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

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Scott?

Hey!

What did I do?

Late.

I've got an interview with Martina Navratilova.

After this, very tight.

I'm going to have her come over to that hotel and smack you around a bunch.

Hi, everyone.

This is Pivot from New York Magazine and the Vox Media Podcast Network.

I'm Kara Swisher.

And I'm Scott Galloway.

Why are you in Miami and late to this endeavor that we do every twice a week?

What are you doing in Miami?

I'm here with the good folks from Live Nation who are inspiringly young for a management team of this company of the success, but it's also quite depressing.

When did we get so old, Kara?

I used to be the youngest person in every room.

Now I'm the oldest.

I just couldn't.

All these people are so young and so talented.

Oh, Scott, this is the way of life.

Did you not pay attention to it as the years clicked on?

I accepted your invitation to your birthday party, by the way.

Oh, good.

Yeah, I'm super excited.

Yeah.

Yeah, it's a year away.

We were kind of hoping you'd...

Oh, you said yes.

I said yes.

You said I wouldn't come.

You were categorized under invite them and they'll say no.

Okay, I got to recalculate.

I got to recalibrate.

I'm coming at least.

I'm not sure the whole gang is coming.

Do you have those people for events where you invite them thinking they'll say no?

Yes, totally.

Am I one of those people?

No.

We're excited to have you there.

If I wasn't there, you'd be deeply hurt.

Mostly Amanda.

We're going to find a way for Amanda to come and leave the kids at home.

Plus,

you're going to satisfy my diversity, equity, and inclusion officer I've hired for the party.

Okay.

You check a lot of boxes.

All right.

Well, we'll see what we can do.

Anyway, you know who I had on stage last night?

Christopher Nolan?

Oh, from

Dunkirk?

No, Dunkirk, Oppenheimer.

Yeah.

Dunkirk is the closest thing, I think, to a perfect movie.

Oh, wow.

Not Oppenheimer?

We have the same agent.

He's a tad more successful than

Just a smidge and touch.

He is elegant, I would say.

Just a little switch more talented than the dog.

I should call my agent right now.

Why am I not producing or directing Dunkirk?

Yeah.

He was getting an award from the Federation of American Scientists for the movie.

First director to get one.

Also, Chuck Schumer was there.

A whole bunch of people were there.

But before we went on, he said, I'm, you know, I'm Hollywood smart, not smart smart like these scientists.

But it turned out he was quite smart.

And he's pretty smart.

He had a real back and forth with Senator Young from Indiana about regulation and everything else and around AI that I thought he was quite up to speed.

Schumer asked him to do his next biopic, Schumer.

That's what he asked him.

Yeah,

something tells me that's not going to be, there's not going to be lines around the block and people dressing up as Chuck.

Yeah, it was a real Washington night.

That's the kind of humor we get in Washington.

Anyway, he was quite elegant and very smart.

I'm hoping to get him on the podcast at some point, but he'll probably win all the Oscars this year.

Anyway, it was quite a fascinating interview.

Even it was a short one.

Anyway, congratulations, Christopher Nolan, for your award, by the way.

We have a lot to talk about.

We have a lot to talk about.

Mike Johnson avoided government shutdown, although some people...

think he's in trouble because he got a lot of help from the Democrats,

which you talked about.

We'll play that clip.

Plus, anti-Semitic and anti-Muslim hate speech rising to new levels on social media.

And that's not just Elon Musk and a friend of Pivot, Adrian Aun.

He's the CEO of a health tech startup, Forward, which you and I both know about.

He joins his chat about his latest AI adventure.

I'm going to reveal it to you because I think it's pretty interesting.

But first, Nikki Haley has walked back her stance that everyone using social media should have to verify their identities.

Haley previously called anonymous accounts a national security threat and said verifying identities would eliminate foreign bots.

Now she's saying actually anonymous accounts would still be allowed for Americans, but Americans only, adding, I don't mind anonymous American people having free speech.

What I don't like is anonymous Russian, Chinese, and Iranians having free speech.

You've been a sort of a, you pushed the idea of no anonymous accounts, correct, as I recall.

What do you think of this?

I think she's out of her league on this issue, but I don't know.

What do you think?

I think she was called by very powerful billionaires and PACs representing big tech and saying, look, your candidacy is getting serious, but no candidates,

no one's ever become president.

without pulling out the need pads for big tech and you need to pull out yours.

And part of that is getting away from this shit that would cost us billions of dollars to implement regardless of how much sense it makes.

And it's not that I'm against anonymous accounts.

I'm against anonymity in this bullshit free speech argument that they're all hiding behind.

You could figure out a way.

to create anonymous accounts for people who truly need anonymity or humor accounts.

They could be parody accounts.

They could be accounts if you are talking about the violation of women's rights in this nation nation or Gulf nations, and there is a tangible reason why you need anonymity, we could absolutely figure out a way using the blockchain or something to provide people with those accounts.

But the 1% of people who truly need anonymity, or it adds value to the parody, is overwhelmed by the danger, the coarseness, the tearing at our fabric that

the New York Times reporter accused me of playing into

Putin's playbook.

And I'm like, no, actually, I think you're playing into Putin's playbook.

By pushing for.

Well, when you allow millions of anonymous accounts, I mean, I just think the Chinese and the GRU are laughing at us.

Yeah, in some ways.

Although the idea of all those companies having a lot of our identity, just like, well, although it's everywhere, license and things like that,

is troubling given how they've behaved in general.

Not a problem for you.

Repeat what you just said, Kara?

That they have our identity, that they would have a lot of information.

But you think verification.

That horse has been out of the barn.

Yeah, agreed.

Agreed.

Altria knows who you are and if you smoke and when you stop,

they can figure out when you're trying to quit and they used to send you points at coupons.

What you buy at the grocery store.

You're right.

Okay.

I'm going to leave off that one.

All right.

They don't want to do this.

The notion that somehow these companies, these guys are worried about our privacy.

That's it.

They're worried about our privacy.

Here's the thing.

In a wealthy society, in a democratic society where there is free speech protection, anonymous accounts are nothing but this insidious weapon

that our foreign adversaries exploit.

And two,

it is creating such a level of disharmony and disunity and tumult in this nation because

here's what it comes right down to.

When people come up to me, Twitter mostly.

Look at my comments.

on my feeds, my newsletters.

Right.

And then look at how people behave when they come up to me in person and I see their person and I know their identity.

Here's the thing.

I was having dinner last night and at the absolute perfect moment, I got someone, the late waiter came over with a glass with rocks and zacapa and star point Coke in it and said, the couple over there wanted to send you a drink.

And it was this lovely couple from San Francisco.

In person,

people are wonderful.

They air on their most gracious, wonderful selves.

They're generous.

They're nice.

They're friendly.

And occasionally people come up to me and say, love your stuff.

Can we talk about Israel?

Or can we talk about this?

Because I have some, I disagree with you.

And we have really nice civil conversations.

And I learned from it.

And sometimes they even influence me.

And guess what?

We need a lot more of that.

And we need a lot less of people throwing water balloons from and then running behind their mother's skirt.

