1 00:00:05,900 --> 00:00:15,300 Welcome. Hey, this is Eric here with dead 2 00:00:15,300 --> 00:00:17,400 cow. We've got Tom and Katie. 3 00:00:17,500 --> 00:00:21,000 We have our friend, Rolf Winkler here from The Wall Street 4 00:00:21,000 --> 00:00:24,200 Journal. Hey guys, he's been writing 5 00:00:24,200 --> 00:00:29,000 about how everybody is going online to get ADHD medication. 6 00:00:29,100 --> 00:00:30,900 I was excited. Read your Your ear off because 7 00:00:30,900 --> 00:00:35,300 one you really like to dig into these kind of shady med tech 8 00:00:35,300 --> 00:00:37,200 companies. I remember a couple years back, 9 00:00:37,200 --> 00:00:41,200 you busted, the chicago-based med tech company for basically 10 00:00:41,200 --> 00:00:45,500 lying about their finances. I think right a Miry clay they 11 00:00:45,500 --> 00:00:50,000 were yeah there was trials. Next year they were basically 12 00:00:50,000 --> 00:00:54,000 misleading their clients in a pretty big way. 13 00:00:54,000 --> 00:00:57,200 And what's that company called wrote it there and it was called 14 00:00:57,200 --> 00:00:59,400 out? Come out come else doesn't exist 15 00:00:59,400 --> 00:01:00,800 anymore. That outcome Health. 16 00:01:00,900 --> 00:01:03,700 Yeah, it didn't work yet but yeah, that that they were 17 00:01:03,700 --> 00:01:05,600 misleading, a bunch of people and then a month later, 18 00:01:06,200 --> 00:01:10,600 investors sued him for fraud and three diamonds, 33 guilty pleas 19 00:01:10,600 --> 00:01:14,500 and then 3 3, felony guilty pleas and then three of diamonds 20 00:01:14,500 --> 00:01:16,500 and that's next year that trou, right? 21 00:01:16,500 --> 00:01:20,900 And so and so now you moved over into easy prescription online, 22 00:01:21,200 --> 00:01:23,900 tech companies and look like like I do before I read most 23 00:01:23,900 --> 00:01:26,700 Wall Street Journal articles, I snorted a line of Adderall 24 00:01:27,600 --> 00:01:30,400 before reading this thing, and I heard that Politics. 25 00:01:30,400 --> 00:01:31,900 Huh, right? Exactly turns out. 26 00:01:31,900 --> 00:01:33,200 It's really easy to get this shit now. 27 00:01:33,200 --> 00:01:35,700 So I wasn't I shouldn't have tried as hard to like, dip. 28 00:01:35,700 --> 00:01:39,900 All of my PC PS2, give it to me, but why don't you, why don't you 29 00:01:39,900 --> 00:01:42,600 break down the world of online prescription? 30 00:01:42,600 --> 00:01:46,300 And how we people who legitimately have ADHD are being 31 00:01:46,300 --> 00:01:48,100 lumped in with the, the infect Amina. 32 00:01:48,100 --> 00:01:49,600 Tom, do you take it easy? Right? 33 00:01:49,900 --> 00:01:51,600 I used to, when I was a kid when I was younger. 34 00:01:51,600 --> 00:01:53,400 Yeah. It's the ideas. 35 00:01:53,400 --> 00:01:56,100 I was on Ritalin, I would say, by the way, up top of 36 00:01:56,100 --> 00:01:59,400 discussing, his whole story we're not writing about how 37 00:01:59,400 --> 00:02:03,000 Adderall Bad for metal, a DD HD. We mentioned, I make sure to 38 00:02:03,000 --> 00:02:06,500 mention every story that psychiatrist will tell you for 39 00:02:06,500 --> 00:02:08,500 somebody's properly diagnosed with ADHD. 40 00:02:09,000 --> 00:02:11,900 These meds are good. These meds have great outcomes 41 00:02:11,900 --> 00:02:14,000 for people helps to study. I don't IE. 42 00:02:14,000 --> 00:02:17,500 I think they are great great, if you need to stay at a party all 43 00:02:17,500 --> 00:02:18,900 night long. Yeah, wild. 44 00:02:18,900 --> 00:02:21,400 See that's the other element is like, there's a reason that 45 00:02:21,700 --> 00:02:25,500 Adderall and other stimulants are schedule to Controlled 46 00:02:25,500 --> 00:02:28,800 Substances because of their in all the risk of abuse other 47 00:02:28,800 --> 00:02:29,800 schedule. Two substances. 48 00:02:29,900 --> 00:02:33,200 Has OxyContin and cocaine fentanyl lot of things are in 49 00:02:33,200 --> 00:02:36,500 that category. So so how did you get onto this 50 00:02:36,500 --> 00:02:38,200 story? Oh, you know I was talking to 51 00:02:38,200 --> 00:02:41,400 some investors and one of them was saying man there. 52 00:02:41,400 --> 00:02:44,200 These companies they're doing controlled substances and 53 00:02:44,200 --> 00:02:46,500 they're kind of using this regulatory loophole. 54 00:02:46,500 --> 00:02:49,900 That's been going on since the epidemic and I wouldn't touch it 55 00:02:49,900 --> 00:02:53,200 with a ten-foot pole, it just it it really gives me the willies 56 00:02:53,200 --> 00:02:55,800 basically and I thought, oh that sounds interesting which Loop 57 00:02:55,800 --> 00:02:57,900 all well that? Yeah, this is the key thing. 58 00:02:57,900 --> 00:03:03,700 So backing up the Public Health, Emergency for covid, created 59 00:03:04,200 --> 00:03:07,200 because of that, they created an exception to something, called 60 00:03:07,200 --> 00:03:10,800 the Ryan hate act. Ryan hate was a guy who got 61 00:03:10,800 --> 00:03:14,300 Vicodin online back in 2000 or 2001. 62 00:03:14,400 --> 00:03:17,000 And he died. And so they passed a federal 63 00:03:17,000 --> 00:03:20,400 law, a years later 2008-2009, saying, you can't get schedule 64 00:03:20,400 --> 00:03:24,500 to controlled mad without at least one in person visit. 65 00:03:24,500 --> 00:03:30,000 Hmm, which makes Telehealth prescribing for ADHD, not A 66 00:03:30,000 --> 00:03:33,800 thing at Tom would know this like if you've got ADHD it can 67 00:03:33,800 --> 00:03:37,500 be it has long been a pain in the ass to get your beds, you 68 00:03:37,500 --> 00:03:40,700 gotta show up at the doctor, sometimes they make you come in 69 00:03:40,700 --> 00:03:44,300 every month even now that still think so. 70 00:03:44,300 --> 00:03:47,800 And for folks, that that is tricky, right? 71 00:03:47,800 --> 00:03:50,900 There's there's Hoops, people jump through, I think largely 72 00:03:50,900 --> 00:03:54,400 because these are controlled substances, and doctors are 73 00:03:54,400 --> 00:03:58,500 just, you know, worried about prescribing them during the 74 00:03:58,700 --> 00:04:01,700 pandemic. The relax, the right heat act. 75 00:04:01,800 --> 00:04:06,500 So now you can do Controlled Substances, online, most 76 00:04:06,500 --> 00:04:08,600 Telehealth companies don't do this. 77 00:04:08,600 --> 00:04:11,400 So I went back and checked for recent story. 78 00:04:11,400 --> 00:04:15,000 We I can get into why I had to do this, but none of the big 79 00:04:15,900 --> 00:04:19,700 General telemedicine companies, none of the big online mental 80 00:04:19,700 --> 00:04:22,400 health companies, do Controlled Substances via Telehealth. 81 00:04:23,200 --> 00:04:25,000 They just, they just don't want to touch it, right? 82 00:04:25,000 --> 00:04:27,400 And they say on their websites, typically, you're not going to 83 00:04:27,400 --> 00:04:28,600 get controlled substances from us. 84 00:04:28,600 --> 00:04:30,300 You're gonna have to go see Or dr. 85 00:04:30,300 --> 00:04:33,500 See somebody, a person, if that's what you want but a 86 00:04:33,508 --> 00:04:35,000 couple startups. What are their names? 87 00:04:35,000 --> 00:04:37,000 We haven't said their names up. Sure. 88 00:04:37,000 --> 00:04:39,000 I there's there's a bunch of them that that are focused on 89 00:04:39,000 --> 00:04:43,800 ADHD, but the biggest one here is cerebral which started off as 90 00:04:43,800 --> 00:04:46,200 general mental health, depression, anxiety insomnia, 91 00:04:46,400 --> 00:04:50,100 and then in 2021, the added ADHD treatment and they'll do 92 00:04:50,100 --> 00:04:52,100 Controlled Substances for all the above. 93 00:04:52,500 --> 00:04:56,000 They'll do benzodiazepines for frames ID, for instance which is 94 00:04:56,000 --> 00:05:00,700 also again not common, tell a dock side, note out Just cite 95 00:05:00,700 --> 00:05:04,100 stock, get hammered 40 percent this week and on their 96 00:05:04,100 --> 00:05:06,500 conference call. One of the things they said is 97 00:05:06,500 --> 00:05:09,700 they blamed the fact that they can't compete for users because 98 00:05:09,700 --> 00:05:13,700 other companies, you know, hint hint nudge nudge cerebral are 99 00:05:13,700 --> 00:05:16,900 offering a fuller menu of like people. 100 00:05:16,900 --> 00:05:19,100 If people want Controlled Substances they're not going to 101 00:05:19,100 --> 00:05:22,200 get it from us and and our mental health are better help. 102 00:05:22,600 --> 00:05:26,100 It can get it for cerebral and so they'll go that direction. 103 00:05:26,100 --> 00:05:28,500 So that's one reason we're it. We are struggling to compete for 104 00:05:28,508 --> 00:05:30,700 clients sort of an interesting side of. 105 00:05:30,700 --> 00:05:34,400 So there's just some of these companies cerebral is one done, 106 00:05:34,900 --> 00:05:40,700 their website is done, first.com Dundee already done is another 107 00:05:41,100 --> 00:05:43,500 their, their ADHD focused pretty much exclusively. 108 00:05:43,600 --> 00:05:47,600 That's the one backed by David Sachs has cracker a sure David 109 00:05:47,600 --> 00:05:50,500 Sachs. Joe Montana, Dave, morons in it. 110 00:05:50,500 --> 00:05:52,400 Then there's a handful of smaller ones or something called 111 00:05:52,400 --> 00:05:55,400 Clarity ADHD. There was one called ahead, 112 00:05:55,400 --> 00:05:58,700 which was a unit of true pill, which just got shut down two 113 00:05:58,700 --> 00:06:01,300 weeks ago, they put it out on the Saying we're no longer to 114 00:06:01,300 --> 00:06:04,000 kind of do this ADHD treatment outline and then there are some 115 00:06:04,000 --> 00:06:07,400 other smaller ones. Can I ask a business question of 116 00:06:07,400 --> 00:06:09,400 front? Yeah, please, how much money is 117 00:06:09,400 --> 00:06:12,700 there really to be made in prescribing Adderall? 118 00:06:12,800 --> 00:06:15,500 I mean, they're basically doing the prescription, right? 119 00:06:15,500 --> 00:06:19,800 They're not getting a cut of every time you get the drug. 120 00:06:19,800 --> 00:06:24,300 Well, the business model for cerebral is and for done. 121 00:06:24,300 --> 00:06:27,200 And for these companies is they charge you a subscription fee 122 00:06:27,500 --> 00:06:29,700 for what they call medication management, Adderall something. 123 00:06:29,900 --> 00:06:34,400 It has to get renewed monthly. So there is a so you show up you 124 00:06:34,400 --> 00:06:36,600 pay them a hundred or maybe a hundred eighty dollars for an 125 00:06:36,608 --> 00:06:38,500 initial evaluation which is 30 minutes. 126 00:06:38,900 --> 00:06:40,800 It's a key fact, we should come back to it. 127 00:06:41,100 --> 00:06:44,800 Initial valuation 30 minutes. And then every month thereafter, 128 00:06:45,000 --> 00:06:48,700 if you've been prescribed a medication, you pay them a t-box 129 00:06:49,000 --> 00:06:52,900 to quote manage that medication which can mean answer questions. 130 00:06:53,200 --> 00:06:56,800 Some companies notably cerebro, often do follow-ups, video. 131 00:06:56,800 --> 00:06:59,500 Follow-ups done. Does not require video follows. 132 00:06:59,900 --> 00:07:02,900 But they'll charge you the 80 bucks per month going forward. 133 00:07:02,900 --> 00:07:05,700 So, that's a great business because you're taking the drug, 134 00:07:05,700 --> 00:07:06,800 you're in a subscription business. 135 00:07:06,800 --> 00:07:09,900 So the goal is retention, keep them coming around. 136 00:07:10,300 --> 00:07:13,200 And, you know, again side note, the accusation. 137 00:07:13,200 --> 00:07:16,400 There was a former executive who sued the company yesterday, 138 00:07:16,400 --> 00:07:19,600 labor law suit. And in that lawsuit, he said the 139 00:07:19,600 --> 00:07:23,800 company did a study of patient retention found that people on 140 00:07:24,000 --> 00:07:27,200 Adderall, were more likely to be retained for people. 