We Built Our Own Salesforce in Months. Here's Why We're Cancelling the $600K Contract | Curative CEO
Lockdowns had just started. Everybody
[music] was starting to freak out. There
was basically nowhere to get a test. So,
our chief scientific officer had in his
spare time developed a COVID test. I
think our peak day was 26,000 people
tested in a single day. I'm so excited
for a freaking wild story today. Fred
Turner, co-founder and CEO of Curative.
This is an English founder in the valley
who scaled a COVID testing business to
$5 billion in revenue. Then he had to
scale it all back. [music] It did not
last postcoid for obvious reasons.
Today, he turned it into a health
insurance provider that's worth $1.3
[music]
billion. And in the show, he says some
pretty wild stuff. And the company went
from about 7 to 7,000 employees in those
first 9 months. We did 2.5 million
[music] vaccinations. That was another
service we did. We also lost a ton of
money on that. That was a terrible
business. We're cutting about 80% of our
SAS spend this year. What's the single
largest contract you signed?
>> Ready to go.
>> [music]
>> Brad, I'm so excited for this. Dude, you
have the most wild story and I heard it
from Justin first uh and then from Anil.
So, thank you so much for joining me,
man.
>> Yeah, thanks for having me.
>> Now, I always find it very telling
entrepreneurs often kind of compelled
either by the fear of losing or by the
thrill of winning. If I were to ask you
which one drives you more, what would
you say it is?
>> Uh, thrill of winning. I feel like
during um certainly during co with what
some of what we built at curative, I got
kind of a taste for the the speed at
which you can move when everything is
like is behind you and all the momentum
is behind you and uh I've been chasing
that ever since.
>> I mean that is the biggest tailwind that
one could have ever expected. We're
going to get to that. You actually grew
up in the UK and then you moved to
Silicon Valley very young. 17.
>> Uh 19.
>> 19. Okay. Could you have built the
business that you did in the UK?
>> No, definitely not.
>> Why is that?
>> I just think the UK doesn't have like
some of the the kind of infrastructure
for um for startups and investing of
like that many people that have kind of
done a startup before and then are
willing to invest in the next
generation. Particularly investing in
younger people. like when I found I
tried to raise a venture round in the
UK. Um, and I couldn't even get
meetings. This was when I was like I was
18. I was in like first year of college
and I was doing this startup on the side
and I couldn't even get meetings with I
think I got like one fund to take an
associate meeting with me. [laughter]
>> Naturally, it went very far.
>> Yes. And and so it just it seemed like
people were more investing like purely
on credentials. And this was a while
ago, right? This was this was, you know,
more than 10 years ago. But it seemed
like people were investing just on, oh
well, you came out of this university.
Um, so if you, you know, you're an
undergrad, like, how could we possibly
look at this? This doesn't make any
sense. Whereas you go to Silicon Valley
and it was like, well, what's the
possibility here? What could you
envision in 10 years if if everything
succeeds? Like, how big a company could
this be? And it it just it was a very
different mindset that they were
optimizing for how to get the best
outcome rather than I always felt like
in the UK it was sort of optimizing for
like mitigating the the worst downstream
outcome.
>> Yes. How do I not get fired,
>> right?
>> Yeah, I totally get that. Um [laughter]
that's pretty funny. Um okay. And so we
decide to move to the valley. Great. Um
>> how does because we go from sepsis
detection. No. Well, cows to sepsis to
>> Can you just walk me through how we go
from cows to sepsis to co just so I
understand this?
>> Yeah. So, my first company that
>> I've never said that statement before in
a 20 VC episode, by the way.
>> There we go. It's a new a new phrase for
you. Yes. So, um I went from initially
cattle testing uh through sepsis to to
co. So it started off my first company
in the UK which was called TL Biolabs at
the time basically sequencing dairy and
beef cows to predict various traits
about the animal from an early age. So
it started off with beef you can predict
that certain cows are going to have more
musculature um from an early age and
some cows can have too much musculature
and then they have trouble giving birth
and so there's like an optimum that
you're shooting for um and I found this
like completely by chance. I won uh the
UK National Science Engineering
Competition and um like was on TV a
little bit and this farmer reached out
to me because he wanted help testing his
cows and he was sending his samples to
the Netherlands and it was taking weeks
and it was terrible. And I initially
told him like I'm not interested in
cows. I was interested in human genetics
at the time. Um like no thank you. Um
and then he kind of kept pressing and he
like sent me samples with a check
attached to the front and I was like oh
okay like this is interesting. And so I
did the first batch of samples for him
and then all of his friends started
sending me samples. And so it kind of
grew from there. And this was all still
in the north of England. I was in the
first year of of college at the time. Um
and uh we started branching out into
dairy and predicting how much milk
animals would make. And I tried to raise
uh the first venture round for the
company in the UK. Didn't get very far
and so ended up uh going to the US for
the US ACT investing conference in San
Francisco. It's my first time in the
States, never been before. Um, and I was
like my last ditch attempt to try and
raise some money. And I met a bunch of
VCs. Didn't raise any money, but I did
meet a guy who had just finished doing Y
Combinator. And he was like, "Oh, you
need to apply to YC. That's like that's
what you need to do. You need to move
the company to the US. You need to apply
to YC. Like that's the only thing you
can do here." Um, and I was like
familiar with YC uh but had never
applied.
>> What year was this? This was like the
end of 2015.
>> Okay.
>> Yeah. So, I went back to the hotel room
and it turned out like the application
deadline was 6 days away. So, I was
like, "All right, it's meant to be." So,
did the application, you know, got the
interview, came back for the interview,
uh, and then moved to to Silicon Valley
for the summer 16 batch.
>> Paul, so how was the interview? Who was
it with?
>> Tim, Jeff, and somebody else. Yeah, it
was I mean, it was all a bit of a blur.
It's very fast.
>> And then you found out you get in.
>> Yes.
>> You moved to the valley. moved to the
valley and then it was the same, you
know, pitch the same company. We were
doing uh mostly dairy testing at that
point. So testing dairy cows to try and
predict uh their milk yield, which for
farmers is actually very valuable
because they don't make milk until
they're 18 months old. And so from day
one, all your animals have to have a
cough every year to keep making milk. So
your herd doubles every year.
>> Is this still the same curative company?
>> No, this is a completely different
company.
>> Okay. I was about to say, god my this is
where investing is so difficult because
like if you hear a founder pitching milk
yield optimization [laughter] and I'm
sure it is like logistically a big town
I'm sure
>> well not big enough that was the
problem.
>> Okay.
>> Yeah. So so we did this went to YC and
we raised a seed round from Andre
>> a seed round from Andre. Yeah, their
their bio uh fund uh did our seed round
right out of YC. Um and I don't think
they did the TAM calculation.
>> Um
>> they backfound us.
>> Credit to you.
>> Yeah, they they were like, "Oh, this
sounds interesting." And they did the
round. It was a small round. It was like
1.65 million. So
>> chum change.
>> It was for the coffee.
>> It was, you know, for for Andreason, it
was like a smaller round.
>> Sure.
>> Um and so we kept developing the
technology. We had customers. Uh, and
then we went to go raise an A. And then
people did do the TAM calculation and
there's about 100 million cows in the
US. If you're doing well, you could
charge 15 to $20 per test. So even if
you assume you could test every cow
every year, you'd be at 1.5 billion like
total market, which is not enough to do
a series A off of. And so what we end up
doing is taking some of the core DNA
testing technology that we had developed
and pivoting and using that for human
diagnostics. And so that was my kind of
first foray into healthcare. Uh we
actually first launched a high
throughput STD testing lab. Um yeah,
which was and we launched an at home STD
test. It was that was tons of fun.
[laughter]
>> I don't I used to run a lot when I was
young and my knees were wonderful. Uh,
and I used to love how I built this cuz
they would ask the questions like this,
which is like, how do you go from like
cows and musculature on cows and milk
yield optimization to at home STD
testing? [laughter] Like, it doesn't
feel that natural a jump.
>> Yeah. On the back end, it's more
natural, right? All of these things have
DNA in them. And so, if you're if you're
looking to do better DNA testing, you're
just looking for markets where people
care more about that. and anything human
people obviously care a lot more about
are more willing to pay for and are much
larger markets. And so we sort of did
like a market first approach of, you
know, where where could there be
interesting things and we narrowed in on
uh antibiotic resistance in STDs as
being like a particularly interesting
area where they're getting harder and
harder to treat because you get more and
more antibiotic resistance. And if
you're doing the DNA testing, you can
predict what the best drug is going to
be early, treat with that drug, and then
you're not using the most aggressive
antibiotics.
>> Do we have more STDs than ever?
>> Yeah. Yeah.
>> [laughter]
>> This conversation's pivoting somewhere.
I didn't expect but I thought we were
having less sex than ever.
>> Yeah, but more STDs.
>> Wow.
>> Yeah,
>> that's worrying.
>> Yeah, it is. And and well, it's a while
since I looked at the statistics because
I've not been doing this for a while
now. Um but when I was like last in this
Yeah. The statistics were just kind of a
like steady increase and then an
increase in resistance. And so it's
getting to the point where certain STDs
are like harder and harder to treat and
some of them might eventually become
untreatable or like you have to be
hospitalized to get a certain really
powerful antibiotic to treat it which is
crazy. Um and so antibiotic stewardship
was a whole thing. And so we did that
with STDs [snorts] and then [laughter]
I love this conversation keep. And then
[clears throat] and then we found a
fascinating market in sepsis. Um and so
sepsis is a disease that kills hundreds
of thousands of people a year. It's
basically where you get bacteria in your
bloodstream. And what kills you is not
actually the bacteria. It's your own
immune system. So, you're not supposed
to have bacteria in your blood, right?
Your blood is supposed to be sterile.
