeah.

33:36

>> Can I ask you when we saw the vaccines

33:38

roll out, did you know they were

33:40

ineffective in the way that they've kind

33:42

of turned out to be? It was not clear at

33:45

the beginning and I think also it's it's

33:47

sort of changed like that when nobody's

33:50

had any exposure to co being vaccinated

33:53

probably provides a lot more benefit

33:55

once everybody's sort of had co a few

33:57

times then the vaccines benefit is much

34:00

less because you've already had it also

34:02

the varants got weaker and weaker uh

34:05

when we were first rolling them out I

34:07

mean I think in you know December of of

34:09

2020 there was benefit for a lot of

34:11

people getting the vaccine

34:12

>> did you get vaccinated.

34:14

>> Yes, we did that. We did 2 and a half

34:15

million vaccinations. That was another

34:16

service we did. We also lost a ton of

34:18

money on that. That was a terrible

34:19

business.

34:19

>> Why?

34:20

>> Um because the government wasn't paying

34:22

enough. We lost money on every single

34:24

dose. It cost more to administer them

34:26

than we were getting paid. So

34:27

>> why did you do it?

34:28

>> Uh giving back. A lot of our partners

34:32

wanted it. So a lot of the partners on

34:33

the government side we're working with

34:34

for testing also wanted us to administer

34:37

vaccinations.

34:39

>> Was it sounds awful? Was it a hard like

34:42

your business with co obviously being

34:44

eased

34:45

>> Yeah.

34:46

>> completely changes

34:48

>> and you have to pivot again.

34:50

>> Yeah. And so that started very early for

34:52

us cuz I wasn't going to last very long.

34:55

>> You were always aware it wouldn't last.

34:56

>> Yes. When we started hiring people at

34:58

the beginning, we told them this is 3

35:00

months. You have a job for 3 months.

35:02

Like don't bank on anything beyond 3

35:04

months. This is a three-month gig and

35:06

we're going to shut it all down in three

35:08

months. Um, so the the CFO and now the

35:12

president of Curative joined at the

35:13

beginning and for her it was going to be

35:15

a six-month gig. [laughter]

35:16

Um, she came out of retirement to help

35:18

with the pandemic for 6 months. Now 6

35:20

years later she's still here. But um, it

35:23

was supposed to be temporary and every

35:26

time you know a surge we got through a

35:27

surge I was like all right that's it.

35:29

It'll be over now. And then they just

35:30

kept happening. [laughter]

35:32

So, we started looking at kind of what

35:34

comes next middle of 2020, like really

35:38

early. Um, yeah.

35:41

>> How did that search for what comes next

35:43

change? You just started looking at

35:45

middle of 2020. It's not until end of

35:47

22, start of 23 when that actual search

35:49

is activated into real-time plan.

35:51

Correct.

35:52

>> Yeah. I think we started probably like

35:53

late 21 is when we got really serious

35:55

about health insurance. It just took a

35:57

while to actually get the license.

35:59

>> Yeah. Why health insurance?

36:00

>> Well, it wasn't the first idea. We

36:02

looked at a bunch of other stuff. We

36:03

looked at other stuff in the lab testing

36:06

industry. Unfortunately, it's just not

36:09

that big an industry. And so even like

36:11

we had this interesting technology that

36:13

could theoretically let you do a lot of

36:16

lab tests that are individual tests

36:17

today like as just one single test,

36:20

which would be scientifically quite

36:22

cool. But even if you say, okay, I'm

36:24

going to displace all of LabC and Quest,

36:27

that's about 30 billion of market cap.

36:29

So that's like the largest company you

36:31

could possibly build is about 30 billion

36:35

which that is a big company but coming

36:38

out of what we did with co I wanted to

36:40

build a much bigger company than that

36:42

and so there's just not a big enough

36:43

market in lab testing um so the lab

36:47

testing was was out and then we briefly

36:49

looked at trying to buy a hospital

36:52

um or multiple hospitals we looked at

36:53

one in Florida and we looked at one in

36:54

Texas and the idea was well if the

36:56

hospitals kind of like the the health

36:59

system becoming the center of where care

37:01

is delivered, they buy have bought up a

37:03

lot of the primary care offices. Um, if

37:06

you can transform that with technology,

37:08

can you drive much better outcomes? What

37:10

we ultimately decided is it doesn't work

37:13

that well because the payer mix is too

37:15

broken up. And so, as a hospital, your

37:18

customer is like 50% the government and

37:21

then a whole bunch of like split up

37:23

smaller insurance plans. and they all

37:25

want different things and they change

37:26

their mind every 5 minutes about what

37:28

they actually want and you're trying to

37:29

like keep them all happy. So your

37:32

ability to really change things from the

37:33

hospital side is quite limited is what

37:35

we ended up deciding. Um and when you

37:37

come back to it like we looked at a

37:40

bunch of preventative care things we

37:41

looked at a primary care chain

37:43

everything sort of ends up coming back

37:45

to the payer like the payer is the one

37:47

that drives behavior in the US healthare

37:49

system. If you are providing the dollars

37:51

people will go where the dollars are. If

37:52

you say I'm gonna pay for this service,

37:54

people will go do that service. If you

37:55

say I'm not going to pay for this,

37:57

people will stop doing that. And so the

37:59

payer is the one that's kind of driving

38:01

things.

38:01

>> If you could do one thing to change the

38:03

structure of the US healthcare system

38:05

today, magic wand, what would you do?

38:09

>> Um,

38:11

I think you have to break up the

38:12

negotiating into smaller units. like

38:15

it's gone to this point where I think

38:18

it's it's quite an efficient system as a

38:20

market when the counterparties are small

38:24

when everything gets very consolidated

38:26

it becomes incredibly inefficient. So

38:28

when we look at for example health

38:29

systems right so we pay for for care at

38:32

health systems

38:34

some of that care you can get in other

38:36

places if we look at how much we'd pay a

38:38

primary care doctor who's independent

38:40

compared to a primary care doctor

38:41

affiliated with a system affiliated with

38:43

a system they get paid an average double

38:46

same service

38:48

you know same credentials it's just that

38:50

this one is part of a hospital system

38:52

and that hospital system will use the

38:54

fact that they

38:56

have a ton of beds that They have this

38:59

ultra special surgery center that you

39:01

need like we need to have that capacity

39:03

in our network because some people need

39:04

to be hospitalized, some people need

39:06

those services that if you want to get

39:08

access to that, you got to pay me double

39:10

for my primary care doctors.

39:13

And so when all of the players are

39:15

small, when you have smaller payers and

39:18

smaller hospitals, you end up kind of

39:19

getting to reasonable negotiations.

39:21

What's happened is you have these

39:23

massive payers like the market is ultra

39:25

consolidated. You basically have like

39:26

four large players that control the

39:29

entire market on the payer side and then

39:31

you get these ultra consolidated

39:32

hospital systems because that's the only

39:34

way for them to survive if they want to,

39:36

you know, fight with Blue Cross. The

39:38

only way to survive is to get really big

39:39

so they have the negotiating power and

39:41

then they just reach these loggerheads

39:43

where nothing gets done and everybody's

39:45

overpaying for everything and

39:47

everything's inefficient. And when you

39:49

have more competition in the market,

39:51

more smaller payers entering more, you

39:54

know, smaller health systems, you start

39:56

to get like an actual efficient market.

39:58

When you're just negotiating for like,

39:59

hey, I have a third of healthcare in the

40:01

state and I have a third of all of the

40:04

employees in the state. It's not an

40:06

efficient market anymore because there's

40:08

no alternative. You h you must reach a

40:10

deal.

40:11

>> If I am sick, is the best place to be

40:13

treated in the US?

40:14

>> Yes, definitely.

40:15

>> Seriously.

40:17

Yeah.

40:19

Yeah. We have the US has the access to

40:23

by far the most cutting edge techniques

40:27

and facilities and drugs than the rest

40:30

of the world and they're willing to

40:32

spend a lot more.

40:33

>> What do you know now, sorry, that you

40:35

wish you'd known when you made the pivot

40:37

into insurance? I think I wish that I

40:40

knew AI was coming

40:43

because I think like the way we designed

40:45

the business in 2022 when we first

40:48

started, we had no idea that this wave

40:51

of AI and LLM was coming. Like we were

40:53

building a health insurance business

40:54

because we thought it was a good

40:56

business to build and we thought it

40:57

needed to be built. We needed a better

40:59

alternatives in the market for health

41:00

insurance. And then in the last like 18

41:04

months, how we do pretty much everything

41:07

is now a completely different workflow.

41:09

And we there's so much I mean all health

41:11

insurance does is like moving bits

41:13

around, right? Like we don't have a

41:14

physical product. We give you a little

41:16

plastic card, but apart from that our

41:18

product is that we move bits around in a

41:20

database that means care is paid for.

