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Speaker 1: This is Wall Street Week. I'm David Weston bringing you

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Speaker 1: stories of capitalism. Everyone loves a winner, but can one

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Speaker 1: man win too much? We look at the staggering wealth

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Speaker 1: of the world's first trillionaire, Elon Musk, what does it

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Speaker 1: tell us about the health of our capitalist system? And

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Speaker 1: that trillion dollars in Elon Musk's pocket comes from the

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Speaker 1: IPO of SpaceX, where investors are backing him personally and

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Speaker 1: what looks like the ultimate key Man provision. But corporate

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Speaker 1: governance concerns have some institutional investors sitting on the sidelines

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Speaker 1: of the biggest IPO ever. Plus, it's a condition half

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Speaker 1: of all people on Earth will experience, but until recently,

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Speaker 1: menopause has largely gone unmentioned and unaddressed by big business. Now,

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Speaker 1: changes in treatments and in regulation are point to a

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Speaker 1: major new healthcare investment opportunities. But we start with the

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Speaker 1: ever changing media world. As leaders have been meeting this

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Speaker 1: week for the annual Allen and Company Conference in Sun Valley.

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Speaker 1: Activate founder and CEO Michael Wolfe has spent his career

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Speaker 1: in media, including as president and COO of MTV Networks.

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Speaker 1: So Michael, this week the media conference of Herbalan and

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Speaker 1: Sun Value has been held. Typically deals come out of

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Speaker 1: that conference. This time we have a couple of big

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Speaker 1: media deals going in, one with Fox and Roku and

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Speaker 1: one with Comcast Decide has spin off NBCU. What do

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Speaker 1: you think the talk is going to be.

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Speaker 2: First of all, it's not just a media conference any longer.

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Speaker 2: A lot of it is tech. You're going to the

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Speaker 2: head of all the major tech companies and the head

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Speaker 2: some all the major AI companies. So I think there

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Speaker 2: may be some other deals that'll come out of it,

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Speaker 2: and they're going to be the conversations are going to

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Speaker 2: be everything about video streaming, big media deals, AI, sports.

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Speaker 2: It all to come together and all these people have

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Speaker 2: a stake in it.

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Speaker 1: Start with Fox Roku because some people said, what are

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Speaker 1: they doing buying Roku?

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Speaker 2: Well, first of all, Fox has been the most disciplined

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Speaker 2: of all the media and entertainment companies in this age

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Speaker 2: of streaming. They really totally avoided the streaming arms race,

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Speaker 2: so they bought a couple of years ago, they bought

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Speaker 2: two be in twenty twenty four hundred and forty million dollars,

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Speaker 2: probably one of the best media deals of the last decade. Today,

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Speaker 2: it's doing over a billion dollars in revenue, and it's

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Speaker 2: all about free advertisers supported television. Eighty six percent of

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Speaker 2: American households today are paying for streaming. You only have

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Speaker 2: about fifty percent that are watching free advertisers supported television.

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Speaker 2: So and they have the largest service in that they

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Speaker 2: have almost one hundred million users. So that's that's their

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Speaker 2: starting place they buy Roku. Roku has one hundred million

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Speaker 2: homes in the US that are using the Roku operating system.

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Speaker 2: Twenty eight percent of all connected TVs in the US

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Speaker 2: are going to go through Roku. They have the Roku channel,

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Speaker 2: which itself is about eighty million users. And so here

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Speaker 2: they have they own They owned the channel, they own

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Speaker 2: the box, they owned the software, they owned the data,

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Speaker 2: and they own the advertising.

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Speaker 3: And so this deal makes a.

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Speaker 2: Huge amount of sense, and it takes them out of

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Speaker 2: the business of competing with everybody else in terms of

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Speaker 2: buying big programming, paying for customer acquisition retention, and worry

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Speaker 2: about where the next subscriber is going to come from.

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Speaker 1: So think about exactly that point. You for a long

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Speaker 1: time been telling me watch the free advertiser supported streaming

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Speaker 1: coming up, But that works better for some content than

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Speaker 1: for others. I mean news and sports. It may work

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Speaker 1: well for I'm not sure it works well for the

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Speaker 1: blockbuster Netflix mega show.

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Speaker 2: Well, it doesn't have to work for the mega show.

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Speaker 2: You've got shows like So for example, on Tube you've

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Speaker 2: got shows like Empire, and you've got movies like to Highlight.

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Speaker 2: A lot of this is not news or sports. A

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Speaker 2: lot of this is largely scripted programming that both the

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Speaker 2: series and films that wouldn't ordinarily be on the major

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Speaker 2: streaming services, or if they are, they're on a streaming

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Speaker 2: service and then they're on to be Roku or Pluto

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Speaker 2: for free.

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Speaker 1: Even with the Roku acquisition, Fox remains a much smaller

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Speaker 1: media company than at Disney or a Netflix, so there

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Speaker 1: not to speak of paramount Warner Brothers. Can it compete

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Speaker 1: in that world.

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Speaker 2: I think we're moving to a point where focus is

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Speaker 2: more important. I think size is not as important. And

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Speaker 2: in these media conglomerates, some of them will work and

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Speaker 2: some of them won't. But Fox is very focused and

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Speaker 2: it's focused on businesses that.

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Speaker 3: Throw off cash.

