Pivot · Nov 17, 2023

Government Shutdown Averted, A Surge in Hate Speech, and Guest Adrian Aoun

Automatic transcript of the end of the episode, from 58:06. Speakers are labeled by software and may contain errors. Highlighted passages are Scott’s predictions.

Guest · 58:06 On this planet and be like, hey. Let's go ahead and sequence my DNA and understand what's gonna happen to me in twenty or thirty years. And they're just gonna look at you like you're crazy, much less say, hey. I've got these wearables that are collecting some data. Do you wanna do anything with it? They're just gonna be like, no. Leave me alone. Right? Like, this is this is the world we live in where literally pretty couches is what we've accepted. Now one of the problems of whether it's the minute Kara Swisher · 58:27 we're You don't like the couches at One Medical then? That's the same Guest · 58:30 I don't even wanna wait. Are you kidding me? Why I have a couch? I'm not trying to hang out at the doctor's office. I'm trying to get shit done. Pardon my language. Okay. So so... Look. So the world, the world that everybody else is going after and the reason they're struggling so much is they're saying, look. We want MinuteClinics to be everywhere. Okay. That's awesome. I I want that too. Right? We want whether it's One Medical or or CVS or all of these to be everywhere. But the problem, the fundamental problem of health care is that there's not enough doctors. They're really expensive, and you know what? Not that many are graduating. So what are you gonna do? Are you gonna magically, like, print me a million doctors that somehow cost almost nothing? You're not gonna do that. There is no solution. So what we're trying to do is say, look. What would it look like if you truly, truly scaled that doctor? Let me give you an analogy. Before this, I was at Google, and I I ran a big, a big segment of the, of the search engine. And one of the one of the things that I had the ability to do was write some code that could literally go out to billions of people later that day, 3,000,000,000 people later that day. Like, that's insane. Right? On the other hand, what's the impact that a doctor can have today? Well, they can affect one person at a time right in front of them. Like, how do we end up in this world? Doctors are more educated than most engineers. Doctors are more altruistic than most engineers. Like, why do we end up here? And it's because the tool sets that doctors use are from the stone ages. So we asked ourselves, could we build tools that allow a doctor to, say, not solve the flu 10 times a day, but to solve the flu once, write the damn protocol, and let the computer execute it for them? And the more you do that, the more you can truly, once and for all, scale health care to the masses. Scott Galloway · 1:00:05 So give us what you think is the most compelling and realistic use case. I sign up. I'm spending $99 a month. Give me an example, a specific example, and walk us through why that is better than the way I interface with the traditional health care system right now. Guest · 1:00:23 Totally. So the health care system that you interface with today is roughly urgent care. You wait for something to go wrong. Oh, I got a rash. I got a flu. Right? And that's what you're using it for. But, like, let's just take a step back, Scott. Like, how many people do you know who have died of the flu? How many people do you know who have died of of a rash? It's like it's not exactly the thing that's killing us. Right? It's the heart disease. It's it's the cancers. And so what you do when you come into Ford, the first thing you do is what's called the baseline. Basically collect a bunch of information about you from your DNA to your blood, to asking you questions, to your familiar history, as much information as we could possibly get, and we're always adding to that. And then once we have that, we sit there and we say, look. It seems like these are the biggest risks for you in the long term. Right? Just think of the health care system we've created as because it's paid for by your employer in most cases. Right? And most people aren't with their employer very long. They're with their employer for what? Two, three years. So if you think about it, that health care system wants to focus on the flu because that's gonna keep you out of work, and they don't wanna focus on the cancer because you're gonna get that in twenty years. Why prevent something that's gonna be the next guy's problem? Why why incur that cost? So we've got a health care system today that's focused on keeping you at work, not keeping you alive, and we're trying to invert that model. Kara Swisher · 1:01:34 So you would go in if you had the flu and it would know... You wouldn't have to waste your time. It would know... It would give you a flu test and here's what you... But there are doctors that then if there's an issue or you want it followed up for a very serious thing. Guest · 1:01:46 Correct. We have doctors because sometimes you just wanna talk to a doctor, and that's cool too. But we also have doctors because sometimes things are just too complex. And you know what? The apps don't support that, and that's fine. And then we just constantly are looking at those and saying, well, hey. Can we build that complexity into a piece of technology? And if we can, great. And if we can't, that's what doctors are there for. But doctors are super, super scalable when they're doing, you know, 1% the amount of work or 2% the amount of work, and that's the world that you want. Kara Swisher · 1:02:10 Just so people know, you go in and then different blood pressure cuffs or testing things or a COVID