And when bacteria get in there, your
immune system kind of freaks out and it
triggers this whole downstream cascade
where your blood vessels start to leak
and all of your organs start failing and
it's basically really bad. And that's
what kills you is your own uh immune
reaction to the bacteria rather than the
bacteria. And so this is, you know, one
of the leading causes of death in the
US. Often if you're dying from something
else, like if you know, you have serious
cancer, it'll be sepsis that ultimately
ends up being what kills you. Um because
you get more susceptible to it uh with
other diseases. And so it's leading
cause of death, like increasing
mortality. It's incredibly expensive.
Outcomes are terrible. Um and so we were
working on basically a better testing
technology where from the earliest date
uh you could detect these bacteria and
what antibiotic they are going to be
susceptible to and treat people faster
because with sepsis basically every hour
that you don't treat somebody is about a
12% increase in mortality. So you want
to get the treatment as soon as
possible.
>> Every hour you don't treat someone is a
12% increase mortality.
>> Yeah.
>> Okay. And so we start the sepsis
testing.
>> So start the sepsis testing. And so this
>> does it instantly go well?
>> No. So this company died at the end of
2019.
>> Oh, I'm sorry.
>> Yes. So, uh, we went to the testing was
working great. Prototypes were, you
know, pursuing the FDA approval process.
We went to do a series B round, uh, with
ended up being a strategic.
>> Sorry, just so I understand. So, we
raised the A from A and it's still the
same company as this milky.
>> Same company. Yeah. It changed its name
from TL BABs to Shield.
>> Oh, love it. Good. It's a good single
name. Okay. So, we go to raise the
series B, bigger TAM, sepsis, death,
more bigger
>> TAM gravitas. Yeah. Many many billions
of dollars TAM uh for testing for this
and ended up getting a term sheet from a
strategic uh large public diagnostic
company. Signed the term sheet, did
three weeks of of work on docs. We were
in the second round of docs and then
their CEO killed it because it was too
competitive with their core products.
Meanwhile, we told all the investors
that, oh yeah, we've got the lead. We're
good to go. Oh, here's the paperwork.
And so, uh, that was the death of the
company. It had, we had about 3 weeks
worth of cash.
>> Would you be where you are today,
though, if that round had come together?
>> No. No. Cuz I don't think we would have
pivoted as hard into CO when CO hit. Um,
I mean, it would have probably been
easier cuz we had at that point, we
actually had a lab license. So, you
know, in the US, you need this thing
called a clear license to run these kind
of tests. And we had got one of these
licenses over like a painstaking
two-year process. Uh, and then in
December of 2019, as part of the
windown, I sold that license to a
company in San Diego for $150,000
uh to pay some of the creditors and then
5 months later acquired a company in
Southern California to get the same
license for 27 million.
So, timing is everything.
>> Whoa, whoa, whoa, wait, wait. So, we're
winding down the company and we sell
this license for $150,000,
>> which is it roughly its market value if
there is not a pandemic.
>> Totally get that. Cool. Okay. And so,
we're winding down the company. I want
to go chronologically cuz that's like a
wild [laughter] number like flies in
shutting down the company in 20 now 20 I
guess.
>> Uh it was Yeah. kind of right at the end
of 2019.
>> Okay. End of 2019. Shutting down the
company strategic alle [ __ ] that.
[snorts] Um
>> and then what happens then? So then I
was kind of looking at what to do next.
Um, and
>> were you like personally devastated?
This is five years of your life. Yes.
Any lessons for founders? Reflections on
that?
>> I think it's a lot easier to build a
company the second time around. Like
there's so many mistakes the first time
where you just you don't know how to do
like thing X, like the first time you
fire somebody, like how to build a good
interview process, how to build a
pipeline. Like there's so many things
that it's really easy to screw up the
first time around. And then when you've
seen them go wrong, it's so much easier
to build it the second time around. And
so like, yes, it's the worst thing in
the world to go, you know, to go through
is having something you poured all that
time and energy into and like, you know,
the 7-day work weeks and the late nights
basically go to zero. But you learn as
long as through that you you learn and
you take those lessons and you go solve
an even bigger problem, I think, you
know, you got something out of it.
>> Okay. And so this company is like
winding down,
>> need to find something else. What
happens now?
>> Yeah. So originally the pitch behind
curative uh was we were going to also
solve sepsis but in a completely
different way. [laughter]
>> You really focused on really. [snorts]
Yeah. So
when we were going through all of this
work with the sepsis diagnostics, one of
the things that kept jumping out in the
data was when you look at other
companies that had tried to do sepsis
diagnostics because we were not the
first. A bunch of big pharma companies
like Ro spent a couple hundred million.
Um Seaman spent a hundred million. A
bunch of companies spent a lot of money
trying to make better sepsis
diagnostics. So it's kind of this like
graveyard of dead sepsis companies. And
when you dig into the data, you find
this really interesting thing that in
academic medical centers when you try
out these new sepsis tests, they work
great and you see much better outcomes
and you see, you know, people live
longer and it's saving lives. And then
you try to replicate that in bigger
studies and they fail. And when you dig
in and look why, it's when you expand
that aperture of who's in the trial out
of the academic medical center and into
community hospitals. What's happening in
a community hospital is they're so
understaffed, they're so overwhelmed
with the volume, particularly in the
emergency room, they don't suspect
sepsis fast enough and as I said
earlier, it's every hour is 12% increase
in mortality. And the intervention that
they have to do is actually pretty
severe. They basically put a big IV line
usually in your femoral artery. They're
pumping you full of fluids. They're
pumping you full of nasty antibiotics
that have bad side effects. So, it's a
pretty aggressive treatment. But if they
don't suspect sepsis early enough and
jump to that treatment, by the time they
get there, it's already too late. And so
if you're in a community hospital and
it's 2 a.m. on a Saturday, is there
someone on staff that actually suspects
sepsis early enough or does it wait
until Monday morning?
And so it doesn't matter if you have a
better test if no one ever runs it. And
so the original pitch behind curative is
let's take the learnings from an
academic medical center and go out to
community hospitals and basically build
mini hospital in a hospital uh that just
manages their sepsis patients. So
whenever they get somebody you know we
will diagnose them as having sepsis out
of the emergency room. We will then take
on that patient. They would pay as a
fixed fee. So no matter what happens
we're on the hook. If we can drive a
better outcome by applying mostly just
getting doctors to follow the
instructions but at scale then you could
drive better outcomes um by getting
those academic medical center type um
like clinical results but helping a
community hospital actually do that.
>> So what happens then we we start that
business
>> start that business we raised uh a
million dollars of seed money. Uh Justin
was the first investor you mentioned at
the beginning Justin Matine. Uh he came
in uh right as I was shutting down
Shield. He was an investor in Shield. Um
and he wanted to put more money into
Shield. And I said, "No, I I don't think
you should do that. I think that company
is is, you know, is not going to make it
unfortunately, but I'm thinking of
starting this new thing." And he was
like, "Yes, I'm in." And he didn't even
know what it was.
>> How much did he put in? He
>> put in, I think, $125,000
uh at a $3 million valuation. Wow.
>> So, he was the first
>> Okay.
>> First money in.
>> First money in. Love it.
>> Um and and so we had a pilot set up with
a first hospital in Wisconsin. This was
a clinician that we'd worked with
before. He was really enthusiastic. And
then we got a call from his assistant
saying this is all on hold and I can't
speak to you for at least 3 months.
>> Huh.
>> And we were like, that's really out of
character that he wouldn't at least call
us or text us or that he's having his
assistant. And when we dug in, they were
getting ready for this thing called CO
19 that they were expecting to see the
first patient in their hospital. And so
that was the first inkling for me of
like, oh crap, this is going to be a big
thing. This is going to be bigger than
people think it is. And so they were
shutting down the entire hospital. And
so it started off for us as like, okay,
well, we can't run our clinical studies.
We can't actually launch this product
because all the hospitals are on
lockdown. maybe we can go help out with
this testing thing for a couple of weeks
until all of this blows over um and then
we'll go back to sepsis.
>> And so at that point we're like we've
move into CO 19 testing.
>> Yes. Yes. And so it all happened quite
quickly from like a lot of me saying no
no no this is not going to be a thing
like don't worry about it like just it's
>> What was the moment where you realized
like where were you like this is
substantially going to be a real thing?
So, I was like in my apartment in San
Francisco looking at some data that I
think was on Twitter. Um, and and I was
like, "Oh crap, if that if this
continues at this rate, like this is
going to be way more substantial than
people realize." And so this was
probably midFebruary. Um, and so then I
started to reach out about sort of
setting up testing capacity uh to well,
first of all, we had the problem of
finding a lab license cuz I just sold
the lab license. [gasps] This was the
150 grand you just sold.
>> So just sold the lab license and so we
didn't have a lab anymore that was
capable of running these kind of tests.
We had a test. Um so our chief
scientific officer at at Curative had in
his spare time developed a COVID test.
And one of the things they' done at a
previous company is they developed one
of these flu tests and just offered it
to employees to make them feel better.
And so he said, "Hey, can I develop a
COVID test? I don't think it'll be very
useful, but it might make our employees
feel good, and it's like a good training
exercise for the team. And so, they had
worked on through January and the early
part of February a COVID test that
they'd been developing uh basically in
their like spare time in evenings and in
weekends. And so then when everything
started to really take off, we actually
already had the test. What we didn't
have was a lab to deploy it in.
>> And so at that point, you then go back
to the old one and buy it for 27
million.
>> No. So I bought a different lab license.
you bought a different lab.
>> So, we reached out I reached out to a
bunch of people I knew in the Bay Area
that had facilities with this kind of
license. Nobody wanted anything COVID
related on site. Nobody wanted, you
know, anything to do with it. And so we
um I like put it out I just put out an
email to like everybody I know. Um, and
there's actually a guy who uh was in the
same YC batch as me um who had become a
VC and he uh connected me to a group in
LA and they had this license and they
were using it for like uh sports doping
testing and they were in what I thought
was LA. I remember telling Justin, "Oh,
Justin, I'm going to to LA. I'll be in
Sand Deas." And he was like, "Where the
hell is Sand Deas?" It's like basically
very far east of actual LA. It's still
in LA County. It's a little city uh best
known for uh Bill and Ted. It's a little
town of like 30,000 people.