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Speaker 2: It's one of the reasons why it's been the absolute

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Speaker 2: best performing media stock and a result of It is

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Speaker 2: just very disciplined, not going after the the battle, but

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Speaker 2: on streaming and sticking to businesses like television stations and

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Speaker 2: a network and cable networks and now to be that

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Speaker 2: throw off cash.

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Speaker 1: When you tell I focus, I think about Brian robertson Comcast,

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Speaker 1: the other big deal here by the way I did this,

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Speaker 1: if you look at the track of the stock of

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Speaker 1: the two companies Fox versus Comcast over the last five years,

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Speaker 1: they're almost in verses of one another. So why is

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Speaker 1: Brian Roberts finally throwing in the town saying let's break

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Speaker 1: it up.

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Speaker 2: You're asking the right question, David, because they're not really

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Speaker 2: throwing in the towel. They're taking this business and essentially

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Speaker 2: earlier they spun off the cable networks and diversant and

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Speaker 2: they're creating three different companies, each of them with different

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Speaker 2: competitive dynamics, different growth profiles, and different economics. So by

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Speaker 2: simplifying the business, the core connectivity business can make the

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Speaker 2: capital investments it wants. Investors aren't worried are they going

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Speaker 2: to spend on more plant and equipment? Are they going

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Speaker 2: to spend on the next series? So it's very focused

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Speaker 2: and also Connectivity has become like a bundle.

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Speaker 3: It isn't. You don't just buy connectivity at home.

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Speaker 2: You buy connectivity, you buy cable, you buy mobile, you

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Speaker 2: buy other services from them. So that business is focused

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Speaker 2: in terms of the NBC Universal, Well, this is a

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Speaker 2: growth business. They're going to be able to go deeper

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Speaker 2: and deeper into some of the areas that they're in today.

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Speaker 2: They're doing unbelievably well. As like your sports destination, it's

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Speaker 2: a default if you want sports, I don't think you

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Speaker 2: can you can get sports if as all of sports

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Speaker 2: unless you're watching NBC or you're you're subscribing to peacocker both.

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Speaker 1: For somebody who's been around this for a while now,

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Speaker 1: streaming seems like a brand new thing, but as rapidly

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Speaker 1: look like an old thing compared to what's next, which

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Speaker 1: is AI and tech. Takes us back to the Allen

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Speaker 1: compers and the other half of the Allen compers. What

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Speaker 1: can we expect in terms of media and tech?

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Speaker 2: The AI guys are investing over seven hundred billion dollars

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Speaker 2: next year in plant, equipment and capital, and they've suddenly

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Speaker 2: realized that content is a critical asset for them, that

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Speaker 2: it is a foundational asset. So they're all going to

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Speaker 2: be trying to do deals with the content companies first

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Speaker 2: of all, around anything that is that is information or news.

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Speaker 2: So that's why we saw earlier this year we saw

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Speaker 2: News Corp. Just do a deal with Meta. We're going

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Speaker 2: to see lots more of those deals with content companies.

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Speaker 2: It's the days are over where where the user is

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Speaker 2: just going to be happy with them scraping the web

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Speaker 2: or going to Wikipedia.

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Speaker 3: And then at the same time they all want.

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Speaker 2: A piece of the They all want a piece of

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Speaker 2: the video creation business. And so right now Google has Veil,

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Speaker 2: which is being used by studios and others to not

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Speaker 2: just convert films make but make new programming. So everyone's

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Speaker 2: going to be trying to figure out how they're going

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Speaker 2: to go from the LLM the query model into one

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Speaker 2: that it helps people create content.

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Speaker 1: With each one of these steps, I wonder whether the

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Speaker 1: margins don't get squeezed more. The size goes up and

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Speaker 1: including internationally globally, but the margin goes down. Back in

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Speaker 1: the good old days, I would say you owned a

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Speaker 1: major market television station, The markets and margins were really big.

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Speaker 1: Wact the first time I went there and got access

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Speaker 1: to it, it was sixty percent of profit margins With each

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Speaker 1: one of these you may have a deal with the

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Speaker 1: AI people to be able to use their content, but

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Speaker 1: isn't it going to be pennies on the dollar.

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Speaker 3: It's really turning out to be a world of have

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Speaker 3: and have nots.

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Speaker 2: If you have a high share station in a good market,

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Speaker 2: you're making a lot of money. If you are a

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Speaker 2: low share station, no matter what the market, you're not

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Speaker 2: making a lot of money. And so TV station business

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Speaker 2: is still a great business. It's slowed down because of

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Speaker 2: what's the decline of cable.

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Speaker 3: But in some of these businesses, the margins are going

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Speaker 3: to decline.

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Speaker 2: And the street, when the street looks at these media

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Speaker 2: and entertainment companies, the street needs to be convinced that's

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Speaker 2: streaming is going to be a good business and it's

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Speaker 2: one that's going to ultimately be a high margin business,

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Speaker 2: and right now it doesn't look that way.

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Speaker 1: To come back to deals and what might or might

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Speaker 1: not come out of the Allen conference, the AI people

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Speaker 1: are spending a lot of money on data centers and

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Speaker 1: about on compute right a lot of money. Are they

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Speaker 1: interested in actually buying a major media company?

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Speaker 3: I really doubt it.

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Speaker 2: I think that that maybe on the information side, because

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Speaker 2: information is so critical, but those deals are going to

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Speaker 2: be easier for them to make those deals. In any

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Speaker 2: of the information companies would be very glad to take

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Speaker 2: a piece of the seven hundred billion dollars that's going

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Speaker 2: to be spent. I do think that that there's going

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Speaker 2: to be more soft deals. I think there will be

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Speaker 2: investment in these different businesses because I don't think that

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Speaker 2: they that they have a choice.