test pops out. Guest · 1:02:18 Or blood tests or diagnostics or swabs. Kara Swisher · 1:02:20 They pop out of doors. They... And they tell you to do it. Guest · 1:02:24 I like your version. We pop out of doors, but I'm gonna go with my version. We've got a glorified vending machine. We got a Coke machine. Right? Like, just think of it like that. Right? There's a tray, and it can just give you more... You know, different things. It can give you everything from a blood test to a blood pressure cuff to... And we're just constantly adding. Right? So you can almost think of it like the iPhone where they just... They launch and then they add three g, five g, LiDAR, TPO. Well, we're just constantly looking at what we can add ourselves. Kara Swisher · 1:02:47 What's your biggest worry here? That people abuse these pods or that... Because they're not monitored? Or Guest · 1:02:52 No. Not really. Kara Swisher · 1:02:54 Or that, what, that you'll have a wrong diagnosis and get sued? Guest · 1:02:57 Not really. I mean, again, so everything goes through doctors on the kind of back end. So so it doesn't seem very likely that we're going to, you know, I don't know, screw something up. But, no, my biggest worry for us is execution. Like, the reason I use the Tesla analogy is in some ways when you look at Tesla, like, every part of what Tesla is doing, like, can be done. People built batteries before. People built gas stations. Sure. You're electric, but whatever. People built mines. People built factories. People built all these things. But then when you look at, like, one company doing all those things, you you wanna pull your hair out. Right? It's, like, really, really complex. And so for us, the number one challenge is just execution. Like, if we die, we're gonna die via suicide, not homicide. Right? Like, it's a very, very tough company to build. Think of it. We do hardware. We do construction. We operate blood labs. We're highly regulated. We have doctors. I mean, this is not an easy business to be in, and and that's the thing we spend all of our time trying to derisk. Kara Swisher · 1:03:49 Scott, thoughts? Last thought? What do you think? How do you think of that? Does I voice the discipline you? Scott Galloway · 1:03:54 I think one of wonderful things about America is that people like yourself take these risks and try and do... Try and leverage technology and build a thick layer of innovation on top of technology. So I'm I'm generally, genuinely pulling for you. It's not a... I think this is exciting, and I just hope that this doesn't digress into what every other, kind of VC backed health care startup, and that is essentially serving one constituency, and that's rich families in Palo Alto. So, I'm pulling for you, brother. Guest · 1:04:25 Well, that won't happen on my watch. I promise that. Kara Swisher · 1:04:28 Alright. Adrian, thank you so much. I hope you enjoyed this, Scott. I like to have a little pitch session. Scott Galloway · 1:04:33 Mean, we're Kara Swisher · 1:04:33 doing new things called pitch Scott. I think it's interesting. Adrian's a very interesting entrepreneur. Scott Galloway · 1:04:37 Yeah. A couple of things. One, I I generally appreciate you trying to surprise me in thoughtful ways. And two, can the next surprise involve handcuffs and a woman pursuing cosmetology who's who's turned to sex work? Can that be my next surprise? Kara Swisher · 1:04:48 No. No. This is about... I wanted to get your your... Actually, like, I just heard about this. Scott Galloway · 1:04:54 I mean, there's good surprises, and there's great surprises, Kara. That was a good surprise. Kara Swisher · 1:04:58 This is a good surprise. This is interesting. That was a good surprise. Anyway, it's an interesting idea. Adrienne's a really interesting entrepreneur, and, oh, I always find him very thoughtful. Scott Galloway · 1:05:06 You're the only woman I would trust to pick out a sex worker for me. Kara Swisher · 1:05:10 What does that say? Is that a good thing or a bad thing? Okay. Alright. We're moving along. Once again, I brought you something substantive and interesting. We're gonna have more of these pitch sessions to see how Scott reacts Duh. How he reacts to these things. It's a hard problem he's trying to solve here, but interesting. I like that he's trying it. Anyway, one more quick break. We'll be back for predictions. [Ad break] — Predictions segment begins — Kara Swisher · 1:06:31 Okay, Scott. Let's hear a prediction and quick because I gotta get to Martina. Scott Galloway · 1:06:35 I like... I'm trying to be more hopeful. My prediction is that the ultimate iron dome for Israel is formed in twelve to twenty four months, and that will be the normalization of relations between the kingdom and Israel. I think Hamas was trying to invoke, an overwhelming response from Israel, which they succeeded in, which created a lot of sympathy for Palestinians. They have succeeded, but I think the second objective was to rally and inspire other Arab nations to declare war on Israel. And because of the leadership of president Biden and 7,500 brave sailors and marines who make up each of the Eisenhower and Ford carrier strike forces where we can deliver more firepower than almost any nation in the world and have it sit off their shore and not ask anyone's permission. The Iranians have been quiet, quite quiet. There's been some skirmishes at the border, but they know that, oh, shit. These carrier strike forces are off the coast. We better cool our jets because they... Basically, we have the entire British military sitting off our shore, and it's not there to say hi. It's there to keep the peace, meaning they will deliver violence