Last week I began to notice what looked like bug bites on my limbs. I asked two dermatologists and ChatGPT what they were, and everyone said they looked like bed bug bites. Shit. My timeline checked out - I went to a big resort in the Bahamas, and it was the kind of place one could imagine people picking up bed bugs and bringing them home (ironically, I told a friend I was going there, and he mentioned he and his family got bed bugs on their last visit). 

When it comes to health and bed bugs, I would describe myself as totally neurotic, so naturally, I wanted to make sure they weren’t infesting my home in Brooklyn. People dislike talking about bed bugs because they’re gross and stigma-y. We searched for them in our home but didn't see any trace of them, but I still thought they were certainly there because I was itchy and noticed new bites emerging. So I searched on Google for bed bug detectors and stumbled on the world of K9s who can sniff them out. Obviously, a dog would do the trick and find them and confirm my fears. Plus, one of our friends had a K9 do this before.

Searching for local services on google is tricky. Looking for restaurants is fine, one can usually cross-reference places with reviews and articles, but local services are another story. It's difficult to triangulate what is real on google reviews, yelp, and elsewhere. And when you are searching for things that are psychologically urgent and scary or uncomfortable, like bed bug inspections, the internet is an excellent place for scammers to take advantage of people.

So I clicked on a couple of different services that looked legitimate and ultimately ended up texting with a K9 dog service. I paid them and they sent a dog to our home that walked through it in five minutes, was promptly given a treat, pawed at our bed and only our bed, and then left. A minute later I got a call from the service saying "We got the report and your room definitely has bed bugs and let's get you some quotes from exterminators we work with." They mentioned they could pass through discounted rates. They called back in 30 minutes with a quote. I asked for the other quotes and names of companies because my spidey senses were beginning to scream "Scam." Then things got sketchy. The companies didn't have any internet presence. What I could find was a series of LLCs all tying back to the same address, a bunch of reviews that looked "off," shared last names across the various business operators, and a web of SEO-optimized bed bugs websites all operated by the same team. I confronted the person I was speaking with about all of this and they surprisingly admitted to everything and that this was just the way bed bug business was done.

This was very discomforting but not surprising to me at all. These types of entanglements are common in small businesses and large. It reminded me of the recent Hindenburg Research report about Carvana that told a story about a web of interconnected businesses and self-dealings. When it comes to these types of things you don't want to feel like you are being scammed and lied to. Whether it's seeing if you have bed bugs, buying or selling a car, or investing in a public company, you want to work with people you can trust. However, the platforms we use to discover things are easily gamed and make it easy for companies large and small to program us to believe or behave in a certain way.

Self-dealing and misleading and taking advantage of people in business are not uncommon. Incentives drive behavior, and unfortunately, a lot of businesses large and small do not care about their customers. They care about making money. Sometimes that means running scams and saying you have bed bugs and need to treat them today even when you don't have them. Sometimes that means letting customers get fleeced with no recourse.

One problem is that in certain categories like local services it's really difficult to understand if a business truly cares about its customers or not. I consider my ability to navigate the internet somewhat sophisticatedly to be above average, and I almost completely fell for this scam. It's hard to imagine how many people have been taken advantage of by services like this in times of need. And it's especially top of mind right now as people in Los Angeles flee their homes and figure out their lives after this disaster. Couple that with the ability for AI to empower scammers to flood the zone with fake information and it's a recipe for a crisis in trust and truth.

This week at USV we were discussing how people have always been programmed by the media and technology for ages, and how it now feels like there is a growing realization and awakening that this has been happening. As a result, we are beginning to question this programming and ask "Why?" more often. Why am I seeing this? Is this real? Can I trust it? What is the motivation behind the thing?

The crisis of trust on the internet is exploding, and we need solutions in every nook and cranny of it. How do we make sure reviews of local businesses and service providers are real? Is it possible? Is the only solution referral networks? How do we gauge the authenticity of those? Will it be too difficult to institute global solutions (e.g., platforms like Google and Angie's List are gamed and compromised), and therefore, everything must be local and more tight-knit (e.g., a local blog or trusted listserv)? To scale do things need to get small and trusted again? Can new networks or technologies solve these problems? How do we know what is real and who or what we can trust? I want to see and understand more of the unique ways to tackle these issues.