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Speaker 1: So you spend your days advising a lot of these

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Speaker 1: companies for their strategies and how to approach this uncertain world.

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Speaker 1: Who's going to win and I don't mean for you

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Speaker 1: to say which name of which company, but the winner

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Speaker 1: will do what? And the ones who don't win will

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Speaker 1: it fail to do what?

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Speaker 4: I think the.

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Speaker 2: Winners will be the people that have the best programming

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Speaker 2: or the best information and the best sports, so programming,

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Speaker 2: they can own sports, They're going to have to have

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Speaker 2: those rights, and sports is huge driver of the entire ecosystem.

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Speaker 2: It's why NBC is moving towards the year round Sundays.

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Speaker 2: So entertainment, long form, scripted reality, whatever it might be,

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Speaker 2: This is really what drives people. It's going to drive

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Speaker 2: that over five hours a day of people in the

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Speaker 2: US watching video. It's going to be sports, it's going

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Speaker 2: to be information, and then finally it's going to be

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Speaker 2: data and people have in order to be able to

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Speaker 2: serve advertising that's going to help advertisers and marketers sell.

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Speaker 3: There needs to be data and that's a piece of.

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Speaker 2: The Fox Roku deal that also we shouldn't forget, which

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Speaker 2: is that gets a huge amount of data through Roku

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Speaker 2: that informs its own advertising.

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Speaker 1: Coming up. Spend a dollar every second for thirty one

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Speaker 1: thousand years. That's what a trillionaire would have to do

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Speaker 1: to go through all his money. It's a lot of money,

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Speaker 1: but what does it mean for the rest of us.

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Speaker 1: This is a story of unimaginable wealth. Elon Musk is

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Speaker 1: now a trillionaire, But the story is about more than

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Speaker 1: one person's enormous fortune. It's about how markets reward capital,

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Speaker 1: how our tax system treats it, and how much power

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Speaker 1: can accumulate at the very top.

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Speaker 5: I give SpaceX less than a ten percent chance of

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Speaker 5: succeeding at all. To be clear, in fact, I told

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Speaker 5: people this, look, we're probably going to fail, but you know,

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Speaker 5: we should give it a try.

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Speaker 1: SpaceX made history last month with the big ever IPO,

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Speaker 1: raising seventy five billion dollars on a market value of

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Speaker 1: nearly two trillion dollars, more than double that of Saudi

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Speaker 1: Aramco's twenty nine billion dollar listing in twenty nineteen.

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Speaker 6: Encouraging more of that type of innovation in the American

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Speaker 6: economy rather than less of it seems important, but also

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Speaker 6: trying to make sure that we are fiscally responsible in discipline.

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Speaker 1: SpaceX is now one of the most valuable public companies

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Speaker 1: in the world, putting its founder and CEO into a

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Speaker 1: category all his own, the world's first trillionaire. As Nobel

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Speaker 1: Prize winning economist Paul Krugman points out, public markets are

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Speaker 1: turning ownership stakes into staggering concentrations of wealth.

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Speaker 7: Until recently, we've been talking about income, and we mostly

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Speaker 7: talk about the top twenty percent or even the top

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Speaker 7: one percent. But wealth is a whole different story, and

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Speaker 7: wealth is really where the action is. So it's on

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Speaker 7: wealth top one percent. It totally dominates wealth, but it's

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Speaker 7: the inequality within the top one percent. It's the top

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Speaker 7: tenth percent with a top point one or whatever that

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Speaker 7: is just a handful of people. Elon Musk obviously is

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Speaker 7: the best known, but really, if you look at the

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Speaker 7: top ten people in the United States, there's an incredible

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Speaker 7: amount of wealth there, and that is relatively new. Even

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Speaker 7: in the year two thousand, we were already talking about

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Speaker 7: the one percent. But this ten billionaires, ten mega billionaires,

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Speaker 7: that's a new story.

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Speaker 1: And at this scale, the numbers start to outrun the

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Speaker 1: language we use to describe them.

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Speaker 6: These numbers like billions, hundreds of billions, trillions, you start

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Speaker 6: to not even be able to realize or understand what

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Speaker 6: the magnitudes really mean or demand of the American economy.

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Speaker 1: To fully comprehend how much a trillion dollars is. Yale

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Speaker 1: law professor and co founder of the Budget Lab, Natasha

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Speaker 1: Sarin offers a different way to measure it.

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Speaker 6: A million seconds is about eleven and a half days.

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Speaker 6: A billion seconds is about thirty two years. A trillion

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Speaker 6: seconds is thirty one thousand, seven hundred years. That is

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Speaker 6: roughly back to when humans worth began painting cave walls,

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Speaker 6: And so a trillion dollars is just such an astounding

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Speaker 6: and significant sum that it is almost hard to grasp

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Speaker 6: what it means.

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Speaker 1: With a trillion dollars elon, Musk could buy every carmaker

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Speaker 1: in the US, Europe and Japan, like GMBMW and Toyota,

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Speaker 1: which total around nine hundred billion dollars and still have

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Speaker 1: nearly one hundred billion dollars left over. NASA's budget for

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Speaker 1: twenty twenty five was twenty four point six billion dollars,

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Speaker 1: meaning Musk could fund the Space Agency forty one times over.

