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[00:00:15] Rick: Welcome to the healthcare nation podcast. Rick Gennady here, your host with our producer, Joe Woolworth. Joe, how are you doing my friend? I'm doing real good. How are you doing? Okay. Look at, you know, it's been a little more than a week since we're in here. So I'm just really itching to get back in.

[00:00:31] There's so much in the news and so much stuff, you know, we take a look and hopefully for those of you who watch the news and sometimes I get. Stuck it looking at the crisis news network. Nothing but bad stuff out there. Certainly not that emphasized the positive, right?

[00:00:47] That's right. But anyway, what's happening with you? Anything new and exciting?

[00:00:50] Joe: A couple of things. Dropped my daughter off for college. That's exciting. Milestone. Yeah. Milestone. That was good. Yeah. We're excited about, we're excited for her, but it feels strange at the same time as parents.

[00:01:00] I had my physical this morning. I thought it was interesting. This is the first time ever in a physical that they asked me about my mental health.

[00:01:07] Rick: Oh, wow. Well, let me ask you, if I can when was your last physical? It was last year. And they didn't ask you about your mental health last year? Not that I recall, no.

[00:01:17] They may be missing something in the USPTF guidelines. I'm not sure about that, but I would say this. Let's, let's just take it for, for what it's worth. Number one, look, everyone's checking in. This is part of a good, I would say this, not to weigh in with any expertise. This is a good part of evaluating someone, right?

[00:01:36] Part of it is you gotta look at their mental health. It's, it's, it's totally intertwined, interconnected, and synthesized with your biological health. So it makes perfect sense, you know. And I think this is honestly something that is now... Hardwired in to annual physical exams or whenever you go for your physical exam biannually, etc.

[00:01:55] And are part of the public health task force guidelines. So, glad they did it. And hopefully this podcast keeps your mental health on balance nicely.

[00:02:05] Joe: Absolutely. So, switching gears I wanted to talk about this recent article in Foreign Affairs that you referenced on one of your recent LinkedIn posts, it highlighted the strategic risk exposure in AI between the U.

[00:02:17] S. and China, and I was wondering if you could elaborate on why you said AI is seen as a zero sum game and how it might affect the global health

[00:02:26] Rick: sector. Sure. Yeah. Thank you for bringing that up. And I did commit in the LinkedIn post that I put out there that I would bring it up here at the, at the podcast and great article written by Ian Bremmer from the Eurasia Group, who is one of my absolute favorites when it comes to, you know, global policy, not necessarily healthcare policy, but But what's happening around the world, not only in in Asia, but Europe and a lot on the U.

[00:02:51] S. But with respect to my responses in that article and focused on what you're asking with respect to zero sum game, I think the bottom line here is, from my perspective arises from from from the competitive stance. This zero sum game perspective between U. S. and China, primarily. And why is that?

[00:03:14] Together, the two countries contribute to over 70% of all the research in, you know, artificial intelligence, generative AI, etc. So how does this relate to the healthcare sector? Look, when you're thinking about national interests, when you're talking about strategic priorities, when you talk about intellectual property, When you, when you put it in context of competitive advantage, if you're really looking at something altruistically like bettering the lives of individuals, patient care delivery, and how absolutely powerful.

[00:03:48] AI diagnostics are and how much they're expected to grow. I think the gaggers well over 40% and when you look at it for the next five years, it's a big issue. So I wanted to comment on it along those lines and the zero sum perspective again, really comes from the competitive stance between the U S and China.

[00:04:06] Joe: And I guess that it's supposedly the global market for a healthcare is supposed to reach 34 billion by 2025. So I mean, that's. It's

[00:04:13] Rick: staggering. It really is. And I think for those of us who dabble in it, who play around with it, who are seeing the absolute benefits it could bring for augmenting what you're doing, you could easily come to that conclusion of why it's that number, if not more.

[00:04:30] Right. And I think

[00:04:31] Joe: a big part of this is collaboration seems like crucial, critical. What countermeasures in strategic planning might enable this, especially considering the national interests that are at

[00:04:41] Rick: play? Yeah, that's a great point. And look, one of my areas of focus, certainly in, in healthcare and what I do advising startups and, and companies that are out there playing in the sector is the risk and the strategy component together.