if we decide to deliver violence against Israel. In addition, the kingdom has been suspiciously quiet around this. And I think that in this, let me just go very crass. It goes to Mykonos. I was in Mykonos a few months ago, and every table there was inhabited by young men and some women, mostly young men, from The Gulf. And I think the most pivotal, transition in the world right now is the pivot from Islamism and terrorism to capitalism in the kingdom. I think MBS, and it's easy to hate, is the most important reformer of the last several decades, and I think they will normalize relations. And when the two largest economies... And by the way, don't think they can do that with either Hamas or Netanyahu in power. I think both those entities need to go, and I'm not creating an equivalency here. But Netanyahu has been a disaster for Israel and Jews worldwide, and Hamas is a terrorist organization. And I think The Gulf, specifically the kingdom, has said, the better way of life is capitalism. And I think that they see opportunity by partnering with the largest economy in The Middle East. And I think that I'm actually quite hopeful. I think the president has shown real leadership here. I think the absence of a multi front war here is a good indication in the fact that many Arab nations, especially the powerful ones, meaning the rich ones, have stayed a lot quieter than Hamas was hoping. So I am hopeful we're gonna go through this, and we're gonna have the normalization of relations between the kingdom and Israel, which will create an unbreakable alliance. Kara Swisher · 1:09:11 Oh, interesting. I think that's a very substantive prediction. That's a really interesting one. I hadn't thought about that. I'm gonna make a short prediction with this revelation of the of the 36% that Google's paying to Apple as a vague. I don't think they're gonna win this case. Scott Galloway · 1:09:25 You think Google's gonna be... You think this... You think Lena's gonna get her win here? Is it the DOJ or the FTC on this one? Kara Swisher · 1:09:31 It was Lena. It's the DOJ. Scott Galloway · 1:09:32 Got it. That's really interesting. What do you think the remedy will be? Kara Swisher · 1:09:35 I don't know. You know, these things can go on and on and on, but boy was that... I had heard it was $10,000,000,000 and I thought, God, that's a lot of money, but now it's there. You know what I mean? Now we know what they're doing. And on the face of it, Maria, you can't argue they're so much better if they're paying. That's their argument, that they're more innovative. It's a lot of vig. That's a lot of vig they're getting. And I think the repercussions for Apple will also be there's other cases involving Apple. So, there's a lot of gatekeepers. A lot of gatekeepers happening here, and they've had it good for a while. But it really does prevent competition. I don't know how else you can look at it. They're not that much better. They're just not. They just have a lot more money. So I don't know. That's my prediction. I looked at that coming out and I was like, oh, well, there you go. Boom. The shoe just dropped. Anyway, we'll see. That's my little prediction. But I like yours better. — Predictions segment ends — Scott Galloway · 1:10:29 Will you send a message to Martina for me? Kara Swisher · 1:10:32 Yeah. What? Scott Galloway · 1:10:32 That jarhead straight guys like me that grew up on I Dream of Genie and Three's Company who were Mhmm. I don't wanna say accidentally homophobic, but were raised to be American, which meant being homophobic, that she had a real impact. I remember personally her saying that that people should stay out of her bedroom and thinking for the first time, I get it. It's kind of none of our fucking business. I think she played a really important role outside of tennis. Kara Swisher · 1:10:56 Alright. We're gonna have an interesting discussion. Scott Galloway · 1:10:58 Yeah, she's an impressive woman. She's made a real difference. Kara Swisher · 1:11:01 Yeah, we're gonna have an interesting discussion. She also has some trans issues. She's been pretty adamant That people born Scott Galloway · 1:11:09 with penises shouldn't play, be allowed to garner all the rewards and endorsement income and accoutrements and scholarships? Kara Swisher · 1:11:15 Yes. Scott Galloway · 1:11:16 You mean she has common Okay. Sense, Kara Swisher · 1:11:18 We're gonna have a long discussion about it. Scott Galloway · 1:11:21 Oh, so she has common sense. Kara Swisher · 1:11:22 Oh, okay. Alright. Scott Galloway · 1:11:24 Where's the sex worker with the handcuffs? Kara Swisher · 1:11:26 I'll be talking to her. Scott Galloway · 1:11:27 Bring on Kara Swisher · 1:11:27 the handcuffs. You go. There's our letters for this week. She can There's... So there's the letter for this week. We had such a nice show. You really need to stop talking right now. We wanna hear from you. Send us your questions about business tech or whatever's on your mind. Go to nymag.com/pivot to submit a question for the show, or call 85551 Okay, Scott. That's the show. Or if you're Jeff Bezos, that's the gun show. We'll be back on Tuesday with more pivot. Please read us out. Scott Galloway · 1:11:56 Today's show is produced by Lara Nayman, Zoe Marcus, and Taylor Griffin. Ernie Entratot engineered this episode. Thanks also to Drew Burrows, Mille Savario, and Gatti McBain. Make sure you subscribe to the show wherever you listen to podcasts. Thanks for listening to Pivot from New York Magazine and Vox Media. We'll be back next week for another breakdown of all things tech in business. I have fucking everything, but it's not enough. Annie, I'm ready for my close-up. [Ad break]