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Speaker 1: And if Musk were his own country, his territory as

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Speaker 1: of now, would be richer than one hundred and fifty

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Speaker 1: six other nations. He sits at number one on Bloomberg's

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Speaker 1: Billionaire Index, followed by former Google CEO Larry Page, with

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Speaker 1: three hundred and fourteen billion dollars, one third of Musk's

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Speaker 1: net worth. But Musk is not the only one benefiting.

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Speaker 1: SpaceX's IPO has created thousands of new millionaires inside the company,

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Speaker 1: and the next wave of wealth creation may already be

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Speaker 1: on its way as more technology companies, especially those tied

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Speaker 1: to artificial intelligence, moved toward the public markets. Both Anthropic

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Speaker 1: and open Ai filed for IPOs in June, with estimated

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Speaker 1: valuations already pushing that trillion dollar mark. Big tech is

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Speaker 1: driving so much of the stock market, for example, right now,

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Speaker 1: and these mega IPOs are AI related in one shape

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Speaker 1: or another. How much of it is tech?

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Speaker 7: A part of it is tech used to be not

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Speaker 7: that long ago. We would think, we used to say

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Speaker 7: Wall Street was really driving this, although not really is tech.

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Speaker 7: The ranks of the super rich asipherm being enormously richer

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Speaker 7: than they used to be.

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Speaker 4: They're all so.

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Speaker 7: Much more sort of monochromatic than they used to be.

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Speaker 1: Often with great fortune comes political influence.

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Speaker 5: The DOGE influence wills to grow stronger. It's I liken

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Speaker 5: it to a sort of Buddhism. It's like a way

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Speaker 5: of life. So it is premeating throughout the government.

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Speaker 1: In twenty twenty five, President Trump put Musk in charge

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Speaker 1: of the Department of Government Efficiency or DOGE, in which

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Speaker 1: government agencies suffered massive financial and employee cuts. As more

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Speaker 1: people cross into billionaire territory and now possibly trillionaire territory,

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Speaker 1: Krugman says, the question becomes larger than net worth. It

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Speaker 1: becomes a question about democracy.

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Speaker 7: The Times did a report saying that three hundred billionaire

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Speaker 7: families are counted for something like nineteen percent of campaign

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Speaker 7: contributions in twenty twenty four. And that's only the explicit

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Speaker 7: stuff that's counted by the Federal Elections Commission. If you

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Speaker 7: count all of the invisible channels of influence, well, if

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Speaker 7: you have that much wealth at the top, it does

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Speaker 7: make us, in a meaningful sense, a less democratic nation.

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Speaker 1: Musk's trillion dollar milestone is historic, but it's not the

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Speaker 1: first time American capitalism created a new financial class. Just

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Speaker 1: over a century ago, John D. Rockefeller became the country's

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Speaker 1: first billionaire through his controlling stake in Standard Oil.

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Speaker 8: The Rockefellers in the early twentieth century were really rich.

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Speaker 8: John D. Rockefeller, the founder of Standard Oil, he crossed

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Speaker 8: the one billion mark in the nineteen tens, and when

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Speaker 8: you adjust that for the share of the US economy,

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Speaker 8: he's about it at trillion dollars. So right now, basically

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Speaker 8: one hundred and twenty years after the first billionaire, we

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Speaker 8: have the first trillionaire sort of hitting basically that same

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Speaker 8: mark in terms of the US economy.

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Speaker 1: Bloomberg reporter Ben Steberman has covered Elon Musk's rise and

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Speaker 1: has seen some similarities between the first billionaire and the

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Speaker 1: first trillionaire, but also some key differences.

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Speaker 8: The Rockefellers did not want to be known as billionaires.

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Speaker 8: They already felt like they had a target on their back.

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Speaker 8: They were in control of this monopoly that was incredibly controversial.

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Speaker 8: A case against them went all the way to the

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Speaker 8: Supreme Court and they lost. So they did not want

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Speaker 8: to be known as billionaires.

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Speaker 1: That sounds different from now. I'm not sure that Elon

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Speaker 1: Musk is that upset about being called a trillionaire. It

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Speaker 1: wasn't just John D. Rockefier. There was a Gilded Age,

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Speaker 1: and there were Carnegies, and there were other people who

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Speaker 1: had a lot of money. Was it a different sort

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Speaker 1: of societal reaction.

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Speaker 4: Yeah.

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Speaker 8: I think there was the Gilded Age in the late

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Speaker 8: nineteenth century and early twentieth century, but the progressive era

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Speaker 8: was coming in and that level of wealth just became

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Speaker 8: incredibly controversial. That level of power in society became very controversial.

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Speaker 1: It was in the time of the Rockefellers, Carnegies, and

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Speaker 1: Vanderbilts that the sixteenth Amendment was ratified, giving Congress the

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Speaker 1: power to tax incomes from whatever source derived, laying the

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Speaker 1: foundation for our modern income tax system. But today's large

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Speaker 1: fortunes are not built mainly from income. They are built

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Speaker 1: through ownership stakes, stock appreciation, and capital gains. There was

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Speaker 1: no conception of a trillionaire then, yeah, was this system

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Speaker 1: set up for trillionaires?