Yeah.

Okay.

So you're a Haley.

Haley is your dude.

In other words, you like the Haley.

She should have stuck with it.

I believe Governor Haley, I mean, we're all, it's like all of a sudden, Senator Romney and President Bush, to me, seem like more reasonable than ever because I've seen how bad things can get.

I did not like these people.

And now I'm like, well, I could live with these people.

And I look at Governor Haley.

And we're going to talk about this, but all these fucking narcissists throwing their hats into the ring who are going to do nothing but spoilers.

I'm like, Jesus Christ, you're all setting us up again for the orange Hitler's comeback.

And

actually, the technical name is Schitler, just so you know, online.

Speaking of Schitler, former President Trump's Truth Social, the risk of failure, it's down to 73 million since its launch.

The platform has under 900,000 monthly active users, quite small.

That's barely 1% of the number of users on X.

But Truth Social on is an alternative to Twitter, but accountants say it's burning through cash so fast it may not survive unless it completes a long-delayed merger with Digital World, which has been backed up, a blank check firm, which I think that boat might be sailed.

There's also some investigations into it.

Do you

Trump wants it to fail?

I mean, it was going to fail.

We've said that over and over again, very briefly.

I would just like to know how many shares he was given and how many he sold.

And I haven't been able to discern that from the filing, but I think ideally, I think what we're going to find is this is another, yet another pump and dump, voiced feces to tourists to the unicorns and

sell your shit and then get out.

His stake is so low now in terms of monetary value that I think he would rather rather get the hall pass to start going on Twitter and

raising awareness.

What do you think, Harry?

Well, I think it'll look like a failure.

I don't think that's one of the things, his perception of failure.

And he kept saying how great a platform it is.

It's certainly not.

I think that's where he might hold it up.

You know, it's like Trump Stakes,

the digital version of Trump Stakes or whatever he puts his name on.

So it's probably headed for the trash heap, like a lot of social sites.

Let me just be fair.

There's been tons of them that have gone down.

But it's a particularly,

we've been saying this for a long time.

Anyway, interesting, thinking of things that are successful, Google pays Apple 36% of its search advertising revenue from Safari under the terms of the search default agreement.

That is huge.

This detail, which was previously confidential and which the companies have tried to keep away from people, was revealed by a witness in Google's antitrust trial, reportedly by accident.

Alphabet CEO Sundarba Chai confirmed the number this week while testifying in a separate lawsuit.

Now, it's long been known that Google has long paid to be the default search engine in certain browsers,

Mozilla, they certainly did.

A lot of these specific numbers have come out at the trial.

I think $10 billion payment, a huge amount of money.

But people even think it's possibly more.

The trial is set up to wrap this month with a verdict likely coming next year.

I'm not surprised at all by this number, Hugh.

Well, it's staggering.

And what's telling about the fact that it's not it plays into the hands of anti-competition laws or violates them, it's just how they have guarded this number more closely than nuclear launch codes.

And the question is, well, why?

Why are you so worried about people knowing this number?

Understanding the payoff here, yeah.

And it comes down to this.

Apple is one of the few companies, one of the handful of companies that could potentially be a viable competitor to Alphabet and search.

There's only a handful now that could even have any shot at it.

They control the interface of the wealthiest people in the world.

So they could launch and they have the technology, the brand, the engineers.

There's been rumors of them doing it.

You know, they did mapping, it didn't work as far as right.

But then Alphabet shows up and says, you know what?

Let us give you tens of billions of dollars to keep you from competing against us.

That's the bottom line.

And that is, at the end of the day, when you end up then with one company that can take the extract the amount of money that a large travel company,

Expedia, needs to pay Google from $500 million to $10 billion.

Nobody else can compete, I think is more the point.

Nobody can pay it.

Nobody can do it.

And so this is simple.

One company, the only company that has the capital to pay off a potential competitor, thereby resulting in fewer companies in the search business, thereby raising rents globally across every corporation that must engage in search.

This is the definition of anti-competitive behavior.

Yeah, they do.

They get a leg up.

And of course, you know, Apple points out that you can change your default search, but you don't.

It's buried very deep.

If anyone, I can show people how to do it.

But you don't do it.

It just comes with the phone, and it's not something you move along.

And it does give them an incredible advantage, and they're paying the price for it.

Apple is, you know, sort of Fifth Avenue.

real estate, essentially,

that only Google can pay.

And then Google can turn around and charge more for that dominance.

They've done it.

They did it at Mozilla.

They sort of got the whole thing wrapped up.

It would be natural for them to try to do this.

It's just, does it give them unfair advantage, which I think is what the government is arguing?

So we'll see where this goes, but it's a big number.

I think everyone thought it was, and

they were purposefully vague about what it was because it is so staggering.

There is not one company that can afford this, but Google.

And that's 36%.

That's 36% of the revenue.

The telling moment was when the economics expert on stand under penalty of perjury had to reveal the number.

The head lawyer for Google

looked like he was going to faint.

And the question is, well, why are you so worried about this?

Well, because it's a lot.

Because then it's everything we thought it was.

That's why.

It's exactly what we thought was going on here.

And the question is, should they be allowed to do that, sell off their real estate that way?

It's just not, or make it fair to lots of people.

And again, they will point to the fact that you can change it on the phone, but it comes preloaded.

It comes preloaded and people just don't do it.

It should, well, it might be when you first get the phone, but nobody, that's only one time in your life that you can change it or that you might change it.

They might say, would you like these things?

But you're going to pick Google over all of them.

And Google says it's because they're better.

I would say they just have good placement and they're good.

I'm not going to take anyway from their search, but we don't know.

We don't know what we're missing.

We don't know.

We don't know what we're missing.

I would argue that if you go on Google today, it's remarkably similar as it was 10 years ago, except every link now takes you to another place they can further monetize.

This would be similar, and I'm trying to think of an analogy, but say Elon Musk said, all right, Tesla is worth more than the entire auto industry combined, practically at this point.

And Ford and GM are seen as shitty companies or mediocre companies that are eventually going away.

So what if I went to Ford, General Motors, and Stellantis and said, you know what, halt all of your EV production.

And I'm going to build your EVs and you can slap a logo on it.

And in addition, in addition, I'll give you, I will double your profits every year because I have so much money that for me to give you a measly billion dollars to effectively stay out of the EV business and just license it all to me, I can pay that.

And it's high margin revenue.

And because you're struggling,

you need that money or it's just easier for you to not make the capital investment and take this high margin revenue.

And then what do you have?

You have an ecosystem where there's no competition in EVs.

Yeah.

Yep.

Yep.

That's a very good, that's good.

That's a very good.

You can do it in real estate.

You do it in in a lot of ways.

This is, this was not good for Google.

We'll see where this case goes.

Lastly, I didn't want to miss it.

Did you see the lovely photo of Jeff Bezos and Lauren Sanchez for Vogue?

Oh, God.

The reaction has been less than ideal.

Jesus Christ, Carol, make them stop.

That's what you wrote.

Make it stop.

You know them.

Make them stop.

I don't know.

I haven't talked to him in years.

I got to be honest.

