The Hustle

⚕️ Big Tech’s health care battle

The Hustle - Silicon Valley Tech News


April 15, 2021

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Crypto exchange Coinbase ended its first day as a public company with a share price of $328.28 and an $85B+ valuation. Shares rose as high as $429.54, which hopefully isn’t where you got in.

The big idea

Health care is the latest Big Tech battleground

It’s no secret that America spends on health care. In 2019, that spending reached $3.8T ($11.6k per person). By 2028, it’s projected to hit $6.2T.

To the folks in Big Tech, any number with a “T” means one thing: opportunity.

This week, Microsoft showed it’s serious about the space

The company announced the $19.7B acquisition of Nuance Communications, known for its AI transcription tools for health care professionals.

Nuance has a healthy following among…

  • Doctors: 55%+ of physicians and 75% of radiologists in the US use its products
  • Hospitals: 77% of US hospitals are Nuance customers
  • Investors: Nuance’s Health Care Cloud revenue grew 37% in 2020

Doctors can use Nuance tech — which is already integrated with Microsoft Teams — to record conversations and automatically transcribe notes.

But Microsoft isn’t alone

Cook, Pichai, and Bezos want in, too:

  • Apple is focused on selling hardware to health care providers and offering software platforms for medical record keeping
  • Google recently introduced its Google-for-medical-records platform Care Studio and bought Fitbit for $2.1B
  • Amazon is the gangster player, having recently released Prime-like online pharmacy and primary care service platforms

Bezos has also gone one step further, debuting the Amazon Halo that’s capable of calculating body fat (of which Bezos has none).

Still, challenges abound

If history is any indication, Big Tech’s success in health care is hardly a given:

  • IBM hyped Watson’s AI-cancer diagnosis capabilities but is now exploring a sale
  • Amazon’s health care venture with Berkshire Hathaway and JPMorgan Chase failed to get off the ground
  • Google faced privacy hurdles when trying to gain access to health care provider data

Regardless, the digitization of health care is a huge market, and Big Tech is gearing up for battle.

Snippets
  • Southeast Asia Superapps: Yesterday, Singapore-based Grab announced the largest SPAC ever (~$40B). Today, Gojek — its Indonesian competitor — announced an $18B merger with another firm, Tokopedia. The new, competing superapp has a glorious name: GoTo.
  • Instagram is letting users decide: The company is testing an option that lets users choose whether to see like counts on their own — or anyone else’s — posts.
  • ScaleAI is scaling and is now valued at $7.3B following a $325m funding round. Former Amazon exec Jeff Wilke will join the data company as an advisor.
  • Speaking of Amazon… the company was accused of copying Apple’s design for its own Echo Buds. Clearly, Apple did something right — 52% of US teens own AirPods.
  • Brace yourselves, New Yorkers… NYC’s Department of Transportation chose Bird, Lime, and VeoRide to participate in its first e-scooter pilot, with 1k scooters each.
  • Hardware-for-machine-learning startup Groq announced a $300m funding round. Groq’s tensor streaming processor architecture is supposedly the industry’s fastest. We’ll take their word for it.
  • Huge deal: Dell is spinning off VMWare, its cloud computing and virtualization business at a value of $9B.
Q&A

Garry Tan’s investment in Coinbase turned $300k into $2B+

In March 2012, Garry Tan — managing partner at Initialized Capital — received a cold email from the address “contact@bitbank.is.”

It contained 0.05 BTC.

At the time, Tan was a partner at startup incubator Y Combinator, and Bitcoin’s total market cap was $1B (today, it’s slightly bigger at $1.1T).

That email came from Brian Armstrong…

… and the startup he founded (Bitbank) is now known as Coinbase, which closed its first day of public trading on Wednesday.

Not long after that cold email, Tan invested $300k into the crypto exchange across Y Combinator and Initialized Capital.

As Tan details in his YouTube channel, the combined stake from those investments is now worth $2B+… for a remarkable return of >6000x.

What made Coinbase work?

The Hustle recently spoke with Tan, and he highlights a few reasons for the crypto exchange’s success:

  • Philosophy: Armstrong’s key insight was that to mainstream the crypto industry, there had to be an interface that worked with existing banks and governments. At the time, most in the crypto community were extremely anti-government and the idea of working with authorities was outrageous.
  • Product: An early point made by Tan and Armstrong was that “Bitcoin is something you protect not with guns but with software.” Armstrong is an engineer. Prior to Coinbase, he battled fraudsters while working at Airbnb. For a crypto exchange to go mainstream, its security had to be top-notch.

What did Tan learn as an investor?

He says to keep an eye on the fringe: What are engineers doing in their free time?

“There are lots of examples of fringe hobbies turning into big things. Think of Steve Jobs and Steve Wozniak building personal PCs,” Tan tells us. “Or Marc Andreessen tooling around on a web browser while studying at the University of Illinois at Urbana-Champaign.”

With the Coinbase outcome, Tan will have the opportunity to fund many more of these new ideas.

(Read the full Q&A here)

The $2B+ cold email

You’ve got a great idea!

So does the person behind you waiting for coffee. Get in line.

Tough talk: Ideas are only as good as the action that follows. So, what can you do?

You’re reading The Hustle, that’s a start. Even better, we’re about to help you turn that idea into action.

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Corporate Perks

The largest office park in the US has a wild horse problem

The Tahoe-Reno Industrial Center (TRI) is a 107,000-acre office park located south of Reno, Nevada. It’s home to ~130 companies, including Tesla’s $5B Gigafactory and fulfillment centers for Amazon, Walmart, and PetSmart.

A recent New York Times article highlights the tension between companies’ attempts to lure employees to TRI with frolicking wild horses — a claim Musk famously tweeted in 2018 — and the reality of… well, wild horses.

Yeah, horses… because office perks are changing

Free lunches, nap rooms, and yoga classes are out. Access to nature, sustainability, and wellbeing are in. Enter 1k Nevada mustangs.

In the case of TRI, letting horses roam its massive, corporate grounds has proven challenging.

The largest tenant, Blockchains, a block chain development company, spends ~$300k a year supporting the horses with volunteers and water tanks.

But caregivers remain strapped for resources, fielding emergency calls for horses needing rescue within the park or managing horse/car accidents as the park’s footprint has expanded.

And TRI is expected to grow

Currently, just 15% of the office park is occupied, but the park’s manager expects that number to double in the next 5 years.

Google purchased 1.2k acres to build a massive $1.2B data center, lured by the area’s tax incentives.

Plus, there’s a brewing ‘Wild Wild Country’ situation…

… between Blockchain’s CEO Jeffrey Berns and Storey County, where TRI is located. Story goes: Berns wanted to build an experimental city within TRI by seceding from Storey. He was just denied.

This likely won’t be the last time you hear about these parts.

Outrageous stats of the day

A pen from Bernie Madoff Securities (Source: Bloomberg / Getty Images)

Bernie Madoff ran the world’s largest Ponzi scheme. On Wednesday, he died in prison at 82 years old while serving a life sentence for his crimes.

Starting in the mid-1980s, Madoff used his position in the industry (he was once the chairman of the NASDAQ) to solicit funds and conceal his scheme.

Some stats:

  • When he confessed to his crimes in December 2008, Madoff held $65B in funds from 4.8k clients (Madoff’s clients included other funds, which also had thousands of clients).
  • The Department of Justice has recovered $14.4B of the $18B stolen funds that have officially been recognized in claims.
  • The scheme was very straightforward, with Madoff keeping money in a single JPMorgan Chase checking account and paying out redemptions when requested. In mid-2008, the checking account had $5.5B in it.
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