[00:04:55] So. When you talk about collaboration, as you brought it up, look, it's, it's complex and thinking about what countermeasures would you want to put in place, at least in context with, you know, international Issues related to ethical AI, you know, I think it's got to be data sharing protocols particularly since given the proliferation now of, of data flows cross borders, this is really important.

[00:05:23] But at the end of the day, I would say for any company, and I'm not talking about the government here, but certainly companies and startups should think about this that have, you know, international either funding or components of the work that's, that's done overseas. Considering policies that have the national interest front and center with respect to everything I just talked about that still advance shared goals and trust, but again, without compromising the national interest is essential.

[00:05:50] So what does that look like? It looks like you've got to do political, economic, strategic, technological assessment of anyone you're going to be doing business with if it's an international player or who's funding you. So I think that's my thoughts on the complexity. And when it comes to the collaboration, that's got to be front and center of any conversation.

[00:06:12] So

[00:06:13] Joe: intellectual property and innovation, these are big issues. How might that be addressed in the context of this debate?

[00:06:21] Rick: Yeah, so listen, I'm not a lawyer, but IP comes up a lot in the conversations I have with the folks that I work with. And look. Protecting your IP so that you can have that competitive advantage and, you know, put your thumbprint on an innovation that's going to be commercialized.

[00:06:37] Absolutely important. So let's just agree on that first and foremost. When you're thinking about China, I'm not characterizing it in a negative way. I don't want to do that, but here's the reality. Look, they're competitive. Many would say they're adversarial. And when it comes to intellectual property, I think the history has not been one of forthright collaboration when it comes to copying everything, if I could.

[00:07:03] I don't know, I wouldn't characterize it that way. So clear agreements and understanding regarding international laws that protect folks who are doing business over there. I would just encourage folks to Seek out those content experts in that area. And, making sure, to the extent you can have it, contractually.

[00:07:21] adherence to regulations that are protecting your IP is vital. And again, look, I'm not an expert on, on the international side of this. I think many know that I teach in, in, at NYU in the Health Law and Strategy program. There are experts out there who, who work in this area. And if you're doing business, With folks who are overseas again, and you have a new and novel idea, particularly when it comes into this space that's developing so fast, AI, generative AI, et cetera, get the experts on your side so you can protect it.

[00:07:56] Joe: And it seems like there's also like in kind of an unspoken extra complication with AI and IP. It's like, well, if AI says it, then whose IP is it? Is it the person who wrote the prompt? And it seems like we agree to disagree on a new. way to do it every couple of days it seems. That's

[00:08:14] Rick: a great point. It's like who owns it?

[00:08:16] Right. If it's being informed and populated by, you know, the aggregate writ large, then how can you sort out who owns what? And I think this is... where the algorithms and the control of everything from prompts to access and the you know, the UI component comes into play. And if there's some unique feature that an individual company might have, and we're talking here obviously about clinical health care health care delivery in the sector.

[00:08:45] So it, there is an area of, I think, real specificity around that, that may make it easier to. to call out the, the, the guardrails and the specifics associated with the nuances of health care. Right.

[00:09:00] Joe: It's, it's interesting to consider the balance of collaboration and competition. What impact is the U. S. China rivalry having on health care delivery, particularly in the developing regions that might rely on technologies from both nations?

[00:09:14] Rick: That's another good point. I'll tell you, because we're talking here, right, it's a global issue, but we're only thinking about this, you know, competitive aspect between the United States and China as it relates to. to this subject, AI and its application in health care. But there's a whole wide world out there.

[00:09:29] And if you take a look at what both countries are doing, and again, I want to stop short of saying I'm an expert and think more in general, generalities here. Both countries are exporting health care technology. But when you look at China's, you know, Belt and Road initiative, they're looking at infrastructure and investment in some of these, you know, third world countries that are out there and where they're dabbling.

[00:09:51] And we know this in what What they're doing in Africa and also I believe in, in certain areas of South America, that's, that's kind of juxtaposed with the U. S. where we project maybe more, more focused attempts to assist, advance and create a different level of structure when we're, when we're exporting healthcare in the developing world.