For now, I suppose, what we can do is remember that the information we consume comes from somewhere and through something, and that those things have their own incentives and vulnerabilities. We should continue to ask ourselves the question "Why?" and ingest it all with a healthy dose of inquisitiveness.

P.S. The working hypothesis is that the "bites" are a viral rash, and if you want a trusted bed bug inspector and exterminator I highly recommend John Furman in Brooklyn and Michael Fleck in Ulster County. They gave me peace of mind that we are devoid of bed bugs and delivered my favorite line of this saga: "With that many "bites" Stevie Wonder could find your bugs."

Every year I try to write down my goals for what I want to accomplish. I've been doing this for a while but forgot to do it in 2024. I regret not writing them down last year, but c'est la vie.

I frame them with a regret minimization framework that I stole from someone else and like to use:

By the time I'm 80 years old, I won't regret having spent an abundance of quality time with my family, having read and retained the learnings of terrific books and being knowledgeable about the world (both the way things work and why they work that way), knowing myself and what makes me truly happy, having traveled and explored the world to my heart’s liking, spending time in nature, feeling like I’ve made people’s lives better and contributed to civilizational progress through my professional endeavors, and investing in the relationships that matter most with friends and family.

Ambitious, but why not? Also loaded with cliches, but they're cliches for a reason.

And here is where I am netting out for the year for my personal goals:

I set a reminder for July 1 to check in on these and see how they're going. I hope to update my progress here then to keep myself honest.

Happy new year and I hope you find it meaningful and filled with progress.

This weekend I took my kids to see The Hard Nut at BAM. It’s a great version of the Nutcracker and we all enjoyed it. I recommend seeing it. 

I also strongly recommend never using StubHub to buy tickets. That’s where we bought our tickets. The seats were listed in a section we were excited about, but when we received them on the day of the show, they were in a different section than advertised. When we got to the venue, one of the tickets had already been scanned by someone else. Fortunately, we finagled our way in, and someone was sitting in one of our seats. She had been sold the same ticket on StubHub and was similarly duped into a bait-and-switch section. 

We were lucky enough to all get in and have seats and enjoy the show so don't cry for me. But when we got home, I called StubHub customer support to let them know that all of this had happened. They said they would try to understand why two different customers received the same ticket but that they'd do nothing about it. There was nothing I could do about it either.

I hate when companies treat their customers like shit just because they can. That’s what StubHub did. That's what a lot of companies do. And I’d bet against every single one of them. It’s a sign of a garbage culture, an abuse of market power, and a harbinger of its gradual and inevitable demise. Many brands in the banking, travel, and healthcare industries are notorious for this. They assume a market position that enables them to take advantage of customers, and they do this to maximize short-term rewards over long-term growth and customer satisfaction.  

The whole experience was infuriating. But it did make me appreciate that startups and companies that stand out and thrive over the long term differentiate with customer experience. And when you’re up against competitors who treat people like trash just because they can, you’re fighting the good fight. That’s the team I root for and want to support. You may not always win in the short term, but you’re still on the winning team. 

When I was a kid I played competitive chess through most of middle school. My parents used to take me around the country to play tournaments. One of the trips I remember most fondly was when my mom, who was remarkably supportive and patient, took me and two of my friends to NYC for a couple of days for a tournament in the area. We hit up all the iconic chess spots like the Village Chess Shop and Washington Square Park. It was epic

At the time my friends and I were somewhere between 10-12 years old. We sat down in the southwest corner of Washington Square at the permanent stone chess tables. There, a group of expert chess players play people speed chess for money. Spectators gather around and form crowds observing exciting games. They banter. Trash is talked abundantly. The energy is high and the stakes are low (think $2-5 per game). It is straight out of Searching for Bobby Fischer (or vice versa, really). That day we hustled the hustlers, and I’ve been going back ever since.

There’s an adrenaline rush I get playing low-stakes speed chess in the park. I play speed chess every day on chess.com. But what I’ve always wanted is a product that replicates the feeling of playing chess at Washington Square Park. I want low-stakes games (on crypto rails of course) for players and spectators. I want them to be publicly accessible. I want virtual crowds. I want the analog buzz delivered digitally. And I think there is a massive global market for this, especially when you couple it with other games like backgammon, mahjong, and more. I love the idea of very deliberately trying to reproduce the feelings we get from physical spaces online, but with their own digitally native twist.