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Speaker 6: You can kind of trace its roots back to concerns

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Speaker 6: about inequality and the first Gilded Age, you know, concerns

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Speaker 6: that there was wealth that was being concentrated in these

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Speaker 6: American oligarchs that we didn't actually have a good handle

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Speaker 6: on how to tax because of the restrictions with respect

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Speaker 6: to the ability to tax income and issues dealing with

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Speaker 6: apportionment that dated back to the Civil War. But it

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Speaker 6: was exactly in response to the needs of the fisk

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Speaker 6: to finance itself and concerns about inequality and its rapid

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Speaker 6: growth in society. And so in some sense, you're kind

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Speaker 6: of seeing the same movie play again, except it turns

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Speaker 6: out that the income tax doesn't seem accepttionally well situated

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Speaker 6: to be able to tackle the nature of inequality in

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Speaker 6: this country, because the income tax is a tool that's

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Speaker 6: leaving out of its tax base something like forty percent

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Speaker 6: of the wealth of those at the very top, and

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Speaker 6: so a bit I have wondered whether one way to

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Speaker 6: understand the sort of ideas that are being put forth

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Speaker 6: with respect to things like wealth taxation or mark to

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Speaker 6: market taxation of capital gains, whether this is the new

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Speaker 6: income tax movement in some sense in this country.

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Speaker 1: The tax system, though, actually has a disincentive to freeing

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Speaker 1: up capital, does it not, Because if your only don't

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Speaker 1: have to pay on returns, and when you realize when

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Speaker 1: you sell the asset or otherwise transfer the asset, then

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Speaker 1: you just tend to sit on the asset, and it's not.

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Speaker 6: Freedom if you look at the way the system is structured.

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Speaker 6: It is structured such that there is a huge incentive

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Speaker 6: for Elon Musk to transfer his ownership stake in Tesla

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Speaker 6: and SpaceX and X to his air rather than to

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Speaker 6: transfer it potentially during his lifetime.

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Speaker 7: Taxes on wealth or on capital income are a real

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Speaker 7: way to curb this. You have corporations paying almost no

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Speaker 7: tax or no tax, passing their profits onto one way

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Speaker 7: or another's people who own stock who then pay little

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Speaker 7: or no tax. So we really have exacerbated this inequality.

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Speaker 1: It's because so much wealth is generated by appreciated capital

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Speaker 1: rather than high incomes. The California is now considering the

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Speaker 1: Billionaire Tax Act, which would impose a one time levy

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Speaker 1: on residents worth over one billion dollars. But unlike during

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Speaker 1: the First Gilded Age, Americans in recent years have had

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Speaker 1: a more nuanced view of the ultra wealthy getting even richer.

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Speaker 8: You don't see a lot of anger actually in the

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Speaker 8: polling at billionaires until fairly recently. So that indicates to

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Speaker 8: me that the average American actually kind of wants to

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Speaker 8: be rich themselves. I think it becomes a problem for

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Speaker 8: a lot of Americans when there's a sense that the

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Speaker 8: system's rigged, or that the people at the top are

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Speaker 8: somehow manipulating things to make their lives harder.

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Speaker 1: How much of this is forgive me envy. I suppose

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Speaker 1: we all had a minimum income everybody in the country

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Speaker 1: that was sufficient. Would we feel better about inequality?

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Speaker 7: We would feel better about inequality if we had the basics,

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Speaker 7: If everybody had healthcare, if everybody had a roof over

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Speaker 7: their heads, if everybody had sufficient nutrition, which by the way,

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Speaker 7: we don't. The thing to say about that is that

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Speaker 7: doing that is quite expensive. I think that there's something

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Speaker 7: fundamentally skewed, demoralizing, corrupting about really extreme inequality. I think

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Speaker 7: a society in which essentially a society in which there's trillion.

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Speaker 7: There's is not going to be a good society even

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Speaker 7: if everybody has the basics. But you know, if we

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Speaker 7: could take a step towards making sure that everybody had

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Speaker 7: the basics, then that would deprogress.

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Speaker 1: Capitalism rewards winners, those who innovate and create successful businesses

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Speaker 1: and help grow the economy overall. But as those rewards

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Speaker 1: soar beyond our wildest imagination, the question becomes whether there

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Speaker 1: can be too much of a good thing, whether the

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Speaker 1: system can provide those lavish rewards without leaving the vast

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Speaker 1: majority of us behind, and ultimately, whether the growing gap

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Speaker 1: could put democracy itself at risk. Up next, The SpaceX

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Speaker 1: launch hasn't just created large gaps in wealth. It's also

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Speaker 1: created large gaps in the power of the shareholders investing

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Speaker 1: in the company, gaps that have led some to question

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Speaker 1: whether it's the right investment for them. This is a

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Speaker 1: story about fairness. When SpaceX went public last month, investors

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Speaker 1: were invited to buy into one of the world's most

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Speaker 1: valuable companies, but they weren't buying equal voting rights. Instead,

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Speaker 1: the IPO cemented Elon Musk's extraordinary control over the company's future,

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Speaker 1: giving him more voting power than all other shareholders combined,

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Speaker 1: as well as locking him in as chairman and CEO.

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Speaker 9: SpaceX as a public company is an investment in Elon

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Speaker 9: Musk and the cult of Elon.

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Speaker 1: Well, you know, I visited SpaceX.

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Speaker 10: It's extraordinary. It's extraordinary what they've done.

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Speaker 9: This has captured the imagination not just of investors, but

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Speaker 9: really everyone.