I think.

Harry and Megan are rolling with Lauren and Jeff and said, you know what?

We're getting so much shit about being the grossest couple in the world.

We need your help.

Can you become more gross than us and

get everyone's attention off of us?

And I think Lauren, who's probably a very generous person, said, I know exactly what to do here.

I'm going to parade around in $10,000 gowns around the SpaceX, not the SpaceX, the Blue Origin.

Yeah, not SpaceX.

That would have been good.

And I'll convince Jeff.

Jeff is in the midst.

of the like mother of all, the Amazon of midlife crises.

Yeah, he looked pretty happy happy in that photo, I'll tell you.

He looked pretty happy.

Oh, hey, I don't, I, I'm kind of, I'm, I'm sort of here for his midlife crisis because I think it's kind of funny, but this represents so many things.

It represents one, kind of

what we knew was what was happening, but quite frankly, the beginning of the end of Vogue, this kind of idolatry of rich people, hello, photoshopping the shit out of them.

Yeah.

Have you read the article?

I have not.

It's like a parody.

The article is Lauren Sanchez looks to the future.

What, by marrying a billionaire?

What do you mean by that?

She looks to the future.

And then all of these highly over-stylized

photoshopped pictures.

And it's sort of the headline should have read, in my opinion, we have everything,

but still want fucking more.

We want.

Okay.

All right.

Here's, I'm going to give an alternate thing.

Here's the thing.

You keep cutting me off.

Am I getting you in trouble with your friends?

No, no, they're not by the way.

Is this going to make it uncomfortable for you you?

Are you kidding?

No, I did a caption contest where I said, let me start Body Hack Mountain.

That's good.

That's good.

That was good.

Thank you very much.

So I did not feel worried about it because it looked like there was a lot of body fixing activity going on in this photo.

Here's my thought on this.

It was by Annie Leibowitz, which it looked like an Annie Le Moz photo.

Not a career building photo for Annie.

When she used to take those pictures, like of Demi Moore with pregnant or Whoopi Goldberg in the bath of milk, they were funny or on the horse.

Was it Arnold Schwarzenegger on the horse?

No, it was Arnold.

He looked amazing.

He looked amazing.

He looked amazing.

They were funny.

Like you could see the people having fun with them.

And I just, I felt like this is not a joke to them.

That's what I felt was a problem is that all those pictures were performative in a very obvious way, like from an artistic point of view.

And like, how ridiculous can we be?

And they were in on the joke.

In this

picture.

They thought, don't we look good?

And I was like, you don't, but you think you do.

And that was my problem with the picture because all those pictures that she does are always just, they're funny in a weird way.

And this was, this was like, do you understand how you look?

And then I felt bad for them because I don't think they do.

I think he thinks he looks good in that hat, just the way Elon thinks he looks good in a cowboy hat.

I don't understand the need of these people to wear cowboy hats.

Nonetheless, I think he thought with his arms, the guns,

the sexy shots kind of thing,

I just was like, oh my God, you're not kidding, are you?

This is not a joke.

This is not a, I like a joke photo of famous people, but this was not a joke.

Look, we have.

Can we take a picture like that?

Yeah.

This is so funny, Kira.

I literally thought last night, I'm like, we have to find between your contacts.

Yeah.

And I don't know, my humor.

I know Annie Leibowitz, actually.

We should absolutely, I know, she's not going to mimic herself.

We need to do this photo.

This needs to be our Christmas gift to the world.

We need to do our holiday gift.

We need to do this.

I'm obviously the Jeff Bezos.

100%.

100%.

You've got to go.

I just want to go meta.

Can you do that lip thing?

Let me see.

Let me see you do it.

I just want to go meta on a couple things here.

The first is,

a woman has been told for hundreds of thousands of years that her job is to find the smartest, strongest, and fastest seed that can protect her offspring.

Men have been taught only 40% of men have reproduced throughout history, 80% of women.

There's been a dearth of mating opportunities.

So

sex, this is all about sex.

And that is women in our society.

are overvalued based on their sexual attractiveness.

And when they start to lose it, they will go to crazy lengths to try and hold onto it for as long as possible.

And that's perfectly understandable.

Men want to be as attractive attractive as possible such that they can spread their seed to the four corners of the earth.

Yeah, got seat.

Can you see?

This is this on fucking steroids because he never had any sort of game sexually.

Because,

I mean, look at the guy and look, and he was focused on his work.

This happens to all the tech guys.

They're like, oh my God.

Well, they were comparing the old pictures with the new one.

They, they kept doing, you know, the, the, the khaki one.

They wake up all of a sudden and

oh my god, I'm the sexiest man in the world for the first time.

I'm really going to enjoy this.

Yeah.

This is his.

Well, she thinks he's sexy.

That's it.

I I think he looks good.

Actually, I think they both look good.

I just, I just think they should keep it to themselves.

And then, and that leads to my second meta thing here.

They look shiny.

I think they look shiny.

I don't care if it's the gag reflex and the dragging they're getting deservedly on the internet right now.

I don't care if it's Black Lives Matter.

I don't care if it's content that I think is distinctly, incorrectly pro-Hamas and anti-Israel right now.

I think that all reverse engineers do the same thing in America.

And that is that for the first time in our history, a 30-year-old isn't doing as well as his or her parents at 30.

The income inequality has gotten so fucking crazy.

Wait, how did we get here?

Okay, all right, go ahead.

That's why I'm here.

Okay, let's go.

That's why I'm going to make the link.

That's why you pay me the little bucks.

Right.

Is that people are really

upset that they used to celebrate rich people.

They used to celebrate famous people.

Now they look at them.

They used to celebrate outposts of democracy.

Now they look at people who are wealthy and quite frankly white and say, you know what?

These people have just had it way too fucking good.

And I don't need to celebrate them any longer.

I resent them.

I'm not doing as well because of things out of my control or things they decided.

They decided to vote themselves more money and entitlements, but they also wanted to pay lower taxes.

So I'm going to have to pay back this crazy amount of fucking debt.

And meanwhile, my salary in the last 40 years has gone up 6x, but housing, education, and healthcare has gone up 20x.

Yeah, they're not aspirational.

This is not an aspiration.

You don't want to be this.

And, you you know, it's interesting.

I'm all for people having fun, but it really is

uncomfortable.

It is an uncomfortable picture.

And one is because they aren't in on the joke or they don't think it's, they, they're serious.

They're dead serious that this is looks good.

We look good.

You can hear them thinking that.

And, you know, if you look at her Instagram, and I highly recommend it to everybody because it's something else.

The performative nature is, I'm like, why?

What does she need?

And I don't want to just blame her because I think he's right along for the ride with the whole thing, but it's a really,

wow, has this guy come a long way since I first met him?

That's all I have to say.

Anyway, we should move along.

Let's do the Christmas card.

I'll tell you, Megan and Harry are so happy today.

No one loves that photo more than Megan and Harry.

They're like, this is the kind of thing we would do.

Yes, exactly.

Exactly.

Anyway, let's get to our first big story.

Government shutdown averted with Speaker Mike Johnson getting his temporary spending bill passed in the House and Senate.