41:22

>> That's it, right? And we do a lot of

41:25

managing kind of managing a marketplace.

41:27

We work with the providers to negotiate

41:29

prices. We work with employers to

41:31

negotiate how much they pay and then we

41:33

try to work with employees to keep them

41:35

healthy. If we can get people to stay

41:37

healthy, we can avoid the long-term

41:38

downstream cost of care. Essentially,

41:40

it's marketplace business. Um, and that

41:42

has been fundamentally like shifted by

41:45

AI. But when we first started building,

41:47

we didn't know that was coming

41:48

>> by AI.

41:49

>> So, so much of that back office work,

41:52

right, has been completely changed by

41:54

AI. There's we now have entire

41:56

departments that used to be people like

41:58

rubber stamping things. Um the first one

42:01

that went to zero people was our

42:03

credentiing department. Um where you

42:05

know this is a process that's incredibly

42:07

labor intensive where you have to check

42:10

all doctors that join our network have a

42:12

valid medical license and aren't being

42:13

sued for malpractice. And this is, you

42:16

know, a person going to the medical

42:18

board website, checking that the license

42:20

record is there, checking transcripts

42:22

from their school, checking like a

42:24

database of of who's been sued by who,

42:27

um, and then like rubber stamping. And

42:28

that used to take us two to three months

42:30

on average and cost about $50. We've now

42:33

built in-house an agent that runs on on

42:36

Claude that does this end to end. and it

42:39

goes to the website, it verifies the

42:41

license, it goes and reads the

42:42

transcript, it puts it all together, it

42:44

stamps it for approval. Um, and we're

42:46

now averaging about 12 hours turnaround

42:48

time for credentiing somebody. And it

42:51

cost us about 20 cents. And so this is

42:53

like a mind-numbing process that payers

42:54

have to do, which is important. We want

42:56

to know the doctors in our network,

42:58

right, are are validly licensed to

43:00

practice medicine. Um, but it's like

43:04

historically has always been kind of

43:06

terrible and payers have been bad at it,

43:08

right? If you're a doctor and you join a

43:10

network and it takes 3 months before you

43:11

can see any patients. It's just

43:13

bureaucracy, right? Like they don't

43:14

Doctors hate that and it's not actually

43:17

adding the value that it should be

43:18

adding. It's just creating paperwork.

43:20

>> How many people did you have in

43:21

credentiing?

43:22

>> That one wasn't that large. I think

43:24

there was like five or six people. We

43:26

had a few other departments that have

43:27

shrunk more than that with the

43:29

>> What other departments? We've seen a lot

43:31

on the claims side, claims processing,

43:34

right, is used to be a very manual

43:35

process where claims comes in and people

43:37

are like manually tweaking and editing

43:39

it. Um, and also on the underwriting

43:41

side, underwriting, you know, the

43:43

process used to be uh a broker comes to

43:46

us with a group, an employer that

43:49

they're looking to insure and they ask

43:51

for competitive bids from multiple

43:53

different insurance companies. And what

43:56

that means is basically sending us an

43:57

email with a bunch of PDFs and

43:59

spreadsheets attached of who are the

44:01

employees, what current claims do they

44:03

have, what's the current insurance look

44:04

like. And you'd think that over time

44:07

they would develop like a standardized

44:09

format for how that should run, but no,

44:12

every single one is like a different

44:13

spreadsheet format, different PDF. And

44:15

we tried to sort of solve that problem

44:17

with software and build like universal

44:20

importers and universal intake. And it

44:22

like it kind of worked, but what we

44:24

found works amazingly is literally to

44:27

give the files to an agent, tell it to

44:29

write Python to get these files into a

44:32

standardized format because they're not

44:33

very good at parsing files. But they're

44:35

incredibly good at codegen. And so you

44:38

can tell it to write a Python script to

44:40

convert any random file into this known

44:42

format and then test it and loop and

44:45

iterate on your script until it's

44:46

working. And then you throw away that

44:48

script. And so it's single use code that

44:50

never gets used again. and you just

44:51

generate that code one time and then

44:53

throw it away. Um, and that works so

44:56

well. And so now brokers, providers,

44:59

employers, when people are sending us

45:01

files, we always used to like insist,

45:03

oh, you have to use our standard format

45:05

for this. And they'd hate it and they'd

45:06

get mad cuz somebody's sitting there in

45:07

a provider office like manually

45:09

reformatting these files into our

45:11

spreadsheet. Now send us whatever you've

45:13

got, whatever format. It can be

45:14

scribbles on a napkin, it doesn't

45:16

matter. The model will figure it out.

45:18

The model will convert it into our

45:20

standard format. and it will do it in

45:21

about 15 minutes. And so you build these

45:23

data ingestion pipelines that used to be

45:26

hundreds of people sitting moving

45:28

spreadsheets around and it's now a model

45:32

writing Python code to do that same

45:34

thing and then every single time you

45:36

throw that Python away and start from

45:37

scratch.

45:37

>> Dude, I have so many questions to ask on

45:39

the back of this. The first one is you

45:40

mentioned there kind of the internal

45:41

agent buildout that you've done for the

45:43

company and for your specific processes.

45:45

Yeah.

45:45

>> Do you buy the SAS is dead theory that

45:47

we will

45:49

>> Why?

45:50

>> Because I see the number of contracts

45:52

we're canceling.

45:54

>> Like we we just recently canceled our

45:56

Salesforce contract because we have an

45:58

internal CRM that was built, you know,

46:01

was vibe coded, that is working better,

46:03

that is managing our process better, um

46:05

is more integrated into what we're

46:07

doing. We run our agents inside of it

46:09

and no one was using Salesforce anymore.

46:11

$600,000 a year.

46:13

>> Wow.

46:13

>> Gone to zero. How long did it take?

46:16

>> Two months.

46:17

>> Is it worth because argument back I

46:20

always like to do both sides. I'm never

46:22

Is it worth the engineering hours to

46:24

vibe code that and then to maintain it?

46:27

>> The maintenance is is definitely one of

46:28

the most challenging pieces. Um I agree

46:31

with that. I think for most businesses

46:33

of of any reasonable scale, yes, it is

46:37

worth it. Now whether they will have the

46:38

tech resources to do that soon, I think

46:41

that's like the bigger question is kind

46:42

of when will this happen? But when you

46:44

build those things custom to your

46:46

workflow, they work better. Like most of

46:48

these big, you know, systems, you're

46:50

paying an administrator. Like we had a

46:52

full-time Salesforce administrator,

46:55

right? You're paying people whose sole

46:57

job is to manage this like archaic

47:00

software platform. Not that Salesforce

47:02

is archaic, but you know, we have a few

47:03

other like internal apps that we were

47:06

paying for like industry software that

47:09

is taking multiple FTEEs to maintain it.

47:12

You can transition that into one great

47:16

engineer and then whenever you want a

47:18

custom feature, you just go build it.

47:21

>> Absolutely [ __ ] wild. [laughter]

47:24

$600,000 a year on Salesforce.

47:26

>> Yeah.

47:26

>> Wow. And so we're seeing, you know,

47:28

there's pockets of software that I think

47:31

persist because they are more

47:32

infrastructure based.

47:34

>> Okay. Which persist?

47:35

>> So we're seeing a lot of backend stuff

47:37

like uh like Sentry like stuff like

47:39

that, right? Where it's like kind of

47:41

become part of your infrastructure. Um

47:43

Slack has been like notoriously hard

47:45

internally for us to like too many so

47:47

many people have built integrations and

47:49

like workflows that are now working in

47:51

Slack. Uh, I think that while they keep

47:53

putting the prices up, if they put the

47:54

prices up too much, then eventually

47:55

it'll make sense to replace that. But,

47:57

um,

47:57

>> what else is on the chopping block?

47:59

>> We we're cutting about 80% of our SAS

48:01

spend this year.

48:04

>> Wow.

48:05

>> So, we have like in in one of our

48:06

internal meetings, we have a slide of

48:08

like when when are SAS contracts due and

48:12

whose job is it to tell them that we're

48:14

not renewing this year?

48:16

>> Well, you can do it in one fell swoop.

48:17

>> Yeah. [laughter]

48:19

>> Well, they have renewals. We have to pay

48:20

them through the renewal. Ah, is it all

48:22

like legacy software like Salesforce

48:24

though?

48:24

>> Some of it's like that. Some of it's

48:25

like very insurance specific software.

48:27

Um, so like our claim system for

48:29

example, right, is this like massive

48:31

off-the-shelf platform that we just

48:34

migrated to a few years ago. This is

48:35

again why like if I'd known AI was

48:37

coming, we would have probably

48:38

approached things differently.