>> And that's where the lab test
>> and that's where the lab was. And so I
flew out there to look at that lab. Uh
this was from uh from San Francisco. And
to look at one other lab license that
was I think affiliated with um with one
of the universities and you know they
had a good space, they had this license
and they were doing pretty minimal
testing. So they just kind of like a
blank slate. And so it started off as a
50/50 JV between Curative and this
company that had the lab license. And we
would bring the test, we would bring the
expertise, they would bring the license.
And it became pretty clear quite quickly
that they didn't have the expertise to
scale it up. Like they were actively
getting in the way of scaling it up. Um
and so we
>> What did you do?
>> We bought them out
>> and that was that was the 27 million.
Where did you get 27 million from?
>> Uh forward revenue from customers. So we
were getting paid. We had our first
testing contract. We were doing the uh
police and the fire department.
>> And so how do you do you have the chief
science officer who's created this
brilliant task kit?
>> Yep.
>> And you go to like San Francisco state
or government.
>> So this is mostly Yeah. And so actually
our very first customer was the sheriff
department in Sand Demos. Well, we did
some like private testing for
individuals that were paying for the
tests. But our first, you know,
government customer was the sheriff's
department in Sand Demus and that came
about because they got wind that we were
setting up a CO lab because people were
freaking out about it in the town. And
so one of their sheriffs reached out to
me on LinkedIn and was like, "Hey, what
are you guys doing?" Um, and so I
connected with him and I explained what
we're doing and how it was very safe and
how we had this way of deactivating the
COVID as soon as it went into the sample
and so there was no live virus on site
and we were not presenting a risk to the
community and actually this was going to
be a good thing and we're going to be
hiring a lot of people and kind of got
him on board that you know we're doing
we knew what we're doing and we're doing
this in a safe way. And then he was
like, "Well, well, we really need
testing." And then the fire department
wanted testing. And then our first
really big contract was the city of LA.
And that came about from a tweet. Um, so
we had uh Laura Deming
>> who was a
>> Yeah, I remember she's YC uh longevity.
Yeah, exactly. So she um you know was
was a friend and would trying to
basically help with the pandemic. And so
she actually drove me down to LA with a
car full of PCR machines um so I could
like work on a laptop and she helped
with a lot of the early development work
and she tweeted, "Hey, we've got CO
testing capacity. Does anybody want some
deputy mayor of LA slid into her DMs
and was like, "Yes, please. We would
like to talk about that."
>> Wow.
>> So that was how our first big contract
came about. And so you speak to
[laughter] the deputy mayor of LA.
>> Yeah. And then so they were doing a
pilot. They said, "Look, we got a couple
of labs. You know, you're going to have
to demonstrate this." Because we were
complete unknown, right? We' done
>> And co wasn't peak ramps now, was it?
This was
>> This was like early March. So people
lockdowns had just started. Everybody
was starting to freak out. There was
basically nowhere to get a test. Like
you unless you were ultra high risk and
in a hospital, there was pretty much no
chance you were getting a test. So
everybody was freaking out. This is when
everybody was still like cleaning their
um you know supermarket bags with wipes
and nobody knows what's going on.
Everything's shutting down. Um it wasn't
so bad on the West Coast, but New York
was like was really bad already by this
point.
>> And so they're paying ahead of time. So
the best thing we could get with the
city of LA because they have obviously
their city there are certain
restrictions is that they would pay
after delivery but they would pay net
one on the invoice. And so we would
deliver the tests for a day and then we
would send somebody to city hall the
next morning to pick up a check for
those tests.
>> Wow.
>> So the tests had been done. They were
paying after we delivered them. Um but
which was not you know your standard
like net 30 [laughter] or net 60 for a
government contract. They were having we
were invoicing them every day for the
number of tests they did and they were
having somebody in their finance
department like get us the check because
we needed that to pay for supplies to
basically grow out that testing capacity
for where they wanted to be.
>> What's the single largest contract you
signed?
>> Probably one of the Florida contracts
was maybe the largest. So we did a
contract with the state of Florida for
all of their nursing home testing. Um I
forget what the dollar figure was, but
it was, you know, in the hundreds of
millions of dollars. And so we were the
they put it out out to bid and we won
it.
>> Hundreds of millions.
>> Yeah. They tested every employee at
every nursing home across the state once
a week for a 3-month period. And so they
did a great job of basically keeping
things open, keeping these nursing homes
open, keeping visitation, but making
sure that the employees of those nursing
homes were not spreading COVID to the
people in the nursing homes. Um, and so
they wanted to test every single
employee that was working at those
nursing homes and then exclude the
people that weren't uh that that had
COVID so they weren't exposing the uh
the residents there. And so we ran this
big program, a bunch of labs or they put
it out to bid and everybody said, "No,
that's too crazy. Like that's
impossible. We cannot possibly test that
many facilities with that tight a
turnaround time. Like this is
impossible." And we bid. We're like,
"Yeah, we can we can do that. We'll make
that work." Um, and we delivered it.
What did you see that others didn't?
>> That you have to kind of scale like
something like that up from scratch that
the existing labs like the lab industry
in general is a very low margin industry
and it's built on efficiency. You look
at the big labs, the Quest and Lab
Corpse and they are ultra efficient
machines. Like they're some of what they
do with automation is incredible. But if
you're asking them to 10x capacity,
that's literally the opposite of what
they're built for. they are built for we
will get 1% extra margin by optimizing
this bit of the process over here so
that it is perfectly efficient and they
are really good at that but if you ask
them to 10x that it really doesn't work
and the mindset isn't there the people
don't know how to scale those kind of
things up all of the supply chain broke
down and so we basically said okay start
from scratch throw all of that away
imagine that you're going to have to
scale this up to hundreds of thousands
of tests a day where do you start and so
we built what we called an orthogonal
supply chain which is just basically a
fancy way of saying we don't use the
things other people use
>> sound like a Mackenzie consultant
specializing in innovation an orthogonal
supply chain yeah great
>> well I found that was like a good fancy
word that like you know was helpful from
a sales
>> stand
what it basically means is everybody was
chasing the same uh consumables the same
supplies everybody was trying to use the
same stuff and if if you know you can
make 1x of that maybe they can increase
to make 1.2x. If everybody's trying to
buy that, us also trying to buy that
doesn't help. That doesn't net increase
the number of tests being done, right?
It just makes us all squabble over it.
>> So that's pointless. So you got to find
other ways of doing the testing using
supplies that maybe wouldn't
traditionally be used for this kind of
testing. Um, so we were sourcing swabs,
you know, from other types of vendors
that were being used for, you know,
electronic testing and then sterilizing
them. we were sourcing. There's this
kind of extraction material that you
usually use and magnetic beads is kind
of the default standard, but there's
this other way of doing it with filter
plates which is more scalable because
it's basically just glass and plastic
and you can scale that up faster than
you can scale up magnetic beads where
they all come from basically two
factories in China. And so we're like,
okay, we should never use magnetic beads
because that's not going to scale as a
technology. we need to go find vendors
who can scale up the plastic and glass
manufacturing and partner with them to
basically 10x it. And so you kind of
approach every single bit of the supply
chain that way. You end up with this
massive scale. Now, outside of a
pandemic, that doesn't work because
people don't want 10x more testing than
they wanted yesterday. But within a
pandemic, you got to approach it
differently. And so we peaked, I think
our peak day was 26,000 people tested in
a single day.
>> 206,000 people tested in a single day.
And that was December of 2020. So that
was within
eight months from zero zero to 26,000.
So and the company went from about 7 to
7,000 employees in in those first nine
months.
>> 7,000 employees in 9 months.
>> Yeah. [laughter]
>> Yeah. It was it was a little crazy.
>> Do you sleep at all? I mean
>> I don't sleep very much now.
>> But like in that time, what was the
craziest thing that you did?
Um, I mean some of the hiring, you know,
you have to get licensed people for
certain roles, but other like more
administrative roles, you don't need
licensed people. And so we would
literally a lot of people wanted to work
on the pandemic, which is very helpful.
We'd have people like line up in the
parking lot um, socially distanced like
down the street and then give them five
minute interview slots and just have
somebody sit there with a clipboard and
it's like 5 minutes and next just to get
the volume of people um, in the door.
>> How much money did you make from co
testing? I think the total revenue ended
up being about five billion over a
three-year period.
>> Five billion. Is that the largest
private provider?
>> We were Yeah, we were the largest like
non-labcest
testing company.
>> That is extraordinary. What is the
margin profile on a co test?
>> So really good during surges and then
really bad not during surges. [laughter]
Um, so what we found was when when there
was a peak, right, so we get a new
variant or, you know, this usually
winter was the biggest peak, but then we
started having these summer peaks, which
was kind of weird. Um, everybody would
run to get tested. Um, and these were
all public testing sites. So these were
in parking lots. These were the
drive-through tests. That was what we
were doing. So if you went to a
drive-through testing site, like the
biggest one was the uh Dodger Stadium
site in LA. It was seven lanes of
traffic, 7:00 a.m. to 7:00 p.m. 7 days a
week.
So they were testing at the peak about
10,000 people a day coming through their
cars getting tested and coming back to
the lab. So when you're at peak capacity
and you're filling all of the labs
volume,
it's very profitable. Then those uh
basically surges subside, right, and you
end up back at testing, you know, using
20 or 30% of your capacity. All your
fixed costs the same. You're still
paying 7,000 to people. Now you don't
have to buy as many consumables, but all
of that infrastructure has to be
maintained for the surge. And so this is
again where it's like the opposite of
the traditional lab industry where they
have a very flat volume. Every year
people do roughly the same amount of
blood work as they did last year or
maybe do like predictably slightly more,
but it's it's within a couple of
percentage points. here you're kind of
building it for that peak capacity
and then during the lulls like
maintaining that capacity is incredibly
expensive and so it was kind of
necessary and this was part of the way
it was set up they increased the price
the reimbursement price uh that they
were paying for these tests because they
needed to incentivize the capacity to be
built because if you don't build that
peak capacity then when you have a surge
it all goes horribly wrong and no one
can get a test but that means you
basically have to pay to overbuild
Because during the dips you have to have
that capacity. You can't just shut it
down, right?