141 00:07:27,200 --> 00:07:29,700 I medications were more likely to be retained when that for 142 00:07:29,800 --> 00:07:32,100 When they had ADHD. So that the Direction came down 143 00:07:32,100 --> 00:07:35,800 from the CEO by Roberson, get the prescription rates according 144 00:07:35,800 --> 00:07:37,900 to the suit, according this is alleged in the suit. 145 00:07:37,900 --> 00:07:40,400 Correct? The executives of former VP of 146 00:07:40,400 --> 00:07:41,300 product, right? Pretty. 147 00:07:41,300 --> 00:07:42,700 Big role product and Engineering. 148 00:07:42,800 --> 00:07:47,300 Yeah, and it dovetails with some of some of we can obviously not 149 00:07:47,900 --> 00:07:49,400 it. I can't say anything. 150 00:07:49,400 --> 00:07:51,200 That's what he's alleging, right, are reporting. 151 00:07:51,600 --> 00:07:54,500 What did things like a new policy? 152 00:07:54,500 --> 00:07:57,900 They have for auditing prescriptions which the nurse 153 00:07:57,900 --> 00:08:01,300 practitioners we spoke to you know, Them uncomfortable and I 154 00:08:01,300 --> 00:08:03,000 could go into that. And that's sort of how I ended 155 00:08:03,000 --> 00:08:07,500 up really going down this path. Yeah, what just talk about that, 156 00:08:07,500 --> 00:08:09,300 right? I mean this scale is the 157 00:08:09,300 --> 00:08:14,100 operation is basically have nurse practitioners meat, over 158 00:08:14,100 --> 00:08:16,600 video chat with a bunch of people and then sort of have a 159 00:08:16,600 --> 00:08:20,200 doctor approval bunch of it or it seemed like in classic Tech 160 00:08:20,200 --> 00:08:23,200 fashion. There's a sort of their skilled 161 00:08:23,200 --> 00:08:26,000 at scaling the amount of prescriptions they can. 162 00:08:26,000 --> 00:08:28,000 This is right. It's a pretty simple. 163 00:08:28,000 --> 00:08:29,400 Yeah, the business model is pretty simple. 164 00:08:29,400 --> 00:08:33,600 It's It's charging 80, 80 bucks to manage the medication, pay 165 00:08:33,600 --> 00:08:36,100 the nurses anywhere from depending on the company, ten to 166 00:08:36,100 --> 00:08:38,600 twenty five dollars per month to manage the patient and renew the 167 00:08:38,600 --> 00:08:42,200 prescription and reinvest in tick-tocking, Instagram ads to 168 00:08:42,200 --> 00:08:46,300 generate new clients. So that's the business model and 169 00:08:46,700 --> 00:08:49,000 really how I got into it. The investor said yeah I 170 00:08:49,008 --> 00:08:50,400 wouldn't touch this and I thought, huh? 171 00:08:50,400 --> 00:08:54,100 That's funny and I went on glass door and glass door had this 172 00:08:54,100 --> 00:08:57,700 Anonymous review. It was titled Adderall for all 173 00:08:58,500 --> 00:09:01,800 and it was a quick paragraph. That said, basically, you have 174 00:09:01,800 --> 00:09:04,500 to be comfortable writing stimulant prescriptions because 175 00:09:04,500 --> 00:09:08,100 you will be expected to write a lot of them. 176 00:09:08,500 --> 00:09:12,600 And especially if a patient scores a certain number on one 177 00:09:12,600 --> 00:09:17,000 of these kind of very standard surveys that you get in as an 178 00:09:17,000 --> 00:09:20,400 intake and if you don't prescribe the medication, if 179 00:09:20,400 --> 00:09:24,200 they score a certain number on this on this test 6 questions, 180 00:09:24,200 --> 00:09:27,900 if they get at least four or five Then the quality team 181 00:09:27,900 --> 00:09:30,400 quote-unquote, will get in touch with you and ask you, why you 182 00:09:30,400 --> 00:09:32,500 didn't. And I thought that's 183 00:09:32,500 --> 00:09:34,000 interesting. I wonder if that's true. 184 00:09:34,600 --> 00:09:36,300 What's this quality? Team went Woods is person 185 00:09:36,300 --> 00:09:37,600 talking about and we went back in. 186 00:09:37,608 --> 00:09:41,600 This was our first real story on this topic was cerebral. 187 00:09:42,100 --> 00:09:44,200 Arendt kind of around the end of last year. 188 00:09:44,700 --> 00:09:47,600 Started, auditing the nurses, right? 189 00:09:47,600 --> 00:09:52,400 And sinners practitioners. And saying like look, only 52% 190 00:09:52,400 --> 00:09:56,600 of our ADHD patients are on Adderall Which is the first-line 191 00:09:56,600 --> 00:09:59,600 treatment. And so here are your patients 192 00:09:59,600 --> 00:10:02,500 that aren't on Adderall either. Put them on a different 193 00:10:02,500 --> 00:10:04,700 medication or change their diagnosis code. 194 00:10:05,100 --> 00:10:07,900 The nurse practitioners are like, hold on a minute. 195 00:10:07,900 --> 00:10:12,100 This is I don't want people at the top of the company which by 196 00:10:12,100 --> 00:10:14,800 the way, the CEOs of these of done, its rib. 197 00:10:14,800 --> 00:10:17,200 Roll have no medical background. I don't want that. 198 00:10:17,200 --> 00:10:19,100 The company telling me what I'm going to prescribe. 199 00:10:19,100 --> 00:10:20,700 It's my job. That's my license. 200 00:10:20,700 --> 00:10:23,200 I'm the one that is supposed to determine how I'm going to be 201 00:10:23,200 --> 00:10:28,000 prescribing. So, And by the way, you're only 202 00:10:28,000 --> 00:10:33,400 given me 30 minutes to diagnose. A patient company says that they 203 00:10:33,400 --> 00:10:34,800 don't have to diagnose in the first meeting. 204 00:10:34,800 --> 00:10:37,500 The nurse practitioners. Say, they don't know what that 205 00:10:37,500 --> 00:10:40,800 means that they've actually had a do diagnosed within the first 206 00:10:40,800 --> 00:10:45,400 30 minute for ADHD. Tom, I don't know what your and 207 00:10:45,600 --> 00:10:48,500 your kind of initial diagnosis was like, but I've seen these 208 00:10:48,500 --> 00:10:52,500 poor Tom is not our test case, I'm happy to explain three four 209 00:10:52,500 --> 00:10:54,600 hours, right? These are feces can be really 210 00:10:54,600 --> 00:10:57,300 long. Diagnostic evaluations because 211 00:10:57,300 --> 00:11:00,300 you have to do things like rule out anxiety and depression or 212 00:11:00,300 --> 00:11:01,900 things that would be treated differently. 213 00:11:02,000 --> 00:11:03,500 And Tom was your, he had tell me. 214 00:11:03,500 --> 00:11:05,300 What was your? Oh I have all those things so 215 00:11:05,300 --> 00:11:07,000 it's you know, you don't throw anything out. 216 00:11:07,700 --> 00:11:10,500 No I mean look this was this was decades ago so it's a very 217 00:11:10,500 --> 00:11:12,400 different time. I mean you have to remember this 218 00:11:12,400 --> 00:11:17,500 was the mid 90s where ADD and ADHD were very fashionable 219 00:11:17,500 --> 00:11:20,900 diagnosis to give to, you know, upper-middle-class white 220 00:11:20,900 --> 00:11:24,600 Suburban kids, especially boys. So my mom is also a 221 00:11:24,600 --> 00:11:26,600 psychologist. Not a Diet wrist and did not 222 00:11:26,600 --> 00:11:30,000 prescribe it to me but sort of my access to that world of 223 00:11:30,000 --> 00:11:33,300 diagnosis and the kind of conversations that people have 224 00:11:33,300 --> 00:11:35,300 around it was extremely close to me. 225 00:11:36,000 --> 00:11:38,500 So it wasn't that difficult at all. 226 00:11:38,800 --> 00:11:42,200 Look from my perspective not having covered, you know, the 227 00:11:42,200 --> 00:11:45,500 medical world and you know, can stay Controlled Substances. 228 00:11:46,100 --> 00:11:50,400 You know, Adderall is a relatively new drug relative to 229 00:11:50,400 --> 00:11:52,000 riddle, and right. I mean it only really kind of 230 00:11:52,000 --> 00:11:55,400 came on the scene as a largely diagnosed medicine and the last 231 00:11:55,500 --> 00:11:58,200 Last two decades, or something. I remember first hearing about 232 00:11:58,200 --> 00:11:59,800 it. When I was in undergrad, I took 233 00:11:59,800 --> 00:12:02,500 over from it, took over or the riddle in Market. 234 00:12:02,500 --> 00:12:04,200 You don't hear about Ritalin anyway, right? 235 00:12:04,200 --> 00:12:06,800 I mean it's probably because it's not as you know, it's not a 236 00:12:06,808 --> 00:12:08,500 strong doesn't that's a give you the kick. 237 00:12:08,800 --> 00:12:11,500 And, you know, for people who have severe ADHD, I'm sure it 238 00:12:11,500 --> 00:12:15,600 does have a positive impact on on, you know, their ability to 239 00:12:15,600 --> 00:12:17,900 function. But I mean, we all went to 240 00:12:17,900 --> 00:12:20,000 college like undergrad. Oh no, maybe kitty, little bit 241 00:12:20,000 --> 00:12:21,300 older. So may be slightly different. 242 00:12:21,300 --> 00:12:23,800 But like I knew lots of people that were taken out at all with 243 00:12:23,800 --> 00:12:27,200 him, okay? Somebody who loves Controlled 244 00:12:27,200 --> 00:12:29,400 Substances. I'm going to say that they're 245 00:12:29,400 --> 00:12:31,500 not always very hard to get. Yeah. 246 00:12:31,600 --> 00:12:36,700 Also the idea that Adderall was a drug that was being abused. 247 00:12:36,800 --> 00:12:38,900 I think predates these companies, but puts these 248 00:12:38,900 --> 00:12:41,000 companies into a really interesting social context. 249 00:12:41,000 --> 00:12:43,000 So Ralph told me about these stories. 250 00:12:43,000 --> 00:12:46,900 A little while ago, I'd read them, we talked about them and 251 00:12:47,500 --> 00:12:50,800 like in the educational realm, right there was a lot of 252 00:12:50,800 --> 00:12:53,800 controversy over how many students were being prescribed, 253 00:12:53,800 --> 00:12:58,100 Adderall particularly We in Elite settings where there was 254 00:12:58,100 --> 00:13:02,400 all sorts of pressure to do well get really good SAT scores get 255 00:13:02,400 --> 00:13:05,400 very high grades and then get into a really good college and 256 00:13:05,400 --> 00:13:08,400 there were so the prescription for Adderall kind of came as a 257 00:13:08,400 --> 00:13:11,600 package because you would get the Adderall prescription and 258 00:13:11,600 --> 00:13:14,800 then say, you had a disability and then you would be given for 259 00:13:14,800 --> 00:13:18,600 example, more time, on the SAT. And so, there are all these ways 260 00:13:18,600 --> 00:13:22,800 in which upper middle class people were using both medical 261 00:13:22,800 --> 00:13:26,000 diagnosis, and prescriptions to kind of game and Occasional 262 00:13:26,000 --> 00:13:27,600 system that had become more competitive. 263 00:13:27,600 --> 00:13:40,600 So, I are talking my SATs in the time limit couldn't have, we 264 00:13:40,600 --> 00:13:42,300 went, we were Public School Tony's. 265 00:13:42,300 --> 00:13:45,800 We didn't want my parents failed me, like, it's just not fair. 266 00:13:46,200 --> 00:13:48,900 Yeah, I mean my parents were also an upper middle class. 267 00:13:48,900 --> 00:13:51,900 White people right here is gonna known but everything. 268 00:13:52,000 --> 00:13:55,300 But like, but like this is something that had already like 269 00:13:55,300 --> 00:13:58,000 the The, the abuse of Adderall was already something that was 270 00:13:58,000 --> 00:14:01,000 like, kind of like, culturally acceptable, particularly amongst 271 00:14:01,000 --> 00:14:04,200 the market that DC's like to market products to people, with 272 00:14:04,200 --> 00:14:06,600 Expendable, Cassius cetera. And so then when Ralph and I 273 00:14:06,608 --> 00:14:09,300 were talking about this, I remembered that I'd been getting 274 00:14:09,300 --> 00:14:14,000 all of these ads for these startups on Tick-Tock and I am 275 00:14:14,000 --> 00:14:16,200 not, I don't think I'm in the demographic. 276 00:14:16,200 --> 00:14:19,300 Oh my God Tick-Tock is always trying to convince me over Haiti 277 00:14:19,300 --> 00:14:20,300 HD. Exactly. 278 00:14:20,900 --> 00:14:28,300 I mean the longer you spend on The algorithm in knows, at 279 00:14:28,300 --> 00:14:31,100 least, it figures out, the you wonder whether you have ADHD and 280 00:14:31,100 --> 00:14:33,000 all of a sudden, you're getting a bunch of, that's the thing. 281 00:14:33,000 --> 00:14:34,600 Like, I don't even think it's that targeted. 