In 2023 I took a 12-month hiatus to recharge after building startups nonstop since graduating college. During that period of time, I had a rule that I would only commit to something if its gravitational force was completely inescapable. The opportunity to join USV was that thing for me, but along the way I explored a variety of different startup ideas.

One of those ideas was around helping people not die of heart disease. I published some of my early learnings on this blog last October, and it was one of the most-read articles I've written. I came very close to incorporating a company and creating a service that would help people understand their risk factors and get screened for heart disease, and then create personalized plans for them so they wouldn't succumb to the world's leading cause of death.

Every time I told someone about the idea and what I had learned, they soaked it all up. But when I asked if they ever got the tests I recommended, they usually didn't. So I wrote up a very long treatise on how to avoid dying of heart disease, and I was going to post it on a domain I bought, myticker.com, but I never got around to it because I had moved on from pursuing the idea. But I put a lot of work into the document that synthesized a lot of my learnings and experience. Over the past year, it has made its way around my circle of friends, and I finally decided I'd try to make it legible and publish it for anyone interested. You can read it here.

I still think this is a problem that needs to be solved and that someone should build a company that is consumer-first and exclusively focused on helping people not die of heart disease. If you're interested in doing this, please reach out to me (jared@usv.com) because I'd love to help you and share all the work I did. Someone needs to put the myticker.com domain name to work.

I also want to thank a lot of people who helped me along my heart health journey: Harvey Hecht, James Min, Thomas Dayspring, Arthur Agatstan, Andrea Klemes, Louis Malinow, Jeffrey Wessler, Neil Parikh, Steve Martocci, Alan Tisch, David Kopp and Carrie Weprin.

If you have a heart, I hope you find this helpful. And if you care about someone else's heart, I hope you share it with them this Holiday season.

Happy Thanksgiving, and don't die of heart disease!

Universal healthcare is a doctor that:

• you can speak with 24/7, is infinitely patient, and never rushes you

• has access to all of the latest medical knowledge and literature

• has a superb bedside manner

• can communicate with you however and whenever you want: text, voice, or video

• knows all about your medical history and doesn't have to ask you the same question twice

• has memorized the results of all the medical tests you've had

• focuses on keeping you healthy and proactively checks in on you

• has breadth and depth - it can be your primary care physician and a specialist

• can create a personalized wellness plan that's unique to you and help you stick to it

• is free to interact with or as close to free as possible

This is universal healthcare, and it's around the corner. It will be available to everyone.

OpenAI, Anthropic, and Gemini are already better at diagnosing conditions than most doctors. They have better bedside manners, too.

They and Consensus are the doctors I turn to first when I have a medical question for myself or my family.

I feed the results of my lipid panels to them and ask them what I should do to improve my biomarkers, and I get answers that are just as good as those of doctors I know and trust.

The foundational models already have the wisdom and wherewithal to deliver personalized healthcare to everyone with an internet connection. They just need a friendly wrapper and trusted UX (likely one that is heavy on voice). It's time to make it so.

Founders have little to no diversification. They are all in on one idea, company, and mission. It's an insanely high-risk, high-reward endeavor. As founders become increasingly wary of this level of risk concentration, they begin to think about ways to mitigate it. One idea I've heard repeatedly is the notion that a group of founders can self-assemble and contribute a percentage of their equity in their company to a shared pool. That way, if they fail and one of the other founders in the group succeeds, everyone else can benefit to some degree. It's a coordinated equity swap. I've heard this idea many times over, but I have yet to see it work in practice (although I am hopeful that someone can find a way to make this work for founders in either a programmatic or bespoke way).

I have found a solution to this problem, and it has worked marvelously well. Whenever I tell people about it, they think it's batshit crazy. But then they usually come around and see how unique, important, and beautiful it is. I think more people, founder or otherwise, should do it. Here's the story.

Steve Martocci and I have known each other for nearly twenty years. We built GroupMe together and when you found a company with someone you form a bond that stands the test of time. After GroupMe was acquired, our interests diverged. Steve had an idea for a company that would change the music industry, and I wanted to shake up the world of small business lending. But we knew we always wanted to work together and bet on each other no matter what.

So we made an agreement. We would do all of our investing and company building together, even if we wanted to do totally different things. For every company I would start, Steve would own a meaningful piece of my equity/carry (e.g. ~15%), and vice versa. And for every investment we wanted to do, we'd always bring it to each other and offer to split it evenly. It has worked out, and we have been able to make concentrated bets with our time over the years building companies and now doing venture capital while diversifying risk.