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Speaker 4: The reality is it's going to be a watersheder vent

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Speaker 4: in terms of the space actor from Musk, our job

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Speaker 4: as institution a bastasis to take calculated risk. The case

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Speaker 4: of Space six, we simply could not make the eighty

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Speaker 4: number say it off.

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Speaker 1: Historically, public companies were simple manners where each share gave

439
00:25:08,400 --> 00:25:12,399
Speaker 1: the holder one vote, something still true for companies like Apple,

440
00:25:12,760 --> 00:25:16,240
Speaker 1: but some founders decided that they needed and deserved a

441
00:25:16,280 --> 00:25:18,600
Speaker 1: more than equal say in the running of the company,

442
00:25:19,000 --> 00:25:22,000
Speaker 1: giving rise to two classes of shares, with some shares

443
00:25:22,040 --> 00:25:26,440
Speaker 1: attached to multiple votes, a dual class share structure, which

444
00:25:26,520 --> 00:25:30,160
Speaker 1: is the case for companies like Alphabet and Meta. Lease

445
00:25:30,280 --> 00:25:33,560
Speaker 1: Buyer is an IPO advisor and the founder of Class

446
00:25:33,560 --> 00:25:36,760
Speaker 1: five Group. She says one advantage of the dual class

447
00:25:36,760 --> 00:25:39,560
Speaker 1: structure is that it allows companies to get their sea

448
00:25:39,640 --> 00:25:41,800
Speaker 1: legs as they adjust to being public.

449
00:25:42,200 --> 00:25:45,359
Speaker 9: The biggest thing is actually keeping activists away when the

450
00:25:45,400 --> 00:25:48,280
Speaker 9: stock falls, and so what that means is founders can

451
00:25:48,320 --> 00:25:50,840
Speaker 9: make decisions that may actually have a negative impact on

452
00:25:50,840 --> 00:25:54,000
Speaker 9: the near term without fear that if the stock falls

453
00:25:54,040 --> 00:25:56,560
Speaker 9: on that news, someone will swoop in and take it away.

454
00:25:56,720 --> 00:26:00,280
Speaker 9: From an investor's perspective, it's a double edged swords. Us

455
00:26:00,359 --> 00:26:03,359
Speaker 9: on one hand, can rightly feel you're taking my money

456
00:26:03,720 --> 00:26:07,119
Speaker 9: I want to vote. On the other hand, investors, no

457
00:26:07,200 --> 00:26:10,800
Speaker 9: matter how savvy they are, don't actually know what's going

458
00:26:10,920 --> 00:26:15,679
Speaker 9: on inside a company. The dual class structure provides a

459
00:26:15,720 --> 00:26:19,040
Speaker 9: safety net for those investors who want to let management

460
00:26:19,080 --> 00:26:22,119
Speaker 9: make the decisions they deem will work out best in

461
00:26:22,160 --> 00:26:25,240
Speaker 9: the long run, without fear of losing their jobs if

462
00:26:25,280 --> 00:26:26,920
Speaker 9: in fact there's a short term hiccup.

463
00:26:27,320 --> 00:26:31,120
Speaker 1: The dual class share structure gained prominence with Ford's landmark

464
00:26:31,320 --> 00:26:35,320
Speaker 1: nineteen fifty six IPO, allowing the Ford family to retain

465
00:26:35,359 --> 00:26:39,239
Speaker 1: control even as the number of public shareholders grew. A

466
00:26:39,240 --> 00:26:42,520
Speaker 1: similar two class model was adopted by some media companies

467
00:26:42,760 --> 00:26:45,880
Speaker 1: like The Washington Post, The New York Times, and Fox.

468
00:26:46,359 --> 00:26:49,480
Speaker 1: But what was once the exception is rapidly becoming the

469
00:26:49,640 --> 00:26:53,359
Speaker 1: rule today. In nineteen eighty, just over one percent of

470
00:26:53,440 --> 00:26:57,719
Speaker 1: IPOs used dual class structures. By last year that figured

471
00:26:57,760 --> 00:26:59,840
Speaker 1: had climbed to forty seven percent.

472
00:27:00,680 --> 00:27:03,439
Speaker 9: They were not coming in any other kind of public

473
00:27:03,480 --> 00:27:06,240
Speaker 9: stock until Google came along in two thousand and four,

474
00:27:06,560 --> 00:27:09,760
Speaker 9: where the founders had some very specific ideas of how

475
00:27:09,760 --> 00:27:11,120
Speaker 9: they wanted to run the company.

476
00:27:11,520 --> 00:27:13,800
Speaker 1: This paved the way for SpaceX to file for an

477
00:27:13,800 --> 00:27:18,359
Speaker 1: IPO under an unusually extreme dual share structure. While Mask

478
00:27:18,440 --> 00:27:21,399
Speaker 1: holds just over forty percent of the company's equity, he

479
00:27:21,480 --> 00:27:25,320
Speaker 1: controls over eighty percent of the total voting power. Lucian

480
00:27:25,359 --> 00:27:28,600
Speaker 1: Bebchik is director of the Corporate Governance Program at Harvard

481
00:27:28,640 --> 00:27:29,399
Speaker 1: Law School.