[00:10:13] The other thing is, I want to get back to your, your previous point when it comes to. where the U. S. does, I think, stand out front first and foremost is, is also the emphasis on IP protection and the alignment with that as well as you know, making sure that from a public health perspective and a global health perspective that we have a leadership role in there.

[00:10:35] Now, at the end of the day, I think that developing countries are going to feel caught between these two different access and, and they're going to be facing, Hey, where's the best return on investment for them? And that's where I think a lot of the advancements that, and this is my opinion, China has made in these third world areas where they're, where they're working as, as paid off for them.

[00:10:56] Yeah.

[00:10:57] Joe: So it's, it's Tuesday when this episode is coming out and tomorrow there is a GOP debate. Now Trump won't be there. But I thought this would be a good time to discuss the health policy perspectives of the candidates. So you want to kind of just give us a quick

[00:11:12] Rick: rundown? Yeah, how do you want to, how do you want to do this?

[00:11:15] I think we've got a nice set of players. I've obviously got the field in my head, but I won't pick everyone, but do you want to do similarities and differences? Yeah,

[00:11:23] Joe: let's, yeah, let's start with similarities. Like overall, what's,

[00:11:26] Rick: okay. So let's, let's break it down into like four different areas. Mental health and talk about Medicare, which is always top of mind.

[00:11:36] You know, reproductive rights, abortion. And then maybe the, the overall system, if I broke it down into those four areas, those are

[00:11:44] Joe: kind of like the good four that they're always in the stump, you know, here's what I

[00:11:48] Rick: got. And then let's hoping from a moderator perspective, they're going to be, you know hopefully there'll be enough time.

[00:11:54] Set aside in the overall debate to really focus in on health policy, because it's big, and it's a make it or break it, you think

[00:12:02] Joe: it's as, health policy is as big of an issue in this election as it has been in previous elections?

[00:12:07] Rick: I think it's a big, first of all, we're looking at now the GOP debate, so looking at a front runner ultimately at the end of the day, and we've talked about this before, from a Democratic or Republican position, there are differences in the approach with respect to health policy, health care delivery.

[00:12:23] And everything that goes into that. I think when we look at this debate with the, with the GOP slate, it's really going to get into the nuances of, that differentiates each individual potential candidate from the others. So that's the way I'm looking at it. And then, Look, we'll, we'll certainly come back with another episode and have some experts on that'll, that'll contrast the, the, the Democratic position with the Republican position and we'll unpack the, the Dem side as

[00:12:52] Joe: well.

[00:12:53] Yeah, I imagine the GOP side is going to be pretty similar, but with differences in approach, like this is how I would do it might be what separates them from each other. Yeah,

[00:13:02] Rick: totally, totally agree with that. There, there are some nuances and we'll break it down. On the mental health side, I would say, look, it's such a big issue.

[00:13:09] Not going near this would be crazy. Right. Forgive me for that. the reality here is, I think there's general agreement among the candidates with respect to mental health and certainly the recognition that it's a significant issue that has to be addressed. Now, when you unpack that former President Trump, Nikki Haley, They talked about maybe the structural components to addressing it, you know, facilities and building out that, that's different from what you will hear from Chris Christie and, and, and Scott and Senator Scott and in also Ramaswamy.

[00:13:48] So, we just want to call that out there without getting into details, but there is general agreement. It's a big issue, but the nuances are in there are, are, are different. Yeah, I think.

[00:13:58] Joe: Some of those nuances probably break down to what they think the problem with mental health is like some people might think hey It's an exciting time for mental health as people are becoming more normalized with it What can we do to help from the medical standpoint places like betterhelp.

[00:14:11] com and more people get access and then? An imposing, completely different point of view might be like, well, how do we handle people with mental disorders that are coming up to police? And so it's, it's a huge topic, and it's tough to like, know exactly what aspect of mental health people are talking about when they talk about mental

[00:14:29] Rick: health.

[00:14:29] You, you hit the nail on the head there, and I think that the homelessness issue, right, or the unhoused issue, however you want to address that, that is clearly... An aspect that is going to be part of the talk track and how mental health answer and with respect to remedy policy solution is going to be, I think, handled by each one of these individuals.