>> And you can't build up 7,000 in 24 hours
in
>> and so you need to maintain that. And so
we would lose a lot of money in every
one of the dips basically.
>> Well, you would actually lose money.
>> Yeah. Yeah. Yeah. We would lose money on
every test during the dips.
>> Oh wow.
>> Yeah.
>> So of the five billion, how much is
profit? So after all was said and done,
the money that we basically put forward
into the uh insurance business, the
health insurance company was about 500
million that we invested into the health
insurance business.
>> It's absolutely astonishing.
>> Yeah.
>> Can I ask you when we saw the vaccines
roll out, did you know they were
ineffective in the way that they've kind
of turned out to be? It was not clear at
the beginning and I think also it's it's
sort of changed like that when nobody's
had any exposure to co being vaccinated
probably provides a lot more benefit
once everybody's sort of had co a few
times then the vaccines benefit is much
less because you've already had it also
the varants got weaker and weaker uh
when we were first rolling them out I
mean I think in you know December of of
2020 there was benefit for a lot of
people getting the vaccine
>> did you get vaccinated.
>> Yes, we did that. We did 2 and a half
million vaccinations. That was another
service we did. We also lost a ton of
money on that. That was a terrible
business.
>> Why?
>> Um because the government wasn't paying
enough. We lost money on every single
dose. It cost more to administer them
than we were getting paid. So
>> why did you do it?
>> Uh giving back. A lot of our partners
wanted it. So a lot of the partners on
the government side we're working with
for testing also wanted us to administer
vaccinations.
>> Was it sounds awful? Was it a hard like
your business with co obviously being
eased
>> Yeah.
>> completely changes
>> and you have to pivot again.
>> Yeah. And so that started very early for
us cuz I wasn't going to last very long.
>> You were always aware it wouldn't last.
>> Yes. When we started hiring people at
the beginning, we told them this is 3
months. You have a job for 3 months.
Like don't bank on anything beyond 3
months. This is a three-month gig and
we're going to shut it all down in three
months. Um, so the the CFO and now the
president of Curative joined at the
beginning and for her it was going to be
a six-month gig. [laughter]
Um, she came out of retirement to help
with the pandemic for 6 months. Now 6
years later she's still here. But um, it
was supposed to be temporary and every
time you know a surge we got through a
surge I was like all right that's it.
It'll be over now. And then they just
kept happening. [laughter]
So, we started looking at kind of what
comes next middle of 2020, like really
early. Um, yeah.
>> How did that search for what comes next
change? You just started looking at
middle of 2020. It's not until end of
22, start of 23 when that actual search
is activated into real-time plan.
Correct.
>> Yeah. I think we started probably like
late 21 is when we got really serious
about health insurance. It just took a
while to actually get the license.
>> Yeah. Why health insurance?
>> Well, it wasn't the first idea. We
looked at a bunch of other stuff. We
looked at other stuff in the lab testing
industry. Unfortunately, it's just not
that big an industry. And so even like
we had this interesting technology that
could theoretically let you do a lot of
lab tests that are individual tests
today like as just one single test,
which would be scientifically quite
cool. But even if you say, okay, I'm
going to displace all of LabC and Quest,
that's about 30 billion of market cap.
So that's like the largest company you
could possibly build is about 30 billion
which that is a big company but coming
out of what we did with co I wanted to
build a much bigger company than that
and so there's just not a big enough
market in lab testing um so the lab
testing was was out and then we briefly
looked at trying to buy a hospital
um or multiple hospitals we looked at
one in Florida and we looked at one in
Texas and the idea was well if the
hospitals kind of like the the health
system becoming the center of where care
is delivered, they buy have bought up a
lot of the primary care offices. Um, if
you can transform that with technology,
can you drive much better outcomes? What
we ultimately decided is it doesn't work
that well because the payer mix is too
broken up. And so, as a hospital, your
customer is like 50% the government and
then a whole bunch of like split up
smaller insurance plans. and they all
want different things and they change
their mind every 5 minutes about what
they actually want and you're trying to
like keep them all happy. So your
ability to really change things from the
hospital side is quite limited is what
we ended up deciding. Um and when you
come back to it like we looked at a
bunch of preventative care things we
looked at a primary care chain
everything sort of ends up coming back
to the payer like the payer is the one
that drives behavior in the US healthare
system. If you are providing the dollars
people will go where the dollars are. If
you say I'm gonna pay for this service,
people will go do that service. If you
say I'm not going to pay for this,
people will stop doing that. And so the
payer is the one that's kind of driving
things.
>> If you could do one thing to change the
structure of the US healthcare system
today, magic wand, what would you do?
>> Um,
I think you have to break up the
negotiating into smaller units. like
it's gone to this point where I think
it's it's quite an efficient system as a
market when the counterparties are small
when everything gets very consolidated
it becomes incredibly inefficient. So
when we look at for example health
systems right so we pay for for care at
health systems
some of that care you can get in other
places if we look at how much we'd pay a
primary care doctor who's independent
compared to a primary care doctor
affiliated with a system affiliated with
a system they get paid an average double
same service
you know same credentials it's just that
this one is part of a hospital system
and that hospital system will use the
fact that they
have a ton of beds that They have this
ultra special surgery center that you
need like we need to have that capacity
in our network because some people need
to be hospitalized, some people need
those services that if you want to get
access to that, you got to pay me double
for my primary care doctors.
And so when all of the players are
small, when you have smaller payers and
smaller hospitals, you end up kind of
getting to reasonable negotiations.
What's happened is you have these
massive payers like the market is ultra
consolidated. You basically have like
four large players that control the
entire market on the payer side and then
you get these ultra consolidated
hospital systems because that's the only
way for them to survive if they want to,
you know, fight with Blue Cross. The
only way to survive is to get really big
so they have the negotiating power and
then they just reach these loggerheads
where nothing gets done and everybody's
overpaying for everything and
everything's inefficient. And when you
have more competition in the market,
more smaller payers entering more, you
know, smaller health systems, you start
to get like an actual efficient market.
When you're just negotiating for like,
hey, I have a third of healthcare in the
state and I have a third of all of the
employees in the state. It's not an
efficient market anymore because there's
no alternative. You h you must reach a
deal.
>> If I am sick, is the best place to be
treated in the US?
>> Yes, definitely.
>> Seriously.
Yeah.
Yeah. We have the US has the access to
by far the most cutting edge techniques
and facilities and drugs than the rest
of the world and they're willing to
spend a lot more.
>> What do you know now, sorry, that you
wish you'd known when you made the pivot
into insurance? I think I wish that I
knew AI was coming
because I think like the way we designed
the business in 2022 when we first
started, we had no idea that this wave
of AI and LLM was coming. Like we were
building a health insurance business
because we thought it was a good
business to build and we thought it
needed to be built. We needed a better
alternatives in the market for health
insurance. And then in the last like 18
months, how we do pretty much everything
is now a completely different workflow.
And we there's so much I mean all health
insurance does is like moving bits
around, right? Like we don't have a
physical product. We give you a little
plastic card, but apart from that our
product is that we move bits around in a
database that means care is paid for.
>> That's it, right? And we do a lot of
managing kind of managing a marketplace.
We work with the providers to negotiate
prices. We work with employers to
negotiate how much they pay and then we
try to work with employees to keep them
healthy. If we can get people to stay
healthy, we can avoid the long-term
downstream cost of care. Essentially,
it's marketplace business. Um, and that
has been fundamentally like shifted by
AI. But when we first started building,
we didn't know that was coming
>> by AI.
>> So, so much of that back office work,
right, has been completely changed by
AI. There's we now have entire
departments that used to be people like
rubber stamping things. Um the first one
that went to zero people was our
credentiing department. Um where you
know this is a process that's incredibly
labor intensive where you have to check
all doctors that join our network have a
valid medical license and aren't being
sued for malpractice. And this is, you
know, a person going to the medical
board website, checking that the license
record is there, checking transcripts
from their school, checking like a
database of of who's been sued by who,
um, and then like rubber stamping. And
that used to take us two to three months
on average and cost about $50. We've now
built in-house an agent that runs on on
Claude that does this end to end. and it
goes to the website, it verifies the
license, it goes and reads the
transcript, it puts it all together, it
stamps it for approval. Um, and we're
now averaging about 12 hours turnaround
time for credentiing somebody. And it
cost us about 20 cents. And so this is
like a mind-numbing process that payers
have to do, which is important. We want
to know the doctors in our network,
right, are are validly licensed to
practice medicine. Um, but it's like
historically has always been kind of
terrible and payers have been bad at it,
right? If you're a doctor and you join a
network and it takes 3 months before you
can see any patients. It's just
bureaucracy, right? Like they don't
Doctors hate that and it's not actually
adding the value that it should be
adding. It's just creating paperwork.
>> How many people did you have in
credentiing?
