Kate

If I want healthcare to be different, I have to practice differently. Today at Redbud we did multiple cases in an environment built around patients, not profit margins. We had time. We had focus. We had the right team in the right setting. One patient came to us after receiving a quote of more than $100,000 for her cancer surgery elsewhere. The operating room fees alone were quoted at over $30,000. We performed her surgery today at Redbud, a CMS-certified facility with fellowship-trained surgeons and experienced nurses for a fraction of that cost. Same standard of excellence. Different priorities. Healthcare does not have to be this expensive in America. It’s not easy to do things differently, but it is possible. And we’re proving that one patient at a time.

Difficulty Levels of Startups: Insane: Robotics Hard: Hardware, consumer social Medium: Consumer Software, marketplaces Easy: B2B SaaS What did i miss?

As a founder, you set the pace every day. And it restarts the next day.

Biotech is fvcked. Not because the science is dead, the business model is backwards. Just this week: > Lyra Therapeutics laid off all 28 employees. 7 years of work. Multiple clinical trials. Still had $22.1M left -enough runway until Q3 2026 > Lucy Therapeutics shut down after 7 years. Backed by Bill Gates and the Michael J. Fox Foundation. $42M raised. Promising animal data. Never made it to human trials Meanwhile ~$17B has flowed into AI drug discovery since 2019, but 1000s of startups later, not a single AI‑discovered novel drug has reached approval. That isn’t a science failure. It’s structural. VCs like to chase AI narratives. And that's the problem. The solution is simple: fund clinical execution.

An $8,000 MRI and a $400 MRI coexist in the same city. Why? No benchmark index. No tradable spread. No way to short the markup. The $8,000 version survives because opacity protects it from capital discipline. Build the index and that protection evaporates.

You can now design directly in your codebase. Select elements, modify them visually, and Cursor writes the code.

Two conversations this weekend make me think that there's a vibe shift afoot in Silicon Valley around what one should work on and what is worthwhile. Culturally, it feels like the moment is ripe for new frameworks: • Davos expert morality is stale and discredited. • It's also apparent that the "just be super based" Counter-Enlightenment is not really an answer. (Yes, woke went too far, but simply inverting it doesn't work.) • EA is no longer the automatic default for smart people. • There's increasing skepticism of slot and slop machine dynamics. Overall, "what is worthy and valuable?" feels like it's becoming more central.

Just watched a TikTok video of a trauma surgeon who makes $165 an hour, which by the way is the exact same data I’m seeing on salaryDr, and comparing that to a CRNA who makes $415 per hour. And which one do you think has more student loans and more training? 🙃

Mark, you’re right about the symptoms; consolidation, high prices, a few players controlling everything. As you know, the cause isn’t the market. It’s the laws that eliminated the market. Congress banned physician ownership, protected facility fees, blocked new surgery centers, and wrote rules that guarantee consolidation. Break those laws and the “few companies” disappear without federal micromanagement. Healthcare is failing because of regulatory capture.