482
00:27:29,680 --> 00:27:35,399
Speaker 10: What we have here goes much beyond just letting Mask

483
00:27:36,040 --> 00:27:40,040
Speaker 10: and determine the business strategy for some time. First of all,

484
00:27:41,720 --> 00:27:47,320
Speaker 10: even if you believe that Mask is now by far

485
00:27:47,600 --> 00:27:53,880
Speaker 10: the best to choose and the business strategy of the company,

486
00:27:54,040 --> 00:27:59,199
Speaker 10: this doesn't mean trusting how we will then allocate the

487
00:27:59,320 --> 00:28:05,040
Speaker 10: pie that is generated by the company between public investors

488
00:28:05,200 --> 00:28:11,560
Speaker 10: and himself. One key role of corporate governance arrangements is

489
00:28:11,600 --> 00:28:18,960
Speaker 10: to constrain insiders from allocating to themselves and excessive slice

490
00:28:19,520 --> 00:28:23,200
Speaker 10: of the pie at the expense of public investors.

491
00:28:23,320 --> 00:28:27,080
Speaker 1: There's also a question, even if you believe wholeheartedly in

492
00:28:27,160 --> 00:28:30,840
Speaker 1: Elon must today, Elon Musk may not be there or

493
00:28:30,880 --> 00:28:33,840
Speaker 1: be the same Elon Musk thirty forty years down the road.

494
00:28:34,359 --> 00:28:40,640
Speaker 10: Yes, David, here you are completely correct. Furthermore, the governance

495
00:28:40,720 --> 00:28:45,960
Speaker 10: structure that entrenches control in the hands of whoever has

496
00:28:46,720 --> 00:28:52,200
Speaker 10: the b shares is indefinite, which means that if Elon Mask,

497
00:28:52,600 --> 00:28:57,600
Speaker 10: or when Elon Mask passes away, we are all motile.

498
00:28:57,840 --> 00:29:07,280
Speaker 10: Then investors cannot rely on Masks, hears or whoever manages

499
00:29:07,480 --> 00:29:12,440
Speaker 10: the trusts through which his high voting shares are head

500
00:29:13,080 --> 00:29:16,720
Speaker 10: that there would be the most fitting leaders.

501
00:29:17,280 --> 00:29:19,280
Speaker 1: And then there's the question of how to ensure that

502
00:29:19,360 --> 00:29:23,080
Speaker 1: a superstar CEO remains fully committed to the company over

503
00:29:23,120 --> 00:29:26,560
Speaker 1: which he has nearly complete control, something that's been an

504
00:29:26,600 --> 00:29:30,120
Speaker 1: issue before for mister Musk at his other venture, Tesla.

505
00:29:30,840 --> 00:29:37,720
Speaker 10: A similar concern arises in connection with SpaceX, because even

506
00:29:37,840 --> 00:29:42,960
Speaker 10: though in the governance structure of SpaceX there is an

507
00:29:43,000 --> 00:29:48,280
Speaker 10: iron clead commitment to have Masks in the CEO and

508
00:29:48,360 --> 00:29:52,840
Speaker 10: share positions, there are no constraints whatsoever on how much

509
00:29:52,960 --> 00:29:58,080
Speaker 10: time and effort he will spend outside SpaceX.

510
00:29:58,440 --> 00:30:02,400
Speaker 1: The world is well aware the extraordinary SpaceX governance structure,

511
00:30:02,560 --> 00:30:06,960
Speaker 1: and it gives some potential investors pause. Under Shelde is

512
00:30:07,000 --> 00:30:11,240
Speaker 1: the chief investment officer of academicer hen Shun, a Danish

513
00:30:11,280 --> 00:30:14,640
Speaker 1: pension fund that manages more than twenty billion dollars in assets,

514
00:30:14,800 --> 00:30:19,160
Speaker 1: primarily on behalf of academics. It recently plays SpaceX on

515
00:30:19,240 --> 00:30:24,560
Speaker 1: an exclusion list for investments, specifically citing the company's catastrophic governance.

516
00:30:24,920 --> 00:30:27,200
Speaker 4: Maybe the Eland Moss brain is very strong in the US,

517
00:30:27,200 --> 00:30:29,680
Speaker 4: but it's not so strong in Denmark. Actually, I would

518
00:30:29,800 --> 00:30:32,040
Speaker 4: rather say that you know, many people drying assist. Let's

519
00:30:32,080 --> 00:30:34,720
Speaker 4: maybe a little bit embarrassed about it. And certainly among

520
00:30:34,760 --> 00:30:38,280
Speaker 4: our scheme members, there's a huge reputation of risk in

521
00:30:38,280 --> 00:30:41,080
Speaker 4: investing in an Elon musk lit company. So I've been

522
00:30:41,120 --> 00:30:43,640
Speaker 4: here for nine years now and I never experienced in

523
00:30:43,640 --> 00:30:48,520
Speaker 4: my nine years as CIO, so many scheme members coming

524
00:30:48,560 --> 00:30:51,920
Speaker 4: back to me with positive comments from a single investment decision,

525
00:30:51,960 --> 00:30:56,040
Speaker 4: as I experienced in the wake of the exclusion of SpaceX.

526
00:30:56,200 --> 00:31:00,200
Speaker 1: What do you look for in governance, either to have

527
00:31:00,400 --> 00:31:02,200
Speaker 1: or to avoid? As you make investments.