>> That one wasn't that large. I think
there was like five or six people. We
had a few other departments that have
shrunk more than that with the
>> What other departments? We've seen a lot
on the claims side, claims processing,
right, is used to be a very manual
process where claims comes in and people
are like manually tweaking and editing
it. Um, and also on the underwriting
side, underwriting, you know, the
process used to be uh a broker comes to
us with a group, an employer that
they're looking to insure and they ask
for competitive bids from multiple
different insurance companies. And what
that means is basically sending us an
email with a bunch of PDFs and
spreadsheets attached of who are the
employees, what current claims do they
have, what's the current insurance look
like. And you'd think that over time
they would develop like a standardized
format for how that should run, but no,
every single one is like a different
spreadsheet format, different PDF. And
we tried to sort of solve that problem
with software and build like universal
importers and universal intake. And it
like it kind of worked, but what we
found works amazingly is literally to
give the files to an agent, tell it to
write Python to get these files into a
standardized format because they're not
very good at parsing files. But they're
incredibly good at codegen. And so you
can tell it to write a Python script to
convert any random file into this known
format and then test it and loop and
iterate on your script until it's
working. And then you throw away that
script. And so it's single use code that
never gets used again. and you just
generate that code one time and then
throw it away. Um, and that works so
well. And so now brokers, providers,
employers, when people are sending us
files, we always used to like insist,
oh, you have to use our standard format
for this. And they'd hate it and they'd
get mad cuz somebody's sitting there in
a provider office like manually
reformatting these files into our
spreadsheet. Now send us whatever you've
got, whatever format. It can be
scribbles on a napkin, it doesn't
matter. The model will figure it out.
The model will convert it into our
standard format. and it will do it in
about 15 minutes. And so you build these
data ingestion pipelines that used to be
hundreds of people sitting moving
spreadsheets around and it's now a model
writing Python code to do that same
thing and then every single time you
throw that Python away and start from
scratch.
>> Dude, I have so many questions to ask on
the back of this. The first one is you
mentioned there kind of the internal
agent buildout that you've done for the
company and for your specific processes.
Yeah.
>> Do you buy the SAS is dead theory that
we will
>> Why?
>> Because I see the number of contracts
we're canceling.
>> Like we we just recently canceled our
Salesforce contract because we have an
internal CRM that was built, you know,
was vibe coded, that is working better,
that is managing our process better, um
is more integrated into what we're
doing. We run our agents inside of it
and no one was using Salesforce anymore.
$600,000 a year.
>> Wow.
>> Gone to zero. How long did it take?
>> Two months.
>> Is it worth because argument back I
always like to do both sides. I'm never
Is it worth the engineering hours to
vibe code that and then to maintain it?
>> The maintenance is is definitely one of
the most challenging pieces. Um I agree
with that. I think for most businesses
of of any reasonable scale, yes, it is
worth it. Now whether they will have the
tech resources to do that soon, I think
that's like the bigger question is kind
of when will this happen? But when you
build those things custom to your
workflow, they work better. Like most of
these big, you know, systems, you're
paying an administrator. Like we had a
full-time Salesforce administrator,
right? You're paying people whose sole
job is to manage this like archaic
software platform. Not that Salesforce
is archaic, but you know, we have a few
other like internal apps that we were
paying for like industry software that
is taking multiple FTEEs to maintain it.
You can transition that into one great
engineer and then whenever you want a
custom feature, you just go build it.
>> Absolutely [ __ ] wild. [laughter]
$600,000 a year on Salesforce.
>> Yeah.
>> Wow. And so we're seeing, you know,
there's pockets of software that I think
persist because they are more
infrastructure based.
>> Okay. Which persist?
>> So we're seeing a lot of backend stuff
like uh like Sentry like stuff like
that, right? Where it's like kind of
become part of your infrastructure. Um
Slack has been like notoriously hard
internally for us to like too many so
many people have built integrations and
like workflows that are now working in
Slack. Uh, I think that while they keep
putting the prices up, if they put the
prices up too much, then eventually
it'll make sense to replace that. But,
um,
>> what else is on the chopping block?
>> We we're cutting about 80% of our SAS
spend this year.
>> Wow.
>> So, we have like in in one of our
internal meetings, we have a slide of
like when when are SAS contracts due and
whose job is it to tell them that we're
not renewing this year?
>> Well, you can do it in one fell swoop.
>> Yeah. [laughter]
>> Well, they have renewals. We have to pay
them through the renewal. Ah, is it all
like legacy software like Salesforce
though?
>> Some of it's like that. Some of it's
like very insurance specific software.
Um, so like our claim system for
example, right, is this like massive
off-the-shelf platform that we just
migrated to a few years ago. This is
again why like if I'd known AI was
coming, we would have probably
approached things differently.
>> Um, and it's just it's very hard to use.
Like it's hard. Their API barely works.
It's hard to get the data out of their
database. Uh, they won't let us manage
it. It's it but that's how insurance
companies are running things and so
we've built our own claim system
completely from scratch in house that's
now uh we've migrated most of the
workflows off will be fully off in July
>> I am a health insurer you know other
health insurers
>> yes
>> I do not have the in-house capability
potentially technically to build the
agentic workforce that you are building
>> am I screwed [laughter]
>> I [snorts] think some of the biggest
insurers will struggle because they they
will not be able to keep up from a
margin standpoint with where we can get
to with agents. I think some of them do
have technical expertise. It's more like
operational and kind of people ops. If
you've built a company of 100,000 people
and in order to get this margin
improvement 50,000 of them have to be
laid off, somebody's fift just got a lot
smaller. And so they will do it slowly
over 10 years.
It will happen. But will it happen
quickly? No. And will we be able to
compete more effectively in the
meantime? Yes.
>> How do margins change?
>> Insurance is a very low margin business.
So 85% of your uh premium that we
collect must go out the door to pay for
care. So if we get in a dollar, we got
to spend 85 cents. Have to
[clears throat] by law.
>> If less than that goes out the door, we
have to give it back to the employer.
Which is another thing that's broken
about US healthcare because that drives
completely the wrong incentive where
actually from an insurance company
standpoint if your profit's capped at
15% the only way to increase profits is
to increase total spending which is not
what you want your insurance company
incentivized to do.
>> Why would I encourage people to go to
the gym eat healthily if actually I'm
not going to get that back anyway? So,
this was part of Obamacare and it's one
of the like
>> there's a lot of
>> there's some good things in Obamacare,
but there was a lot of things that I
think like the second order consequence
was not considered. It sounds like a
great PR thing to say we've capped
insurance company profits, right? That
sounds good, but it's BS.
>> It's like capping a CEO's like fiscal
base pay. Sounds great. Yeah. So, let's
just pay them 27 million in equity
compens. That's the reason why we have
such egregious comp packages for exacts
cuz they cap the equ the salary pay.
Ridiculous. With that, how's your
anthropic cost gone? [laughter]
>> Yes. So, I mean, this is one of I think
the kind of leading indicators for us is
that our anthropic cost over the last
like six or seven months has 6xed every
month from, you know, a base of, you
know, a couple of tens of thousands of
dollars now up to millions of dollars a
month. and it just keeps eventually
we're going to have to stop that
spending increase because you know it'll
get unreasonable but um we just keep
finding new things to do with it. And
then the other thing we found that's
been fascinating we're seeing a lot of
areas where it's not that we are
necessarily replacing the team. It's
that we're repurposing the team
[clears throat] and they are now so much
more productive. And so one area that
has always been like a particularly
challenging thing that makes it hard to
build a new insurance company is we have
to build this network. So the network is
all the doctors and all the hospitals
and all the people that we have to
contract with. And there's about 1.2
million of those in the US that you want
to have contracted. That ends up being
like 60 70,000 contracts that you have
to do. That's just a lot of work to go
out, get their attention, get them like
do a negotiation, get them to sign an
agreement, load all of their data and
have them in your network. And this has
been one of the biggest like pieces of
staying power of the big health plan
businesses is they built that over 100
years for Blue Cross and over like 50
years for United Sign. And so they did
it slowly over a long period of time. If
you're trying to from scratch come in
and start a new health plan, you've got
to reach out to all of those doctors and
negotiate. And so we have a team of
about 45 people who do those network
contracts and they reach out and they
negotiate. What we launched earlier this
year is an agent called Gwen.
And Gwen does the same workflow. You
give her basically a lead. Hey, there's
a primary care office over here. Uh
here's the address. and she will go
Google it, research them, learn a little
bit about their practice, um, figure out
what other payers are paying them
because there's a lot of this data out
there and these transparency files now
of how much are they getting paid. Find
their email address from Zoom Info.
Reach out to them and then basically
ping them repeatedly until they answer
her with custom emails like, "Hey, I
know about your practice. I know what
you're doing." Like customized content
to them. Uh, and then when she gets
their attention, negotiate the rates
back and forth, usually over like
multiple rounds of negotiation,
negotiate and redline the language. And
that's another place where we found
Python is great. These models are
terrible at editing Word documents, but
if you tell them to write Python to edit
a Word document, they're great at it.
Great hack. Um, and then sign the
agreement. And so she now signs the
agreements with my signature. She'll
open up the docyign link and then click
the button and it's my signature on that
agreement. And so this has taken us from
doing about a 100 contracts a week to
about 100 contracts a day.
And the last year as an entire team we
did 2,300 contracts. So far in about the
last 8 weeks the agent alone has done
3500. And so what this is letting us do
is like that team doesn't go to zero.
We've refocused that team to work on
these bigger contracts, right? Because
some of these deals we can do entirely
over email. This agent is email only.
And some of these providers will work
completely over email to enter into an
agreement. And actually, how many of
them will do the whole thing over email
surprised me. There's a lot of
millennials I guess on the other end
that don't want to get on the phone um
and would rather do the whole
negotiation completely electronically,
which is fantastic because the model is
great at that. [snorts] But some of
them, the bigger hospital systems, the
bigger doctors uh doctor groups, they
want to have a phone call. They want to
meet in person. They want to learn who
we are. And the team now get to spend
their time going and having those
inerson meetings, going and developing
those relationships, working with those
bigger groups. And then even when it
gets to the paperwork, handing the
paperwork off to the model and then all
of the smaller the individual PCP over
here, the small behavioral health
provider here, the therapist over here,
the agent just gets it done and can sign
a contract end to end in a few hours
where you wouldn't be able to do that
volume with people. Given the
transformational nature of what you're
describing, if Anthropic doubled their
price, would it impact your usage? When
we look at a lot of the financials of
these core businesses today,
>> yeah,
>> they are challenged businesses in their
current infrastructure and pricing.
>> If they double pricing, would it stay
the same?