48:39

>> Um, and it's just it's very hard to use.

48:41

Like it's hard. Their API barely works.

48:44

It's hard to get the data out of their

48:45

database. Uh, they won't let us manage

48:48

it. It's it but that's how insurance

48:51

companies are running things and so

48:52

we've built our own claim system

48:54

completely from scratch in house that's

48:56

now uh we've migrated most of the

48:59

workflows off will be fully off in July

49:01

>> I am a health insurer you know other

49:03

health insurers

49:04

>> yes

49:04

>> I do not have the in-house capability

49:07

potentially technically to build the

49:10

agentic workforce that you are building

49:14

>> am I screwed [laughter]

49:16

>> I [snorts] think some of the biggest

49:17

insurers will struggle because they they

49:20

will not be able to keep up from a

49:21

margin standpoint with where we can get

49:23

to with agents. I think some of them do

49:26

have technical expertise. It's more like

49:31

operational and kind of people ops. If

49:33

you've built a company of 100,000 people

49:35

and in order to get this margin

49:37

improvement 50,000 of them have to be

49:38

laid off, somebody's fift just got a lot

49:41

smaller. And so they will do it slowly

49:45

over 10 years.

49:47

It will happen. But will it happen

49:49

quickly? No. And will we be able to

49:51

compete more effectively in the

49:52

meantime? Yes.

49:53

>> How do margins change?

49:55

>> Insurance is a very low margin business.

49:57

So 85% of your uh premium that we

50:01

collect must go out the door to pay for

50:04

care. So if we get in a dollar, we got

50:06

to spend 85 cents. Have to

50:09

[clears throat] by law.

50:10

>> If less than that goes out the door, we

50:14

have to give it back to the employer.

50:17

Which is another thing that's broken

50:18

about US healthcare because that drives

50:19

completely the wrong incentive where

50:22

actually from an insurance company

50:23

standpoint if your profit's capped at

50:24

15% the only way to increase profits is

50:27

to increase total spending which is not

50:29

what you want your insurance company

50:30

incentivized to do.

50:31

>> Why would I encourage people to go to

50:33

the gym eat healthily if actually I'm

50:35

not going to get that back anyway? So,

50:36

this was part of Obamacare and it's one

50:38

of the like

50:39

>> there's a lot of

50:41

>> there's some good things in Obamacare,

50:43

but there was a lot of things that I

50:44

think like the second order consequence

50:46

was not considered. It sounds like a

50:48

great PR thing to say we've capped

50:50

insurance company profits, right? That

50:52

sounds good, but it's BS.

50:54

>> It's like capping a CEO's like fiscal

50:57

base pay. Sounds great. Yeah. So, let's

50:59

just pay them 27 million in equity

51:01

compens. That's the reason why we have

51:03

such egregious comp packages for exacts

51:05

cuz they cap the equ the salary pay.

51:07

Ridiculous. With that, how's your

51:10

anthropic cost gone? [laughter]

51:13

>> Yes. So, I mean, this is one of I think

51:15

the kind of leading indicators for us is

51:17

that our anthropic cost over the last

51:20

like six or seven months has 6xed every

51:23

month from, you know, a base of, you

51:27

know, a couple of tens of thousands of

51:28

dollars now up to millions of dollars a

51:30

month. and it just keeps eventually

51:32

we're going to have to stop that

51:33

spending increase because you know it'll

51:35

get unreasonable but um we just keep

51:38

finding new things to do with it. And

51:40

then the other thing we found that's

51:41

been fascinating we're seeing a lot of

51:43

areas where it's not that we are

51:45

necessarily replacing the team. It's

51:48

that we're repurposing the team

51:50

[clears throat] and they are now so much

51:52

more productive. And so one area that

51:55

has always been like a particularly

51:56

challenging thing that makes it hard to

51:57

build a new insurance company is we have

51:59

to build this network. So the network is

52:01

all the doctors and all the hospitals

52:02

and all the people that we have to

52:03

contract with. And there's about 1.2

52:05

million of those in the US that you want

52:08

to have contracted. That ends up being

52:11

like 60 70,000 contracts that you have

52:14

to do. That's just a lot of work to go

52:16

out, get their attention, get them like

52:19

do a negotiation, get them to sign an

52:22

agreement, load all of their data and

52:24

have them in your network. And this has

52:25

been one of the biggest like pieces of

52:27

staying power of the big health plan

52:29

businesses is they built that over 100

52:32

years for Blue Cross and over like 50

52:33

years for United Sign. And so they did

52:36

it slowly over a long period of time. If

52:39

you're trying to from scratch come in

52:40

and start a new health plan, you've got

52:42

to reach out to all of those doctors and

52:45

negotiate. And so we have a team of

52:47

about 45 people who do those network

52:50

contracts and they reach out and they

52:51

negotiate. What we launched earlier this

52:54

year is an agent called Gwen.

52:58

And Gwen does the same workflow. You

53:02

give her basically a lead. Hey, there's

53:03

a primary care office over here. Uh

53:05

here's the address. and she will go

53:08

Google it, research them, learn a little

53:10

bit about their practice, um, figure out

53:13

what other payers are paying them

53:14

because there's a lot of this data out

53:15

there and these transparency files now

53:17

of how much are they getting paid. Find

53:19

their email address from Zoom Info.

53:22

Reach out to them and then basically

53:24

ping them repeatedly until they answer

53:26

her with custom emails like, "Hey, I

53:28

know about your practice. I know what

53:29

you're doing." Like customized content

53:31

to them. Uh, and then when she gets

53:33

their attention, negotiate the rates

53:36

back and forth, usually over like

53:37

multiple rounds of negotiation,

53:39

negotiate and redline the language. And

53:41

that's another place where we found

53:42

Python is great. These models are

53:44

terrible at editing Word documents, but

53:45

if you tell them to write Python to edit

53:47

a Word document, they're great at it.

53:50

Great hack. Um, and then sign the

53:52

agreement. And so she now signs the

53:54

agreements with my signature. She'll

53:55

open up the docyign link and then click

53:57

the button and it's my signature on that

54:00

agreement. And so this has taken us from

54:01

doing about a 100 contracts a week to

54:04

about 100 contracts a day.

54:07

And the last year as an entire team we

54:10

did 2,300 contracts. So far in about the

54:13

last 8 weeks the agent alone has done

54:16

3500. And so what this is letting us do

54:19

is like that team doesn't go to zero.

54:23

We've refocused that team to work on

54:25

these bigger contracts, right? Because

54:28

some of these deals we can do entirely

54:30

over email. This agent is email only.

54:32

And some of these providers will work

54:34

completely over email to enter into an

54:35

agreement. And actually, how many of

54:36

them will do the whole thing over email

54:38

surprised me. There's a lot of

54:39

millennials I guess on the other end

54:41

that don't want to get on the phone um

54:43

and would rather do the whole

54:44

negotiation completely electronically,

54:46

which is fantastic because the model is

54:48

great at that. [snorts] But some of

54:49

them, the bigger hospital systems, the

54:51

bigger doctors uh doctor groups, they

54:54

want to have a phone call. They want to

54:56

meet in person. They want to learn who

54:58

we are. And the team now get to spend

55:01

their time going and having those

55:03

inerson meetings, going and developing

55:05

those relationships, working with those

55:06

bigger groups. And then even when it

55:08

gets to the paperwork, handing the

55:09

paperwork off to the model and then all

55:11

of the smaller the individual PCP over

55:13

here, the small behavioral health

55:14

provider here, the therapist over here,

55:16

the agent just gets it done and can sign

55:19

a contract end to end in a few hours

55:22

where you wouldn't be able to do that

55:24

volume with people. Given the

55:26

transformational nature of what you're

55:28

describing, if Anthropic doubled their

55:31

price, would it impact your usage? When

55:35

we look at a lot of the financials of

55:36

these core businesses today,

55:38

>> yeah,

55:38

>> they are challenged businesses in their

55:40

current infrastructure and pricing.

55:43

>> If they double pricing, would it stay

55:44

the same?

55:45

>> If I say yes, I don't want our anthropic

55:47

rep to double our pricing. [laughter]

55:49

>> But it would

55:50

>> it would work. It would be fine. Yeah.

55:51

So, it costs with people, it cost us

55:53

about $1,500 to $2,000 on average to do

55:56

a contract. Um, the average with Gwen

55:59

has been about $70.

56:02

So it would still work fine. Um and so

56:06

that's what we've seen is like partly

56:07

why the token use has exploded for us.

56:09

>> Am I being a complete idiot then? But

56:11

then if they 5x their pricing if you

56:13

went on the labor displacement theory,

56:15

>> it would still work.