282 00:14:34,600 --> 00:14:37,800 I really think they're just spending because I am the last 283 00:14:37,800 --> 00:14:42,500 person on this planet, who needs an upper one is speed art. 284 00:14:42,600 --> 00:14:46,400 Maybe at the beginning content, like just the discussion on ADHD 285 00:14:46,400 --> 00:14:49,600 on Tick-Tock the room. Like, I don't, I don't even get, 286 00:14:49,600 --> 00:14:52,700 I'm not even in those. If you saw my Tick Tock feed, 287 00:14:53,000 --> 00:14:54,700 I'm not even I'm not exposed to any of that. 288 00:14:54,700 --> 00:14:58,500 It's like my Talk feet is very clearly, like middle-aged lady 289 00:14:58,500 --> 00:15:03,000 cooking stuff, like really random Japanese things and then 290 00:15:03,000 --> 00:15:10,000 like, first round, eight HD sounds like targeted ads for 291 00:15:10,000 --> 00:15:13,600 benzos. That's the wrong stuff. 292 00:15:13,800 --> 00:15:16,200 Yeah, well I mean Ralph, I mean to get back to your story, what 293 00:15:16,200 --> 00:15:18,400 I find so interesting about, you know, Katie's sort of 294 00:15:18,400 --> 00:15:21,700 explanation here and your Origins and getting to this 295 00:15:21,700 --> 00:15:25,100 story is that it really seems like a Kind of Perfect Storm 296 00:15:25,100 --> 00:15:27,300 cast. Dating series of events all 297 00:15:27,300 --> 00:15:30,800 related to the pandemic because in one sense, we have this 298 00:15:30,800 --> 00:15:34,100 particular loophole that gets opened up at the beginning of 299 00:15:34,100 --> 00:15:37,100 the pandemic. There's also the rise of 300 00:15:37,100 --> 00:15:40,500 Telehealth as kind of, the dominant form of medical care, 301 00:15:40,500 --> 00:15:43,700 or arising from a medical care. And then there's the advertising 302 00:15:43,700 --> 00:15:45,100 through Tick-Tock, which is huge. 303 00:15:45,100 --> 00:15:48,100 Pandemic winner, as people spend all their time at home, trying 304 00:15:48,100 --> 00:15:49,400 to find some ways to occupy themselves. 305 00:15:49,400 --> 00:15:52,700 And it's like it almost seems inevitable that there are going 306 00:15:52,700 --> 00:15:57,400 to be companies out there that Recognize the what some wood, 307 00:15:57,400 --> 00:15:59,800 some would say opportunity and efficiency others would say, 308 00:16:00,100 --> 00:16:04,000 exploit you know, the weaknesses in the system to basically find 309 00:16:04,000 --> 00:16:05,800 a way to build a big business off of it, right? 310 00:16:05,800 --> 00:16:07,700 I mean, it's always the word, tell the doc used on their 311 00:16:07,700 --> 00:16:11,500 earnings call today's exploit. Yeah, it just seems, you know 312 00:16:11,500 --> 00:16:14,600 it, you know, it reminds me of to I remember a couple of years 313 00:16:14,600 --> 00:16:17,900 ago. Remember, he's the weed app that 314 00:16:17,900 --> 00:16:19,600 everyone is using in Sam? Yeah, doc. 315 00:16:19,800 --> 00:16:24,000 Oh yeah, this was back before. We'd was legalized in California 316 00:16:24,200 --> 00:16:25,300 and you would meet with a doctor. 317 00:16:25,500 --> 00:16:28,300 Who it if you didn't have a prescription in like I would 318 00:16:28,300 --> 00:16:32,700 say, 45 seconds. Prescribe you marijuana and it 319 00:16:32,700 --> 00:16:34,900 was such a joke to me, but of course it was weed. 320 00:16:34,900 --> 00:16:39,200 So it was all for a good cause, but like he was just very clear 321 00:16:39,200 --> 00:16:43,700 to me that like the ability to prescribe someone over, you 322 00:16:43,700 --> 00:16:47,500 know, through Telehealth was going to create, you know, 323 00:16:47,500 --> 00:16:51,800 Grease the wheels a lot and to correct a connect-the-dots even 324 00:16:51,800 --> 00:16:53,900 more. I think we're off my realizes 325 00:16:54,400 --> 00:16:57,900 David Sachs was a A seed investor and he's as well. 326 00:16:58,000 --> 00:17:04,500 So clearly has had his Insight that Telehealth on stuff. 327 00:17:04,500 --> 00:17:06,599 People really want is a smart strategy. 328 00:17:06,599 --> 00:17:09,700 Know the timing I still have to figure out the timing by the 329 00:17:09,700 --> 00:17:15,400 way, because done and cerebral were both founded in 2019. 330 00:17:15,400 --> 00:17:19,200 Lee 2019 cerebral launched in 2020, I think done lunch early 331 00:17:19,200 --> 00:17:21,300 20s. This is before depend emic 332 00:17:21,900 --> 00:17:23,900 cerebral dislodged. They were doing controlled 333 00:17:23,900 --> 00:17:25,300 substances when they when they started. 334 00:17:26,000 --> 00:17:30,200 And I actually don't know, the started kind of late in 2020, I 335 00:17:30,208 --> 00:17:33,600 don't know what done which was focused on it, which is focused 336 00:17:33,600 --> 00:17:36,400 on ADHD, like what was their planned right at the beginning. 337 00:17:36,400 --> 00:17:39,500 I haven't yet figured that out like, what was without the 338 00:17:39,508 --> 00:17:42,300 public health emergency was out. Is there a sense that the law 339 00:17:42,300 --> 00:17:45,500 will get changed back? Or like you know what sort of is 340 00:17:45,500 --> 00:17:47,500 there a, you know, what's the procedure? 341 00:17:47,900 --> 00:17:51,300 And I would be at? Yeah, it's my understanding and 342 00:17:51,300 --> 00:17:55,700 this is not sophisticated enough it is that when the A public 343 00:17:55,700 --> 00:17:58,000 health emergency ends this all goes away. 344 00:17:58,300 --> 00:18:01,800 Now I think there may be ways for this particular thing to be 345 00:18:01,800 --> 00:18:06,300 extended and their reasons. Why both Democrats and 346 00:18:06,300 --> 00:18:09,000 Republicans now kind of don't want the public health emergency 347 00:18:09,000 --> 00:18:12,200 to end because there are policies that come with it that 348 00:18:12,300 --> 00:18:16,300 they like and it's a good excuse for those to continue. 349 00:18:17,000 --> 00:18:20,300 So you know it just kind of keeps getting extended for. 350 00:18:20,700 --> 00:18:24,100 I use it six-week increments. Hmm so you're right it said 351 00:18:24,100 --> 00:18:25,800 really is dead. Really is Part of it. 352 00:18:25,800 --> 00:18:28,900 But but you know what, by the way, we should say this kind of 353 00:18:28,900 --> 00:18:31,900 near the top. One thing these companies say is 354 00:18:31,900 --> 00:18:34,200 that look, we're expanding access to mental health 355 00:18:34,200 --> 00:18:37,200 treatment and important medications that people don't 356 00:18:37,200 --> 00:18:39,300 have access to, that's not wrong. 357 00:18:39,500 --> 00:18:41,700 I talked a lot of people and they say, look, there's a lot of 358 00:18:41,700 --> 00:18:44,000 people particularly in rural areas who have no access to 359 00:18:44,000 --> 00:18:50,000 mental health care and the can suffer from ADHD to, right? 360 00:18:50,000 --> 00:18:51,700 Are they? But they can't, they may not 361 00:18:51,700 --> 00:18:55,700 have a psychiatrist nearby whose and Owen eaten by the the way 362 00:18:55,700 --> 00:19:00,900 nor the money to spend on a three hour for our evaluation 363 00:19:01,300 --> 00:19:03,400 that's and you know that's the other thing that's one thing 364 00:19:03,400 --> 00:19:07,600 these companies say and then the question comes down to is is the 365 00:19:07,600 --> 00:19:10,100 is the but the expert the experts we talked to basically 366 00:19:10,100 --> 00:19:13,400 say well, You know, there needs to be more access. 367 00:19:13,400 --> 00:19:19,800 That's true and really where they focus on is the 30-minute 368 00:19:19,800 --> 00:19:22,200 evaluations. They just say, you know, that's 369 00:19:22,200 --> 00:19:27,000 not that's too fast to a proper diagnosis but there is a truth 370 00:19:27,400 --> 00:19:29,300 that with mental health diagnosis. 371 00:19:30,000 --> 00:19:34,400 A lot of the direction is being taken by the patient. 372 00:19:34,400 --> 00:19:37,700 And if the patient really wants Adderall, I mean, you can just 373 00:19:37,700 --> 00:19:41,100 Google what the symptoms are and you could just say you have 374 00:19:41,100 --> 00:19:44,500 which Citing sources. I talked to say they drink and 375 00:19:44,500 --> 00:19:46,300 they're certainly for any Provider. 376 00:19:46,300 --> 00:19:48,300 By the way, you could do that for any provider, not just an 377 00:19:48,308 --> 00:19:51,800 online and if you're an elite, you can just find sort of the 378 00:19:51,800 --> 00:19:56,100 psychiatrist who prescribed, your friends Adderall and they 379 00:19:56,100 --> 00:19:58,700 clear and they did that psychiatrist can sleep easy at 380 00:19:58,708 --> 00:20:01,700 night saying that patients know what they want. 381 00:20:01,700 --> 00:20:04,600 Well I mean it's it's mental health drugs are very 382 00:20:04,600 --> 00:20:09,700 complicated to prescribe and do largely sort of in my view fall 383 00:20:09,700 --> 00:20:13,500 to the patients and hiding like what's appropriate for them 384 00:20:13,500 --> 00:20:16,800 because they're describing their own mental state. 385 00:20:17,100 --> 00:20:18,400 There's no, there's very little data. 386 00:20:18,500 --> 00:20:22,100 You know, the DSM-5 says that check me on this but, you know, 387 00:20:22,100 --> 00:20:26,600 the latest Psychiatry handbook says that ADHD doesn't exist 388 00:20:26,600 --> 00:20:28,800 unless you had it before each 12. 389 00:20:29,100 --> 00:20:33,000 The prior version of that of that textbook said it had to be 390 00:20:33,000 --> 00:20:34,900 seen prior to age 5. Hmm? 391 00:20:35,100 --> 00:20:37,600 Right. So, you know, I'm not a 392 00:20:37,608 --> 00:20:39,000 psychiatrist. I'm not an expert. 393 00:20:39,000 --> 00:20:40,700 Sure. Okay, but it's just, it's a 394 00:20:40,708 --> 00:20:43,800 testament to your point. That we're working on subjective 395 00:20:43,800 --> 00:20:45,900 stuff here, not necessarily part deal. 396 00:20:45,900 --> 00:20:47,700 There's no for mental health care. 397 00:20:47,700 --> 00:20:50,500 There's no blood test. You can take the tells you 398 00:20:50,500 --> 00:20:54,300 you've got Russian and there are the there are very complex, like 399 00:20:54,300 --> 00:20:55,900 exams. You can take. 400 00:20:55,900 --> 00:20:58,300 I don't really know the details but like you, you know, there 401 00:20:58,300 --> 00:21:01,300 are groups that have like psychological batteries that you 402 00:21:01,300 --> 00:21:03,300 can take to see. But are we really? 403 00:21:03,300 --> 00:21:06,600 You know, we would never really require that before a 404 00:21:06,600 --> 00:21:09,000 psychiatrist prescribes mental health drugs. 405 00:21:09,000 --> 00:21:12,000 So that you can always say, oh there's more you can Do I mean 406 00:21:12,000 --> 00:21:14,400 obviously to me I can give my opinion. 407 00:21:14,400 --> 00:21:18,800 I mean 30 minutes seems really fast Controlled Substances like 408 00:21:19,200 --> 00:21:21,800 it's naturally something where you just try to create friction 409 00:21:22,100 --> 00:21:24,700 and just sort of see like to somebody seem to want this like 410 00:21:24,700 --> 00:21:27,300 do we have human beings? We're really spending time with 411 00:21:27,300 --> 00:21:30,200 them and thinking about them or we truly monitor, you know, 412 00:21:30,200 --> 00:21:33,600 there are even though you could be sort of cynical that at the 413 00:21:33,608 --> 00:21:36,500 end of the day, if somebody really wants Adderall, you don't 414 00:21:36,500 --> 00:21:38,300 have to be a genius to figure out how to get it. 415 00:21:38,300 --> 00:21:41,400 There's still a value in friction and oversight. 416 00:21:41,600 --> 00:21:46,600 In human contact and connection. Yeah, well, it seems to me one 417 00:21:46,600 --> 00:21:50,600 of the biggest accelerants to this problem. 418 00:21:50,600 --> 00:21:53,700 If you want to call it a problem is the business model, right? 419 00:21:53,700 --> 00:21:56,100 The fact that these are Venture Capital funded companies, who 420 00:21:56,100 --> 00:21:58,500 are trying to thwaite find a way to scale it. 421 00:21:58,800 --> 00:22:02,000 And once you realize that there's money, frankly in 422 00:22:02,200 --> 00:22:04,700 prescribing this particular drug. 423 00:22:05,400 --> 00:22:06,900 And that there's an audience that wants it. 424 00:22:06,900 --> 00:22:09,000 For one reason or another. I understand. 