[00:14:55] There's no doubt about it. And I do think this, you know, you mentioned You know, the technology piece. Yeah, you see that pop up in some of what we're seeing in the policy work that has been done by these candidates. And let me just say one quick thing before I move on with this. It's interesting, now, of course Former President Trump, because he was in office, had built out so much.

[00:15:19] He has a pretty robust plan out there. So does Mike Pence. You can understand that. They were, they were in office before. So I want to, I want to make sure that I mentioned that because the other candidates, it seems like they're still developing and co and co lacing their, their particular policy positions.

[00:15:37] Now, when it comes to the big issue for me, it's always Medicare. And I would say this, look, of the candidates. We know that Trump, DeSantis, Scott, and Pence, they've come right out and said, preserve Medicare. In general, that's it. Preserve Medicare. Smart move, right? When you think about who votes. Absolutely.

[00:15:56] This definitely juxtapositions, and I'll talk about the differences in a second, from what we heard again, with nuance from Nikki Haley and Chris Christie. So we'll get into that in a second. With respect to reproductive rights, abortion, we know this, while there are nuances. All of the candidates are opposed to abortion.

[00:16:16] It really depends upon their approach to state level handling versus federal. And then the, what the ban would be if it was federal. And we know that. Say Florida, for instance, was DeSantis six weeks, but there's also Senator Scott suggesting 15 week federal bans. So that's out there. And the other piece is what would go through federally because of the aspect of needing Senate votes.

[00:16:43] So right. Otherwise, there's, there's clearly uniformity on the, on the issue from the opposition piece. And then the last piece, you know, looking at the systemic component, which would include everything from, let's say, Social Security, Medicare, Medicaid. Also, how could you get away from talking about the CDC, or the FDA, particularly because of COVID, and even going into COVID handling.

[00:17:08] I think here most of the candidates have, Some level or form of, of policy to, to change that structure. Chris Christie, the most ambitious plan, we'll talk about that in a second when we get to differences. Why? Because he's, he's specifically talking about Social Security, Medicare, and Medicaid. And just quickly, that's, that's different, say, from Mike Pence, who's, who's looking at competition, affordability, quality.

[00:17:36] That's those

[00:17:37] Joe: themes in there. Right. Do you think that some of that has to do with like, I, I fit every time I hear somebody talk about reform and they haven't been in office yet, it makes me think like, I bet they just don't have access to the information like, like the guys that haven't been in office or women that haven't been in office yet always have the most sweeping reform plans.

[00:17:55] Like, yeah, I got to change everything. And then it's like, Oh, once they start talking to the people, understanding more how it got the way that it is, it seems like we pair back a

[00:18:04] Rick: lot. Yeah, I would. Yeah. And that goes right to. The, you know, recognizing that sure, you know, President Trump, Vice President Pence would have a much more, you know, thoughtful, built out policy because they were in office and had access and understood the competitive nature, not only of what's happening from A political perspective, but the realities of getting policies through so, so, so that makes, makes perfect

[00:18:32] Joe: sense.

[00:18:32] So those are some of the similarities. Let's, let's jump into the differences.

[00:18:36] Rick: Yeah, I think, you know starting on the mental health piece president Trump, I think it's called agenda 47, which he has in his policy books. A really ambitious plan that looks at facilities and very different, I don't want to say getting into a more institutional approach, particularly with respect to addressing homelessness issues and it's linked to mental health.

[00:19:00] I think if you took a, take a look at Nikki Haley's policies, probably fall in along the, along the same line. So that's, that's one piece. I think Governor DeSantis, he has talked about bi, bipartisan approaches, his intention to create a bipartisan task force to look at That medical agency piece, right?

[00:19:22] That overall, everything from the CDC, FDA, et cetera, that sounds pretty good, right? You see anyone who says bipartisan, I think that's something that is certainly a differentiator when it comes to The governor and, and the other slate of GOP potentials when it comes to his approach to that overall agency perspective.