56:17

>> It would still work. I think what

56:19

they're betting and what also we've seen

56:21

is you don't just displace the labor. So

56:24

here like I think contracting is a

56:26

perfect example. We've not said okay

56:28

we're doing 100 a week so we'll get the

56:30

agent to do 100 a week. What we've done

56:32

is said, "Well, now that we have the

56:33

agent, we can do 10 times as many

56:35

contracts this year as we could do last

56:38

year. So, we're going to do 10 times and

56:39

then we're going to try and do 20 times

56:40

and we would just do a lot more volume

56:43

than you could possibly have done with a

56:45

human team."

56:46

>> Everyone's like, "Oh, I lose my job.

56:47

Lose my jobs." Do you think that's

56:49

warranted?

56:50

>> I think for a lot of these back office

56:53

jobs, yes, because

56:54

>> So, how how do we determine between I'm

56:57

just going to do more?

56:58

>> Yeah. A lot of people say with

56:59

developers, we're not going to get rid

57:00

of developers. There's an insatiable

57:02

appetite for more software, better

57:04

software.

57:05

>> That side I do agree with. I think

57:07

>> how do we determine between functions

57:08

where we'll do more versus we'll be

57:10

replaced.

57:11

>> So what we've tried to kind of

57:12

differentiate at curative is there's

57:14

like two areas where we're really

57:16

investing in people. That's technical

57:19

skills and relationships. Those are two

57:22

aspects that I don't see going away

57:24

anytime soon is we still have a team

57:27

that are actually deploying all of this

57:29

AI. They use a ton of AI in all of their

57:31

day-to-day work, right? They're not

57:32

writing any code anymore. They're not

57:34

even reading the code anymore. They're

57:36

deploying all of this with cloud code or

57:37

codecs. Um, and seeing like incredible

57:41

results out of one senior engineer now

57:43

is so much more productive than they

57:45

were a year ago that we're investing in

57:48

having those people. At the same time,

57:50

there's a side particularly to health

57:52

insurance that is relationship driven

57:54

that I don't see as going away anytime

57:56

soon. Ultimately, we ensure a member and

57:59

that member wants to be able to call and

58:01

talk to a person. We have a lot of AI

58:03

they can talk to. The AI is great. They

58:05

love talking to the AI, but there has to

58:07

be a person somewhere in the loop. We

58:09

also work with these provider groups. We

58:11

have a relationship with that provider

58:13

group that we're providing a chunk of

58:15

your revenue. You know, we work with

58:17

you, you work with us. There's a

58:19

relationship aspect there that has to be

58:20

maintained particularly for the larger

58:22

groups by a person and then on the sales

58:24

side we sell through a broker and that

58:28

broker wants to have a finalist

58:30

presentation. They want to go to dinner.

58:32

They want to go and play golf and so

58:35

what we've seen is on the sales side

58:37

like that relationship is if anything

58:40

more powerful. Do you think they still

58:42

will in 5 years? A lot of people talk

58:43

about agent agent transactions and how

58:46

that changes the process. Do you think

58:47

we will still have that heavy

58:48

relationship interpersonal cell in 5 10

58:51

years? I think on in in some aspects yes

58:55

because I think in some aspects that's

58:57

kind of becomes the foundation of trust

59:00

and it's like almost the scarce resource

59:02

right of if you want to do a deal that's

59:04

important then you're going to use your

59:06

scarce resource of people to manage that

59:08

as almost like

59:11

>> it's also the bigger the contract

59:14

>> the more important it is to have the the

59:15

whites of the eyes and the trust in the

59:18

relationship

59:18

>> and and most of these contracts right

59:20

most employers even our smallest

59:22

employers is it's a million-doll

59:23

contract at least.

59:24

>> I always think they like when you look

59:25

at accountants and lawyers and a lot of

59:27

the people who bluntly could be

59:28

replacing some of the more simple

59:29

especially NBAs or

59:31

>> but you would never not have a law firm

59:33

do it because if it goes wrong they're

59:35

getting fired.

59:37

>> Yeah. But I think I I I think you'll see

59:40

it work differently though where I mean

59:42

what we're seeing with with Gwen is we

59:44

had a contract a standard template

59:47

contract that was drafted by a law firm

59:49

and then we have kind of like guardrails

59:51

for what Gwen can agree to. But she just

59:53

redlines it and then signs it. She

59:56

doesn't it doesn't go to a law firm for

59:58

review. Like we're signing hundreds of

59:59

these contracts a day. It would be too

1:00:00

encumbering. It would be too slow and

1:00:02

they would just be reviewing with AI

1:00:04

anyway. So we kind of trust the agent to

1:00:07

do that legal review within certain

1:00:09

parameters.

1:00:10

>> In 3 years time, knowing what you do now

1:00:13

about the capabilities that you use it

1:00:15

for, how big do you think anthropic will

1:00:17

be?

1:00:18

>> A lot bigger than they are today.

1:00:19

>> Do you think it could be 5 trillion?

1:00:21

>> I think it could be 10 trillion.

1:00:26

>> Bugger. [ __ ] [laughter]

1:00:29

>> Is just extraordinary, isn't it?

1:00:31

>> Yeah. because I think you just find all

1:00:33

these new things that you can do that

1:00:34

you just couldn't do before that it like

1:00:36

wasn't possible to do. So Gwen is

1:00:39

sending on average 15,000 emails a day.

1:00:42

Customized emails to providers that know

1:00:45

about their practice, that know about

1:00:46

their work, and one of the things we

1:00:48

found is like that relentlessness of the

1:00:50

follow-up is what works. A lot of

1:00:52

providers will get them on the ninth

1:00:54

email. There's no way that a human is

1:00:56

going to email them nine times because

1:00:58

you know people that's like you have to

1:01:00

kind of have no shame to reach out that

1:01:02

many times.

1:01:02

>> Do you want to hear something funny? You

1:01:04

mentioned Salesforce. I got Mark Benny

1:01:05

off on the show cuz I emailed him 53

1:01:07

times [laughter] once every week for a

1:01:11

year and a week.

1:01:12

>> There we go.

1:01:13

>> I'm basically an AI model. I lost my

1:01:16

personality.

1:01:16

>> Very effective AI model.

1:01:18

>> That is extraordinary.

1:01:19

>> But that works so well in sales and it's

1:01:21

and and the best sales people will will

1:01:23

do that. But it's really hard to scale

1:01:25

that and you end up getting people that

1:01:27

reach out three times then give up.

1:01:29

>> Yeah.

1:01:29

>> And when you're trying to scale

1:01:30

something up if you can scale up that

1:01:33

relentlessness like that is really

1:01:36

valuable.

1:01:36

>> So you fundamentally buy the companies

1:01:38

will be inherently smaller in the future

1:01:40

and that's why we're seeing layoffs.

1:01:41

>> Yes.

1:01:42

>> Are layoffs today just an excuse for

1:01:45

overhiring in 2021 and 2022?

1:01:47

>> I think it's a mix. Yeah,

1:01:48

>> I mean I think there is definitely some

1:01:49

of that and you know it's also companies

1:01:52

are seeing valuation boosts by doing it.

1:01:54

So that's incentivizing maybe bad

1:01:56

behavior but some of it for sure is that

1:02:00

these workflows are changing.

1:02:02

>> How big are you today?

1:02:03

>> We're about 650 people now.

1:02:05

>> How big will we be in 5 years time?

1:02:08

>> Well, in 5 years we'll probably be

1:02:10

bigger. In the short term I think we're

1:02:12

going to be quite a bit smaller.

1:02:14

>> Smaller?

1:02:14

>> Yeah. We're not done yet with all of

1:02:17

these backend workflows.

1:02:18

>> How does that go to 400?

1:02:20

>> Uh somewhere [clears throat] around

1:02:22

there.

1:02:22

>> Wow.

1:02:23

>> There's some aspects of the business

1:02:24

that are are clinical workflows. Uh so

1:02:27

all of our members get a care navigator

1:02:29

um who stays with them for their entire

1:02:31

journey and that is just going to grow

1:02:33

linearly with our membership. So we want

1:02:35

you to have that human point of contact

1:02:37

that is available. But the care

1:02:39

navigators are now getting significantly

1:02:41

more useful because they can actually

1:02:43

use the agents to do a lot of the

1:02:45

follow-up on their behalf and they're

1:02:47

not having to remember to reach out to

1:02:49

this diabetic member every week about X.

1:02:51

They can kind of manage it at a

1:02:53

population scale. And so there we're

1:02:55

like keeping the same headcount relative

1:02:57

to our membership growth, but just

1:03:00

letting them do so much more than they

1:03:01

could do before.