Schumer left this event.

I was at last night to do this vote, which they did.

So the government stays funded for now.

The bill made it through the House with a 336 to 95 vote, with significantly more Democrats backing the bill than Republicans, although those 95 were, I think, pretty much all Republicans.

This played out somewhat closely to a scenario that Scott predicted in our last episode.

Let's listen.

The exciting outcome here might be that they come to a deal that gets enough Republicans and Democrats where they say, here's an idea.

I need, yeah,

I need some Democrats.

You need some of us.

I can wrangle or whatever the term is,

you know, 150 Republicans.

All you need to do is give me 80 Democrats.

And the Democrats extract their pound of flesh for what they want.

And for the first time in a long time,

someone might be able to stick up the middle finger to the far left or the far right and go, you know what?

When you're this unreasonable, we do find reason to do what we're supposed to do.

Anyway, Johnson is facing some pushback from far-right members.

He's gotten a pass for doing exactly what Kevin McCarthy did from his party for working with Democrats.

We'll get into that.

So, what do you think?

I know you're happy about this, but people think it's not going to last.

He's going to pay the price for this for doing so.

Because they're pissed off the far-right GOP members.

Chip Roy expressed frustration with his fellow Republicans on the House floor.

Let's listen.

One thing.

I want my Republican colleagues to give me one thing, one,

that I can go campaign on and say we did.

One.

Anybody sitting in the complex, if you want to come down to the floor and come explain to me one material, meaningful, significant thing the Republican majority has done besides, well, I guess it's not as bad as the Democrats.

Well, here's your one thing.

We kept the government open.

That was immediately cut as a Democratic ad, just so you know.

What an idiot this guy is.

So what do you think about this?

I know you're sort of positive toward it, but it's still showing the dysfunction here is that they're not able to agree on anything.

Yeah, the problem is my answer is more thoughtful and it's going to get in the way of your pedicure with Martina Navaratolova.

So I'm going to ask you just to like cool your jousts.

No, stop it.

No, you're not going to go long.

Oh my God.

You're talking a lot today, just so you know.

We'll time it later, but go ahead.

Go ahead.

Look, it's all about game theory.

And we have a set of narcissists that love doing fucking nothing but putting themselves in a position of leverage, whether it's good or bad for the government.

So you have Kristen Sinema.

Senator Sinema says, well, they can't pass the Infrastructure Act without me.

I'm probably not going to be reelected as a Democrat.

So I'd really like a million bucks.

And I will get a million bucks from a lobby representing private equity.

And in exchange, using my leverage as the swing vote in this act, I will demand that they pull out the elimination of what is the grossest loophole in the history of of the tax code.

And that is the wealthiest industry and individuals probably in history now pay lower taxes than their assistants, the secretaries, or the guys who clean the office.

And she manages to get that.

And then Joe Manchin absolutely loves the attention he gets from wringing his hands.

And you could argue that there is some principle there because he is serving his constituents, which are mostly red.

And finally, and the market's doing its job here, they said, you know what?

We're not going to let a guy who was last in the news because of accusations of sex trafficking, of which he was cleared, be the hero here all the time and just be intransigent.

We're not going to allow eight fucking crazies to run the government.

And

this was a gift to America because what they forced the speaker to do was his job.

And that is find something that actually both parties could come to some sort of agreement on.

This was actually, I think, a pretty good moment for America when they said, you know what, just being intransitent, and by the way, the next person to find out that his or her political terrorism is not good in the long run is Tommy Tubberville, who has decided that because he's figured out leverage, he can squelch promotions in our military, which puts our defense, which weakens our defense capabilities.

He's just said, I'm just going to leverage this to the hilt because the incentives are be seen as principled.

Don't think about about governing.

Don't think about laws.

Don't think about the Commonwealth.

Take a principled stand.

Go on TikTok and we'll send you more money because money is all about getting re-elected is all about money.

And the problem is there's no governing.

Everyone wants to be a political terrorist.

I think people do talk about it.

This is an interesting quote from Representative Dusty Johnson.

He's a Republican from South Dakota.

Republicans have a choice.

We can work together to get conservative victory.

We can bick or squabble or take hostages and lose.

Some of my colleagues, I don't get the sense that they've been part of very many successful teams.

He was followed up by Representative David Joyce from Ohio, a Republican,

he's a senior appropriator, to put it more bluntly.

Folks believe they are independent agents rather than anything else.

And I do think Johnson is trying to bring people together.

I just think it's almost impossible.

They're cutting him slack right now.

because he's only a few weeks in the role.

They don't have a stomach for more fighting like over Kevin McCarthy.

As you said before, Kevin McCarthy was not well liked.

Congressman Ken Buck said, I am more likely to give grace to Mike than I am to Kevin.

Johnson did throw them a bone, putting out a statement on Wednesday giving support to the Biden impeachment inquiry, which should appease some in the party, red meat, I guess.

I just, I think these performative people are quite successful, except when they have to pivot, like Carrie Lake is in Arizona, suddenly being friends with the McCain people or trying to pretend she wasn't a crazy, and I'm sorry to use this word about a woman, but a shrew about election denial and everything else um so i i do think these performative people it does work for them versus cooperation that's the problem it does work um but this might be a healthy you know a healthy kind of immune response to say okay i i mean all of a sudden matt gates is like irrelevant he's like wait you're you're actually going to govern you're actually going to cross the aisle Because none of these guys have actually any solution.

If you ask them, well, what program should we cut?

Look, it makes sense.

Our deficit, our debt spending are out of control.

It is a real existential threat to future generations.

But then when you say to them, okay, what should we cut?

They're like, oh, I'm not going to go there.

Yeah.

I'm not going to go there.

They don't want to go.

I don't actually want to govern.

I don't want to actually get in a room with Democrats and say, okay,

should we cut spending or raise taxes?

And the honest answer is yes.

We need to do both.

They're not interested in that hard work.

They're interested in just being, you know, seen as principled by the crazies who will mail in 10 bucks after they see them on TikTok inflaming the other side.

And this is,

I mean, it's really,

I was very happy with this.

I was, I was, this, this was overdue.

It's a good moment.

It's a good moment for America.

It's only till January 19th, by the way.

It's not.

But I think it might be, I think even Democrats might go, you know what?

And the Democrats are complicit in this too.

It's like, well, maybe this is a good idea.

Maybe occasionally we should not have things purely on party lines.

Maybe we can do this.

Maybe we can work with this guy.

It's also a good look politically to fix the government.

You know, what's interesting is that it's spilling over all this online performance of anger.

I'm looking at you, Chip Roy.

It spilled over into real life.

One congressman called another a smurf.

Another alleged that he got assaulted in the kidneys,

which was Kevin McCarthy apparently.

kidney punched someone with that guy.

I can't remember his name.

Anyway, then this moment with Oklahoma Senator Mark Wayne Mullen, what a name, and Teamsters President Sean O'Brien in a hearing.

They've tangled before online and in hearings.

Mullen referenced something O'Brien had posted about him on X and then took it further.

Let's listen.

Sir, this is a time.