>> If I say yes, I don't want our anthropic
rep to double our pricing. [laughter]
>> But it would
>> it would work. It would be fine. Yeah.
So, it costs with people, it cost us
about $1,500 to $2,000 on average to do
a contract. Um, the average with Gwen
has been about $70.
So it would still work fine. Um and so
that's what we've seen is like partly
why the token use has exploded for us.
>> Am I being a complete idiot then? But
then if they 5x their pricing if you
went on the labor displacement theory,
>> it would still work.
>> It would still work. I think what
they're betting and what also we've seen
is you don't just displace the labor. So
here like I think contracting is a
perfect example. We've not said okay
we're doing 100 a week so we'll get the
agent to do 100 a week. What we've done
is said, "Well, now that we have the
agent, we can do 10 times as many
contracts this year as we could do last
year. So, we're going to do 10 times and
then we're going to try and do 20 times
and we would just do a lot more volume
than you could possibly have done with a
human team."
>> Everyone's like, "Oh, I lose my job.
Lose my jobs." Do you think that's
warranted?
>> I think for a lot of these back office
jobs, yes, because
>> So, how how do we determine between I'm
just going to do more?
>> Yeah. A lot of people say with
developers, we're not going to get rid
of developers. There's an insatiable
appetite for more software, better
software.
>> That side I do agree with. I think
>> how do we determine between functions
where we'll do more versus we'll be
replaced.
>> So what we've tried to kind of
differentiate at curative is there's
like two areas where we're really
investing in people. That's technical
skills and relationships. Those are two
aspects that I don't see going away
anytime soon is we still have a team
that are actually deploying all of this
AI. They use a ton of AI in all of their
day-to-day work, right? They're not
writing any code anymore. They're not
even reading the code anymore. They're
deploying all of this with cloud code or
codecs. Um, and seeing like incredible
results out of one senior engineer now
is so much more productive than they
were a year ago that we're investing in
having those people. At the same time,
there's a side particularly to health
insurance that is relationship driven
that I don't see as going away anytime
soon. Ultimately, we ensure a member and
that member wants to be able to call and
talk to a person. We have a lot of AI
they can talk to. The AI is great. They
love talking to the AI, but there has to
be a person somewhere in the loop. We
also work with these provider groups. We
have a relationship with that provider
group that we're providing a chunk of
your revenue. You know, we work with
you, you work with us. There's a
relationship aspect there that has to be
maintained particularly for the larger
groups by a person and then on the sales
side we sell through a broker and that
broker wants to have a finalist
presentation. They want to go to dinner.
They want to go and play golf and so
what we've seen is on the sales side
like that relationship is if anything
more powerful. Do you think they still
will in 5 years? A lot of people talk
about agent agent transactions and how
that changes the process. Do you think
we will still have that heavy
relationship interpersonal cell in 5 10
years? I think on in in some aspects yes
because I think in some aspects that's
kind of becomes the foundation of trust
and it's like almost the scarce resource
right of if you want to do a deal that's
important then you're going to use your
scarce resource of people to manage that
as almost like
>> it's also the bigger the contract
>> the more important it is to have the the
whites of the eyes and the trust in the
relationship
>> and and most of these contracts right
most employers even our smallest
employers is it's a million-doll
contract at least.
>> I always think they like when you look
at accountants and lawyers and a lot of
the people who bluntly could be
replacing some of the more simple
especially NBAs or
>> but you would never not have a law firm
do it because if it goes wrong they're
getting fired.
>> Yeah. But I think I I I think you'll see
it work differently though where I mean
what we're seeing with with Gwen is we
had a contract a standard template
contract that was drafted by a law firm
and then we have kind of like guardrails
for what Gwen can agree to. But she just
redlines it and then signs it. She
doesn't it doesn't go to a law firm for
review. Like we're signing hundreds of
these contracts a day. It would be too
encumbering. It would be too slow and
they would just be reviewing with AI
anyway. So we kind of trust the agent to
do that legal review within certain
parameters.
>> In 3 years time, knowing what you do now
about the capabilities that you use it
for, how big do you think anthropic will
be?
>> A lot bigger than they are today.
>> Do you think it could be 5 trillion?
>> I think it could be 10 trillion.
>> Bugger. [ __ ] [laughter]
>> Is just extraordinary, isn't it?
>> Yeah. because I think you just find all
these new things that you can do that
you just couldn't do before that it like
wasn't possible to do. So Gwen is
sending on average 15,000 emails a day.
Customized emails to providers that know
about their practice, that know about
their work, and one of the things we
found is like that relentlessness of the
follow-up is what works. A lot of
providers will get them on the ninth
email. There's no way that a human is
going to email them nine times because
you know people that's like you have to
kind of have no shame to reach out that
many times.
>> Do you want to hear something funny? You
mentioned Salesforce. I got Mark Benny
off on the show cuz I emailed him 53
times [laughter] once every week for a
year and a week.
>> There we go.
>> I'm basically an AI model. I lost my
personality.
>> Very effective AI model.
>> That is extraordinary.
>> But that works so well in sales and it's
and and the best sales people will will
do that. But it's really hard to scale
that and you end up getting people that
reach out three times then give up.
>> Yeah.
>> And when you're trying to scale
something up if you can scale up that
relentlessness like that is really
valuable.
>> So you fundamentally buy the companies
will be inherently smaller in the future
and that's why we're seeing layoffs.
>> Yes.
>> Are layoffs today just an excuse for
overhiring in 2021 and 2022?
>> I think it's a mix. Yeah,
>> I mean I think there is definitely some
of that and you know it's also companies
are seeing valuation boosts by doing it.
So that's incentivizing maybe bad
behavior but some of it for sure is that
these workflows are changing.
>> How big are you today?
>> We're about 650 people now.
>> How big will we be in 5 years time?
>> Well, in 5 years we'll probably be
bigger. In the short term I think we're
going to be quite a bit smaller.
>> Smaller?
>> Yeah. We're not done yet with all of
these backend workflows.
>> How does that go to 400?
>> Uh somewhere [clears throat] around
there.
>> Wow.
>> There's some aspects of the business
that are are clinical workflows. Uh so
all of our members get a care navigator
um who stays with them for their entire
journey and that is just going to grow
linearly with our membership. So we want
you to have that human point of contact
that is available. But the care
navigators are now getting significantly
more useful because they can actually
use the agents to do a lot of the
follow-up on their behalf and they're
not having to remember to reach out to
this diabetic member every week about X.
They can kind of manage it at a
population scale. And so there we're
like keeping the same headcount relative
to our membership growth, but just
letting them do so much more than they
could do before.
>> That's amazing. I was speaking to a
major airline where they were saying
actually about exactly that that like
premium care customer service where it's
like they're able to give so much more
for your recommendations for you and
your wife's trip to New York and
everything's so perfected and tailored
because all the [ __ ] that they used
to do is gone and for you as the end
consumer it's amazing
>> and the response time the response time
is so much better
>> you get a response back in a few minutes
that's that's the usual place where we
see people ask Gwen if she's an AI is um
when she responds to your email within 5
minutes because in healthcare. If you
get a response same week from an
insurance company, you're doing so well.
>> And people think that I'm an AI because
I respond very quickly on email and to
the point I'm like, no, I just have no
life. [laughter]
>> You said about kind of the different
data inputs like, oh, you can just send
us anything now. I always was like data
cleansing, data structures would be the
biggest inhibitor to enterprise adoption
of AI. Is that totally wrong [ __ ]
VC?
I think if you approach it in the right
way, then the cleanliness doesn't really
matter that much because the models are
so good at cleaning up the data if you
give them the right context. And so
that's one of the things we found
actually with migrating away from some
of these SAS vendors is uh we we moved
away from Looker um right Google's
Looker product for visualizations. It's
super expensive. Um and we moved to do
it in Snowflake um and it's been a lot
cheaper. It's worked really well. Part
of that migration is moving all of our
dashboards and all of the things that
fed from Looker would have taken like
probably like a year and a whole bunch
of engineers and data scientists. Uh we
did most of it with an agentic workflow
that would spin up, find the next
dashboard, figure out how to convert it
into what we needed and then close it
down on the Looker side and boot it up
on the other side. And it ended up being
like a project for uh one or two people.
And it took it still took a couple of
months, but it was a lot more doable
because we didn't have to have somebody
ingest or like figure out that data. You
can just feed that data into a model and
let it figure out how to structure it
going forward.
>> It's just really interesting cuz I you
know I often think about what role does
not exist today that will be massive in
5 years time. And I thought like data
cleansing would be one of those roles.
If I asked you what role does not exist
today that you think will be very big in
5 years time, what would you say? agent
supervisor.
>> What does that mean?
>> One of the things we've found that's
been like a bottleneck is when you
launch these agent workflows, there's
always things that they you don't want
to let it do everything, right? So, like
with our contracting or our sales
workflow, like there's a certain margin
threshold where the sales agent can't
promise a client that we'll do it at
that margin, but we don't necessarily
want it to say no. we want to make a
business decision about whether this is
the right thing to do for that client.
>> Um, and so you end up generating this
like massive list of approval requests
that is now much longer than it would
have been because you're doing 10 times
as much work. So you're now getting even
if you're only getting an approval
request 1% of the time, you're still
getting 10% or 10 times as many as you
were last year. And so one of the things
we found is like actually how do you
manage all of those exceptions that now
become like a really high volume. So we
tried agents supervising agents which I
think works to a degree and maybe as the
models get better as well you can also
have like a more expensive right like if
we ever get mythos and it costs $100 per
million tokens you probably wouldn't use
it for the core workflow but you could
maybe use it as a supervisor
but how you actually manage those agents
at scale with like the volume of
exceptions that they generate um because
you don't want them just rubber stamping
yes or no either way like you need a
more nuanced decision there.
>> If you were advising your younger
brother or sister on how to prepare for
that role, what would you advise them to
do to be adequately skilled to do that?