1:03:02

>> That's amazing. I was speaking to a

1:03:03

major airline where they were saying

1:03:04

actually about exactly that that like

1:03:05

premium care customer service where it's

1:03:08

like they're able to give so much more

1:03:09

for your recommendations for you and

1:03:11

your wife's trip to New York and

1:03:14

everything's so perfected and tailored

1:03:16

because all the [ __ ] that they used

1:03:17

to do is gone and for you as the end

1:03:19

consumer it's amazing

1:03:20

>> and the response time the response time

1:03:22

is so much better

1:03:23

>> you get a response back in a few minutes

1:03:24

that's that's the usual place where we

1:03:26

see people ask Gwen if she's an AI is um

1:03:29

when she responds to your email within 5

1:03:31

minutes because in healthcare. If you

1:03:32

get a response same week from an

1:03:34

insurance company, you're doing so well.

1:03:36

>> And people think that I'm an AI because

1:03:37

I respond very quickly on email and to

1:03:40

the point I'm like, no, I just have no

1:03:41

life. [laughter]

1:03:43

>> You said about kind of the different

1:03:44

data inputs like, oh, you can just send

1:03:45

us anything now. I always was like data

1:03:48

cleansing, data structures would be the

1:03:50

biggest inhibitor to enterprise adoption

1:03:52

of AI. Is that totally wrong [ __ ]

1:03:54

VC?

1:03:56

I think if you approach it in the right

1:03:58

way, then the cleanliness doesn't really

1:04:00

matter that much because the models are

1:04:01

so good at cleaning up the data if you

1:04:03

give them the right context. And so

1:04:05

that's one of the things we found

1:04:06

actually with migrating away from some

1:04:07

of these SAS vendors is uh we we moved

1:04:11

away from Looker um right Google's

1:04:14

Looker product for visualizations. It's

1:04:16

super expensive. Um and we moved to do

1:04:19

it in Snowflake um and it's been a lot

1:04:23

cheaper. It's worked really well. Part

1:04:24

of that migration is moving all of our

1:04:27

dashboards and all of the things that

1:04:29

fed from Looker would have taken like

1:04:32

probably like a year and a whole bunch

1:04:33

of engineers and data scientists. Uh we

1:04:36

did most of it with an agentic workflow

1:04:38

that would spin up, find the next

1:04:41

dashboard, figure out how to convert it

1:04:43

into what we needed and then close it

1:04:45

down on the Looker side and boot it up

1:04:47

on the other side. And it ended up being

1:04:49

like a project for uh one or two people.

1:04:52

And it took it still took a couple of

1:04:53

months, but it was a lot more doable

1:04:55

because we didn't have to have somebody

1:04:58

ingest or like figure out that data. You

1:05:00

can just feed that data into a model and

1:05:02

let it figure out how to structure it

1:05:04

going forward.

1:05:05

>> It's just really interesting cuz I you

1:05:06

know I often think about what role does

1:05:07

not exist today that will be massive in

1:05:09

5 years time. And I thought like data

1:05:11

cleansing would be one of those roles.

1:05:14

If I asked you what role does not exist

1:05:16

today that you think will be very big in

1:05:18

5 years time, what would you say? agent

1:05:21

supervisor.

1:05:22

>> What does that mean?

1:05:23

>> One of the things we've found that's

1:05:25

been like a bottleneck is when you

1:05:27

launch these agent workflows, there's

1:05:29

always things that they you don't want

1:05:32

to let it do everything, right? So, like

1:05:34

with our contracting or our sales

1:05:35

workflow, like there's a certain margin

1:05:37

threshold where the sales agent can't

1:05:40

promise a client that we'll do it at

1:05:42

that margin, but we don't necessarily

1:05:44

want it to say no. we want to make a

1:05:47

business decision about whether this is

1:05:49

the right thing to do for that client.

1:05:51

>> Um, and so you end up generating this

1:05:54

like massive list of approval requests

1:05:57

that is now much longer than it would

1:05:59

have been because you're doing 10 times

1:06:00

as much work. So you're now getting even

1:06:03

if you're only getting an approval

1:06:04

request 1% of the time, you're still

1:06:06

getting 10% or 10 times as many as you

1:06:08

were last year. And so one of the things

1:06:09

we found is like actually how do you

1:06:11

manage all of those exceptions that now

1:06:15

become like a really high volume. So we

1:06:17

tried agents supervising agents which I

1:06:20

think works to a degree and maybe as the

1:06:22

models get better as well you can also

1:06:24

have like a more expensive right like if

1:06:27

we ever get mythos and it costs $100 per

1:06:30

million tokens you probably wouldn't use

1:06:32

it for the core workflow but you could

1:06:34

maybe use it as a supervisor

1:06:37

but how you actually manage those agents

1:06:39

at scale with like the volume of

1:06:40

exceptions that they generate um because

1:06:42

you don't want them just rubber stamping

1:06:44

yes or no either way like you need a

1:06:45

more nuanced decision there.

1:06:48

>> If you were advising your younger

1:06:50

brother or sister on how to prepare for

1:06:52

that role, what would you advise them to

1:06:54

do to be adequately skilled to do that?

1:06:58

>> I think just play with the models. Like

1:07:01

I think a lot of people severely

1:07:02

underestimate what they're capable of.

1:07:05

um because maybe they like tried ChatGBT

1:07:07

two years ago

1:07:10

[snorts] and and it like they're moving

1:07:11

so fast and they're so much better than

1:07:13

they were even six months ago that if

1:07:15

you're not like relentlessly trying them

1:07:17

then you're going to significantly

1:07:19

underestimate and then also like where

1:07:20

they are today is not where they're

1:07:21

going to be clearly in a few years. So

1:07:24

you got to skate to where the puck is

1:07:25

going to be.

1:07:26

>> Where will they be in a few years?

1:07:28

>> Ahead of humans on most capabilities.

1:07:32

>> Are you excited? [laughter]

1:07:33

Yes, cuz I think that opens up so many

1:07:35

possibilities like unlimited

1:07:38

intelligence.

1:07:39

>> Are you not worried about in the short

1:07:41

term societal unrest, labor displacement

1:07:44

and what that will do to a hollowing out

1:07:46

an inequality increase in the US?

1:07:49

>> I think that can be dealt with by

1:07:51

significant action whether or not we do

1:07:53

that or not.

1:07:54

>> What significant action would you do to

1:07:56

mitigate that?

1:07:57

>> I mean, I think eventually some version

1:07:59

of universal basic income.

1:08:01

>> Really?

1:08:01

>> Yeah. and you buy that works.

1:08:03

>> I mean, I think we have to build the

1:08:04

social structures that give those people

1:08:06

purpose and meaning outside of work

1:08:10

because I don't think that we're going

1:08:11

to have and I also I don't think that's

1:08:13

a bad thing. Like a lot of these

1:08:15

mid-level jobs that are being replaced

1:08:17

are awful jobs. They're people sitting

1:08:18

at a desk with like fluorescent lamps

1:08:21

shining at their face reviewing random

1:08:24

paperwork. Like that's not what people

1:08:27

like, you know, when you're little and

1:08:29

you say, "What do you want to be when

1:08:30

you grow up?" I want to sit in an office

1:08:31

and rubber stamp insurance forms. Like

1:08:33

it's not a good job.

1:08:35

>> I would be worried if my child.

1:08:36

[laughter]

1:08:37

>> Right. So these are not like it's not

1:08:39

like you're taking some like super

1:08:41

aspirational thing away from people. I

1:08:43

think these are jobs that we'll look

1:08:45

back and say, "God, I can't believe we

1:08:47

had people doing that kind of work.

1:08:48

That's crazy."

1:08:49

>> You know, I I walk with my mother a lot

1:08:51

and I always say my job is to invest in

1:08:53

the things that we say, "God, I can't

1:08:55

believe we used to do it that way." I

1:08:57

[laughter] said, "Do you remember? I

1:08:58

would never put my credit card on the

1:08:59

internet or you'd never find your like

1:09:02

husband on the internet.

1:09:04

>> You'd never get in a stranger's car and

1:09:06

uh and have them drive you where you

1:09:07

want to go.

1:09:07

>> What is insane today that will be

1:09:09

incredibly d obviously you have your

1:09:11

card online, obviously you meet your

1:09:12

partner online. What is insane today

1:09:15

that you think will be like obviously in

1:09:17

10 years? I think empowering agents to

1:09:19

do things on your behalf. Like we've

1:09:22

seen internally getting the team I think

1:09:25

like uh Isaac our our CTO and co-founder

1:09:28

and I have like trusted the agents

1:09:29

faster than most of the team and we're

1:09:31

okay like giving the agent authority to

1:09:33

do things like it was a big internal

1:09:35

dispute getting the agent to sign these

1:09:38

contracts. So the agent opens Docu Sign

1:09:40

and clicks the sign button and it's

1:09:42

legally binding and it has my signature

1:09:44

on the page. And getting that like

1:09:47

figured out internally was very it took

1:09:52

a lot of rounds of convincing people

1:09:53

that that was okay and that we could do

1:09:55

that. And so I think it will take time

1:09:58

for people to trust these agents with

1:10:01

stuff like you know give it your credit

1:10:02

card and let it go book a a holiday,

1:10:05

right? like getting getting people to

1:10:06

trust

1:10:09

it acting on your behalf I think will

1:10:11

take longer

1:10:12

>> but I'm thrilled that you signed me your

1:10:13

house for $12.