425 00:22:09,000 --> 00:22:10,600 Even if you want to be responsible, you're still 426 00:22:10,600 --> 00:22:13,000 incentivised. Do more and that gets to, you 427 00:22:13,000 --> 00:22:16,000 know, The NPS complaining about the fact that they were being 428 00:22:16,000 --> 00:22:18,900 reprimanded by their bosses for not prescribing, it often 429 00:22:18,900 --> 00:22:20,900 enough, right? It's like who's really in 430 00:22:20,908 --> 00:22:22,900 control here? Is it the need? 431 00:22:22,900 --> 00:22:27,200 Is it like the public need for this for altruistic and socially 432 00:22:27,200 --> 00:22:29,700 beneficial reasons? Or is it the business model that 433 00:22:29,700 --> 00:22:32,400 says, hey, let's double down on this, you know, we're a SAS 434 00:22:32,400 --> 00:22:34,300 product. We found like a great Market, 435 00:22:34,300 --> 00:22:37,400 let's figure out a way to maximize the people and the 436 00:22:37,408 --> 00:22:41,400 most, you know, profitable user base within addiction is a very 437 00:22:41,600 --> 00:22:43,800 Good business model, like asphalt cigarette. 438 00:22:43,800 --> 00:22:45,900 Come the best. A dictionary. 439 00:22:48,400 --> 00:22:52,500 Investor will tell you that I think speaking of Texas, right? 440 00:22:52,800 --> 00:22:56,200 I deleted it was too much. I couldn't like I looked at my 441 00:22:56,300 --> 00:22:59,700 staff, there was a day when I had been on Tick-Tock. 442 00:22:59,700 --> 00:23:02,000 Nine hours. I was like, first of all, I work 443 00:23:02,000 --> 00:23:08,000 tonight our day. I'm deleting it right now but 444 00:23:08,300 --> 00:23:11,400 changes from week to week, these companies also really were 445 00:23:11,500 --> 00:23:15,600 Remind me of some of the early crypto businesses and Bitcoin 446 00:23:15,600 --> 00:23:18,200 businesses and a, what am I an early like the current 447 00:23:18,600 --> 00:23:21,300 cryptocurrency businesses? Because they're working in a 448 00:23:21,300 --> 00:23:25,400 gray area around regulation. And so, you're seeing right now 449 00:23:25,400 --> 00:23:28,300 as the federal government wants to expand the definition of what 450 00:23:28,300 --> 00:23:31,800 an exchange has its expanding it so much. 451 00:23:31,800 --> 00:23:35,200 That would inevitably sweep up all of these crypto currency 452 00:23:35,200 --> 00:23:37,500 exchanges that had not been regulated and they're fighting 453 00:23:37,500 --> 00:23:39,300 it. Because once that happens, the 454 00:23:39,308 --> 00:23:40,900 cost of doing business will go up. 455 00:23:40,900 --> 00:23:43,500 They will have Put in all these regulatory pieces will have to 456 00:23:43,500 --> 00:23:46,000 hire General, counsel's blah, blah and then they will not be 457 00:23:46,000 --> 00:23:47,600 as profitable. Well, they'll probably still 458 00:23:47,600 --> 00:23:50,100 make money, but they won't make the kind of money that made 459 00:23:50,100 --> 00:23:52,000 them. Good, VC, Investments. 460 00:23:52,100 --> 00:23:54,600 And so, you're seeing this, like, big lobbying push around 461 00:23:54,600 --> 00:23:56,400 it. And similarly, with these 462 00:23:56,400 --> 00:24:00,400 companies, I wonder One our Pharma companies work, you know, 463 00:24:00,400 --> 00:24:02,900 how did the Pharma companies feel about these startups? 464 00:24:02,900 --> 00:24:06,200 Because if they like them, these startups will have an enormous 465 00:24:06,200 --> 00:24:08,600 lobbying operation at their fingertips. 466 00:24:09,000 --> 00:24:14,500 And then to, you know, have we seen any sort of work by these 467 00:24:14,500 --> 00:24:18,700 companies to keep this area unregulated or lightly 468 00:24:18,700 --> 00:24:20,500 regulated? Yeah, I don't know. 469 00:24:20,700 --> 00:24:23,400 And the other question for you Ralph is he were talking to, you 470 00:24:23,400 --> 00:24:25,500 know, former maybe some current employees. 471 00:24:25,500 --> 00:24:29,600 These companies, especially the, the medical professionals are 472 00:24:29,600 --> 00:24:32,400 these side jobs for them, are they full time employees for it? 473 00:24:32,400 --> 00:24:35,400 Or is this kind of that particular typically contractors 474 00:24:35,700 --> 00:24:37,700 their contractors? Yeah, I know work for more than 475 00:24:37,700 --> 00:24:40,000 one they often they're often doing this for more than one 476 00:24:40,000 --> 00:24:41,400 platform. And there are lights. 477 00:24:41,600 --> 00:24:44,400 It's often they have a day job. Yeah, it's kind of a side gig. 478 00:24:44,400 --> 00:24:46,100 They're doing tell they're picking up Telehealth 479 00:24:46,100 --> 00:24:49,100 appointments in the side. Yeah, I've noticed a rising 480 00:24:49,100 --> 00:24:53,500 trend of that and that seems to also be ripe for these kinds of 481 00:24:53,500 --> 00:24:55,900 problems. Because if this is basically a 482 00:24:55,908 --> 00:24:58,300 pitch to them saying, hey, do you want to make more money? 483 00:24:58,600 --> 00:25:01,600 Why don't you spend a couple hours during the week quickly 484 00:25:01,600 --> 00:25:04,000 press, you know, meeting with people and prescribing stuff to 485 00:25:04,000 --> 00:25:07,300 them and of course doctors will say and rightfully so that, you 486 00:25:07,300 --> 00:25:10,800 know, there they care about the seriousness of their profession 487 00:25:10,800 --> 00:25:12,900 and the The Integrity of their license. 488 00:25:12,900 --> 00:25:16,000 But you know, there's just certain Financial incentives 489 00:25:16,900 --> 00:25:20,300 working extra on anecdotes that was on the financial incentives 490 00:25:20,300 --> 00:25:23,800 that I think. I know that for reader reactions 491 00:25:23,800 --> 00:25:25,800 that got some of the biggest reactions. 492 00:25:25,800 --> 00:25:29,500 We spoke to one done nurse practitioner and she shared how 493 00:25:29,500 --> 00:25:35,000 it works and she said, you know, she's got 2,300 patients, all 494 00:25:35,000 --> 00:25:38,500 ADHD all getting at are all substantially all I'm sure 495 00:25:38,500 --> 00:25:41,300 there's a handful that aren't but she said substantially all. 496 00:25:41,600 --> 00:25:44,600 And Sheeran is them every month. And she doesn't see all of them 497 00:25:44,600 --> 00:25:46,900 every month. Basically, they send in a form 498 00:25:47,100 --> 00:25:49,100 that says and sometimes they leave it blank. 499 00:25:49,100 --> 00:25:51,600 She says, if it's Blake, that means you're good to go. 500 00:25:51,600 --> 00:25:53,400 You're stable, that's great, and she renews them. 501 00:25:53,400 --> 00:25:55,700 And she said, she returns the prescription sometimes as fast 502 00:25:55,700 --> 00:25:59,400 as two-minute, and it works out because the way done pays its 503 00:25:59,400 --> 00:26:01,800 nurse practitioners, you don't have to see them for the 504 00:26:01,800 --> 00:26:04,700 follow-up. You can just you just get paid a 505 00:26:04,700 --> 00:26:08,200 percentage of your hourly rate to manage them on a monthly 506 00:26:08,200 --> 00:26:11,300 basis that and that works out to depending on your earlier. 507 00:26:11,500 --> 00:26:14,700 Rate somewhere between seven and ten dollars, I did the math with 508 00:26:14,700 --> 00:26:17,200 her. And I said, okay, 2,300 509 00:26:17,200 --> 00:26:21,300 patients, 89 bucks per month to clear and 20K. 510 00:26:21,500 --> 00:26:23,900 She said, yeah, yeah. Twenty twenty thousand dollars a 511 00:26:23,908 --> 00:26:25,900 month. It's great and make better by 512 00:26:25,900 --> 00:26:30,000 make more than a lot of doctors. So, you know, yeah, that 513 00:26:30,000 --> 00:26:33,100 Financial incentive for nurses on that Partners practitioners 514 00:26:33,100 --> 00:26:35,800 on that platform is kind of what you said it. 515 00:26:35,800 --> 00:26:39,300 It's it's it's just to renew quickly now, right? 516 00:26:39,300 --> 00:26:41,400 I will be. Let's that I want to, you know, 517 00:26:41,500 --> 00:26:44,600 Say that sheep certainly said she feels she's doing great 518 00:26:44,600 --> 00:26:46,900 stuff. She gets a lot of really caring 519 00:26:46,900 --> 00:26:49,700 emails from people who say this is changing and wife is helping 520 00:26:49,700 --> 00:26:51,600 them to better at work. This is helping them in their 521 00:26:51,600 --> 00:26:55,600 relationship. So, you know, I can't, I can't 522 00:26:55,600 --> 00:26:57,600 just beat that, you know, there are probably a lot of people 523 00:26:57,600 --> 00:27:01,300 that say, this is great and she's helping them so, you know, 524 00:27:01,400 --> 00:27:03,000 it's up to readers to judge, right? 525 00:27:03,100 --> 00:27:06,200 I mean, first of all, the traditional medical system is 526 00:27:06,300 --> 00:27:10,800 not great or always attentive and you can talk about the this 527 00:27:10,800 --> 00:27:14,000 speed Need of, which Telehealth can be delivered here? 528 00:27:14,000 --> 00:27:17,400 She can seem troubling but the sort of slowness and lack of 529 00:27:17,400 --> 00:27:19,300 access. The traditional, you know, if 530 00:27:19,300 --> 00:27:23,200 you need this drug and you can't even get sort of the medical 531 00:27:23,200 --> 00:27:26,300 systems attention, you know? That that it's it's own problem 532 00:27:26,400 --> 00:27:29,300 but also just it speaks to me. Like and maybe this is just the 533 00:27:29,300 --> 00:27:31,800 mindset of what I cover. But like the Giga fication of 534 00:27:31,800 --> 00:27:34,900 the Healthcare System, right? That this this model which has 535 00:27:34,900 --> 00:27:38,600 proved so popular to venture capitalists is going to be 536 00:27:38,600 --> 00:27:41,200 attempted in almost every single industry. 537 00:27:41,200 --> 00:27:45,900 That Allow for and we've clearly seen it come in into, you know, 538 00:27:45,900 --> 00:27:49,500 the the medical world. And you know it's not the 539 00:27:49,500 --> 00:27:52,400 dominant form by any means. You know, this is still kind of 540 00:27:52,400 --> 00:27:56,000 like a burgeoning startup kind of industry but we've seen what 541 00:27:56,000 --> 00:27:58,600 happens with Giga fication. That's actually really important 542 00:27:58,600 --> 00:28:00,900 Point Tom. Because one of the things the 543 00:28:00,900 --> 00:28:05,500 nurse practitioners told me, they said, look, I get, I have a 544 00:28:05,800 --> 00:28:09,300 readout an employee kind of feedback read out to tell me how 545 00:28:09,300 --> 00:28:12,400 well I'm doing and I get reviews from my Patients, write from 1 546 00:28:12,400 --> 00:28:15,900 to 5 and then comments to tell me how I'm doing and she said, 547 00:28:15,900 --> 00:28:17,800 you know what, I'm not an Uber driver. 548 00:28:17,900 --> 00:28:19,800 I'm supposed to be able to say no to people. 549 00:28:19,800 --> 00:28:23,000 If I don't think they're, if I think there are here, seeking 550 00:28:23,000 --> 00:28:25,100 medication that is inappropriate. 551 00:28:25,500 --> 00:28:27,800 And of course, those are the people that give me a 1, right, 552 00:28:27,800 --> 00:28:29,000 right. Yeah, works, right. 