Alex Frommeyer

Health care companies only care about one thing: profits. Single-payer now.

Every non-biotech person I describe Verve to is floored. They can't believe this is a future we get to live in - permanent solution for high cholesterol and strokes - even after I tell them it means editing their genes. At the same time more than 90% of the biotech VCs I've talked to are bearish on exactly this direction. "Why cure a disease if you can do monthly injections" "Insurance would never cover cures" I am excited for those people to not make any money when they are proven wrong. Its striking that no one sees that cures have been out of vogue for very silly reasons - we equated one-and-done to viral vectors, rare disease TAMs, and rare disease prices. None of those are relevant assumptions, and Lilly has multiple bets in this space to prove everyone wrong.

Today we reduced headcount by 22%. The business is the strongest it's ever been. So I think it's important to be direct about what I'm seeing and why. First, I made this decision and I own it. I did it because the way to operate at the highest level of productivity is changing, and to win the future, ClickUp needs to change with it. Second, this wasn't about cutting costs. Most savings from this change will flow directly back into the people who stay. We'll be introducing million-dollar salary bands. If you create outsized impact using AI, you'll be paid outside of traditional bands. Most importantly, I have the deepest gratitude for those affected. We're doing this from a position of strength specifically so we can take care of people properly. Everyone affected receives a package aimed at honoring their contributions and easing the transition. I only see two options: wait for this to play out gradually in the market or be honest about what I'm seeing and act proactively. THE 100X ORGANIZATION The primary change is that we're restructuring around what I call 100x org. The goal is 100x output. The roles required to build at the highest level are fundamentally different than they were a year ago. Incremental improvements to existing systems won't get us there. We need new ones. That means creating enough disruption to rebuild rather than iterate on what's already broken. The common narrative is that AI makes everyone more productive. It doesn't. Many of the workflows of today, if left unchanged, create bottlenecks in AI systems. These roles will evolve. But waiting for that to happen naturally means falling behind now. The 100x org is actually heavily dependent on people - infinitely more than today. This is only possible with 10x people that have embraced and adopted new ways of working. THE BUILDERS, AGENT MANAGERS, AND FRONT-LINERS — THE BUILDERS: 10X ENGINEERS I don't think most companies have internalized what's actually happening with AI in engineering. The common narrative is that AI makes all engineers more productive. That may be true in isolation, but at an organization level - that is the farthest thing from reality. Here's what we've validated recently at ClickUp: the great engineers, the ones who can orchestrate, architect, and review, are becoming 100x engineers. They're not writing code. They're directing agents that write code. The skill is judgment. AI makes the best engineers wildly more productive, and everyone else using AI slows these engineers down. Think about it - the bottlenecks are (1) orchestration - telling AI what to do, and (2) reviewing - what AI did. Everything is leapfrogged and no longer needed. So who do you want orchestrating and reviewing code? And how do you want your best engineers to spend their time? If your best engineers are spending time reviewing other people's code, then this is inherently an inefficient bottleneck. These engineers can review their agent's code much faster than reviewing human code. The new world is about enabling your 10x engineers to become 100x. The wrong strategy is to push every engineer to use infinite tokens. Companies doing this are celebrating 500% more pull requests. But customer outcomes don't match the volume of code being generated. I call this the great reckoning of AI coding, and every company will face this soon if not already. More code is just another bottleneck to the best engineers, and ultimately to your company's impact as well. — THE BUILDERS: 10X PRODUCT MANAGERS Product management and design roles are merging. Designers that have customer focus, become more like product managers. And product managers that have intuition for UX become more like designers. The bottleneck of user research is gone. It takes us just one mention of an agent to kickoff research and analyze results. The bottleneck of product <> design iteration is also gone. The product builder iterates on their own, along with agents and skills that ensure alignment with quality and strategy. Also controversial today - I believe that the wrong strategy is to have your PMs shipping code - that just introduces another bottleneck that the best engineers will waste their time on. To be clear, PMs should be coding but they should do this in a playground to iterate, validate, and scope. That code should not go to production. Everything outside of managing systems, orchestrating AI, and reviewing output becomes a bottleneck. That's why the other roles that are critical along with these are the systems managers (to reduce bottlenecks) along with a bottleneck you can't replace - customer meeting time. — THE SYSTEM MANAGERS Ironically, the people that automate their jobs with AI will always have a job. They become owners of the AI systems - agent managers. We have many examples of these people at ClickUp. The underlying systems in which we operate are absolutely critical to get right. I think most companies are delusional to think they can iterate on existing systems and compete in this new world. You must create enough disruption so that old systems are deprecated entirely. If there's any definition for 'AI native' that's what it is. — THE FRONT-LINERS In a world that will become saturated with AI communication, the human touch will matter more than anything to customers. This is a bottleneck that you shouldn't replace - even when agents are high enough quality to do video meetings. One-on-one meeting time with customers is something that shouldn't be automated. The systems around the meetings should be - so that front-liners spend nearly 100% of their time with customers. REWARDING 100X IMPACT In a world where companies are able to do so much more with less, where does that excess money go? In our case, much of the savings in this new operating model will flow directly back to those that enabled it. We must reward people that create productivity accordingly. This aligns incentives on both sides. Plus, in a world where your best people create 100x impact, you can't afford to lose them. You should aim to retain these employees for decades. The context they have and their ability to efficiently orchestrate and review will be nearly impossible to replace. Compensation bands of today should be thrown out the door. We're introducing $1 million cash/year salary bands with a path available to nearly everyone in the company if they produce 100x impact by creating or managing AI systems. THE FUTURE Nearly every company will make changes like these. The ones that do it proactively will define what comes next. The future is not fewer people. It's different work, new roles, and better rewards for those who embrace it. We're already seeing entirely new roles emerge, like Agent Managers, that didn't exist a year ago. ClickUp is positioning to lead this shift, not just internally, but for our customers too. I've never been more certain about where we're headed.