>> I think just play with the models. Like
I think a lot of people severely
underestimate what they're capable of.
um because maybe they like tried ChatGBT
two years ago
[snorts] and and it like they're moving
so fast and they're so much better than
they were even six months ago that if
you're not like relentlessly trying them
then you're going to significantly
underestimate and then also like where
they are today is not where they're
going to be clearly in a few years. So
you got to skate to where the puck is
going to be.
>> Where will they be in a few years?
>> Ahead of humans on most capabilities.
>> Are you excited? [laughter]
Yes, cuz I think that opens up so many
possibilities like unlimited
intelligence.
>> Are you not worried about in the short
term societal unrest, labor displacement
and what that will do to a hollowing out
an inequality increase in the US?
>> I think that can be dealt with by
significant action whether or not we do
that or not.
>> What significant action would you do to
mitigate that?
>> I mean, I think eventually some version
of universal basic income.
>> Really?
>> Yeah. and you buy that works.
>> I mean, I think we have to build the
social structures that give those people
purpose and meaning outside of work
because I don't think that we're going
to have and I also I don't think that's
a bad thing. Like a lot of these
mid-level jobs that are being replaced
are awful jobs. They're people sitting
at a desk with like fluorescent lamps
shining at their face reviewing random
paperwork. Like that's not what people
like, you know, when you're little and
you say, "What do you want to be when
you grow up?" I want to sit in an office
and rubber stamp insurance forms. Like
it's not a good job.
>> I would be worried if my child.
[laughter]
>> Right. So these are not like it's not
like you're taking some like super
aspirational thing away from people. I
think these are jobs that we'll look
back and say, "God, I can't believe we
had people doing that kind of work.
That's crazy."
>> You know, I I walk with my mother a lot
and I always say my job is to invest in
the things that we say, "God, I can't
believe we used to do it that way." I
[laughter] said, "Do you remember? I
would never put my credit card on the
internet or you'd never find your like
husband on the internet.
>> You'd never get in a stranger's car and
uh and have them drive you where you
want to go.
>> What is insane today that will be
incredibly d obviously you have your
card online, obviously you meet your
partner online. What is insane today
that you think will be like obviously in
10 years? I think empowering agents to
do things on your behalf. Like we've
seen internally getting the team I think
like uh Isaac our our CTO and co-founder
and I have like trusted the agents
faster than most of the team and we're
okay like giving the agent authority to
do things like it was a big internal
dispute getting the agent to sign these
contracts. So the agent opens Docu Sign
and clicks the sign button and it's
legally binding and it has my signature
on the page. And getting that like
figured out internally was very it took
a lot of rounds of convincing people
that that was okay and that we could do
that. And so I think it will take time
for people to trust these agents with
stuff like you know give it your credit
card and let it go book a a holiday,
right? like getting getting people to
trust
it acting on your behalf I think will
take longer
>> but I'm thrilled that you signed me your
house for $12.
>> Uh do you worry about the concentration
of value when you look at the Mag 7
providing 85% of gains here today in
stock markets and then anthropic open AI
maybe one or two more. Do you worry
about that concentration of value? I'm
quite bullish now because I think a lot
of what's going on in AI is going to
massively boost earnings in other areas
of the economy that have struggled to
grow earnings any other way. Like if
you're health insurance,
>> like health insurance, like how do you
grow health insurance earnings? Well,
it's been or you go chase government
business and you pay a bunch of
lobbyists to get the government to
overpay for care. That's all now
backfired and all the government
business, Medicare and Medicaid is now
like a bad business and they're all
losing money. Everybody has insurance.
So unless you're going to increase the
total spending, how do you grow
earnings? Well, if you can make it more
efficient so you're not spending 9% of
your premium on admin tasks, that's a
way you can grow earnings without having
to deliver a worse product.
>> You're in a really good business as well
cuz it's like unwaveringly not in the
path of the model providers as well.
>> Yes, I not going to start an insurance
company. in the past like we're big
invest in wallets which is like business
[clears throat] banking like anthropics
is not going into business banking
>> in Southeast Asia [laughter]
>> I would be surprised I think things that
have some like regulation around them
and are like complex industries yes
they're going to see the advantages of
the models but they're not going to see
competition from anthropic or open AAI
>> I totally get that when I listen to you
I'm like Jesus if I was you I'd also
take a chunk of my money and invest it
actively into anthropic um can I ask you
have you taken secondaries along the
way?
>> Uh no, no, we haven't sold any
secondaries. We did uh there was a
dividend at the end of co we paid out
some uh all the investors got uh 10x
their money back uh before we started
the health insurance company and then
they still have their shares today.
>> We haven't sold any secondaries now.
>> Are you [ __ ] serious? They got 10x
their money back and then they kept the
shares.
>> We didn't have that many investors but
yes they they all did well.
>> That is an amazing deal. [laughter]
10x and then you keep the shares. Yeah.
>> What?
>> Well, I think that's why we've seen them
double down, right? It's like they made
money with us before and so, you know,
this last round was was led by insiders.
>> And how big was the last round?
>> 150 million.
>> What was the prize?
>> 1.3 billion.
>> Wow. Nice round actually. Not too much
dilution. Enough that it's really
impactful cashwise to come in.
>> Yeah.
>> Wow, dude. That's insane. So, can I ask
you then personally? I asked this
actually, do you know Josh Browder? He's
another Brit in the valley. Okay. Um, a
phenomenal guy, but like when you look
at your personal allocation today, given
our insider access and what we know,
>> is there anything funky that you do with
your money
>> outside of of curative? Yeah,
>> I invest primarily in companies of
people that I know and I do very little
investing if I don't know the founders.
>> Does that work well?
It's had mixed results, but some of them
are too early to tell. Some of them are
the best investment.
>> Um,
they're all they're all a bit too early
to to tell. [laughter]
>> Do you have any energy investments?
>> Uh, yes. So, there is a company that um
I co-founded with my wife, Subcritical,
that is um in the nuclear fision space.
So, this was based on an an idea that I
had a few years ago that um we need more
power and that nuclear is a really good
way to do this. Uh and it started off
actually as looking for an investment.
This was like one of my f first times I
was like we should find a company that's
doing nuclear power and try and invest
in it and see if we can make it go
faster. Um because I kind of thought
I'm pretty good at making things go
faster in really regulated spaces. Like
that's kind of what I'm what I'm good
at.
>> That's your thing. Yeah, that's my
thing. You know, everybody's got to have
a thing.
>> And so,
>> is that your hook on the first date?
Regulated industries make a good first
hook on our first date. So, after our
first date, we both shared our genome
files with each other, our VCF like um
and so she said she'd done this before
and the guy thought it was really
strange and we both were like, "Oh, we
should share our genomes and then, you
know, compared and check that we were
compatible so it was worth having a
second date." And we were both totally
into that. So, we We knew it was meant
to be. We were compatible by genome.
>> We have two beautiful kids, so we uh we
knew it was meant to be.
>> I'm sorry. If you're incompatible by
genome, you have like a
>> If you both have like the same
>> You have a ginger child.
>> Well, that was a concern. My brother is
ginger. So, I carry the ginger.
>> My brother is ginger, too. Yeah.
>> We We don't see him anymore. We took him
to the woods and said, "Run free."
>> Makes sense. Yeah. [laughter] So, I do
carry the ginger gene. And if she had
carried the ginger gene, that would have
been a deep concern. but she luckily
doesn't. And so that was that was one of
the key tests.
>> You progressed to the second date.
>> Yes. So we made it to the second date.
>> What does no one know about nuclear that
everyone should know about nuclear?
>> That it is very safe. I think and that
it's not a science or engineering
problem. Like that was when when we
started looking at companies to invest
in that was for me that the thing that I
was sort of disappointed by is everybody
was approaching it as if nuclear is this
massive engineering challenge. And sure
like the engineering is hard. It is
complicated. But fundamentally we have
built safe nuclear reactors since the
60s. They work great. The technology has
not really changed or progressed since
then. We know how to build these. That's
not the problem. The problem is that due
to a lot of the anti-uclear push in the
80s, we have had a regulatory
environment that has been incredibly
restrictive and difficult to get new
nuclear reactors built particularly in
the US but also worldwide. Uh there's
been this push to say how do you
guarantee that under any possible
circumstance like once in a million-year
events that you will never have anything
go wrong. And in traditional nuclear
that is very hard to guarantee. In
traditional nuclear one of the reasons
it's difficult you're basically
balancing on this knife edge. So in a
reactor you have uh what's called
criticality right which is where you
have to produce enough neutrons each
generation that they go off and do
exactly one more reaction and it keeps
itself going. If you get too much of
that too many neutrons it's a bomb,
right? It will be a runaway reaction and
it will blow up. That's very bad. that's
only ever happened once by accident,
which is Chernobyl. Um, all the others
have been not criticality events. Um, so
you don't want that. If it happens not
enough, then it just turns off. So if
you go too far below this exact 1.0
threshold, you get no power out. And so
you're trying to balance perfectly on
that knife edge of exactly 1.0 where you
can control it. And that is a hard
problem to guarantee. And this is the
fundamental issue with nuclear
regulation. How do you guarantee that
under no possible circumstances will you
deviate from that perfect control?
And so I was initially pretty
disheartened. I was like, well, we're
not going to get new nuclear power. This
is not going to work. And then I
stumbled on this idea of what's called
the energy amplifier. And it's not a new
technology. It's been around since like
the late ' 80s, early 90s. It was really
pushed by a guy Kar Rubia who used to be
the CERN director. He was a new uh Nobel
laurat in physics. And the idea is you
always operate below that 1.0 threshold.
So we are designed to operate at 0.97.