553 00:28:29,000 --> 00:28:34,100 He's supposed to be able to say, no. 554 00:28:34,100 --> 00:28:36,400 I know it's, you know, with with other customer service 555 00:28:36,400 --> 00:28:38,400 businesses, the customer is always right to what the 556 00:28:38,408 --> 00:28:41,300 customer wants. You know, it makes sense here. 557 00:28:41,700 --> 00:28:44,800 In medicine. We asked prescribers nurse 558 00:28:44,800 --> 00:28:46,700 practitioners a doctor's. We give them a special 559 00:28:46,700 --> 00:28:49,100 responsibility to be able to say, in my professional 560 00:28:49,100 --> 00:28:50,700 judgment. This is what you got. 561 00:28:50,700 --> 00:28:52,300 You don't have this. You think you have it? 562 00:28:52,400 --> 00:28:55,500 I don't think so, right? Yeah, and I mean we can get his 563 00:28:55,500 --> 00:28:58,300 political I guess as we want here but like obviously this is 564 00:28:58,300 --> 00:29:01,600 the inevitability of a for-profit Health Care Systems 565 00:29:01,900 --> 00:29:06,200 like this is, you know, people who are making money that didn't 566 00:29:06,200 --> 00:29:08,200 you know of the in the dr. Sam when they realize they could 567 00:29:08,200 --> 00:29:11,500 make more money by doing extra work on the side and this is A 568 00:29:11,500 --> 00:29:14,200 system that is allowing for a huge amount of people that are 569 00:29:14,200 --> 00:29:18,600 unattended for that are unserved finding an outlet in which they 570 00:29:18,600 --> 00:29:20,500 can be served. Now, again, like you're saying, 571 00:29:20,700 --> 00:29:23,200 most people are using it legitimately and most people do 572 00:29:23,200 --> 00:29:26,700 really need these drugs. But again, the system allows for 573 00:29:26,700 --> 00:29:30,200 all kinds, not just II. Really, there's a view of this 574 00:29:30,200 --> 00:29:35,100 where I mean, it exposes regulatory distortions, right? 575 00:29:35,100 --> 00:29:39,200 Obviously, if Adderall wasn't regulated, there wouldn't be 576 00:29:39,200 --> 00:29:42,800 this workaround to get people to To get people access to the 577 00:29:42,800 --> 00:29:46,700 approvers who they need, right? I mean, the reason these nurse 578 00:29:46,700 --> 00:29:50,200 practitioners are able to make so much money is because they've 579 00:29:50,200 --> 00:29:54,900 basically been given a special power to dispense something that 580 00:29:54,900 --> 00:29:58,100 people want. So there is do not follow this 581 00:29:58,100 --> 00:30:00,100 or I mean not really called a argument because like you could 582 00:30:00,100 --> 00:30:02,500 make the same argument with the pill Mill doctors and opioids, 583 00:30:02,500 --> 00:30:04,000 right? Like right, it made a lot of 584 00:30:04,008 --> 00:30:06,400 money, certainly, they had this special power, right? 585 00:30:06,400 --> 00:30:09,400 But that doesn't mean that the power should be exploited or, 586 00:30:09,400 --> 00:30:13,100 and to be clear that the And I mentioned, the one nurse has 587 00:30:13,100 --> 00:30:15,700 2,300 patients. That's an outlier most. 588 00:30:15,700 --> 00:30:18,700 Most of the people we spoke to current and former, you know, 589 00:30:18,800 --> 00:30:22,100 did I heard patient counts between 200 and 400? 590 00:30:22,100 --> 00:30:25,600 To 500 was was really tired. The higher bar, there are some 591 00:30:25,600 --> 00:30:27,900 definitely we've heard of and reported out that have more than 592 00:30:27,900 --> 00:30:30,400 that. But I only say that because I 593 00:30:30,400 --> 00:30:32,400 did the thing that bad a lot of his nurse practitioner, they 594 00:30:32,400 --> 00:30:35,600 aren't actually cleaning up. They aren't actually making a 595 00:30:35,600 --> 00:30:37,600 ton of money. So Fritz is the cerebral ones, 596 00:30:38,200 --> 00:30:41,200 they get frustrated because they have a half hour appointment. 597 00:30:41,600 --> 00:30:44,700 To diagnose people to get paid for half hour appointment. 598 00:30:44,800 --> 00:30:47,800 They don't get paid to do documentation and administrative 599 00:30:47,800 --> 00:30:51,100 stuff outside of that time. So a lot of times they can't 600 00:30:51,100 --> 00:30:54,600 necessarily hey I'm gonna Zoom with you but I'm typing because 601 00:30:54,600 --> 00:30:56,800 I get to take notes. I got because that's the time 602 00:30:56,800 --> 00:30:59,600 I'm going to pay for and by the way we've got patients back back 603 00:30:59,600 --> 00:31:02,300 back back use it to. They don't actually make a ton 604 00:31:02,300 --> 00:31:04,900 of money and a lot of them, they cycle through very, very 605 00:31:04,900 --> 00:31:07,100 quickly. There's a lot of, there's a lot 606 00:31:07,100 --> 00:31:09,900 of turnover, with a lot of the nurses, some other like some 607 00:31:10,000 --> 00:31:12,200 others, like the gig. I don't really want to stick 608 00:31:12,200 --> 00:31:13,600 around and been doing it for a long time. 609 00:31:13,600 --> 00:31:15,700 Have built Big patient panels others. 610 00:31:15,800 --> 00:31:17,700 You know they cycle through pretty quickly because they're 611 00:31:17,700 --> 00:31:19,300 they're not make enough money or they just cut it. 612 00:31:19,300 --> 00:31:21,800 Don't like the arrangement. I mean that sounds like uber 613 00:31:21,800 --> 00:31:26,800 yeah it's another gig you know dynamic current through a lot of 614 00:31:26,800 --> 00:31:29,000 people, it's a way for people to make money on the side. 615 00:31:29,000 --> 00:31:30,500 It shouldn't be your full-time job. 616 00:31:30,800 --> 00:31:33,500 The companies don't optimize for it to be your full-time job. 617 00:31:33,500 --> 00:31:36,300 There are some jobs where I do want it to be the person's full 618 00:31:36,300 --> 00:31:38,900 time job. Like I really do want my health 619 00:31:38,900 --> 00:31:43,700 provider who seeing me who Give me a powerful drug for it to be 620 00:31:43,700 --> 00:31:45,800 their full-time job. Or at least they think they can 621 00:31:45,800 --> 00:31:47,100 at least give their full-time attention. 622 00:31:47,100 --> 00:31:49,000 Interesting. Of course you know if I'm 623 00:31:49,000 --> 00:31:52,400 playing devil's advocate here if you want to increase access and 624 00:31:52,400 --> 00:31:54,700 I'm the companies and I believe in that mission, you say to 625 00:31:54,700 --> 00:31:56,700 yourself. You know what guys you're right. 626 00:31:56,800 --> 00:31:58,900 We'd love to give everybody two hours, three hours, give 627 00:31:58,900 --> 00:32:01,000 everybody. We can't the people who don't 628 00:32:01,000 --> 00:32:03,800 have access to this and typically can afford it, they're 629 00:32:03,800 --> 00:32:06,200 not going to pay us what it would take what what, what it 630 00:32:06,200 --> 00:32:09,500 would cost us to pay a nurse practitioner to give you three 631 00:32:09,500 --> 00:32:12,600 hours of their time and then To see you every month. 632 00:32:12,600 --> 00:32:15,100 This is what you could afford. So this is what you're going to 633 00:32:15,108 --> 00:32:16,300 get. This is the mental health care, 634 00:32:16,300 --> 00:32:19,300 you can afford and we'll get kind of thing which, which is 635 00:32:19,300 --> 00:32:20,600 not. I'm not saying that in a way 636 00:32:20,600 --> 00:32:24,000 that that, I mean pejoratively. I mean, this is the economics 637 00:32:24,000 --> 00:32:27,300 to, to I forget which one you said this is the economics of a 638 00:32:27,300 --> 00:32:30,100 for-profit health care. So, exactly, exactly, exactly. 639 00:32:30,100 --> 00:32:32,500 It's like everybody gets what they can. 640 00:32:32,500 --> 00:32:35,000 All raise our hands and shake her head and say, oh my God, 641 00:32:35,000 --> 00:32:36,100 they're not getting the best care. 642 00:32:36,100 --> 00:32:37,900 They should have more care. I think about this when I report 643 00:32:37,900 --> 00:32:41,200 this and you say, well sure, I'd love to give him more curious. 644 00:32:41,400 --> 00:32:43,900 But who's going to pay for that? I mean, this is a friend of mine 645 00:32:43,900 --> 00:32:47,400 when she had a baby in New York City which if you want to see 646 00:32:47,400 --> 00:32:49,500 the for-profit Health Care system at work, that's the best 647 00:32:49,500 --> 00:32:51,700 place on the planet. You know, she gave birth. 648 00:32:51,700 --> 00:32:55,300 I think it was NYU so she's an upper middle-class person. 649 00:32:55,300 --> 00:32:58,000 So she gave birth in a room that had lots of other women but they 650 00:32:58,000 --> 00:33:00,700 all have like a curtain and some sense of privacy. 651 00:33:01,100 --> 00:33:03,800 And if you have more money, you get your own Suite with like, 652 00:33:03,800 --> 00:33:06,700 really nice amenities and places to sleep for guests. 653 00:33:06,700 --> 00:33:08,800 And if you don't have any money, you're in a cure and a 654 00:33:08,800 --> 00:33:11,100 basically, a Corral. Yeah. 655 00:33:11,400 --> 00:33:13,900 Can I propose something? And I'm kind of amazed that no 656 00:33:13,900 --> 00:33:17,000 VC is thought about this, but to me, it seems like the solution 657 00:33:17,000 --> 00:33:20,700 to all of this, which is. Why isn't it that my Uber driver 658 00:33:20,700 --> 00:33:24,600 can prescribe me medication? I did, was he like look? 659 00:33:24,700 --> 00:33:28,700 Yeah, look if I'm in the car for 15, 20, 30 minutes, an 660 00:33:28,700 --> 00:33:30,500 absolutely aggravated. Yeah. 661 00:33:30,500 --> 00:33:33,500 As your driver, you draw, I'll be at your most unfocused, your 662 00:33:33,500 --> 00:33:36,500 most mentally unwell when you're, you know, in a in one of 663 00:33:36,508 --> 00:33:38,600 these cars, you know, rushing off to the airport or something 664 00:33:38,600 --> 00:33:40,700 like that. No one better than your Uber 665 00:33:40,700 --> 00:33:42,200 driver to. Describe these things. 666 00:33:42,300 --> 00:33:45,100 I've certainly heard of Uber drivers selling people 667 00:33:45,100 --> 00:33:47,300 marijuana. So, yeah, there's certainly a 668 00:33:47,300 --> 00:33:51,300 question, like the benzo, right? Why is Uber failing to extract? 669 00:33:51,300 --> 00:33:53,600 Its cut here. You know, know you're building 670 00:33:53,600 --> 00:33:57,100 the super. I thought about just delivering 671 00:33:57,100 --> 00:33:58,700 the drugs about prescribing them. 672 00:33:58,700 --> 00:34:00,200 I'm just want to know what's done that. 673 00:34:00,600 --> 00:34:04,700 So what kind of other turn to this in a story you wrote Ralph 674 00:34:04,700 --> 00:34:09,100 is that it sounds like some of the big pharmacies are pushing 675 00:34:09,100 --> 00:34:11,199 back on some of these prescriptions, right? 676 00:34:11,300 --> 00:34:13,900 Right. Like CVS and was it maybe Rite 677 00:34:13,900 --> 00:34:16,400 Aid or Walgreens have declined to fill some of the 678 00:34:16,400 --> 00:34:18,600 prescriptions from Walmart startups, Walmart? 679 00:34:18,699 --> 00:34:20,900 Yeah, this is, this is kind of an interesting wrinkle. 680 00:34:20,900 --> 00:34:23,900 We had heard from sources that they would have problems with 681 00:34:23,900 --> 00:34:26,400 pharmacies often individual locations. 682 00:34:26,400 --> 00:34:29,600 Done had a particular problem with Walmart specifically, seem 683 00:34:29,600 --> 00:34:32,400 to be blocking a number of their prescribers from filling 684 00:34:32,400 --> 00:34:33,800 prescriptions. So, at one point, they just 685 00:34:34,000 --> 00:34:37,800 stopped any prescriptions to Walmart and Walmart confirmed on 686 00:34:37,800 --> 00:34:40,500 the record that they block some shame prescribers for done. 687 00:34:41,600 --> 00:34:45,199 And Don has a basically appeal, that and no decision has been 688 00:34:45,199 --> 00:34:50,600 made to to unblock the vertices are well, big corporates just 689 00:34:50,600 --> 00:34:52,699 wielding, but it makes sense because they just got think 690 00:34:52,699 --> 00:34:55,000 about how much money they just had to pay in all these opioids 691 00:34:55,000 --> 00:34:58,000 settlements because they were no screaming pharmacies and they 692 00:34:58,000 --> 00:35:00,900 got they were sued, they have lost a lot of money. 693 00:35:00,900 --> 00:35:04,600 If I were, if I were a pharmacy, I'd be like extremely cautious 694 00:35:04,600 --> 00:35:05,900 right now. Because right. 695 00:35:06,000 --> 00:35:08,200 They went into the opioid crisis thinking. 696 00:35:08,200 --> 00:35:10,500 It's just some open, it's just, it's just rice. 697 00:35:10,500 --> 00:35:12,700 Craptions. It's just breakthrough pain. 698 00:35:12,700 --> 00:35:15,600 It's just it's just the early 90s and we're just making people 699 00:35:15,600 --> 00:35:17,800 feel better, but it isn't. It is interesting that we have 700 00:35:17,800 --> 00:35:20,900 these huge companies that can act as sort of many governments, 701 00:35:20,900 --> 00:35:23,500 you know, saying, no, you're not allowed to do this, right? 