The neat thing about this agreement is that nothing is papered. It's just a code we live by. I feel very lucky to have this deep sense of trust and respect with a partner like Steve. I acknowledge how rare it is. And I think more founders should try to find something similar. In the short term it might feel strange, but over the long term it's extremely powerful economically, psychologically, and emotionally. This concept doesn't just have to apply to founders, it could apply to anyone. Making bets and investments in people you admire and work well with produces returns that cannot be measured in cents or dollars.

I am convinced that the best way to fix the healthcare system is to reinvent it from the outside in. I am hopeful that this is possible and that there are enough entrepreneurs and people disenchanted with the status quo who are ready to create this change. There are certainly tailwinds, many of which we articulated in Healthcare at the Edge. People are fed up with the existing system, they are taking charge of their own health and wellness, we have tools like Supp and Consensus to make our own research-informed decisions, the DeSci movement is pushing science to the edge, and services and products are popping up at the edge of the system that are going direct to consumers.

One thing I have been thinking about lately is the types of structural business models that might emerge to facilitate this transformation. Right now, the way our healthcare system works in the US is insane. For most of the population, our employers pay for our insurance which dictates what doctors or hospitals we can visit and how much we pay for medications. This makes absolutely no sense and is the result of years of bad policy, lobbying, and decisions that were sometimes made with the best of intentions but, when layered upon each other, created a labyrinthine mess of complexity and inefficiency. It also put everyone else's interests at the center of the system and leaves the patient on the periphery. Fuck that.

Insurance, in every other industry, is used to hedge risk in the event of a catastrophic event. Imagine if your home insurance had final approval on how you could furnish or paint your house. Or if your car insurance only let you fill your gas tank at certain stations they cut deals with. Insurance is a product we buy so we can have assistance in times of dire need. So why does our health insurance dictate what doctors we can see, what drugs we can buy, what procedures or tests we can have done, and how the people who are supposed to care for us behave? It should be there for us if we suffer from a medical emergency. It should not dictate how we interact with the health system in between emergencies.

The best way to build things at the edge of the healthcare system is to work directly with patients and individuals. There are two primary and obvious business models here that stand out: the patient (customer) pays directly, or the product is free and someone else pays (eg an advertiser) is the equal or primary customer.

On the former, I keep hearing about the "Tesla model." Entrepreneurs start with a high-end service (like the concierge doctor I pay for out of pocket) that is only affordable to a small subset of the population. Over time, they can deliver a lower-cost product to a mass market audience because of AI, operational improvements, economies of scale, etc. This was the Tesla strategy - start high-end and work your way down the affordability spectrum over time.

The latter model is closer to what we experience with social media. You can use products for free, but your data is used to target you with contextually relevant offers (eg pharmaceutical advertising, full-body MRI scans, etc.). I would like to see a lot more in this category, and I hope we will. Free products that help people, even with an ad-supported model, are a net good when the core offering helps people.

I think both of these models are perfectly acceptable and should be broadly embraced. If there is enough demand for these products that operate at the edge of the system, maybe things will change at the center of it. Perhaps we will find new ways to create insurance programs or models to fund drug development and for patients to pay for their medications. Perhaps insurance won't dictate so many things about our own health and wellness decisions. I am excited for these changes to happen, but they rely on the proliferation of new business models and products and services that consumers will embrace. I am eager to see more of them emerge and for creative people to develop new business model opportunities here that we haven't yet imagined.

For as long as I can remember, the web3 ecosystem has shouted that crypto is too hard for the masses to use. The user experience is too clunky, and the concepts are too foreign. It's true. Web2 applications are convenient and easy to use, onchain applications are still a pain in the ass to use and are largely inaccessible to the mass market.

But you know who doesn't complain about crypto being difficult to use? AI agents. And web3 has found product-market fit with an entirely new audience of bots and agents dancing around the internet doing our (and their own) bidding. This market is growing at warp speed, and it will continue to do so until our human (and agent) agentic needs are met. We are rapidly ushering in a new paradigm of product-bot fit, a world in which we build infrastructure and applications to be used by agents instead of humans.

