#69 - Anne Wojcicki of 23andMe and Sam Altman

**Craig Cannon** (0:00)
Hey, how's it going? This is Craig Cannon, and you're listening to Y Combinator's podcast. Today's episode is with Anne Wojcicki and Sam Altman. Anne's the co-founder and CEO of 23andMe, and they provide direct-to-consumer genetic testing. And Sam's the president of YC Group. He interviewed Anne for a series called How To Build The Future, and you can check it out on our YouTube channel.
All right, here we go.

**Sam Altman** (0:23)
Today, we're here with Anne Wojcicki, co-founder and CEO of 23andMe. We always like to start with how you came up with the idea and sort of the founding story of the company.

**Anne Wojcicki** (0:33)
So I was working on Wall Street.

**Sam Altman** (0:35)
That doesn't sound very fun.

**Anne Wojcicki** (0:37)
It was actually pretty fun.
I loved it. So I grew up in academia. I always thought I'd end up being an academic.
I got very, my parents, I went to a job fair right out of college. My parents made me go, and I got this job offer to go on Wall Street. And it's one thing I always tell young people, like you never really know what's gonna come your way. Just take every opportunity. So I very randomly got this job on Wall Street. I had no idea what it was, but I kind of figured, I actually only took the interview because they gave me free frequent flyer miles, or I wanted the flight, I wanted the frequent flyer miles.

**Sam Altman** (1:09)
You had to fly there, but you got to keep the frequent flyer miles.

**Anne Wojcicki** (1:10)
Yeah, no, I was just excited. I was like, it's a free trip. It will be 5,000 miles. That's pretty awesome. So I was on Wall Street for 10 years, and I loved it. For me it was, because it wasn't just about trading and making money and doing these things, but it was like, I gotta learn about companies. And the one thing that is amazing on Wall Street is that you get to go deep on certain companies when you're really interested in them, and then really broad knowing the whole sector.
So I got to know small cap biotechs and pharma companies and hospital systems and insurance companies. And I got to have a really broad landscape of healthcare. And in the beginning, I had this eternal optimism, like healthcare is gonna totally change. There's antibodies. There's all this new, there's technology. There's all these new discoveries coming. It's gonna be so different. And then when the bubble burst in 2000, a lot of innovation dried up. And I started to see more what healthcare really is. And at the end of the day, healthcare is an amazing business that really effectively monetizes illness. And I used to always say, if I successfully get you to never be diabetic, no one makes money.
But if you do become diabetic, there's all kinds of ways I can make money.
And at the end of the day, when I think about what I care about, what's in the best interest of me, I'd rather just never be diabetic. I'd rather never be sick. And there's no one in the system today that really thinks about how to keep me healthy. So after 10 years of investing, I felt like I really understood the system. And I also understood that you have this, all these people with the right intentions who really care, but the ship's just pointing in the wrong direction.
And that no one's actually focused on keeping people healthy and that I want to have a company that was frankly somewhat rebellious and was going to inspire people to try to really be healthier. And I felt like it was, again, it had sort of that, a little bit of a Robin Hood kind of mentality in the beginning of, you can't change the system from within, so we got to do something more radical from outside.

**Sam Altman** (3:16)
One of my favorite Charlie Munger quotes is, incentives are a superpower.
And I always believe this, and I think this is the clear problem you just identified. So how do you think about how you design a system or a company that is incented to keep people healthy?

**Anne Wojcicki** (3:30)
Well, I realize the main thing in healthcare is that you don't actually ever have a voice. Like you don't, like you don't actually, because you're not the payer in healthcare, like you the individual, you don't actually make decisions. It's your insurance company, your doctor, the pharmacy benefit manager. There's all kinds of people in the back who actually make decisions. And I think there's all this data now about, you know, you go in for surgery and there's doctors coming into the surgery that you've never even met.