702 00:35:23,500 --> 00:35:25,300 Exactly. Like leave it to all done, well 703 00:35:25,300 --> 00:35:26,800 to know what do you know what though? 704 00:35:26,800 --> 00:35:28,800 It's simpler than that. It's not necessarily the 705 00:35:28,800 --> 00:35:32,000 company's, it's the pharmacist, the pharmacist themselves at the 706 00:35:32,000 --> 00:35:34,900 local level. This isn't what makes this story 707 00:35:35,400 --> 00:35:38,400 interesting to report the companies will see the companies 708 00:35:38,400 --> 00:35:41,700 that ADHD prescribers the sources will say, yeah, Issues 709 00:35:41,700 --> 00:35:45,400 with pharmacies and you call the pharmacies and they sometimes 710 00:35:45,400 --> 00:35:48,900 say, yeah, we believe it but we may not see it because the 711 00:35:48,900 --> 00:35:51,700 pharmacist at the local level, it's their corresponding 712 00:35:51,700 --> 00:35:55,600 responsibility to vet the prescription and decide is this 713 00:35:55,600 --> 00:35:58,300 somebody we want to prescribe to because for instance, they could 714 00:35:58,300 --> 00:36:00,700 check the prescription drug monitoring database to see if 715 00:36:00,700 --> 00:36:03,300 the patient got this prescription for a controlled 716 00:36:03,300 --> 00:36:05,300 substance elsewhere and now they're coming to you for the 717 00:36:05,300 --> 00:36:09,000 same thing, they be drunk shopping this all these 718 00:36:09,000 --> 00:36:12,000 databases, you know. So, That's one thing as the 719 00:36:12,000 --> 00:36:15,000 pharmacist at the at the local level sometimes and and there's 720 00:36:15,000 --> 00:36:18,800 sometimes stop this and so the ADHD company will see that light 721 00:36:18,800 --> 00:36:20,300 were not getting filled over here. 722 00:36:20,300 --> 00:36:21,800 Let's figure out how to fill this. 723 00:36:22,100 --> 00:36:23,700 And by the way, there's obviously a lot of other 724 00:36:23,700 --> 00:36:26,100 administrative reasons, things don't get filled for sure like 725 00:36:26,100 --> 00:36:28,300 insurance doesn't cover it or they're out of stock that that 726 00:36:28,300 --> 00:36:32,100 that also happens. But there's this other thing but 727 00:36:32,100 --> 00:36:35,200 she's gets to Katie's point about in the week of the opioid 728 00:36:35,200 --> 00:36:38,500 crisis. They created these basically 729 00:36:38,500 --> 00:36:41,800 Central compliance groups. The pharmacies did To monitor 730 00:36:41,800 --> 00:36:45,000 their own networks. Of pharmacies to see what 731 00:36:45,000 --> 00:36:46,300 prescriptions are coming in to see. 732 00:36:46,300 --> 00:36:50,700 Are there prescribers, who have a suspiciously high volume of 733 00:36:50,700 --> 00:36:54,000 something that we need to be careful about Controlled 734 00:36:54,000 --> 00:36:58,100 Substances, specifically, right. And Walmart, that controlled 735 00:36:58,100 --> 00:37:00,200 that. So we did get to the central 736 00:37:00,200 --> 00:37:01,800 group to Walmart. It wasn't just individual 737 00:37:01,800 --> 00:37:03,600 subscribers. The central group is the one 738 00:37:03,900 --> 00:37:07,000 that is blocking some done prescribers because they, they 739 00:37:07,000 --> 00:37:11,100 saw stuff come in that they were clearly uncomfortable with and 740 00:37:11,200 --> 00:37:14,400 They made they made that choice. So that is that is an 741 00:37:14,400 --> 00:37:17,500 interesting kind of other piece of this is yeah that the 742 00:37:17,500 --> 00:37:20,600 pharmacies are, you know, they just want to get a handle on. 743 00:37:20,600 --> 00:37:24,500 Controlled substances are all is one and so, they're treading 744 00:37:24,500 --> 00:37:26,300 carefully there. There's, they're mine. 745 00:37:26,500 --> 00:37:28,800 Why don't you deny they had legal liability? 746 00:37:28,800 --> 00:37:32,100 That the opioid issue is because they had people who worked in 747 00:37:32,107 --> 00:37:35,600 their networks, who flagged prescribed, who flagged 748 00:37:35,600 --> 00:37:38,900 prescriptions and pharmacists, who were ignored. 749 00:37:39,000 --> 00:37:43,800 So that is one of the reasons why These big pharmacies even 750 00:37:43,800 --> 00:37:46,400 had like legal exposure in the first place. 751 00:37:46,700 --> 00:37:49,800 So it's not that this is new that now their flagging and 752 00:37:49,800 --> 00:37:51,400 noticing with Adderall what it is. 753 00:37:51,400 --> 00:37:54,000 They were also flagging and noticing with opioids and just 754 00:37:54,000 --> 00:37:56,100 not paying attention to it. So they're just paying attention 755 00:37:56,100 --> 00:37:59,000 to and one other interesting wrinkle is that the companies, 756 00:37:59,000 --> 00:38:02,600 the pharmacies can't see, typically that a prescription is 757 00:38:02,600 --> 00:38:05,800 coming from cerebral or done, they see a prescriber 758 00:38:05,800 --> 00:38:07,900 information. Yes, they see the patient's 759 00:38:07,900 --> 00:38:12,100 information with cerebral, we reviewed Dude, you know, we were 760 00:38:12,100 --> 00:38:14,500 viewed. We reviewed one prescription 761 00:38:14,900 --> 00:38:17,600 that was sent over and they confirm this. 762 00:38:17,600 --> 00:38:20,900 That basically, you know, there's support phone number 763 00:38:21,400 --> 00:38:24,500 that is common that if they called that number it would be a 764 00:38:24,500 --> 00:38:26,900 cerebral could customer service representative. 765 00:38:26,900 --> 00:38:29,200 So if the pharmacist had a question about the prescription, 766 00:38:29,200 --> 00:38:32,000 they could call the number, then they'd see that it's coming from 767 00:38:32,000 --> 00:38:35,400 cerebral Telehealth provider, but that's not something that's 768 00:38:35,400 --> 00:38:36,500 readily. Apparent will in the 769 00:38:36,500 --> 00:38:38,400 prescription comes in through the system. 770 00:38:38,700 --> 00:38:41,100 So you know, the dump people were wondering, how does? 771 00:38:41,300 --> 00:38:44,000 How does Walmart know it's coming from us? 772 00:38:44,200 --> 00:38:48,300 That was something a sorceress and their guess was the support 773 00:38:48,300 --> 00:38:49,400 phone. Number was common to a few 774 00:38:49,400 --> 00:38:51,800 different people. Mmm, so maybe they were drawing 775 00:38:51,800 --> 00:38:54,900 drawing a connection there. But yeah, that's so that, that 776 00:38:54,900 --> 00:39:00,300 also complicates things for the pharmacies anyway, side note to 777 00:39:00,500 --> 00:39:04,200 those databases that they have to monitor prescribers. 778 00:39:04,300 --> 00:39:06,800 They don't share information but a mean between home. 779 00:39:06,800 --> 00:39:11,100 So CVS only sees what's happening soon as well. 780 00:39:11,300 --> 00:39:13,000 Only sees what's happening in Walmart's Network. 781 00:39:13,200 --> 00:39:15,900 So, whereas with the prescription drug monitoring 782 00:39:15,900 --> 00:39:19,800 databases for patients that if you get Adderall, if you get an 783 00:39:19,800 --> 00:39:23,300 arrow prescription or been so that goes onto your readouts, 784 00:39:23,600 --> 00:39:26,300 every pharmacist in its Fritz there by state. 785 00:39:26,300 --> 00:39:28,700 So everything you got in a state is there when you got to 786 00:39:28,707 --> 00:39:31,800 Walgreens CVS, a local Farm, some other Independent Pharmacy. 787 00:39:32,300 --> 00:39:34,900 All of them can see that data, but as he stated their mind you 788 00:39:34,900 --> 00:39:39,300 so much apart a goes, how like they were able to how the bank's 789 00:39:39,300 --> 00:39:41,100 because they didn't share information on. 790 00:39:41,300 --> 00:39:44,000 They're only sharing centralized information on loans and 791 00:39:44,000 --> 00:39:46,300 collateral that created this huge blind spot. 792 00:39:46,300 --> 00:39:48,900 Like that's so crazy. Yeah, I mean there's also 793 00:39:48,900 --> 00:39:51,500 assuming that there is an incentive on the part of the 794 00:39:51,500 --> 00:39:54,900 individual pharmacies to try to root this out, right, like even 795 00:39:54,900 --> 00:39:58,300 the decision to call up these support numbers to find out what 796 00:39:58,300 --> 00:40:01,300 the fuck is going on here. That's coming from the 797 00:40:01,300 --> 00:40:04,700 individual, impulse on the pharmacist to be like, this is a 798 00:40:04,700 --> 00:40:07,400 little weird to me. I should find out, which, if you 799 00:40:07,400 --> 00:40:10,300 are overworked, maybe you are working as a pharmacist as a 800 00:40:10,308 --> 00:40:13,200 part-time job, as Another thing, you again, may not be 801 00:40:13,200 --> 00:40:16,700 incentivized to look into it. Like the system is not pushing 802 00:40:16,700 --> 00:40:19,500 for this. It's Tommy visual of socialist, 803 00:40:20,400 --> 00:40:23,000 I'm just saying, it's the system we live in. 804 00:40:23,000 --> 00:40:27,300 Do you hate capitalism? Well, I mean, again, it got me, 805 00:40:27,300 --> 00:40:29,500 my Ritalin. When I was a see, you know, 11, 806 00:40:29,500 --> 00:40:34,000 so it's worked for me. I made friends through that, you 807 00:40:34,000 --> 00:40:36,100 know, it's like you go to the bathroom and you give out your 808 00:40:36,100 --> 00:40:38,600 extra riddle in the people. If you're not readily making 809 00:40:38,600 --> 00:40:41,800 friends, like you gotta find something be in Dylan kid is a 810 00:40:41,800 --> 00:40:45,000 way to do it as one of the more capitalists Among Us. 811 00:40:45,000 --> 00:40:49,000 I mean, I do think maintaining Norms in the healthcare system 812 00:40:49,000 --> 00:40:52,800 is essential for what it does, and sort of the telemedicine 813 00:40:52,800 --> 00:40:55,700 system goes against that in certain ways because it 814 00:40:55,700 --> 00:40:59,600 abstracts, I mean, the whole gig economy system abstract, sort of 815 00:40:59,600 --> 00:41:02,700 Labor from the person getting the good. 816 00:41:02,700 --> 00:41:04,800 So I certainly agree. That's troubling here. 817 00:41:05,100 --> 00:41:08,500 I'm also always the one defending sort of the Venture 818 00:41:08,500 --> 00:41:11,600 Capital model and sort of rolling my eyes at like Who 819 00:41:11,600 --> 00:41:14,700 cares? If they you know, blow up like 820 00:41:14,700 --> 00:41:17,800 if it's some random software company or whatever I do 821 00:41:17,800 --> 00:41:21,100 certainly agree that here. It's just a case where like is 822 00:41:21,100 --> 00:41:25,100 that much lost for Humanity if this grew slowly. 823 00:41:25,500 --> 00:41:27,700 You know, it's just sort of like it's an interesting idea, but 824 00:41:27,700 --> 00:41:29,500 there's something real is why not? 825 00:41:29,500 --> 00:41:33,500 Just grow it slowly and like see if it if it's better or not. 826 00:41:33,500 --> 00:41:37,000 But like the idea that it's Blitz, scaling, it seems like 827 00:41:37,000 --> 00:41:40,700 wholly unnecessary from a society perspective, the pot, 828 00:41:40,800 --> 00:41:45,300 the Show positives of delivering Adderall to people who would not 829 00:41:45,300 --> 00:41:49,100 be able to get it just don't in any way seemed to overwhelm the 830 00:41:49,100 --> 00:41:52,200 potential negatives. And so it just seems like an 831 00:41:52,200 --> 00:41:55,500 obvious business where slow growth seems far more 832 00:41:55,500 --> 00:41:58,800 appropriate, tell that to David Sachs are but they're certainly 833 00:41:58,800 --> 00:42:02,100 money to be made in moving into areas where other people's sin 834 00:42:02,100 --> 00:42:05,700 Clauses might block them and where there's regulatory 835 00:42:05,700 --> 00:42:09,500 Arbitrage, and points of inflection and writing. 836 00:42:09,500 --> 00:42:12,500 It's just going to affect all the All the dick pill companies 837 00:42:12,500 --> 00:42:15,100 that came on the scene, the last couple of years. 838 00:42:15,100 --> 00:42:19,600 I guess, I guess they predate, they predict these may not stop 839 00:42:19,600 --> 00:42:22,100 the march of the deck pillow. You think it sound? 