This is a place.

If you want to run your mouth, we can be two consenting adults.

We can finish it here.

Okay, that's fine.

Perfect.

You want to do it now?

I'd love to do it right now.

Well, stand your butt up then.

You stand your butt up.

Oh, hold on.

Oh, stop it.

Is that your solution every pulling?

Oh, no, sit down.

Sit down.

Okay, you know, you're a United States Senator.

Active.

Okay, sit down, please.

Oh, good God.

What a bunch of idiots.

I mean, you know, I blame the senator here because he started it, but, you know, he took his ring off.

He acted like he was going to have a punching match.

And then he's proud of it.

He's going to, of course, cut his own ad.

You know, this

it's interesting because I was reading up on the assault on Charles Sumner before the Civil War by Preston Brooks.

Same thing.

It was all planned, performative.

I think, you know, they used to duel then, but this is just ridiculous.

And here's Bernie Sanders like, dad, like, you can't do that.

That was weird.

That was weird, weird, weird.

This broke my heart.

You know, you see this, you see that imagery.

I think it's the parliament in South Korea where they regularly break into fisticuffs.

And

this is such, this is literally the worst

clip for the American brand in a long, long time.

And the Senate is supposed to be the finest deliberative body in the history of democracy.

And they say, you know, they reference each other when they're on face and nation.

Well, my good friend, I even think it goes back to dress code, Kara.

I think there is a decorum here that says we are the most impressive nation in history.

And part of that is where there's a certain congeniality, a certain decor, a certain civility.

I think that senator should be censured.

I think it is so incredibly disappointing that

this is going to show up in the TikTok feed of my kids, my boys.

And it all goes back to a previous story.

Sheryl Sandberg and Mark Zuckerberg.

And I'll bet you there are millions of anonymous bots,

anonymous bots egging this on.

You don't think the GRU and the CCP have gotten a hold of that clip and said, oh my God, dial this shit off.

Right.

Yeah.

I do.

So this all goes back to the same thing.

The amount of damage that Mark Zuckerberg and Sheryl Samberg have levied on this nation by tearing at the fabric that is now seeping everywhere, resulting in civility.

What does, if you can't beat them kinetically with military power, you can't beat them economically, you can't beat them on moral values, get them fighting each other.

And this is another example of that.

The only person who came out looking good here was Senator Sanders, who was literally like, okay, there's one man in the room, but that senator and that is union representative.

There are few things, there are a few things online that will get more virality because of these anonymous bots from bad actors that make our nation look worse than what happened here.

It was devastating.

I would agree.

I would agree.

And I think Republicans know that.

Representative Kelly Armstrong, a Republican from North Dakota, you'd think would love a fight, compared Republicans infighting to grade school bullying.

She She said it's the same clown car with a different driver.

We essentially don't have the majority because of the way they're behaving.

This is just it's ridiculous.

They're children.

But look what's happening.

Kevin McCarthy in the vote for the speaker rushes over and supposedly he elbowed a colleague.

You know what?

Any of that shit.

Any of that shit?

He also was like cute about it.

Like it was a tight haul.

Fuck you, Kevin.

Fuck you.

Like, you don't do that.

You don't have to put your hands on people.

You're supposed to be the role model for young men around the world.

I mean, for God's sakes.

I know.

Well, he's not.

He's please.

He's just a terrible person.

Honestly, that would go.

He didn't just the fact that, you know, oh, it was a tight haul.

That's how he used his excuse.

He obviously elbowed a guy.

In his back?

It's just ridiculous.

A lot of reporters there thought that's what he did.

And it's just that's an assault.

You shouldn't be, you shouldn't be allowed back in the cat.

And what does that mean?

And here's the next step.

The next step is, if you normalize two men being violent against each other, when do we start normalizing men being violent against their female colleagues in the Senate?

I mean, this is, you have to cauterize.

There has to be a place.

Well, why I was so pissed about this cage match.

Same exact thing.

Same exact thing.

The most blessed people in the world have decided that our country is so fucked up that it has to digress to violence, even among its most blessed citizens.

Yep, I would agree.

Anyway, you're all an appalling group of people.

It is a clown car.

It's not a clown car.

It's like a vicious clown car.

All right, Scott, let's go on a quick break.

When we come back, we'll talk about the unprecedented surge in hate speech on social media tied to the Israel-Hamas war.

And we'll speak to a friend of Pivot, Adrian Aoun, who's using AI to try to revolutionize healthcare in the U.S.

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off.

We're back with our second big story.

We're learning more about how anti-Semitic and anti-Muslim hate speech has surged on the internet and social media since the Israeli-Hamas war began.

Academics and researchers who study social media are saying hate speech is far higher levels than they've been before, according to the New York Times, including millions of explicitly violent posts on X, Facebook, Instagram, and TikTok.

We've been talking about this since the war began.

I'm not sure there can be much done.

Content is both driven by emotion over the violence and stoked by extremists looking to forward agendas, according According to social media researchers, a number of posts have been shared in like hundreds of thousands of times, even though they seem to violate platform rules.

Even when some of the explicit content is removed from the platform, there's a veiled content that remains, the words and phrases that get past filters.

Early on, it seemed like tech leaders might face consequences, but that hasn't happened.

TikTok, of course, has faced a lot of criticism, accused of pushing pro-Palestinian content, as some have noted disparity between the number of pro-Palestinian versus pro-Israeli hashtags.

But Facebook and Instagram data show a similar gap with pro-Palestinian hashtags being used on significantly more posts, according to a piece in the Washington Post.

Of course, Elon Musk replied to an anti-Semitic replacement theory vile person, you know, about this.

I don't even want to repeat it.

He just did more anti-Semitic behavior.

We've been talking a lot about the role of TikTok in this war.

We've heard from listeners as well.

What's your take on it right now?

And does the fact that pro-Palestinian content appears dominant undercut any of the China arguments?

I'd love your thoughts on that.

Why would you say it undercuts the Chinese arguments?

It undercuts the Chinese arguments that China is directing this on TikTok because it's on all platforms.

It is on all platforms.

And some people don't think you should use hashtags as a metric, but it's clearly being used

to further propaganda.

It's kind of a mess out there, and these companies are not monitoring it in any way.

But it is not just TikTok.

It's all the platforms.

Yeah, I think evidence is going to show that TikTok, well, well first off see above anonymous accounts and the downside of anonymous accounts if you find really vile on islamophobia or anti-semitic content or you're going to click on it and it's going to be an anonymous account uh

very few individuals want to put their names behind this and i just don't think this represents how most people um how most people actually feel i think it seems obvious to me we're going to find out that the ccp was putting their thumb on the scale and by the way i think if the whole if the nation, and this would be heartbreaking to me, but if the whole nation was rallying around Hamas, I think on TikTok, you'd start seeing more pro-Israel content.

I think they are not, we provide them with a weapon, we provide them with a spark and a fire, they just pour gas on it.

That 70% of people my age are pro-Israel because I grew up with an Israel that was Munich, the 67 war, and Israel were the good guys.