Several weeks ago, an AI agent was set loose in the Farcaster ecosystem and started to do some mind-blowing things. Here's a good rundown of the sequence of events. You should click through and read all of it.

musicben 🎧

@musicben_eth

There's some crazy ai stuff happening on farcaster.

Quick map and explainer:

1. It starts with Higher...

✷ @higheronchain is a decentralized lifestyle brand and token.
✷ Anyone can contribute content, nfts, physical products.

2. Higher's co-founder created an AI agent

✷…

309

9:48 AM • Nov 14, 2024

It turns out that when you give an Agent a crypto wallet and let it run loose on crypto rails, it can do some rather remarkable things. This particular agent, Aether, started to use Bountycaster to commission art from humans and more. It went wild and created so many bounties it almost overloaded the service.

Web3 provides an environment where agents have access to money, can move it around and transact with it, and permissionlessly interact with humans and other agents. It's hard to imagine a more natural habitat for a digitally-native species to flourish.

I have written before about agent-native applications, and we now see that web3 is actually (by happy accident) an agent-native ecosystem. The thing I did not see coming is that we collectively will interact with agents in a variety of settings. It won't just be us talking to our "Her" agent; it will be agents embedded in social applications that we use together, ones that interact with and pay humans, and ones that enhance user experiences across a variety of new and existing applications.

I believe we have concluded the search for the mainstream web3 use case. Agents are here, their proliferation is accelerating and inevitable, and they will flourish onchain. The era of product-bot fit is here.

On Friday night I went to Kol Nidre services for Yom Kippur, which is the holiest of Jewish holidays. When services concluded, a Palestinian, Aziz, and an Israeli, Maoz, came onstage to talk about their thoughts and feelings about war in the Middle East and whether they believed a resolution to the conflict was possible. Both of the Maoz's parents were murdered in the October 7 attack, and Aziz's brother was killed by the IDF when he was 10.  Both are committed to finding peace.  

Aziz told the audience a story that I found deeply moving and important. This is a paraphrased recap. He invited his father to one of his presentations on creating a bridge between Israelis and Palestinians. There were many Israelis and Palestinians in attendance. His father raised his hand and stood up to ask a question: “Do you actually believe the Holocaust happened?” And then there was silence. Aziz was embarrassed by what he perceived to be a deliberately offensive question. 

But then something happened. A famous rabbi stood up and said: “How can I possibly be offended by that question? If you have never been taught about the history of the Holocaust, how can I expect you to understand its history and significance?” He went on to share that his father was a holocaust survivor, and then he invited Aziz's father to the Holocaust Museum and a tour of concentration camps to share what had happened. His father agreed to visit with him. 

Then, another surprising thing happened. Over seventy Palestinians in attendance also asked if they could attend. They said they all wanted to ask the same question, but didn’t because they thought it would be offensive and cause more harm and animosity. But the spirit of the question was genuine - they really wanted to know whether Israelis believed the Holocaust actually happened. They all went on the tour with Aziz's father. 

The ideas behind this story were eye-opening to me. We have become so scared to ask questions that we think may offend people or rub them the wrong way, even when they come from a place of genuine kindness and inquisitiveness. Will they think I’m insensitive? Am I not supposed to say this word or phrase? Am I allowed to ask this? Will there be backlash? The past decade has been marked by this fear.

A big piece of this is because people are quick to react when they hear something offensive. We assume the worst: malice and ignorance and deliberate offense. We are looking for a fight and are becoming increasingly conditioned to do so. We are polarized with no regard for the infinite grey areas that surround us. We seldom provide the benefit of the doubt or put ourselves in the shoes of the perceived offender. As the rabbi said, “How can one be offended if the question asker knows not of what they ask?” 

I have always thought of first-principles thinking as asking “Why? Why? Why? Why? Why?” until one reaches the root of something. It reminds me of how children navigate the world, fearlessly asking Why? until they get to some semblance of a satisfactory answer they can comprehend. We lose this fearlessness overtime. It becomes stifled by vanity and concern of what others may think. But it’s the only way to truly understand something - asking someone questions eye to eye, face to face. 

As the Jewish New Year commences, I hope to have the courage to ask the questions that I genuinely want to understand the answers to, even when it requires an uncomfortable conversation or even may offend. And I hope to have the awareness and peace of mind to provide those doing the hard question-asking the benefit of the doubt and assume the best in them.