840 00:42:22,100 --> 00:42:24,800 Do you think the US Congress would make her the DEA would 841 00:42:24,800 --> 00:42:28,100 make those pills control size? Means I think the rise. 842 00:42:30,300 --> 00:42:34,400 Yeah, they're going to take their dick pills away from 843 00:42:34,400 --> 00:42:37,700 congressional Reliance on dick. Pills is probably equal to those 844 00:42:37,700 --> 00:42:40,800 of Controlled Substances. So I would say, you know, as 845 00:42:40,800 --> 00:42:43,700 long as they Can keep the flow of spice going for both they're 846 00:42:43,700 --> 00:42:48,000 probably they're probably okay individually but yeah I don't 847 00:42:48,000 --> 00:42:51,300 suppose hymns is going to be wrapped up in any sort of 848 00:42:51,308 --> 00:42:54,600 crusading Congress person's desire to to regulate these 849 00:42:54,600 --> 00:42:57,300 companies but you never know. Can I ask you a very basic 850 00:42:57,300 --> 00:42:59,500 question and Ralph? We can cut this if you don't 851 00:42:59,500 --> 00:43:02,500 know you're not a doctor but like what is if somebody gets 852 00:43:02,500 --> 00:43:07,200 Adderall and they're not like they don't have ADHD like what? 853 00:43:07,200 --> 00:43:10,200 What is the crisis or like, they're addictive. 854 00:43:10,300 --> 00:43:12,700 It's a difference. Doing blow and so that's just 855 00:43:12,700 --> 00:43:15,300 going to deteriorate their health over time or like what 856 00:43:15,300 --> 00:43:18,600 they have like heart problems or like, what, what is the problem? 857 00:43:18,600 --> 00:43:22,200 Like, it's so there the Essex. So there are side effects that 858 00:43:22,500 --> 00:43:27,300 can include the heart related issues, cardiovascular issues, 859 00:43:27,300 --> 00:43:31,900 that's something we've reported. So, you know, you want to check, 860 00:43:31,900 --> 00:43:35,100 this is another challenge with Telehealth is sometimes. 861 00:43:35,500 --> 00:43:39,500 Certainly for older people who get diagnosed with ADHD which 862 00:43:39,500 --> 00:43:43,000 happens you want, Get a blood pressure cuff on them. 863 00:43:43,000 --> 00:43:44,800 You want to check their blood pressure because you don't want 864 00:43:44,800 --> 00:43:46,400 to necessarily give them a stimulant. 865 00:43:46,400 --> 00:43:49,200 If they've got a blood pressure issue, that's not something you 866 00:43:49,200 --> 00:43:52,600 can do over Telehealth. So yeah. 867 00:43:52,600 --> 00:43:53,900 There there are those side effects. 868 00:43:53,900 --> 00:43:56,800 I think you're right. You should talk to a doctor for 869 00:43:56,800 --> 00:43:59,900 more of it. Some of the readers that have 870 00:43:59,900 --> 00:44:02,600 come to us. And after our stories of said, 871 00:44:02,800 --> 00:44:06,500 you know, look, I got myself addicted to stimulants and it 872 00:44:06,500 --> 00:44:09,800 became a problem for me. Others have said, you know, 873 00:44:09,800 --> 00:44:14,500 sometimes, Stimulants lead them to other kinds of uppers other 874 00:44:14,500 --> 00:44:17,800 kinds of drugs. But that's not, you know, how 875 00:44:17,800 --> 00:44:19,600 many of the kids you went to college, who pop it out? 876 00:44:19,600 --> 00:44:23,400 Are all this predates me to really are they all having 877 00:44:23,400 --> 00:44:25,900 serious problems? No, probably know. 878 00:44:25,900 --> 00:44:26,800 They're all, they're all investors. 879 00:44:26,800 --> 00:44:29,200 They're all Wall Street. Weezer there is this interesting 880 00:44:29,200 --> 00:44:31,000 question? I have you like, I mean, like, I 881 00:44:31,000 --> 00:44:34,900 know a lot of people who did a lot of cocaine not and I'm we're 882 00:44:34,900 --> 00:44:38,500 all in our 40s and 50s now and they're not all Rogue addicts, 883 00:44:38,500 --> 00:44:41,100 but a lot of them I bring that up. 884 00:44:41,100 --> 00:44:44,400 So we don't all accidentally become like drugs scolds it's 885 00:44:44,400 --> 00:44:45,300 funny. I feel like we're all. 886 00:44:45,900 --> 00:44:48,800 I won't speak for I'm Pro, you know, recreational drugs but 887 00:44:48,800 --> 00:44:52,300 then you know you hear like oh the prescribed drugs and all of 888 00:44:52,300 --> 00:44:55,100 a sudden it's like, oh, that that needs to be done the right 889 00:44:55,100 --> 00:44:56,800 way. I also think we're why are we 890 00:44:57,000 --> 00:45:00,300 why are we making this false like barrier between like like 891 00:45:00,300 --> 00:45:02,500 recreational prescription, drugs, prescription drugs, are 892 00:45:02,500 --> 00:45:05,000 recreational drugs, right. And we should also State out. 893 00:45:05,600 --> 00:45:07,000 That's not what they're for, but they're off. 894 00:45:07,200 --> 00:45:09,800 I'm just saying, prescription drugs, and prescription 895 00:45:09,800 --> 00:45:13,300 Veterinary. Arie drugs are not uncommonly 896 00:45:13,300 --> 00:45:15,100 used as Recreation, right, right. 897 00:45:15,100 --> 00:45:17,400 And we don't want to come off as like you're saying on drug 898 00:45:17,400 --> 00:45:20,900 scolds and deciding, which drugs, you know, are acceptable 899 00:45:20,900 --> 00:45:23,900 socially and not, I do think it is dead, cats stated platform 900 00:45:23,900 --> 00:45:26,800 that we are anti whippets that's program than anyone. 901 00:45:27,100 --> 00:45:29,400 I'm just not comfortable inhaling things. 902 00:45:29,400 --> 00:45:33,800 Like I, if I needed stream, whatever, guys. 903 00:45:33,900 --> 00:45:35,500 Oh wow. Well, we'll have to take this up 904 00:45:35,500 --> 00:45:38,400 in the next day at our next meeting because I know you were 905 00:45:39,200 --> 00:45:40,600 either way. I didn't think we've never 906 00:45:40,600 --> 00:45:44,600 discussed. So we're like, I think if this 907 00:45:44,600 --> 00:45:46,800 show stands for anything, it should be inside a lot of 908 00:45:46,800 --> 00:45:49,100 restaurants. So like, you know, I just like 909 00:45:49,300 --> 00:45:51,600 Something's Happened. Well, what? 910 00:45:51,600 --> 00:45:53,900 Well, I do I just really Adderall criticism. 911 00:45:53,900 --> 00:45:56,300 There is this like the medical system still has this 912 00:45:56,300 --> 00:46:01,100 assumption, they'll like the Baseline human psychology is 913 00:46:01,100 --> 00:46:03,000 like preferable. Like, you know, we're not in 914 00:46:03,000 --> 00:46:05,400 this like world, where people are like, oh yeah, like 915 00:46:05,400 --> 00:46:10,700 Limitless is good, but it's not clear like long-term whether we 916 00:46:10,700 --> 00:46:13,000 could. Decide that like every human 917 00:46:13,000 --> 00:46:17,800 being is better like, with some like pharmacological adjustment, 918 00:46:17,800 --> 00:46:20,000 whatever happened to bath salt, we want, do you want to live in 919 00:46:20,000 --> 00:46:22,700 that world? Yeah, I mean, if it's better, if 920 00:46:23,000 --> 00:46:27,000 I mean that's I stood out to be in your story, what a part of 921 00:46:27,008 --> 00:46:29,800 one of responding to is it's like, oh, people can get high 922 00:46:29,800 --> 00:46:31,200 off Adderall. It's like, oh man, they 923 00:46:31,200 --> 00:46:34,900 experience like euphoria that they wouldn't have otherwise 924 00:46:34,900 --> 00:46:37,500 like this is like terrible, you know. 925 00:46:37,500 --> 00:46:40,800 I that that that's sort of the impulse that I don't quite get 926 00:46:40,800 --> 00:46:44,700 like, Isn't it good that people get extraneous Euphoria, if 927 00:46:44,700 --> 00:46:48,000 there weren't other negative consequences, just like, what is 928 00:46:48,000 --> 00:46:50,400 the issue with people getting more Euphoria than they would 929 00:46:50,400 --> 00:46:51,400 have? Otherwise? 930 00:46:51,400 --> 00:46:54,700 I don't have a process of that. But that's just what it's like 931 00:46:54,700 --> 00:46:57,400 the problem with all drugs, that's all that's like. 932 00:46:57,800 --> 00:47:00,600 Sometimes they're very, very addictive, and people can't 933 00:47:00,600 --> 00:47:02,800 become addicted to them. I'm sure there are people out 934 00:47:02,800 --> 00:47:06,000 there who have like done heroin and didn't end up complete 935 00:47:06,000 --> 00:47:07,900 addicts. Right, right, right. 936 00:47:07,900 --> 00:47:10,600 I mean, it's, you know, there's there's the local dance reason 937 00:47:10,600 --> 00:47:12,900 of Drugs. It's like the old Bill Hicks you 938 00:47:12,900 --> 00:47:15,300 know routine about like you never see a news story about 939 00:47:15,300 --> 00:47:19,000 someone who took acid and had expanded Consciousness and like 940 00:47:19,000 --> 00:47:21,100 understood the world in a slightly more interesting way. 941 00:47:21,100 --> 00:47:23,700 It's always some like dip Shady jumped off of a roof. 942 00:47:23,900 --> 00:47:26,500 That becomes the story but then Michael Pollan, writes a great 943 00:47:26,500 --> 00:47:28,900 book about it though. Yeah, it's good. 944 00:47:29,100 --> 00:47:30,700 Yeah. I say that I even write it. 945 00:47:30,700 --> 00:47:32,300 Is it good? I got to read it as a good but 946 00:47:32,700 --> 00:47:34,500 it's like an ex. Did you like the New Yorker? 947 00:47:34,600 --> 00:47:37,800 A say version. I have read that either that 948 00:47:37,800 --> 00:47:42,400 reference trying to sound smart and absolutely Does that make me 949 00:47:42,400 --> 00:47:45,200 even have those guys look like no? 950 00:47:45,300 --> 00:47:49,400 But look at ya know. You've nailed her audience. 951 00:47:49,400 --> 00:47:51,500 It's people who want to sound smart by claiming they've read 952 00:47:51,500 --> 00:47:54,000 books. That's well, Tom has never 953 00:47:54,000 --> 00:47:56,900 claimed that he won't even read the fucking time about. 954 00:47:56,900 --> 00:47:59,600 So right. I've read the covers of a lot of 955 00:47:59,600 --> 00:48:02,800 books and I feel like I got the vibe in our last few minutes 956 00:48:02,800 --> 00:48:04,300 here. Do you want to talk briefly 957 00:48:04,300 --> 00:48:06,400 about? You Lon, does anybody have a new 958 00:48:06,400 --> 00:48:10,100 thought on a Lon? I've probably read 80,000 words 959 00:48:10,100 --> 00:48:12,400 on Elon Musk, Scanned, the lab. He won't do it. 960 00:48:13,100 --> 00:48:15,200 My thanks to her. Like this is all, this is all 961 00:48:15,200 --> 00:48:17,400 not gonna happen. These actually gonna bail on it, 962 00:48:17,800 --> 00:48:19,800 I don't think so, but it's possible. 963 00:48:19,800 --> 00:48:21,800 I love those takes. I don't, he's already sold a lot 964 00:48:21,800 --> 00:48:23,500 of Twitter stock in order to do that. 965 00:48:23,500 --> 00:48:27,400 So I was like, yeah, we're not Scott Galloway who does not get 966 00:48:27,400 --> 00:48:31,700 much mind sharing my brain but he had predicted incorrectly 967 00:48:31,700 --> 00:48:35,200 that, you know, Elon would have, you know, the acquisition 968 00:48:35,200 --> 00:48:37,000 wouldn't happen. You know, I that was my 969 00:48:37,000 --> 00:48:40,200 inclination to, but now he's like doubling down saying that 970 00:48:40,200 --> 00:48:43,000 this isn't going to happen. Vince like it's putting like, 971 00:48:43,000 --> 00:48:45,500 you know, good money after bad. Yes. 972 00:48:45,500 --> 00:48:48,700 Especially since that, you know, almost everyone was wrong about 973 00:48:48,700 --> 00:48:50,300 this, right? And every step along the 974 00:48:50,300 --> 00:48:55,900 process, the idea that like, okay, you did not happening, no 975 00:48:55,900 --> 00:48:59,100 fucking private Equity, saviors, coming in the singing, companies 976 00:48:59,100 --> 00:49:02,200 piece of dogshit, only Elon Musk going to take it and this is the 977 00:49:02,200 --> 00:49:05,600 stronger than I heard. But you did, you did come down 978 00:49:05,600 --> 00:49:07,300 on my knees. I did say that about private 979 00:49:07,300 --> 00:49:09,800 equity and I did say that Twitter was a dog shit. 980 00:49:10,000 --> 00:49:11,800 It is. Definitely You know, you said he 981 00:49:11,800 --> 00:49:14,200 lied, you thought he was going to buy it so I you could stand 982 00:49:14,200 --> 00:49:15,300 behind that. Pretty strongly. 