[00:19:45] I talked about Mike Pence, former Vice President Pence, his, his emphasis on freedom and choice. He's front and center with this, right? It's competition, it's choice, it's transparency, it's empowerment of individuals. It gets back to leveraging technology a bit from what you said. Anyone who's a free market capitalist who believes in innovation and competition are going to be, I think attracted to that particular emphasis that he did.

[00:20:14] Nikki Haley I would say this is a difference. She, I will, I will characterize it as entitlement programs, but she has proposed limiting benefits, right? For those in a certain tax bracket, let's call it the wealthy the expansion of Medicare advance advantage. We talked about that many times and it certainly makes sense if you're going to stratify things like that.

[00:20:38] And also she, like Pence. Does focus on competition to reduce costs. So that's another piece. And then, you know, Chris Christie. I mentioned it when you look at his approach. And by the way, this isn't new. You go back to what he wrote about when he was governor, when he ran before his platform. It has been fairly consistent, I could say that.

[00:20:59] He has called out straight up necessary cuts to Social Security and Medicare, means testing, changing the retirement age, right? That's, that clearly sets his policies apart from President Trump, Pence. and others in there, right? So there, there's a reality in there. Yeah. Is

[00:21:21] rick_and_joe-pvcbjj906__raw-synced-video-cfr_rick-and-joe_2023-aug-21-0537pm_healthcare_nation: that

[00:21:21] Joe: primarily because he's the only person that said, here's some things I would change?

[00:21:26] Most people say reform. They're like, it's got to change, but it's almost just clearly a stump thing. Like, we all know it's got to change.

[00:21:32] Rick: Yeah, I, you know I'd have to dig deep. I would say this, he's been consistent on this. It goes back to when he, the governor of New Jersey, he really, and I also believe he wants to, to have a sharp differentiation between himself.

[00:21:45] And, and former President Trump and the rest of the field, and this is one way to do it. He's also calling out the fact that this is, you know, the issue. And no one is paying attention to it, but all of these programs will become insolvent and you've got to, you've got to face reality. So he's trying to be this sober minded individual.

[00:22:04] I don't know how that strategy is going to work, by the way, because again, you know who votes? And most of those voters are Medicare age, so that's, that's the reality. And if you

[00:22:13] Joe: say, I want to change the age in which you can retire, that can greatly influence somebody's vote. I

[00:22:19] Rick: think that could be a very catalyzing issue out there and, you know, perhaps a deal breaker with some folks.

[00:22:26] Joe: And I doubt it's going to be, let's make it younger. Right. No,

[00:22:29] Rick: that's not going to happen. Right. And you know, Vivek Ramaswamy, look, he's a former biotech, you know, innovator in the field, you know, was very successful in that space. Give him credit along those lines, 100%. You and I talk about this with our guests all the time.

[00:22:48] That kind of background, that is, we could say this, it's probably going to influence his perspectives. And he has come right out when we talk about the medical structure, the infrastructure, When it comes to policy and, and federal government agencies, he's come straight out and said he would expose and got the FDA he's unique among the other candidates with that perspective.

[00:23:12] And it, again, I think it's because of his former, you know, job and what he did in that space, so there's no doubt about that. You know, Senator Scott, the one thing that I thought was interesting, he's calling out, and this goes back to the point you made about mental health and apps, etc., the push for medical innovation and really being a catalyst for change and advancing things and leveraging, you know, technology and research in that space.

[00:23:41] I found that refreshing. We'll see. I hope, again, that in the... In the debate, they get enough time to talk about health policies, so many other issues that are out there, but this

[00:23:52] Joe: is a biggie. Yeah, there's a lot to debate. I think also, we were talking about the plan for addressing homelessness, for example.

[00:24:01] In my opinion, this is one of the few things that I actually think should be better handled at the federal level because it seems like at the state level, specifically at the city level, the answer to homelessness is like, well, let's make some programs, but let's not make them too nice because then we'll attract more homeless, which isn't really what we want to do.

[00:24:23] And so it seems like at the state and city level, we're always kind of pulling punches with programs to help

[00:24:28] Rick: homelessness. Yeah, you know, I I'm not linking these two together, but you could say the same thing about immigration policies. And, and, and just look, I lived in, in both these states. You could look at, at California and you could look at Florida and you could look at New York and you could look at Florida and you could look at Texas and both of the.