1:10:16

>> Uh do you worry about the concentration

1:10:18

of value when you look at the Mag 7

1:10:21

providing 85% of gains here today in

1:10:23

stock markets and then anthropic open AI

1:10:27

maybe one or two more. Do you worry

1:10:29

about that concentration of value? I'm

1:10:32

quite bullish now because I think a lot

1:10:34

of what's going on in AI is going to

1:10:36

massively boost earnings in other areas

1:10:38

of the economy that have struggled to

1:10:39

grow earnings any other way. Like if

1:10:41

you're health insurance,

1:10:42

>> like health insurance, like how do you

1:10:43

grow health insurance earnings? Well,

1:10:44

it's been or you go chase government

1:10:46

business and you pay a bunch of

1:10:47

lobbyists to get the government to

1:10:49

overpay for care. That's all now

1:10:50

backfired and all the government

1:10:52

business, Medicare and Medicaid is now

1:10:53

like a bad business and they're all

1:10:55

losing money. Everybody has insurance.

1:10:58

So unless you're going to increase the

1:11:00

total spending, how do you grow

1:11:02

earnings? Well, if you can make it more

1:11:03

efficient so you're not spending 9% of

1:11:06

your premium on admin tasks, that's a

1:11:09

way you can grow earnings without having

1:11:12

to deliver a worse product.

1:11:13

>> You're in a really good business as well

1:11:15

cuz it's like unwaveringly not in the

1:11:17

path of the model providers as well.

1:11:19

>> Yes, I not going to start an insurance

1:11:21

company. in the past like we're big

1:11:23

invest in wallets which is like business

1:11:25

[clears throat] banking like anthropics

1:11:26

is not going into business banking

1:11:28

>> in Southeast Asia [laughter]

1:11:30

>> I would be surprised I think things that

1:11:32

have some like regulation around them

1:11:34

and are like complex industries yes

1:11:36

they're going to see the advantages of

1:11:37

the models but they're not going to see

1:11:39

competition from anthropic or open AAI

1:11:42

>> I totally get that when I listen to you

1:11:43

I'm like Jesus if I was you I'd also

1:11:45

take a chunk of my money and invest it

1:11:47

actively into anthropic um can I ask you

1:11:51

have you taken secondaries along the

1:11:52

way?

1:11:54

>> Uh no, no, we haven't sold any

1:11:55

secondaries. We did uh there was a

1:11:57

dividend at the end of co we paid out

1:11:59

some uh all the investors got uh 10x

1:12:01

their money back uh before we started

1:12:03

the health insurance company and then

1:12:04

they still have their shares today.

1:12:06

>> We haven't sold any secondaries now.

1:12:08

>> Are you [ __ ] serious? They got 10x

1:12:10

their money back and then they kept the

1:12:12

shares.

1:12:12

>> We didn't have that many investors but

1:12:14

yes they they all did well.

1:12:16

>> That is an amazing deal. [laughter]

1:12:19

10x and then you keep the shares. Yeah.

1:12:22

>> What?

1:12:24

>> Well, I think that's why we've seen them

1:12:25

double down, right? It's like they made

1:12:27

money with us before and so, you know,

1:12:29

this last round was was led by insiders.

1:12:32

>> And how big was the last round?

1:12:34

>> 150 million.

1:12:35

>> What was the prize?

1:12:36

>> 1.3 billion.

1:12:38

>> Wow. Nice round actually. Not too much

1:12:40

dilution. Enough that it's really

1:12:42

impactful cashwise to come in.

1:12:44

>> Yeah.

1:12:45

>> Wow, dude. That's insane. So, can I ask

1:12:48

you then personally? I asked this

1:12:50

actually, do you know Josh Browder? He's

1:12:51

another Brit in the valley. Okay. Um, a

1:12:54

phenomenal guy, but like when you look

1:12:56

at your personal allocation today, given

1:12:59

our insider access and what we know,

1:13:02

>> is there anything funky that you do with

1:13:04

your money

1:13:04

>> outside of of curative? Yeah,

1:13:07

>> I invest primarily in companies of

1:13:09

people that I know and I do very little

1:13:12

investing if I don't know the founders.

1:13:14

>> Does that work well?

1:13:16

It's had mixed results, but some of them

1:13:19

are too early to tell. Some of them are

1:13:20

the best investment.

1:13:22

>> Um,

1:13:24

they're all they're all a bit too early

1:13:25

to to tell. [laughter]

1:13:27

>> Do you have any energy investments?

1:13:30

>> Uh, yes. So, there is a company that um

1:13:32

I co-founded with my wife, Subcritical,

1:13:36

that is um in the nuclear fision space.

1:13:39

So, this was based on an an idea that I

1:13:41

had a few years ago that um we need more

1:13:46

power and that nuclear is a really good

1:13:47

way to do this. Uh and it started off

1:13:49

actually as looking for an investment.

1:13:51

This was like one of my f first times I

1:13:52

was like we should find a company that's

1:13:54

doing nuclear power and try and invest

1:13:58

in it and see if we can make it go

1:13:59

faster. Um because I kind of thought

1:14:03

I'm pretty good at making things go

1:14:04

faster in really regulated spaces. Like

1:14:06

that's kind of what I'm what I'm good

1:14:07

at.

1:14:07

>> That's your thing. Yeah, that's my

1:14:09

thing. You know, everybody's got to have

1:14:10

a thing.

1:14:12

>> And so,

1:14:12

>> is that your hook on the first date?

1:14:14

Regulated industries make a good first

1:14:16

hook on our first date. So, after our

1:14:18

first date, we both shared our genome

1:14:19

files with each other, our VCF like um

1:14:23

and so she said she'd done this before

1:14:25

and the guy thought it was really

1:14:27

strange and we both were like, "Oh, we

1:14:29

should share our genomes and then, you

1:14:31

know, compared and check that we were

1:14:33

compatible so it was worth having a

1:14:34

second date." And we were both totally

1:14:36

into that. So, we We knew it was meant

1:14:38

to be. We were compatible by genome.

1:14:40

>> We have two beautiful kids, so we uh we

1:14:43

knew it was meant to be.

1:14:44

>> I'm sorry. If you're incompatible by

1:14:45

genome, you have like a

1:14:47

>> If you both have like the same

1:14:49

>> You have a ginger child.

1:14:52

>> Well, that was a concern. My brother is

1:14:54

ginger. So, I carry the ginger.

1:14:55

>> My brother is ginger, too. Yeah.

1:14:57

>> We We don't see him anymore. We took him

1:14:59

to the woods and said, "Run free."

1:15:01

>> Makes sense. Yeah. [laughter] So, I do

1:15:03

carry the ginger gene. And if she had

1:15:05

carried the ginger gene, that would have

1:15:06

been a deep concern. but she luckily

1:15:08

doesn't. And so that was that was one of

1:15:09

the key tests.

1:15:10

>> You progressed to the second date.

1:15:12

>> Yes. So we made it to the second date.

1:15:13

>> What does no one know about nuclear that

1:15:15

everyone should know about nuclear?