Many aspects of American healthcare that patients dislike are downstream of having a third party (insurance) pay for services that should simply be paid in cash or HSA. Probably true for physicians too. Health insurance should be insurance, not some weird group purchasing scheme. You don’t need to submit to the humiliation of 8 pages of paperwork and several frustrating phone calls to buy a haircut and it shouldn’t be true for a primary care visit either. Nor does someone who does a new haircut need to lobby the haircut board to create a haircut billing code like 92133 “ZOOMER BROCCOLI CUT W/ FADE”. We know markets work. Healthcare isn’t some magic part of the economy that defies the laws of physics. E.g. LASIK which is all cash pay has gotten cheaper in real terms and better since the ‘90s. The preciousness of healthcare doesn’t need to blind everyone to common sense and evidence. There is a button and you can just push it.

Our new wearable mic is so sensitive it can hear your heart beat

Bill Maher asks how the government is “failing the poor so badly” when he pays “60 PERCENT” of his earnings in taxes. “Last week was tax day… I paid the government probably almost 60% of what I earn. That’s a lot.” “And I… wouldn’t mind if Bernie Sanders would stop saying the rich don’t pay taxes.” “The top 10% pay 72% of all federal income taxes. And the bottom half, 3%.” “The Democratic Socialists talk about socialism like we don’t already have a lot: Social Security, unemployment, Medicare, nutritional assistance, Medicaid, Obamacare, disability, housing subsidies.” “How can you be soaking the rich and failing the poor so badly? How can it be that the federal government alone took in over 5 trillion in taxes last year, and we still need that?” “Are we really this incompetent and corrupt?”

White supremacy went up because the SPLC changed the definition and applied it to everybody. Supply and demand problem fixed. Fkn magicians.

People are capable of far more than they think, on far shorter timelines. Problems expand to fill the time you give them.

Now that Buffett is stepping down and the Buffett premium will disappear, everyone will see proof that Berkshire Hathaway is the meme coin for boomers. The "value investors" hate it, but it doesn't change the fact it is true.

How much manufacturing are we bringing back to the United States if healthcare costs for blue collar workers grow 20% each year? Lots of talk of re-industrialization in Silicon Valley, but very little of the real constraints healthcare puts on small / medium-sized employers. I was speaking in Michigan last week and 20% cost inflation is the reality for one furniture manufacturer. Similar stories for many firms throughout the Midwest. Can AI help? Policy in the next year or two will dictate the outcome: regulation at FDA / states; reimbursement norms from CMS. But 1/3 Americans already use AI chat bots for medical advice and it is cynical to believe there is no potential to build upon.