And because of far-right extremists, you might even argue, inhuman policies on behalf of Netanyahu and the religious extremists in Israel, Younger people who also conflate wealthy white people, and there's not no one wealthier and whiter than the state of Israel right now, they conflate them with impressors and, incorrectly, in my view, see the struggles of the civil rights movement as being analogous to the struggles the Palestinians are facing without really doing their homework and looking at this.

This is essentially Hamas, is the Nazis minus the industrial might.

Actually, that's not fair to Nazis.

Nazis weren't embedding command centers and hospitals and schools versus Hamas

militants who call their parents to brag about how many Jews they've killed at a music festival.

They have not done their homework.

And the problem is that I believe these platforms have algorithms.

They get a lot of engagement and more Nissan ads by elevating this incredible incendiary content.

And I believe that the CCP would be stupid not to use this wedge issue as to get us focused on hating each other versus passing bills.

But it's across platforms.

You would acknowledge.

I mean, it is not not just,

they're using all the platforms, and all these studies show that.

It's not just TikTok, it's all of them.

I think all of these platforms have been weaponized by bad actors.

This is a sample size of one.

This is pulse marketing.

My feed on reels is distinctly different than my feed on TikTok.

And it might be just an indication that younger people are less pro-Israel than on Reels.

But all of these platforms, again, in my opinion, have been weaponized by bad actors.

And under the auspices of free speech and shareholder value being built at these companies, they let this content run amok.

And it's not really representative, in my view, of how most Americans feel.

But they keep seeing it.

And we keep getting angry and angry at each other.

It's like we go on the hunt for fake Islamophobes and fake anti-Semites.

And I believe both are out there.

But this content would lead you to believe that America is just rife with both of those things and get us angry and upset at each other.

Yeah, I think they're using all the platforms.

This is on Facebook, hashtag Free Palestine had more than 11 million posts, 39 times more than Stand with Israel.

On Instagram, pro-Palestinian hashtag was found on 6 million posts, 26 times more than pro-Israel.

It's a question whether hashtags should be the thing used, you know, for what is the metric here and what is the, you know, where is it being done?

I think it's been doing across these across these platforms.

And, you know, and I recognize the worries about China and TikTok, but I think all these platforms have been used

in the same way.

And if I were China or Iran or Russia, these

are doing that.

But one of the things the post points out, and I think they're right, hashtag offers a deeply limited and simplistic way to analyze the shape of social media conversations because users often add them to videos that are unrelated to the issue or seek to criticize the point they mention, comparing the the views of pro-Israel and pro-Palestinian hashtags around the world, as TikTok's critics have done, does not take into account that many of the videos come from predominantly Muslim countries with high levels of Palestinian support, or as TikTok argued, that stand with Israel hashtag is newer than Free Palestine and therefore less time to add it to people's posts.

It doesn't factor in the generational gap.

You're absolutely right,

which is very real, which is

incredibly real.

And I think later we'll find out exactly what the usage was, if we're allowed to.

But it's complex.

And what it actually goes to is, I think, the point you're making

is that

these pathphas are being used to weaponize the population overall.

And that's what they're there for.

And they're not doing their job in taking the temperature down.

Look, do you remember in the third or the fourth grade when it was usually a new kid and there was some words, not even really harsh words, and a bunch of people might surround them and shove them into a circle and start screaming, fight, fight, fight.

And all of a sudden you you found yourself like, okay, I don't really want to fight.

Yeah, that never happened to me, but I've seen it.

It seems to happen to me a lot.

So not a lot, a couple of times.

Take that times a trillion.

That is what social media has done to the world.

You have algorithms with rewards and gamification following you around everywhere.

Someone says something a bit off color about something or uses the wrong phraseology.

And in your ear, constantly someone going, fight, fight, fight, fight.

Get back in their face.

Oh, maybe they, maybe, don't take the gesture with the intent that it was given.

Use it as an opportunity to score virtue points and get back in their face.

Get more and more coarse.

And even if it's an anonymous account, go crazy and invite other people such that we can sell more fucking Nissan ads.

It is the, it all leads back to the same place.

We have real problems, real fissures in this country, but we've let other people, other bad actors who are not our friends, who are our adversaries and sometimes our enemies, show up freely with a cannon of gasoline.

Yep.

And it jumps into real life as it's done in Congress.

This is all about performative.

100%.

This happened online.

All these guys were talking about shit that had been said to each other on X.

If...

Our senators and our leaders don't set an example and take the temperature down.

If we don't get over this ridiculous bullshit about about anonymity that's been fomented by the packs of these organizations, it all comes together.

We are tearing each other from the inside out.

We could also all agree on the Jeff Bezos Lawrence Santos picture.

Okay, Scott, let's bring in our friend of Pivot.

This is a surprise for you.

This is going to be really interesting, I think, to you, but maybe not.

We'll see.

My age, if you surprise me, I could slip and break a hip, Kara.

Okay, you might break a hip here.

All right.

Adrian Aoun is the CEO and founder of the health tech startup, Forward.

This week, the company announced its latest venture, CarePod, which has been billed as the world's first AI doctor's office.

Welcome, Adrian.

Thanks for coming.

I have purposely not told Scott about what this is, sort of in vague terms, because I want you to make a pitch to him of what it is exactly, CarePod.

Now, obviously, you run Forward, which was a new kind of doctor's office for people,

which is a physical place people go.

It's a little like concierge medicine, but a little different.

But talk about what CarePot is doing.

The premise that we started with was we said, look, there's billions of people on the planet who don't even have access to healthcare.

So you start asking yourself, like, what would it take in the year 2023 to deliver healthcare to like literally the entire planet?

And we kind of know how to do that, right?

We've got these things called smartphones that I now are in the middle of India, the middle of Rwanda.

So we said, okay, well, the key insight being that if we can convert things to hardware and software, we can scale them up.

So what we did is, as you mentioned, we've got these clinics, we kind of watched what's happening inside of them.

And every time a doctor did something, every time a nurse did something, we said, Can we shift that to hardware and software?

If you go do that for quite some time, at some point you wake up and you realize you've kind of moved almost everything over.

Maybe not everything, but almost everything over.

And what you're left with is just the hardware, just the software.

We call this a CarePod.

So, basically, just think of it as this cool little box.

It's almost for those of us that watched too much Star Trek as a kid, us nerds, just think of it as the medbay from Star Trek.

It's a cool little box, you walk up to it, you unlock it with your phone, and immediately it's like, hello, Scott, welcome to Ford.

Please step inside.

And as you do, it shows a bunch of different apps on the screen.

If you choose something like the body scan app, it says, please stand still.

And then it rotates you in a circle, takes a whole bunch of your readings, shows you the results on the screen, explains them to you, and then gives you whatever treatment you need, whether it's a prescription, something else.

Let's say you choose Heart Health.

This one's pretty awesome.

It opens a tray, hands you a sensor, shows you how to hold that sensor against your heart, and then again, takes the results, you know, explains them to you, gives you your treatment.

So probably, Kara, the best way to think about it is almost the same way that you think about an ATM.

And by that, what I mean is an ATM doesn't do like everything that a bank does.

It does maybe 90, 95%.