1:15:18

>> That it is very safe. I think and that

1:15:21

it's not a science or engineering

1:15:23

problem. Like that was when when we

1:15:25

started looking at companies to invest

1:15:26

in that was for me that the thing that I

1:15:29

was sort of disappointed by is everybody

1:15:31

was approaching it as if nuclear is this

1:15:33

massive engineering challenge. And sure

1:15:35

like the engineering is hard. It is

1:15:38

complicated. But fundamentally we have

1:15:40

built safe nuclear reactors since the

1:15:42

60s. They work great. The technology has

1:15:45

not really changed or progressed since

1:15:47

then. We know how to build these. That's

1:15:48

not the problem. The problem is that due

1:15:52

to a lot of the anti-uclear push in the

1:15:54

80s, we have had a regulatory

1:15:57

environment that has been incredibly

1:15:59

restrictive and difficult to get new

1:16:01

nuclear reactors built particularly in

1:16:04

the US but also worldwide. Uh there's

1:16:07

been this push to say how do you

1:16:08

guarantee that under any possible

1:16:10

circumstance like once in a million-year

1:16:13

events that you will never have anything

1:16:14

go wrong. And in traditional nuclear

1:16:17

that is very hard to guarantee. In

1:16:20

traditional nuclear one of the reasons

1:16:21

it's difficult you're basically

1:16:22

balancing on this knife edge. So in a

1:16:25

reactor you have uh what's called

1:16:27

criticality right which is where you

1:16:29

have to produce enough neutrons each

1:16:31

generation that they go off and do

1:16:33

exactly one more reaction and it keeps

1:16:35

itself going. If you get too much of

1:16:38

that too many neutrons it's a bomb,

1:16:40

right? It will be a runaway reaction and

1:16:42

it will blow up. That's very bad. that's

1:16:44

only ever happened once by accident,

1:16:45

which is Chernobyl. Um, all the others

1:16:49

have been not criticality events. Um, so

1:16:52

you don't want that. If it happens not

1:16:54

enough, then it just turns off. So if

1:16:56

you go too far below this exact 1.0

1:16:59

threshold, you get no power out. And so

1:17:01

you're trying to balance perfectly on

1:17:03

that knife edge of exactly 1.0 where you

1:17:05

can control it. And that is a hard

1:17:08

problem to guarantee. And this is the

1:17:10

fundamental issue with nuclear

1:17:11

regulation. How do you guarantee that

1:17:13

under no possible circumstances will you

1:17:15

deviate from that perfect control?

1:17:18

And so I was initially pretty

1:17:19

disheartened. I was like, well, we're

1:17:21

not going to get new nuclear power. This

1:17:22

is not going to work. And then I

1:17:24

stumbled on this idea of what's called

1:17:26

the energy amplifier. And it's not a new

1:17:28

technology. It's been around since like

1:17:30

the late ' 80s, early 90s. It was really

1:17:32

pushed by a guy Kar Rubia who used to be

1:17:35

the CERN director. He was a new uh Nobel

1:17:37

laurat in physics. And the idea is you

1:17:40

always operate below that 1.0 threshold.

1:17:44

So we are designed to operate at 0.97.

1:17:46

So that means you never have enough

1:17:48

neutrons to keep the reaction going. The

1:17:50

reaction will always fizzle out. So no

1:17:52

matter what you do, it's going to fizzle

1:17:54

out. But normally that would mean you

1:17:55

get no power output. What you do in the

1:17:57

energy amplifier is you point a really

1:17:59

powerful particle accelerator at that

1:18:02

fuel and that puts in the extra neutrons

1:18:05

to drive the reaction forward. But if

1:18:06

you turn that accelerator off, all of

1:18:08

your energy output just stops. And so

1:18:10

you basically have this big onoff switch

1:18:11

where you can control fision and you can

1:18:14

guarantee that no matter what you do to

1:18:16

it, the fision will never run away. Even

1:18:18

if you put in 10 times as much power

1:18:19

from the accelerator, it will never run

1:18:22

away. There's nothing you can do to it

1:18:23

to cause it to go critical or to have a

1:18:25

criticality accident. And so it's a

1:18:27

fundamentally safer way of doing nuclear

1:18:29

fision that is

1:18:33

just approaching it from a different

1:18:34

angle. How will the composition of our

1:18:37

energy providing change in the next 5 to

1:18:39

10 years? Like will nuclear be a

1:18:41

demonstrabably larger part of energy

1:18:43

provision than it is today?

1:18:44

>> Yes, I think what we're seeing kind of

1:18:46

all across the supply chain in nuclear

1:18:48

is a push to get more nuclear online. Um

1:18:51

and I think you know Subcritical is kind

1:18:53

of leading the way there with a faster

1:18:55

path to market than any of the other

1:18:57

players. Uh but there's a lot of people

1:18:59

working on deploying a lot of new

1:19:00

nuclear power

1:19:01

>> which current provision will diminish

1:19:04

significantly.

1:19:06

>> Um I mean I think any power from coal

1:19:09

will will mostly go away. I think you're

1:19:11

still going to see a lot of gas just

1:19:13

because particularly in the US it's

1:19:14

cheap, it works, it's fast, but I think

1:19:18

coal is going to go away. Um and then

1:19:20

you're just going to see more of

1:19:21

everything. What company will be larger,

1:19:24

curative or subcritical?

1:19:27

>> Subcritical. Yeah.

1:19:28

>> Or subcritical.

1:19:29

>> That's a great question. Um, curative

1:19:31

has a larger market opportunity, but I

1:19:33

think they're both

1:19:33

>> has a larger market opportunity.

1:19:35

>> Yeah. I think they're both, you know,

1:19:37

>> power generation.

1:19:38

>> Yeah. The uh US spends or US employers

1:19:42

spend $1 half trillion dollars a year on

1:19:43

healthcare, which is that's our like

1:19:45

direct TAM every single year.

1:19:47

>> How much does the US spend on energy?

1:19:49

through energy that can be addressed

1:19:51

through um through nuclear. It's a

1:19:54

similar order of magnitude.

1:19:56

>> I mean, you chose good ts.

1:19:57

>> They're both they're both yield

1:19:59

optimization. I feel like you've really

1:20:01

really taken this

1:20:02

>> I figured out the TAM thing. [laughter]

1:20:03

No, they're both like trillion dollar

1:20:05

opportunities if we execute right.

1:20:08

>> [ __ ]

1:20:08

>> Yeah.

1:20:11

>> Wow. We're also seeing AI on the on the

1:20:13

nuclear side in the design

1:20:16

>> because design is like traditionally a

1:20:18

thing that is done by a whole bunch of

1:20:20

people sitting doing drawings and

1:20:23

mechanical engineering

1:20:24

>> and the models have gotten really good

1:20:26

at that. And so we're seeing that you

1:20:29

can do the design with far fewer people

1:20:31

using AI to optimize a lot of the design

1:20:34

parameters where historically you might

1:20:36

have needed a hundred mechanical

1:20:37

engineers to design every single nut and

1:20:39

bolt and part. You can do it with with

1:20:42

20 really good mechanical engineers that

1:20:44

are designing the critical pieces, the

1:20:46

important pieces um and overseeing the

1:20:49

AI on like well I need a little bracket

1:20:51

that joins this piece to this piece that

1:20:53

doesn't need a human to design that. I

1:20:56

was actually meeting a company the other

1:20:57

day which basically said like you know

1:20:58

the challenge with hardware engineers is

1:21:00

they don't often know what software

1:21:01

engineering and the beauty of today is

1:21:03

like we've turned hardware engineers

1:21:04

into software engineers overnight.

1:21:06

>> Yeah.

1:21:07

>> And that's amazing.

1:21:07

>> Well, it's another place where we saw

1:21:09

like codegen as the solution and I think

1:21:11

you know this is one of the bets

1:21:12

anthropic made and they're totally right

1:21:14

on.

1:21:15

You can generate really good CAD models

1:21:17

by having it write Python to make the

1:21:18

CAD model. like it's not good at

1:21:21

necessarily good at like 3D space

1:21:23

visualization or outputting a drawing

1:21:26

um right as as vectors but it's really

1:21:29

really good at generating plausible

1:21:31

Python code that can draw that part.

1:21:34

>> It is the most exciting time to be alive

1:21:35

in many respects.

1:21:37

>> Yeah. Yeah. Well, that's why we ended up

1:21:38

starting Subcritical is I you know very

1:21:40

busy running curative but that was an

1:21:42

idea that was just too important to pass

1:21:45

up and there was nobody else. So uh the

1:21:49

only one that is under like active

1:21:51

construction of those systems is in

1:21:53

China based on a US design from the

1:21:56

2010s that the US stopped working on

1:21:58

after Fukushima.

1:21:59

>> How much money do you need to make

1:22:00

subcritical significant?

1:22:03

>> Uh well each one of our deployments

1:22:05

would be about a billion dollars of

1:22:07

construction cost for a 300 megawatt

1:22:09

facility. So it's but it's not you know

1:22:11

it wouldn't be the same like you

1:22:13

wouldn't raise that as equity. It would

1:22:14

be a mix into the plant of equity and

1:22:16

debt. So, it's a different kind of it's

1:22:19

more infrastructure build financing.

1:22:21

>> What do you know now about marriage that

1:22:23

you wish you'd known at the beginning?

1:22:24

Seriously, like it's an amazing thing to

1:22:26

build a company with your wife.

1:22:27

>> It's a challenging thing as well.

1:22:29

>> Yes.

1:22:30

>> How do you make it work?

1:22:33

>> So, I we're very well matched, I think,

1:22:34

is one of the things is we basically

1:22:36

never argue. And that's, you know, how I

1:22:38

knew very early on that it was meant to

1:22:40

be is we're always on the same page

1:22:42

about things. And so it's actually very

1:22:44

easy to run a company together uh

1:22:46

because we're we we usually see eye to

1:22:49

eye on like how something should be

1:22:50

done.

