From the VC’s perspective

Venture Capitalists (VC’s) are the private version of grant committees. There has been relatively little research about the efficacy of a centralised decision-making system for scientific research. “No research about research”- so as to say. Therefore, I am curious about the big ticket VC funding (aka business loans in exchange for equity/ownership) and rights to “sell out” (called exit). This remains a highly simplified explanation about a complex transaction happening in the background.

The success of VC firms depends on the hype cycles they can create-therefore, creating solutions for problems that don’t even exist. I can’t wade into a political hot potato of “climate change”, but “plant-based burgers” was something no one asked for. My interest in the linked write up from Financial Times perked up because Vinod Khosla mentioned his investment in a firm called “curate AI” that aims to provide primary physician care virtually. Telehealth came into prominence during the pandemic, with the creation of “virtual waiting rooms” and “access to reports online”, but it was marred by issues around reimbursements or failure to understand the transactional model of a physical meeting place.

Nevertheless, here’s an interesting bit he had to say:

Vinod Khosla: AI and climate investors can help western values win out | Financial Times

There’s no question in my mind, expectations will get ahead of reality. Let me give you an example. My son has a primary-care company, called Curai, trying to build [an AI] primary-care doctor. They have a human in the loop, so the AI never does a diagnosis or a prescription — a human doctor has to do it. The AI can recommend to the human doctor, and the human doctor can say, “I looked at the conversation you had with the patient and, yes, this is OK.” Or they may add additional questions to ask the patient, which is the way a junior doctor would work with a senior doctor. So AI will be an intern.

I say to my son: reduce the cost of a primary care session by 1 per cent a month so, over [the] years, you get the cost down by 80 per cent for providing medical service, and you’ve scaled the number of physicians by five times. If the cost is down by 80 per cent, it means each physician can do five times as many patients. That’s the way to scale primary care globally. But people immediately jump to, “Oh! Is the AI doing the diagnosis today?”

I don’t think they will keep the human in the loop, always. It is a matter of time before the monopolisation and concentration of power dynamics takes place to “lobby” changes of regulations. Medicine will be fundamentally altered with this rapid encroachment, and this company, in effect, is only optimising the “platformisation of healthcare” to provide healthcare at an industrial scale. Like milking cows through udder attachments or culling of chicken to provide “industrial meat”. This may sound overtly dramatic, but we have been firmly conditioned to believe that subscriptions are the answer to everything; till the companies rob you of the health as a subscription model. Its going to start from primary healthcare, and as always, there is no problem to be solved here. People fall ill and seek healthcare. No one is interested in preventive healthcare, but they will use directed advertisements to drive their specific pharmacies. Amazon has invested heavily in this business arm and is building it up rapidly.

As always, the VC’s have a bird’s eye view of the rapidly evolving healthcare landscape. I don’t agree with Khosla’s assessment of the healthcare landscape, but he’s entitled to his opinion.

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