[00:24:47] The other state, and it's, it's, there needs to be a comprehensive federal policy. There's no doubt. Maybe at the state level, if you take a look at, at homeless issues, mental health, et cetera, it's somehow addressed through Medicaid because a lot of the patients or folks could be younger, right? And that might be one way.

[00:25:07] So I don't know. We'll see. But Joe, that's a, that's a great point. And

[00:25:11] Joe: certainly some states have a larger homeless issue than other states based on how much of their Properties urban, for example, you know,

[00:25:20] Rick: yeah, I mean, right there, there, there are things that influence that. But I think what we're seeing now is more and more folks who.

[00:25:25] And, and the numbers just are staggering you know, in highly dense populated areas lose their job and things go from, you know 100 to zero overnight. So it's crazy, but listen, I would say the bottom line on, on all of this, and it'll be interesting when we do, let's just say a post debate wrap up, I would say there's certainly more alignment and you would expect that.

[00:25:54] Then divergence in the policies right that are out there when it comes to Medicare. There's no doubt that Trump and Pence definitely are more of we're preserving it, right? There's no doubt. On the other side, you would say Chris Christie and Nikki Haley with with means testing and limitations. No doubt about it.

[00:26:18] They're going in a different direction. Let's see if that kind of plays out and those are the the the unique kind of aspects and Strategies that are that are going to be I think the the details right and you said it how they handle homelessness How they handle entitlement programs choice And and reform at the

[00:26:39] Joe: end of the day, it's funny that you only mentioned Chris Christie is having the bipartisan support because it seems like that's primarily the only way any change is going to happen.

[00:26:50] As far as a major reform goes, you know, it seems like this is just Joe's opinion, this is not.

[00:26:56] Rick: Now we love Joe's opinion. But I

[00:26:57] Joe: like, I like my, I like my I like my government very divided. Like if we had a Republican president, I want everything else to be Democratic.

[00:27:07] And if we've got a Democratic president, I kind of want everything else the other way. So we can avoid this pendulum thing where people make all these sweeping changes that seem to be just based on the partisan nature. And not so much on what the best approach is. All right, so Joe

[00:27:24] Rick: That's a big overview, but that's, that's a balanced power guy.

[00:27:27] We like that. We like it, yeah. Joe, listen, we know this, and you can see this played out in a lot of states, right? Whether if you have a governor and they're of one party and then the state legislature's got a super majority, what does that mean? It means things are going in one direction, you know, and there's There's certainly less balance there.

[00:27:48] There are times when these huge swings I don't want to say have have have been beneficial or negative, but they certainly, which is your point, have brought about sweeping changes. We know this. We know this. And I think everyone strives for that, that middle ground. And getting back to the slate of GOP candidates, it's interesting because don't forget.

[00:28:10] They're all vying for, I think, the preservation of that base, whether you call it the base that's associated with former President Trump, and some, and you gotta have and some, which includes the independents and let's just say the Democratic folks who are in the middle or right of center you know, I think the Reagan Democrats in that area and how they could influence them over, so.

[00:28:39] You know, this to me, and I think hopefully for our listeners is a little bit on what we have seen in our research, et cetera, to be the key points without detail from a health perspective. And certainly that will impact healthcare delivery and to a certain extent, the health sector. Yeah. And hopefully

[00:28:59] Joe: we can help inform people as they make a decision.

[00:29:02] Yeah.

[00:29:03] Rick: Yeah. So, and, you know, I will tell you this and, and I think many folks know. My own work, whether you call it my side hustle or my hustle with Washington Square Advisors, I a lot, I advise a lot of startups, right many in California, and they're dealing with two, our two topics today. The first part is intellectual property, artificial intelligence, competition, everything from what's going to be affected in their capital stack when it comes to going for funding to regulations that may.

[00:29:36] Make it easier or not with respect to deploying some new innovative technology in the space like generative AI and healthcare. So, I work with folks a lot and in fact, I want our audience to know that. If you, if you, if you need our assistance, go to please check out Washington Square Advisors wsadvisors.