983 00:49:15,300 --> 00:49:17,100 Okay. Here's my here's my one take and 984 00:49:17,100 --> 00:49:20,300 this is extremely Insider e, but I guess this is the red venue 985 00:49:20,300 --> 00:49:24,600 for this venue for the yeah, the last 50 minutes or whatever. 986 00:49:24,600 --> 00:49:25,800 We're out of dead cat. Yeah. 987 00:49:25,800 --> 00:49:30,500 Anyway, yeah, I am really fucking tired of journalists who 988 00:49:30,500 --> 00:49:33,000 are tweeting out, you know, they're like, oh, I'm on the 989 00:49:33,000 --> 00:49:35,900 hell site beat for MTV News or something. 990 00:49:36,100 --> 00:49:38,500 I can tell you what Twitter is going to look like under Elon 991 00:49:38,500 --> 00:49:40,800 Musk, and let me do a whole thread about what this is going 992 00:49:40,800 --> 00:49:42,900 to. You like is I spend my time, you 993 00:49:42,908 --> 00:49:46,700 know, dming people who have groper I you know Abby's and I 994 00:49:46,700 --> 00:49:49,000 understand the true hell of what the internet can be. 995 00:49:49,000 --> 00:49:50,700 It's like you don't fucking know. 996 00:49:50,900 --> 00:49:54,300 I'm sorry just because you spent a whole bunch of time on 8chan 997 00:49:54,500 --> 00:49:57,300 and feel like you have a better read on like you know, the new 998 00:49:57,300 --> 00:50:00,600 form of Nazis that are out there that you have like a read on 999 00:50:00,600 --> 00:50:02,500 what's going to happen here. Nobody knows. 1000 00:50:02,700 --> 00:50:05,400 Nobody has any clue? And so I'm tired of you claim it 1001 00:50:05,400 --> 00:50:07,600 expertise here. We're all in this together. 1002 00:50:07,700 --> 00:50:11,200 Was that in cidery enough orders making predictions as As 1003 00:50:11,200 --> 00:50:14,200 actually long been Katie's stance, reporters making big 1004 00:50:14,600 --> 00:50:17,900 predictions is just like a dangerous strategy, don't do it. 1005 00:50:18,200 --> 00:50:20,600 We already come off as know-it-alls were bad at making 1006 00:50:20,600 --> 00:50:23,300 predictions. Like I mean that's I do think 1007 00:50:23,300 --> 00:50:25,900 with the Elan thing, you know reporters are used to 1008 00:50:25,900 --> 00:50:29,700 traditional fight MMA, right? And so if you looked at it by 1009 00:50:29,700 --> 00:50:32,100 traditional lemon, a standards, it looked like it was never 1010 00:50:32,100 --> 00:50:34,400 going to happen. But the whole thing about Elon 1011 00:50:34,400 --> 00:50:35,600 is that he doesn't even look like. 1012 00:50:35,600 --> 00:50:38,200 It wouldn't happen for normal investor rights are private 1013 00:50:38,200 --> 00:50:42,700 Equity investor along. Right, something pretty good, 1014 00:50:42,700 --> 00:50:43,400 right? It's right. 1015 00:50:43,400 --> 00:50:45,300 You on frame. You should have been Does Elon 1016 00:50:45,300 --> 00:50:48,400 tend to succeed on things that nobody believed in. 1017 00:50:48,400 --> 00:50:52,100 Yes. So maybe he's going to 1018 00:51:05,200 --> 00:51:09,000 come up with the money in my pockets in the Deep Pockets of 1019 00:51:09,000 --> 00:51:12,200 my two friends, right? Keep in mind, I never thought 1020 00:51:12,200 --> 00:51:15,200 the money was a barrier, right? That was the thing for a while. 1021 00:51:15,200 --> 00:51:21,500 So I think I deserve to be sold a bunch of Tesla shares and the 1022 00:51:21,508 --> 00:51:23,600 stocks up lap before we started recording. 1023 00:51:23,600 --> 00:51:26,200 The stock was up. So it's classic like you think 1024 00:51:26,600 --> 00:51:28,700 it's still way down? Since this Twitter thing was 1025 00:51:28,700 --> 00:51:29,700 announced it. Yes. 1026 00:51:29,700 --> 00:51:32,800 But it's but as of the actual cell, he's getting a Bargains 1027 00:51:33,700 --> 00:51:35,700 up, right? Getting a deal unless you think 1028 00:51:35,700 --> 00:51:39,100 the actual eventual price is going to be 0 but otherwise 1029 00:51:41,000 --> 00:51:43,700 Frame. We should have said he surely 1030 00:51:43,700 --> 00:51:46,700 should try to diversify away from Tesla and this is the best 1031 00:51:46,700 --> 00:51:50,100 excuse, anybody could ever come up with to sell some Tesla 1032 00:51:50,100 --> 00:51:53,800 shares its to use that money to invest in a financially ruinous 1033 00:51:53,800 --> 00:51:54,600 decision. Right? 1034 00:51:54,900 --> 00:51:56,400 Yeah. And I'm gonna come, I'm gonna 1035 00:51:56,400 --> 00:51:59,000 say that. I'm really happy that the like I 1036 00:51:59,000 --> 00:52:02,300 very rarely make predictions but the two that I've made that I 1037 00:52:02,308 --> 00:52:05,700 was right on one. Donald Trump becoming president 1038 00:52:05,700 --> 00:52:10,300 211 must like Twitter. When I mean, there's a certain 1039 00:52:10,300 --> 00:52:12,900 there's a certain Connected here that may seem to have tested 1040 00:52:13,300 --> 00:52:17,300 which is the dumbest possible outcome wasn't that elon's thing 1041 00:52:17,300 --> 00:52:21,000 the the funnest outcome will be the true one or whatever. 1042 00:52:21,100 --> 00:52:23,100 I don't know if that's related to eat lunch specifically but it 1043 00:52:23,100 --> 00:52:25,800 clearly I think what you want is tweeted, something like that. 1044 00:52:26,000 --> 00:52:28,800 Rob, give us a neon tape. Give it whatever her doll or 1045 00:52:28,800 --> 00:52:30,400 takes, but what do you want, take? 1046 00:52:30,600 --> 00:52:34,500 Oh god. Um, you know, it's it's funny to 1047 00:52:34,500 --> 00:52:37,900 me all of the people along the way who have been doubters a 1048 00:52:37,900 --> 00:52:41,900 deal on the short Sellers and Tesla for I think a lot of 1049 00:52:41,908 --> 00:52:44,600 people are still suing him over funding secured because, you 1050 00:52:44,600 --> 00:52:47,300 know, they lost money on that. And meanwhile, the stock is up 1051 00:52:47,500 --> 00:52:50,000 oh much. Since then I, you know, 1052 00:52:50,000 --> 00:52:53,100 everybody thought that compensation package, he got was 1053 00:52:53,100 --> 00:52:55,900 just nutty and crazy and it's never going to amount to 1054 00:52:55,900 --> 00:52:57,400 anything and it made him the richest person. 1055 00:52:57,400 --> 00:53:01,300 But all right, said, actually raises rates substantially could 1056 00:53:01,300 --> 00:53:03,500 all end. Yeah, the FED actually went to 1057 00:53:03,500 --> 00:53:06,400 like 5% or something. I want to see what high beta 1058 00:53:06,400 --> 00:53:08,000 stocks like Tesla, doing that world. 1059 00:53:08,000 --> 00:53:10,400 Where I feel like I went to the heart of heard on the street, 1060 00:53:10,400 --> 00:53:12,900 like I feel like Like we were just transferred of it like 1061 00:53:13,200 --> 00:53:16,200 until like the essence of heard on the street distilled. 1062 00:53:16,200 --> 00:53:18,300 It was very, it was very wonderful. 1063 00:53:18,400 --> 00:53:21,300 Hey Kurt on the street was very negative on Tesla for a long 1064 00:53:21,300 --> 00:53:23,900 time because no cash flow. This devaluation doesn't make 1065 00:53:23,900 --> 00:53:26,700 sense in. This is all crazy but, you know, 1066 00:53:27,000 --> 00:53:29,200 and the other thing I will say Zealand. 1067 00:53:29,600 --> 00:53:33,300 I mean he's been angry at me before I when I got minor league 1068 00:53:33,300 --> 00:53:35,500 scoop and you know he's threatened, I'm never gonna talk 1069 00:53:35,500 --> 00:53:37,500 to you again, Ralph. If you write this story even 1070 00:53:37,500 --> 00:53:39,200 ever talked to me, once he won, right? 1071 00:53:41,800 --> 00:53:45,400 Oh that's classic. That's yeah. 1072 00:53:45,400 --> 00:53:48,600 This Jared Burchell guy that was he was kind of get seeing his 1073 00:53:48,600 --> 00:53:50,100 name was helpful to Landing that scoop. 1074 00:53:50,100 --> 00:53:51,300 He's he falls. He's always said, I'm getting 1075 00:53:51,300 --> 00:53:55,900 written about but uh, you know, see what you peace, I know in a 1076 00:53:55,908 --> 00:53:57,500 lot of ways and unpleasant, dude. 1077 00:53:57,900 --> 00:54:01,100 But you know what people say? Oh, he's a fraud, he's this, 1078 00:54:01,100 --> 00:54:02,200 he's that. But you know what? 1079 00:54:02,400 --> 00:54:04,900 Look at the cars in the road. Look at the rockets that blame 1080 00:54:04,900 --> 00:54:08,600 themselves and think about strategically to speaking is 1081 00:54:08,600 --> 00:54:12,100 American for a minute. I like the is that there's an 1082 00:54:12,100 --> 00:54:15,200 American car company that is leading the EV with the lead in 1083 00:54:15,200 --> 00:54:17,300 the show in V's. I like that. 1084 00:54:17,300 --> 00:54:23,100 We are no longer a hostage to Aryan space and the soyuz rocket 1085 00:54:23,100 --> 00:54:26,400 to get to space. It's nice that we have an 1086 00:54:26,400 --> 00:54:28,800 American company that actually makes us competitive. 1087 00:54:28,800 --> 00:54:31,800 There it would be really great if we had a lot of other 1088 00:54:32,000 --> 00:54:35,700 American companies that built their own stuff, you know, I 1089 00:54:35,700 --> 00:54:37,900 don't know. For all the all the reasons that 1090 00:54:37,900 --> 00:54:40,800 it get somebody like trouble. I did right right org. 1091 00:54:40,900 --> 00:54:43,400 Or Draw the same reasons to draw a lot of support to somebody 1092 00:54:43,400 --> 00:54:46,000 like Bernie Farhad in the New York Times, just wrote a 1093 00:54:46,100 --> 00:54:48,800 positive. Eli, I didn't read for Hans take 1094 00:54:48,800 --> 00:54:51,600 but, you know, on the one hand, yeah, he's a super be in a lot 1095 00:54:51,600 --> 00:54:53,100 of ways is super unpleasant, dude. 1096 00:54:53,100 --> 00:54:57,100 But you know, he built rockets that that land themselves, he, 1097 00:54:57,500 --> 00:55:00,200 you know, has convinced everyone that Evie's were going to be 1098 00:55:00,200 --> 00:55:02,400 saying, guess what? If he's a real thing, it's not 1099 00:55:02,400 --> 00:55:04,200 it's good, that's it. These are good things. 1100 00:55:04,200 --> 00:55:06,800 I do think there's like an ant ice-cold mood. 1101 00:55:06,800 --> 00:55:10,500 Like, I mean, clearly I'm on board with being more positive. 1102 00:55:10,500 --> 00:55:14,100 It'll be Interesting to see if, I don't know that we get 1103 00:55:14,100 --> 00:55:17,000 positive on Ilan as the owner of Twitter. 1104 00:55:17,100 --> 00:55:19,300 I don't know the entire time, I don't know about that. 1105 00:55:19,300 --> 00:55:24,200 But, you know, to it together. I mean, it makes sense 1106 00:55:24,200 --> 00:55:27,600 tactically for Ilan to Cozy up to the far right. 1107 00:55:27,700 --> 00:55:29,900 You know, especially if you ever sells this fucking truck, you 1108 00:55:29,908 --> 00:55:34,500 know, that's like the customer base for his cyber truck and and 1109 00:55:34,500 --> 00:55:37,900 clearly, if you were like, oh and EV CEO like, who's their 1110 00:55:37,900 --> 00:55:40,500 natural families, who would be the libs? 1111 00:55:40,900 --> 00:55:44,300 There's a certain, like, go against type and keep everybody 1112 00:55:44,300 --> 00:55:47,900 in the fold, but I feel like he's is sort of going above and 1113 00:55:47,900 --> 00:55:50,500 beyond, it's starting to seem a little too sincere. 1114 00:55:50,500 --> 00:55:54,100 He keeps engaging with like terrible people. 1115 00:55:54,100 --> 00:55:57,100 I'm right wing Twitter and I keep sort of naively. 1116 00:55:57,100 --> 00:55:59,000 Hoping he's going to rein it back. 1117 00:55:59,000 --> 00:56:02,400 Trust the Plan, Eric plan, it's all we can do. 1118 00:56:03,100 --> 00:56:04,200 All right, thanks for joining Ralph. 1119 00:56:04,200 --> 00:56:06,200 This is great. Hey, thanks for having me. 1120 00:56:18,900 --> 00:56:20,200 Goodbye. Goodbye. 1121 00:56:20,200 --> 00:56:22,800 Goodbye, goodbye, goodbye. Goodbye. 1122 00:56:18,900 --> 00:56:20,200 Goodbye. Goodbye. 1123 00:56:20,200 --> 00:56:22,800 Goodbye, goodbye, goodbye. Goodbye.