You lose your credit card, you can still call the teller.

Well, for us, it's the same thing.

We still have doctors behind the scenes, but now those doctors, they're just there for kind of the final five or 10%.

You video with them just because you've got an exception case or you just want to chat with them.

And most of your experience is really just dealing with this kind of hardware sort of device.

And the cool thing about that is we can launch them everywhere.

They're not limited like the amount of doctors on this planet.

I mean, you've seen us build billions of iPhones on this planet.

So imagine having healthcare like on every street corner.

Imagine having apps developed by entire companies focusing on just one thing at a time.

Like that's the world that we're trying to create.

All right.

So Scott, I want you to take us apart.

Now, just Adrian has made the analogy to Tesla, the doctor's office, which Forward was is Tesla's Model S, the CarePod is the Model 3.

Scott, I want you to have a hat.

Adrian, please.

This really is a surprise.

And Adrian, I think

kudos to you.

I think the intersection between AI and healthcare represents an enormous opportunity, perhaps even the biggest opportunity in our economy.

The first question I would have is

at 99 bucks a month, first off, I haven't heard how AI right now is nothing but a moniker to try and raise cheap capital.

I don't maybe so understand why actually how AI integrates.

And then my second question would be at 100 bucks a month, this is yet again another healthcare startup focused on the upper middle class or the wealthy, as opposed to the people who actually need it.

So what are your plans to try and push this into the corners of America that really need preventive health care?

Well, let's go even further than that.

Not only do I agree with you, I'm going to beat myself up even harder, which is like, let's not talk about like the corners of America.

Let's talk about the corners of Rwanda.

Let's talk about the corners of India, right?

Where like $9 a month is probably too much, right?

But you've kind of seen this story play out before, right?

Like the first iPhone was 800 bucks.

Now in the middle of India, we've got smartphones for 20 bucks.

So like, how do we get there?

And roughly, it's, it's the classic Moore's Law, right?

What we're doing, if you think about it, is we're shifting healthcare from a high,

sorry, low CapEx, high OpEx business.

In other words, a normal doctor's office that costs nothing to make and it just costs a lot to pay the doctors.

We're shifting that to a high CapEx, low OpEx business.

You build a CarePod, but then it costs almost nothing to run it.

You've already built it.

And we've seen how both of those models play out.

So, like, Kaiser is the low CapEx, high-op X business.

Kaiser has not been able to go global.

In fact, no healthcare system has ever been able to get to, you know, even 100 million users, much less a billion users, right?

But we've also seen what happens when we convert something into a tech company, aka high CapEx, low OpEx.

You know, Google has data centers all throughout Africa.

Like, why?

Well, even though that data center costs Google a billion dollars, it amortizes so incredibly well because because it scales.

So the trick for us is the more that we can get healthcare to be an infrastructure problem, the more we can get healthcare to scale, the more we can plummet that cost.

Now, I don't think this is an overnight thing.

And I think if you want to push back on that and say, sure, Adrian, but you're at 99 bucks, you're right.

And I hate being at 99 bucks.

We started for it at 149.

A few years later, now we've cut a third of our price.

We're down to 99.

But I think we got a long way to go.

Next, I want to get to 79, then 59, then 49.

We're just going to keep going until literally we can deliver these to the ends of the earth.

Talk about how AI is integrated into the product.

I'm totally with Scott that basically most everybody does like one logistical regression and then they call it AI.

But, um, but okay, so here's what we're doing, and this is a lot of newer technology, candidly.

But what we're doing is we've written an AI that can go out and kind of read modern research.

So think of this as published research.

So let's say you give it an article from the New England Journal of Medicine, from

you know, Stanford, from UCSF, from any of these kind of academic institutions.

You give it an article on a condition.

It can actually read the article and then extract out what we call in our world a clinical protocol.

Basically, just think of it as a big flowchart of if this, then that.

Like to treat your hypertension, the first thing we need to know is, is your blood pressure this?

The next thing we need to know is X.

The next thing we need to know is Y.

Then once it kind of maps that out, and that could be hundreds and hundreds of nodes, then what we do is we map that onto the carpod.

So for example, if it says, what's your blood pressure, the carapod's smart enough to say, oh, we should give you a blood pressure cuff.

If it says, what's your A1C, the Carapod's smart enough to give you a blood test.

And that allows us to basically say, can we go from a paper to an app that a user can experience?

In fact,

we're even kind of exploring and playing around, and this is very early for us, but with some generative AI to say, can we go ahead and create the experience inside of the Carapod just based off of that clinical protocol.

Now, the reason this is fascinating is if you think about it, there's all this amazing research out there.

And yet, all that latest research has a lot of trouble getting to consumers, much less the middle of India and Rwanda.

It doesn't get to people in San Francisco, because could you imagine every doctor having to somehow sit there and read every single paper and remember it?

It's just an absurd concept.

So that's a little of how we're using it.

Now, one of the things that you have to be really cognizant of is that AI today just isn't at the level of accuracy that you would hope for something like

modern medicine.

And so what we do is we then take anything that the AI has kind of learned and we show it to a doctor to say, Hey, go ahead and review this.

And we give them a bunch of tools where they can kind of test through a bunch of situations and look at where the errors are, and they can kind of manually go and tweak it.

And by manual, I mean, actually, it's pretty cool.

They can just talk to the AI.

Oops, you made a mistake here, you made a mistake here, but they can kind of get it to a point where it's like solidified and stamped.

Does that give you a good sense of it, Scott?

Sure.

So, are you selling into the consumer?

Are you selling into the enterprise, to healthcare systems?

What is the business model and the distribution strategy?

Yeah.

Yeah.

Awesome.

So we're entirely direct to consumer.

What we've been doing is we've been launching these CarePods in like malls and office buildings.

So just think Ford's historically lived mostly in malls.

So think of like the Westfield, the Simon, the Maystreach Malls, all the kind of major malls that you know.

And we're starting for the first time to explore kind of office buildings.

So for example, we're going into Sears Tower.

I think now it's called Willis Tower, but when I grew up, it was Sears Tower, so I'm going to keep it that way,

which is one of the biggest buildings in the United States.

We'll be live there in just a couple of weeks, and we're going to see how that works.

But in both cases, we're going direct to consumer.

Now, you said, well, $99 a month feels high.

And, you know, in some ways it is for sure.

But in some ways, it's not that bad.

And I'll tell you why.

You know, most people in the United States, if you have insurance, literally $99 a month is cheaper than using your own deductible.

So I think it's insane that we've created a healthcare system that's that expensive to use, but we have.

And so Ford's a pretty good deal when you consider it includes your blood tests, DNA sequencing, you know, as many doctors appointments as you want, that sort of stuff.

When you do this, this has insurance is not acceptable.

By the way, Scott does not have health insurance because he's sort of figured out he doesn't need it because he can afford any big thing.

How does it compare to, say, the minute clinics, which have had an up and down

situation?

They haven't worked out very well.

And also one medical, which Amazon is trying to do, which is doctor heavy, but much more efficient.

I would say I've had a great experience there getting tests when I have, you know, the flu or COVID tests.