[00:29:57] org. The other side of it is You know, I'm teaching policy at NYU and these issues are constantly, certainly in the health law and strategy area, they're top of mind for everyone because it's where the action is. If you, if you think about certainly from a time of year, time of, of Meaning voting time, it's top of mind for political scientists, for, for academics who are in the space.

[00:30:27] Right. Because there's so many highly loaded propositions that are on the table right now. And I think

[00:30:32] Joe: that's kind of, a little bit of, just the, the way of the, the way of the world in the sense of when, when something has the, the largest delta, like in, like we've AI a lot. Like that has the ability to change so much.

[00:30:47] It's, it feels like it demands our time and energy. And I've seen like, so AI started what, like about, I don't know, we're coming up on almost a year before it was like a thing that kind of made its way through which had GPT and everything. And I was starting to think last month, man, I wonder if, if this whole generative AI is going to be like.

[00:31:09] Dogecoin. Yeah, like we're just gonna that was remember when we were talking about that all the time and that was fun And then it's not gonna turn into anything. But now I'm starting to think I think for some yes It actually was a fad and now it's over But I think for some industries and I think healthcare is one of them It's going to continue to be a thing because it's actually very useful and the stuff that it's proving to be good at is very useful like analyzing large amounts of data So you might not really care about analyzing large amounts of data if you're a graphic designer.

[00:31:40] Right. But if you're in healthcare, you absolutely care. Because this is, this is a competitive advantage or a possible competitive advantage. Yeah,

[00:31:47] Rick: and, and let me respond to that in two different ways. First part is the, the low hanging fruit applicability in healthcare. And we talked about this on the podcast before, you know, augmenting a clinician's interaction.

[00:32:02] We know that AI is found to be equally, if not more, empathetic and compassionate, which is interesting. Right. And how it could, you know, I'm not necessarily saying deploy bots in the, in the space, but how augmenting clinicians, physicians, nurses. Others in the care delivery model frees up time for those individuals to spend with patients at the bedside or in critical, you know, scenarios like, say, surgery or the ED, etc.

[00:32:31] So that's one piece. The other side is and full disclosure, I'm a big supporter of free market capitalism and what it does with respect to innovation. If you take a look at Generative AI, the applications, and we'll just stick with, with, with healthcare and the health sector. There's so many opportunities.

[00:32:53] I, I would say right off the bat, going back to those low hanging fruit, if you looked at accelerating pre authorization, if you looked at everything from scheduling and wait times and that 30% of administrative... B. S. that is so costly in the health care, you know, economic structure. If we could put a dent in that, it's going to mean there'll be more resources for direct patient care.

[00:33:22] And I see that as a really good thing. And for those entrepreneurs out there that are working in that space, fantastic. More power to you. And work with Washington Square Advisors. We love you.

[00:33:32] Joe: Yeah. I completely agree. I think, too, there's another component that when, when the tools get easier and it makes innovation possible, in other words, you don't have to have access to this crazy amount of you can, you can solve a problem because you now have access to a more powerful tool is exciting.

[00:33:49] And I think it's, it's funny. You mentioned how we talked about it on the show before the idea of a making it. the right suggestion for a doctor coming into a room as opposed to the next thing to say, instead of like, here's exactly what you say. It's funny that the word prompt is appropriate. Cause that's like a big part of champ GPT, but like I filled out my paperwork for my You're physical.

[00:34:11] It took me 20 minutes online in the portal. Did it put in all the new, whatever I was taking and got it all in there, got there. It's like they had no idea I did it right now. Like if, if there was something there that was like, so, Hey, how's the new medicine doing on this, this and that is you've been taking it for, you know, X amount of time now that would have been a great prompt.

[00:34:30] And I would have felt like my doctor knew what was going on in my life and was reading

[00:34:34] Rick: the chart. Listen, imagine a world where all of that. Data that you put in, right, actively. But also, imagine what would or could be acquired passively, right, through the internet of Joe's things. If that was aggregated in a way where a generative model could make sense of it.

