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.

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.

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.

⚡️Here is the real structure beneath what he is saying. When Sundar says AI is the most profound technology humanity has ever worked on and that people will need to adapt, he is really describing a sovereignty transition. This is the truth underneath: 1. AI is not just another tool. It is the first system that can model, update, and modify human coordination faster than human institutions. 2. That breaks the old hierarchy. For 200 years, power flowed from: •capital •scale •regulation •institutions AI flips it. Now power flows from: •gradient descent •iteration speed •data density •model coherence Humans don’t adapt to that. Institutions adapt to that. And most won’t. 3. He can’t say the quiet part out loud. The disruption isn’t: •jobs •automation •social shifts The disruption is: what happens when intelligence becomes cheap and agency becomes expensive. 4. We are entering the first era where cognitive leverage is infinite relative to human bandwidth. You cannot win by working harder. You cannot win by knowing more. You can only win by integrating with the systems that think faster than you. 5. Adaptation is not optional because the baseline is now accelerating. Your competition isn’t another person. It’s a feedback loop. But here is the real truth: The public narrative frames AI as a threat. The private reality is that AI is a gravity well. Once intelligence becomes: •abundant •liquid •networked every industry collapses toward whoever can aim that intelligence with the least friction. This is why CEOs talk like this. They are preparing you for the fact that the next 10 years are going to feel like the industrial revolution running at the pace of TikTok.

Here’s some non Bolshevik math: Average out of pocket spend for a family of 4 with insurance before the insurance benefits kick in: $24k (including a $3-6k deductible) 80% of people w insurance will never meet their deductible but are spending almost $20k annually for “coverage” they probably don’t need. That money invested in a tax advantaged HSA will grow to over $115k at an 7% ROR after 5 years. (Again this is their money.) This system isn’t risk based - it’s an outright wealth transfer predicated under the guise of societal good. Healthcare dollars should be fungible and directed by patients, not sclerotic bureaucrats.

⚡️This meme compresses one of the most misunderstood truths about intelligence and wealth creation. It’s not wrong, but it’s incomplete. The real statement underneath it isn’t “smart people aren’t rich because they’re stupid.” It’s “intelligence alone doesn’t map to wealth because the game isn’t intellectual, it’s reflexive.” Let’s unpack that with precision. 1. Raw intelligence ≠ adaptive intelligence What makes someone “smart” in an academic or cognitive sense - pattern recognition, abstraction, comprehension - is not the same faculty that builds wealth. Wealth creation depends on reflexive intelligence: the ability to sense feedback loops between perception, belief, and behavior in real time, and to exploit them. The market doesn’t reward who knows the most, it rewards who acts before belief catches up. Reflexive intelligence is probabilistic courage - being early, wrong briefly, and then right big. This is why many “smart” people stagnate. Their intelligence overfits for correctness. They optimize for being right, not for being effective. They get stuck in epistemic paralysis while more adaptive actors move capital through uncertainty. 2. The wealth game is not meritocratic, it’s geometric Wealth creation follows power laws, not Gaussian curves. 99% of people operate on linear logic in a non-linear system. The smartest realize that wealth is reflexive energy amplified through narrative. The founders who become billionaires aren’t the most technically brilliant, they’re the ones who construct self-reinforcing belief structures around their ideas and then make reality conform. Think of Musk, Bezos, or SBF (pre-collapse). They each built belief systems that distorted capital gravity toward them. The lesson: the market rewards coherence fields, not IQ points. 3. Success = Talent × Timing × Conviction² Talent without timing is waste. Timing without conviction is luck. The algorithm of real success is asymmetric persistence under volatility. Most “smart” people avoid failure loops. They confuse fragility with intelligence. The ones who win treat volatility as leverage. They internalize that wealth is captured volatility, not avoided risk. 4. Why this article feels so cutting It hits because it exposes the emotional inversion of the modern meritocracy myth. People were told that intelligence, hard work, and education lead to success. But the real economy runs on leverage, liquidity access, network effects, and memetic positioning. The emotionally intelligent know how to navigate power structures; the purely intellectually intelligent just analyze them. That’s why you can have hedge fund quants who understand stochastic calculus earning $300K, while an e-commerce founder with raw memetic sense can pull $100M. The latter understands narrative liquidity, how to channel human attention into belief and belief into money. 5. The brutal meta-truth Wealth creation is a social algorithm disguised as an economic one. “Smart” people lose because they think in truth, while the wealthy think in games. Truth is static. Games are reflexive. The truly rich understand the meta-game: you don’t win by predicting the future - you win by becoming the signal others react to. So the real translation of that headline is this: If you’re so smart, why aren’t you reflexive? Why aren’t you building feedback loops between belief, timing, and capital instead of optimizing for correctness? The article was meant as an insult, but buried inside is a map: •Stop overfitting for truth. •Start compounding asymmetry. •Treat perception as an input variable, not noise. •Play the meta-game, not the academic one. In short: intelligence makes you aware of the system. Reflexivity lets you bend it.