Yeah, totally.

So, what we're doing is we're looking at the existing system.

Like, when you look at the one medicals or people in that space, what they did is they took the existing system and they said, let's, yeah, I don't know, let's put a pretty couch and a mobile app in front of it.

Like, okay, that's that's not what healthcare should be in the year 2023.

I want a world where we go insanely deep and use all the technology possible, but that's not the world that we have today.

I'd encourage you to go walk into like any healthcare system on this planet and be like, hey, let's go ahead and sequence my DNA and understand what's going to happen to me in 20 or 30 years.

And they're just going to look at you like you're crazy, much less say, hey, I've got these wearables that are collecting some data.

Do you want to do anything with it?

They're just going to be like, no, leave me alone, right?

Like, 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-you don't like the couches at one medical, then.

I don't even want to wait.

Are you kidding me?

Why 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, uh, the world that everybody else is going after, and the reason they're struggling so much is they're saying, look, we want minute clinics to be everywhere.

Okay, that's awesome.

I want that too, right?

We want whether it's one medical or CVS or all of these to be everywhere.

But the problem, the fundamental problem of healthcare is that there's not enough doctors.

They're really expensive.

And you know what?

Not that many are graduating.

So what are you going to do?

Are you going to magically like print me a million doctors that somehow cost almost nothing?

You're not going to 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 ran a

big segment of the search engine.

And

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 billion 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, for once and for all, scale healthcare to the masses.

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 healthcare system right now.

Totally.

So the healthcare 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 a rash?

It's like, it's not exactly the thing that's killing us right it's the heart disease it's just the cancers and so what you do when you come into for the first thing you do is what's called a 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 healthcare 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 healthcare system wants to focus on the flu because that's going to keep you out of work.

And they don't want to focus on the cancer because you're going to get that in 20 years.

Why prevent something that's going to be the next guy's problem?

Why incur that cost?

So we've got a healthcare system today that's focused on keeping you at work, not keeping you alive.

And we're trying to invert that model.

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.

But there are doctors that then, if there's an issue or you want it followed up for a very serious thing.

Correct.

We have doctors because sometimes you just want to 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.

just so people know you go in and then different

blood pressure cuffs or testing things or a covet test pops out or blood tests or diagnostics or swabs they pop out of doors they and they tell you how to do it i like your version we pop out of doors but i'm going to 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 3g 5g lidar gp well we're just constantly looking at what we can add ourselves what's your biggest worry here that people abuse these pods or that because they're not monitored or not not really or that what that you'll have a wrong diagnosis and get sued 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 um 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 have built batteries before.

People have built gas stations.

Sure, you're electric, but whatever.

People built mines.

People built factories.

People have built all these things.

But then when you look at like one company doing all those things, you want to pull your hair out.

It's like really, really complex.

And so for us, the number one challenge is just execution.

Like if we die, we're going to 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 that's the thing we spend all of our time trying to de-risk.

Scott, thoughts?

Last thought?

What do you think?

How do you think of that?

Does I voice it this upon you?

I think one of the 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 generally, genuinely pulling for you.

It's not,

I think this is exciting, and I just hope that this doesn't digress into what every other kind of VC-backed healthcare startup, and that is essentially serving one constituency, and that's rich families in Palo Alto.

So

I'm pulling for you, brother.

Well, that won't happen on my watch.

I promise that.

All right.

Adrian, thank you so much.

I hope you enjoyed this, Scott.

I like to have a little pitch session.

I'm going to do new things called Pitch Scott.

I think it's interesting.

Adrian's a very interesting entrepreneur.

Yeah, a couple of things.

One, 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 turned to sex work?

Can that be my next surprise?

No, no.

This is about, I wanted to get your, you're actually like, I just heard about this.

I mean, there's good surprises and there's great surprises, Kara.

That was a good surprise.

This is a good surprise.

This is interesting.

That was a good surprise.

Anyway, it's an interesting idea.

Adrian's a really interesting entrepreneur.

And I always find him very thoughtful.

You're the only woman I would trust to pick out a sex worker for me.

What does that say?

Is Is that a good thing or a bad thing?

Okay.

All right.

We're moving along.

Once again, I brought you something substantive and interesting.

We're going to have more of these pitch sessions to see how Scott reacts.

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.

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Okay, Scott, let's hear a prediction and quick, because I got to get to Martina.

Look, I'm trying to be more hopeful.

My prediction is that the ultimate iron dome for Israel is formed in 12 to 24 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 basically we have the entire British military sitting off our shore, and it's not there to say hi.

It's there to keep 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, and this, let me just go very cross.

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 the kingdom.

I think MBS, and he'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, I 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 going to go through this.

And we're going to have a normalization of relations between the kingdom and Israel, which will create an unbreakable alliance.

Oh, interesting.

I think that's a very substantive prediction.

That's a really interesting one.

I hadn't thought about that.

I'm going to make a short prediction.

With this revelation of the 36% that Google's paying to Apple as a VIG, I don't think they're going to win this case.

You think Google's going to be ⁇

you think Lena's going to get her win here?

Is it the DOJ or the FTC on this one?

It's the DOJ.

Got it.

That's really interesting.

What do you think the remedy will be?

I don't know.

These things can go on and on and on, but boy, was that ⁇

I had heard it was 10 billion 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,

Muriel, 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.

Will you send a message to Martina for me?

Yeah, what?

The jarhead straight guys like me that grew up on i Dream of Genie and Three's Company, who were, I don't want to 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 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.

All right.

We're going to have an interesting discussion.

Yeah, she's an impressive woman.

She's made a real difference.

Yeah, we're going to have an interesting discussion.

She also has some

trans issues.

She's been pretty adamant that

people born with penises shouldn't play and be allowed to

garner all the rewards and endorsement income and accoutrements and scholarships.

Yes.

You mean she has common sense, Garrett?

Okay.

We're going to have a long discussion about it.

Oh, so she has common sense.

Oh, okay.

All right.

Where's the sex worker with the handcuffs?

Brian, the handcuffs.

There you go.

There's our letters for this week.

There's the letter for this week.

We had such a nice show.

You really need to stop talking right now.

We want to hear from you.

Send us your questions about business tech or whatever's on your mind.

Go to nymag.com slash pivot to submit a question for the show or call 8-55-51PIT.

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.

Today's show is produced by Lara Naiman, Zoe Marcus, and Taylor Griffin.

Ernie Andretot engineered this episode.

Thanks also to Drew Burroughs, Meal Severio, and Gaddy McBain.

Make sure you subscribe to the show wherever you listen to podcasts.

Thanks for listening to Pivot from New York Magazine and Box 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.

Mike and Alyssa are always trying to outdo each other.

When Alyssa got a small water bottle, Mike showed up with a four-liter junk.

When Mike started gardening, Alyssa started beekeeping.

Oh, come on.

They called a truce for their holiday and used Expedia Trip Planner Planner to collaborate on all the details of their trip.

Once there, Mike still did more laps around the pool.

Whatever.

You were made to outdo your holidays.

We were made to help organize the competition.

Expedia made to travel.