[00:34:54] Sure. And teed it up for a clinician before you came in. Right. And again, this blue sky, imagine the power and the insights that you can get on an individual's health status across the board. I mean, not only say their physical well being, but whether they could. You know, pay for their prescriptions based on their economic status, which was derived from something like, say, their credit report or X.

[00:35:24] Right. Now, there is, there is definitely an invasive and dark side to this, but that's why we talk about the regulatory aspects, how important it is to make sure there's oversight on this, because the, the balance, back to the balance of power, between, you know, the doing good. With it versus not is going to be in the guardrails that we put in the end of the day There's probably a lot more positive than negative

[00:35:54] Joe: I can see that being very frightening for people the the fear that you know My information is now out there in some way, but I mean, we just got to remind ourselves technology is amoral It doesn't care.

[00:36:04] It doesn't have a good and bad. It's a tool like a hammer you know, you can use to build something you use to break something and You're absolutely right. It's all about the guardrails and what we do moving

[00:36:15] Rick: forward. Yeah, and and I think starting with the fact that look you can't get away from bias in the system.

[00:36:21] It's created with everything that's out there. I'm saying this in general. Everything that's out there is biased. So that's just a reality. We have to, we have to, we have to cut through that and that's why the human element will never Be excluded from part of the equation that leverages in my opinion.

[00:36:40] Yeah, AI and generative AI

[00:36:43] Joe: And I think if the first great thing that generative AI can do for the health is to make doctors come across as more empathetic and caring for their patients. What are we scared about?

[00:36:55] Rick: It's a win for me, right? There's no, no doubt about it. When you think about getting back to your, you know, your, your physical, which I'm, I trust then that everything went well, but, but yes, when they, the, the questions that are asked the one piece is to check in, but imagine if you had things logically organized and there was some historical perspective that could be refreshed in the doctor or nurse's mind so that they can get further faster on the things that are most important with, with respect to your health, but also have enough time left over where they don't in any way corrupt the, and I will just say it, the clinician patient relationship, which is so important.

[00:37:40] Joe: Right. And I don't know the, the fear that people have about like the origin of. Why somebody cares about you like I think about like people that used to be in sales and work from a Rolodex and on The back of card for you know, Jeff Smith, they mutter out, you know, 14 year old daughter interested in this and then when they call And they're like, oh and how's your daughter?

[00:37:59] They go to the back and find that little piece of information I don't think anybody ever got mad at

[00:38:06] Rick: Rolodexes for cheating in

[00:38:08] Joe: relationships. You know, they're, they're tools designed to help that person, best case scenario, be better at their job, nefarious worst case scenario, manipulate people into buying

[00:38:21] Rick: something.

[00:38:21] No, I'm I hear you. I think a lot of it is. You know, there's so much out there now, so much information that it's more organizing, right? I mean, for me, it's like I don't have access to it. But I'll just go back to a personal anecdote. So years ago, I volunteered in a free clinic. And folks know that my background includes being a nurse practitioner.

[00:38:46] And I've seen patients there. And what I realized was the most important question I could really ask that would give me a better idea of their health trajectory, certainly for the next month, and that's a short time, is where did you sleep last night? And was it, you know, in an apartment or a house? Or was it in your car?

[00:39:10] Or was it, you know, under a tree? And at a free clinic, you know, that makes a big difference. Just like, you know, whether someone could pay their rent versus And you will change and, and your care will be influenced if you have that level of information. That's clearly a drastic example, but what I'm saying is there's so much out there.

[00:39:33] Wow. The power of it. Right.

[00:39:36] Joe: If we could ask the right question, Right. As opposed to an esoteric question, what a difference it would

[00:39:41] Rick: make. Yeah. And look, it's going back to those prompts. Mm hmm. So listen, this has been great conversation, Joe. I can't wait. We have lots of cover. Certainly. Post this, this first GOP debate and a lot on the docket for the Healthcare Nation.

[00:39:56] So thank you, my friend, for making a great show. And for those of you out there, send us your questions. Check us out at healthcarenation. com. Check out Washington Square Advisors my firm and and for those of you who are interested in the topics that we cover here, everything is out there on your favorite page.

[00:40:19] podcast platform, as well as our YouTube channel, healthcare nation podcast.

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