1:22:51

>> Fatherhood. You said two kids. Two kids.

1:22:54

Two and a halfyear-old and 6 months.

1:22:56

>> Anything that you would advise a new

1:22:58

father knowing what you know now?

1:23:00

>> You should definitely have kids. Don't

1:23:02

wait. I mean I think there's too much

1:23:04

like um sentiment of people. Oh, you

1:23:07

know, live your life and wait until

1:23:09

you're in your, you know, late 30s and

1:23:12

then have kids. I think no, like have

1:23:14

kids early when you're have the energy

1:23:17

and can run around and not sleep and

1:23:19

it's one of the best things you'll ever

1:23:21

do. You should just get on with it.

1:23:22

[laughter]

1:23:22

>> Okay, we're going to do a quick fire.

1:23:24

Sound good?

1:23:25

>> Yep.

1:23:25

>> Dude, that was the most uh twisting and

1:23:28

turning conversation ever from like the

1:23:29

proliferation of STDs to fatherhood and

1:23:32

nuclear. I mean, really, we crushed it.

1:23:34

What have you changed your mind on most

1:23:36

in the last 12 months?

1:23:38

>> I think probably a year ago I have

1:23:40

changed my mind that there are workflows

1:23:43

that can't be done with the models with

1:23:45

today's models. I think today the

1:23:48

current gen models can do every back

1:23:50

office task we have at curative it's

1:23:52

just a matter of deploying them like

1:23:54

getting them set up getting them

1:23:55

configured having the right policies and

1:23:58

and I think a year ago

1:24:01

I thought there was opportunity I

1:24:03

thought there was things we could do but

1:24:04

I don't think I would have said you

1:24:06

could do every single one of our current

1:24:08

back office flows

1:24:09

>> what one change would you make to Europe

1:24:11

if I made you president of Europe in

1:24:13

this very strange title to stay in the

1:24:16

brace for competitiveness.

1:24:18

>> Uh you have to have some kind of like

1:24:20

burden for passing regulation. There

1:24:21

needs to be some penalty. Like right now

1:24:23

you pass a regulation that's like okay

1:24:25

you you did a good job. Like the goal is

1:24:27

to pass regulation. There has to be some

1:24:29

penalty. Like the if you pass regulation

1:24:32

your country must pay some tax

1:24:33

additional tax for having passed that

1:24:35

regulation. just adding and adding and

1:24:36

adding uh without like refining what

1:24:39

you've got today and like really going

1:24:41

and digging in how is this regulation

1:24:43

affecting things on the ground like just

1:24:45

more additive regulation is bad. You

1:24:47

need to be looking at the effect of what

1:24:49

you've done and refining it and

1:24:51

iterating on it and not just trying to

1:24:53

add some new landmark regulation.

1:24:56

>> It's very anti-European Fred. You're not

1:24:57

going to [laughter] do anything. You're

1:24:58

not going to do very well here for a

1:24:59

reason. I mean, you know, I'm a Texan

1:25:01

now. Um, uh, Mark Benio said he spent

1:25:03

300 million on Anthropic. Equated across

1:25:05

the developers that they have, it works

1:25:07

out to be about 3.8% of developer salary

1:25:10

spent on Anthropic. What do you think

1:25:12

total percent of developer salary spend

1:25:15

will be on anthropic in 3 years time?

1:25:18

>> Between maybe two and 5x be the two and

1:25:21

5x salary. I think that's probably

1:25:23

>> 2 to 5x is the whole salary.

1:25:24

>> Yeah.

1:25:26

>> Whoa.

1:25:28

So from 3.8% 8% of salary to

1:25:30

>> Yeah. Because I think the way I mean the

1:25:31

way we're driving workflows is that you

1:25:34

have one senior engineer managing a

1:25:37

bunch of downstream agents that are

1:25:38

actually doing the work. And then we're

1:25:40

now getting to the point we have like

1:25:42

mostly unsupervised agents taking

1:25:44

feedback from the team on things,

1:25:46

implementing features, and then the the

1:25:49

engineers are coming in and actually

1:25:51

checking that what it built makes sense.

1:25:54

So they're becoming more the reviewer

1:25:56

and like the architect. And then you

1:25:59

have these downstream

1:26:01

>> doing the two to five. I mean that's not

1:26:03

like 3.8 to 20% [laughter] 50%. If it's

1:26:06

50% anthropics like a 20 trillion

1:26:09

company.

1:26:09

>> Yeah. I I think that that's what the

1:26:11

workflows will be is people are people

1:26:13

are going to be deploying more agents

1:26:15

than engineers

1:26:17

and they're going to keep the same

1:26:18

number of engineers. We're just going to

1:26:20

build a lot more.

1:26:21

>> Going to message my friend to let me

1:26:22

into that new anthropic round.

1:26:24

[laughter] Just message Larry. [snorts]

1:26:26

There we go. Uh, what's the kindest

1:26:29

thing anyone's ever done for you?

1:26:31

>> I think when I first was getting

1:26:32

started, there were a lot of people that

1:26:35

helped make it be possible to move to

1:26:37

the US and kind of like made a bet on a

1:26:40

kid coming from the north of England to

1:26:43

come to Silicon Valley. some of the

1:26:44

earliest investors. Um the guy Josh

1:26:48

Buckley who, you know, was one of the

1:26:50

first in guys who invested in us during

1:26:52

the YC batch

1:26:55

just because he liked what we were doing

1:26:57

and he thought it was it was cool. But,

1:26:59

you know, being willing to kind of take

1:27:01

a bet on a kid,

1:27:03

>> you know, Josh is like my best friend.

1:27:05

>> I didn't know that. I haven't seen him

1:27:07

in a while.

1:27:07

>> Yeah, I I say hi to him.

1:27:09

>> I I speak to Josh every single night.

1:27:12

>> Okay. uh barring say Christmas.

1:27:14

>> All right. Well, he he invested in cows.

1:27:17

>> That is amazing.

1:27:18

>> And then STDs.

1:27:20

[laughter and snorts]

1:27:20

>> Oh, you know,

1:27:22

investor Mark.

1:27:24

That's amazing. I didn't know that on

1:27:26

Josh.

1:27:27

>> Yeah. He like a month into the YC batch

1:27:30

like came by the lab and was like super

1:27:32

supportive of what we're doing. And I

1:27:34

think just coming from like the British

1:27:35

background, we couldn't even get

1:27:36

meetings with investors

1:27:37

>> and he was young. I mean,

1:27:39

>> he was Yes. But to get I mean he'd been

1:27:41

through YC and like had a successful

1:27:43

company and it was just awesome to like

1:27:45

have someone like that take a bet on

1:27:47

what you're doing. Coming from the UK

1:27:50

where I was used to like the cold

1:27:52

shoulder and no one was interested in

1:27:54

what I was building and you know no one

1:27:56

wanted to take a meeting. [laughter]

1:27:58

>> That makes me so happy to hear. Okay,

1:28:01

final one. What's the best advice that

1:28:03

you've been given? I think one thing

1:28:06

that I have learned is to always try and

1:28:10

get a lot of different perspectives on a

1:28:12

problem. Um I think I I would

1:28:15

historically have sort of approached

1:28:16

things from like one scientific

1:28:19

viewpoint and sometimes people would say

1:28:22

[clears throat] no like take a step back

1:28:24

and think about that problem more

1:28:26

broadly. And one of the things I learned

1:28:28

during the curative co push is we had to

1:28:31

bring together a bunch of people from

1:28:32

very different backgrounds. We hired a

1:28:33

bunch of former military people who were

1:28:36

just like incredible at deployment, but

1:28:38

they speak a different language. And

1:28:40

then we're trying to get them to talk to

1:28:42

scientists. And then we hired a bunch of

1:28:43

Silicon Valley developers. And they all

1:28:45

like think about the problem. They're

1:28:46

all trying to solve the problem, but

1:28:48

they all come at it from like a

1:28:50

completely different perspective. And a

1:28:51

lot of times I wouldn't have considered,

1:28:54

you know, that point of view on doing

1:28:55

it. And I think what I found is that the

1:28:58

more of those perspectives that you can

1:29:00

kind of get on a problem, the closer to

1:29:02

ground truth you get. Like you're never

1:29:04

gonna no not one of those people is

1:29:06

going to give you the ground truth. But

1:29:07

if you hear a lot of perspectives, you

1:29:09

can kind of get to that ground truth

1:29:11

faster.

1:29:12

>> Fred, that was the most extraordinary

1:29:14

show that I've ever done in

1:29:16

[clears throat] breadth, depth, uh,

1:29:19

variance of conversation. Thank you so

1:29:21

much for joining me and it's so great to

1:29:23

do it in person.

1:29:24

>> Yeah, thanks for having me.

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