VC Bill Gurley on transforming health care

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Hello, and welcome to the Ezra Klein Show, a podcast on the Vox Media Podcast Network. I am Ezra Klein, and my guest this week is Bill Gurley. Bill is a general partner at Benchmark, one of Silicon Valley's really legendary venture capital firms, and he is one of Silicon Valley's really legendary venture capitalists. He was named the venture capitalist of the year in 2016 at the TechCrunch's annual Crunchy Awards. He's been an early investor in Grubhub and Opentable and Uber and Zillow and all kinds of things. Very, very smart guy, very thoughtful guy. And we've been talking recently because he's been thinking a lot about health care. And they've recently made some investments in that space. And the reason I wanted to have him on was that we have been having this conversation in Washington about how do you reform the health care system? What would a better health care system look like? What would a cheaper health care system look like?

And it is a very narrow conversation. It is had from a very policy-oriented perspective. What can we write into a law?

And it is made by people who, I think, often have a pretty limited set of views and experiences on the topic. So Gurley's been attacking this from another perspective, that of the entrepreneur. Where can you actually enter the system? Where can somebody come in and make something better and make some money off of it? And he's been working on this now for a couple of years. So I thought this would be a good way to sort of think about this from a broader perspective. Think about what is possible and what isn't. You'll hear and hear that Bill and I have somewhat different views on this. I am pretty skeptical of consumer driven healthcare systems. I think that is not what people want in healthcare and as such it is not what we are going to get, but he has a different view. And I think an interesting one. Talk a lot about the Singaporean healthcare system, which has become definitely an obsession of mine. He talks about his view that maybe democracy and capitalism are just gonna eat each other alive. We should be looking at China for the real innovations now. So this is a fun, interesting conversation. I like healthcare a lot. I talk more than I typically try to, even though I typically talk a lot in this podcast, but I hope you enjoy it anyway.

Before we jump into it, a quick couple of plugs. Check out my other podcast, The Weeds, which also has a great discussion of the Singaporean healthcare system. You can download The Weeds live episode for that.

And my colleague at Vox, Todd Vanderwerf, our critic at large, has a great new podcast called I Think You're Interesting. He has an interview with a bunch of the Samantha Bee writers recently. That is a great interview. And I think if you're into the folks I'm talking to, you will be into that one. Again, that is I Think You're Interesting by Todd Vanderwerf. You can get it wherever fine podcasts are downloaded.

But without further ado, here is Bill Gurley.

Bill Gurley, welcome to the podcast.

Bill Gurley (3:48)

Thank you, Ezra.

Ezra Klein (3:50)

So when we talked recently, you told me that you've been on a multi-year learning deep dive on health care.

Tell me a bit about that. What got you interested and how have you been studying the system?

Bill Gurley (4:04)

Great, so our firm's been fortunate enough to be an investor in numerous what people call marketplaces. I think it started with eBay, but then we got into more vertical specific ones like Zillow or Grubhub or Opentable and Uber that I'm on the board of.