So that means you never have enough
neutrons to keep the reaction going. The
reaction will always fizzle out. So no
matter what you do, it's going to fizzle
out. But normally that would mean you
get no power output. What you do in the
energy amplifier is you point a really
powerful particle accelerator at that
fuel and that puts in the extra neutrons
to drive the reaction forward. But if
you turn that accelerator off, all of
your energy output just stops. And so
you basically have this big onoff switch
where you can control fision and you can
guarantee that no matter what you do to
it, the fision will never run away. Even
if you put in 10 times as much power
from the accelerator, it will never run
away. There's nothing you can do to it
to cause it to go critical or to have a
criticality accident. And so it's a
fundamentally safer way of doing nuclear
fision that is
just approaching it from a different
angle. How will the composition of our
energy providing change in the next 5 to
10 years? Like will nuclear be a
demonstrabably larger part of energy
provision than it is today?
>> Yes, I think what we're seeing kind of
all across the supply chain in nuclear
is a push to get more nuclear online. Um
and I think you know Subcritical is kind
of leading the way there with a faster
path to market than any of the other
players. Uh but there's a lot of people
working on deploying a lot of new
nuclear power
>> which current provision will diminish
significantly.
>> Um I mean I think any power from coal
will will mostly go away. I think you're
still going to see a lot of gas just
because particularly in the US it's
cheap, it works, it's fast, but I think
coal is going to go away. Um and then
you're just going to see more of
everything. What company will be larger,
curative or subcritical?
>> Subcritical. Yeah.
>> Or subcritical.
>> That's a great question. Um, curative
has a larger market opportunity, but I
think they're both
>> has a larger market opportunity.
>> Yeah. I think they're both, you know,
>> power generation.
>> Yeah. The uh US spends or US employers
spend $1 half trillion dollars a year on
healthcare, which is that's our like
direct TAM every single year.
>> How much does the US spend on energy?
through energy that can be addressed
through um through nuclear. It's a
similar order of magnitude.
>> I mean, you chose good ts.
>> They're both they're both yield
optimization. I feel like you've really
really taken this
>> I figured out the TAM thing. [laughter]
No, they're both like trillion dollar
opportunities if we execute right.
>> [ __ ]
>> Yeah.
>> Wow. We're also seeing AI on the on the
nuclear side in the design
>> because design is like traditionally a
thing that is done by a whole bunch of
people sitting doing drawings and
mechanical engineering
>> and the models have gotten really good
at that. And so we're seeing that you
can do the design with far fewer people
using AI to optimize a lot of the design
parameters where historically you might
have needed a hundred mechanical
engineers to design every single nut and
bolt and part. You can do it with with
20 really good mechanical engineers that
are designing the critical pieces, the
important pieces um and overseeing the
AI on like well I need a little bracket
that joins this piece to this piece that
doesn't need a human to design that. I
was actually meeting a company the other
day which basically said like you know
the challenge with hardware engineers is
they don't often know what software
engineering and the beauty of today is
like we've turned hardware engineers
into software engineers overnight.
>> Yeah.
>> And that's amazing.
>> Well, it's another place where we saw
like codegen as the solution and I think
you know this is one of the bets
anthropic made and they're totally right
on.
You can generate really good CAD models
by having it write Python to make the
CAD model. like it's not good at
necessarily good at like 3D space
visualization or outputting a drawing
um right as as vectors but it's really
really good at generating plausible
Python code that can draw that part.
>> It is the most exciting time to be alive
in many respects.
>> Yeah. Yeah. Well, that's why we ended up
starting Subcritical is I you know very
busy running curative but that was an
idea that was just too important to pass
up and there was nobody else. So uh the
only one that is under like active
construction of those systems is in
China based on a US design from the
2010s that the US stopped working on
after Fukushima.
>> How much money do you need to make
subcritical significant?
>> Uh well each one of our deployments
would be about a billion dollars of
construction cost for a 300 megawatt
facility. So it's but it's not you know
it wouldn't be the same like you
wouldn't raise that as equity. It would
be a mix into the plant of equity and
debt. So, it's a different kind of it's
more infrastructure build financing.
>> What do you know now about marriage that
you wish you'd known at the beginning?
Seriously, like it's an amazing thing to
build a company with your wife.
>> It's a challenging thing as well.
>> Yes.
>> How do you make it work?
>> So, I we're very well matched, I think,
is one of the things is we basically
never argue. And that's, you know, how I
knew very early on that it was meant to
be is we're always on the same page
about things. And so it's actually very
easy to run a company together uh
because we're we we usually see eye to
eye on like how something should be
done.
>> Fatherhood. You said two kids. Two kids.
Two and a halfyear-old and 6 months.
>> Anything that you would advise a new
father knowing what you know now?
>> You should definitely have kids. Don't
wait. I mean I think there's too much
like um sentiment of people. Oh, you
know, live your life and wait until
you're in your, you know, late 30s and
then have kids. I think no, like have
kids early when you're have the energy
and can run around and not sleep and
it's one of the best things you'll ever
do. You should just get on with it.
[laughter]
>> Okay, we're going to do a quick fire.
Sound good?
>> Yep.
>> Dude, that was the most uh twisting and
turning conversation ever from like the
proliferation of STDs to fatherhood and
nuclear. I mean, really, we crushed it.
What have you changed your mind on most
in the last 12 months?
>> I think probably a year ago I have
changed my mind that there are workflows
that can't be done with the models with
today's models. I think today the
current gen models can do every back
office task we have at curative it's
just a matter of deploying them like
getting them set up getting them
configured having the right policies and
and I think a year ago
I thought there was opportunity I
thought there was things we could do but
I don't think I would have said you
could do every single one of our current
back office flows
>> what one change would you make to Europe
if I made you president of Europe in
this very strange title to stay in the
brace for competitiveness.
>> Uh you have to have some kind of like
burden for passing regulation. There
needs to be some penalty. Like right now
you pass a regulation that's like okay
you you did a good job. Like the goal is
to pass regulation. There has to be some
penalty. Like the if you pass regulation
your country must pay some tax
additional tax for having passed that
regulation. just adding and adding and
adding uh without like refining what
you've got today and like really going
and digging in how is this regulation
affecting things on the ground like just
more additive regulation is bad. You
need to be looking at the effect of what
you've done and refining it and
iterating on it and not just trying to
add some new landmark regulation.
>> It's very anti-European Fred. You're not
going to [laughter] do anything. You're
not going to do very well here for a
reason. I mean, you know, I'm a Texan
now. Um, uh, Mark Benio said he spent
300 million on Anthropic. Equated across
the developers that they have, it works
out to be about 3.8% of developer salary
spent on Anthropic. What do you think
total percent of developer salary spend
will be on anthropic in 3 years time?
>> Between maybe two and 5x be the two and
5x salary. I think that's probably
>> 2 to 5x is the whole salary.
>> Yeah.
>> Whoa.
So from 3.8% 8% of salary to
>> Yeah. Because I think the way I mean the
way we're driving workflows is that you
have one senior engineer managing a
bunch of downstream agents that are
actually doing the work. And then we're
now getting to the point we have like
mostly unsupervised agents taking
feedback from the team on things,
implementing features, and then the the
engineers are coming in and actually
checking that what it built makes sense.
So they're becoming more the reviewer
and like the architect. And then you
have these downstream
>> doing the two to five. I mean that's not
like 3.8 to 20% [laughter] 50%. If it's
50% anthropics like a 20 trillion
company.
>> Yeah. I I think that that's what the
workflows will be is people are people
are going to be deploying more agents
than engineers
and they're going to keep the same
number of engineers. We're just going to
build a lot more.
>> Going to message my friend to let me
into that new anthropic round.
[laughter] Just message Larry. [snorts]
There we go. Uh, what's the kindest
thing anyone's ever done for you?
>> I think when I first was getting
started, there were a lot of people that
helped make it be possible to move to
the US and kind of like made a bet on a
kid coming from the north of England to
come to Silicon Valley. some of the
earliest investors. Um the guy Josh
Buckley who, you know, was one of the
first in guys who invested in us during
the YC batch
just because he liked what we were doing
and he thought it was it was cool. But,
you know, being willing to kind of take
a bet on a kid,
>> you know, Josh is like my best friend.
>> I didn't know that. I haven't seen him
in a while.
>> Yeah, I I say hi to him.
>> I I speak to Josh every single night.
>> Okay. uh barring say Christmas.
>> All right. Well, he he invested in cows.
>> That is amazing.
>> And then STDs.
[laughter and snorts]
>> Oh, you know,
investor Mark.
That's amazing. I didn't know that on
Josh.
>> Yeah. He like a month into the YC batch
like came by the lab and was like super
supportive of what we're doing. And I
think just coming from like the British
background, we couldn't even get
meetings with investors
>> and he was young. I mean,
>> he was Yes. But to get I mean he'd been
through YC and like had a successful
company and it was just awesome to like
have someone like that take a bet on
what you're doing. Coming from the UK
where I was used to like the cold
shoulder and no one was interested in
what I was building and you know no one
wanted to take a meeting. [laughter]
>> That makes me so happy to hear. Okay,
final one. What's the best advice that
you've been given? I think one thing
that I have learned is to always try and
get a lot of different perspectives on a
problem. Um I think I I would
historically have sort of approached
things from like one scientific
viewpoint and sometimes people would say
[clears throat] no like take a step back
and think about that problem more
broadly. And one of the things I learned
during the curative co push is we had to
bring together a bunch of people from
very different backgrounds. We hired a
bunch of former military people who were
just like incredible at deployment, but
they speak a different language. And
then we're trying to get them to talk to
scientists. And then we hired a bunch of
Silicon Valley developers. And they all
like think about the problem. They're
all trying to solve the problem, but
they all come at it from like a
completely different perspective. And a
lot of times I wouldn't have considered,
you know, that point of view on doing
it. And I think what I found is that the
more of those perspectives that you can
kind of get on a problem, the closer to
ground truth you get. Like you're never
gonna no not one of those people is
going to give you the ground truth. But
if you hear a lot of perspectives, you
can kind of get to that ground truth
faster.
>> Fred, that was the most extraordinary
show that I've ever done in
[clears throat] breadth, depth, uh,
variance of conversation. Thank you so
much for joining me and it's so great to
do it in person.
>> Yeah, thanks for having me.
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