528
00:31:02,440 --> 00:31:05,920
Speaker 4: We hold good governance very very highly. We think it's

529
00:31:06,120 --> 00:31:10,720
Speaker 4: extremely important into order to shore accountability and transparency and

530
00:31:11,080 --> 00:31:14,400
Speaker 4: sound decision making. And I think you know, good governance

531
00:31:14,480 --> 00:31:17,920
Speaker 4: to us, to our mind realizes that the core of

532
00:31:17,960 --> 00:31:21,480
Speaker 4: the trust that we need in public markets one share,

533
00:31:21,560 --> 00:31:25,120
Speaker 4: one vote. The distribution of power should be proportional to

534
00:31:25,160 --> 00:31:29,800
Speaker 4: the money invested. We have the separation of power between

535
00:31:29,920 --> 00:31:32,360
Speaker 4: CEO and chairman of the board. We don't like that

536
00:31:32,440 --> 00:31:35,400
Speaker 4: to be the same person. We think that creates a

537
00:31:35,520 --> 00:31:41,360
Speaker 4: risk of poor decision making and excessive risk taking. And finally,

538
00:31:41,400 --> 00:31:44,720
Speaker 4: the third principle is independence. We want an independent board.

539
00:31:44,880 --> 00:31:46,800
Speaker 1: Do you see a trend or are you concerned about

540
00:31:46,800 --> 00:31:50,080
Speaker 1: a trend with the success of SpaceX that other companies

541
00:31:50,080 --> 00:31:52,560
Speaker 1: may follow a suit with respect to cover governance.

542
00:31:52,960 --> 00:31:58,760
Speaker 4: Definitely fear that, you know, this might inspire other to

543
00:31:59,320 --> 00:32:01,520
Speaker 4: go in the same direction. We could be hitting in

544
00:32:01,520 --> 00:32:04,920
Speaker 4: that direction, even further concentration of power with a few

545
00:32:04,960 --> 00:32:08,600
Speaker 4: founders in some very very major companies. And I think

546
00:32:08,640 --> 00:32:12,640
Speaker 4: that is in that environment if it's important that via

547
00:32:12,840 --> 00:32:15,360
Speaker 4: institution a vestas try and pull in the other direction

548
00:32:16,040 --> 00:32:17,520
Speaker 4: to get the balance right.

549
00:32:18,240 --> 00:32:22,480
Speaker 1: When the balance so unevenly favors one person's interests. What

550
00:32:22,600 --> 00:32:25,880
Speaker 1: power do the rest of the shareholders have? After all,

551
00:32:25,960 --> 00:32:28,560
Speaker 1: it is also their money that's on the line.

552
00:32:30,000 --> 00:32:33,120
Speaker 9: Investors who have one really important tool at their disposal,

553
00:32:33,560 --> 00:32:36,360
Speaker 9: they don't like what's going on, they can sell the stock.

554
00:32:37,400 --> 00:32:40,680
Speaker 9: That's their point of leverage. Retail investors, to be quite honest,

555
00:32:40,800 --> 00:32:42,920
Speaker 9: don't have much of us say anyway, because most of

556
00:32:42,960 --> 00:32:46,280
Speaker 9: them don't have enough voting power to make a difference.

557
00:32:46,600 --> 00:32:50,120
Speaker 9: So should they care? Sure, because there should be some

558
00:32:50,200 --> 00:32:53,440
Speaker 9: forcing functions on management teams to remember that they have

559
00:32:53,680 --> 00:32:59,000
Speaker 9: sold stock to the public in return for committing to

560
00:32:59,160 --> 00:33:01,440
Speaker 9: run the business like a public company.

561
00:33:03,440 --> 00:33:06,240
Speaker 1: Ultimately, it will be for markets to decide whether that

562
00:33:06,360 --> 00:33:09,920
Speaker 1: balance of power is fair for all shareholders or tilts

563
00:33:09,960 --> 00:33:13,440
Speaker 1: too far towards the founders. As always, the markets speak

564
00:33:13,560 --> 00:33:16,720
Speaker 1: most loudly through the value put on the stock, and

565
00:33:16,920 --> 00:33:19,960
Speaker 1: at least at the beginning, Elon Musk is not facing

566
00:33:20,000 --> 00:33:24,200
Speaker 1: too much pressure given SpaceX's initial market cap of over

567
00:33:24,280 --> 00:33:25,920
Speaker 1: two trillion dollars.

568
00:33:26,240 --> 00:33:34,080
Speaker 10: To whatever value you estimate and you attach to the

569
00:33:34,120 --> 00:33:39,440
Speaker 10: business prospects of SpaceX, you need as an investor to

570
00:33:39,600 --> 00:33:46,480
Speaker 10: discount it significantly because of the governance flows did the

571
00:33:46,640 --> 00:33:54,160
Speaker 10: market provide attached such an adequate discount. We cannot tell

572
00:33:54,200 --> 00:33:57,600
Speaker 10: from what we see in the market, but I think

573
00:33:57,640 --> 00:34:00,360
Speaker 10: it would be important for public investors to do so,

574
00:34:01,000 --> 00:34:04,560
Speaker 10: and I hope that this interview might help a little

575
00:34:04,560 --> 00:34:11,000
Speaker 10: bit in informing public investors about this issue to which

576
00:34:11,080 --> 00:34:12,560
Speaker 10: they should pay close attention.

577
00:34:14,440 --> 00:34:17,920
Speaker 1: Up next, the growing business of treating menopause and how

578
00:34:18,000 --> 00:34:30,879
Speaker 1: a change in FDA rules has given it new life.

579
00:34:31,160 --> 00:34:34,600
Speaker 1: This is a story about market failure, failure of the

580
00:34:34,640 --> 00:34:37,759
Speaker 1: markets to address something half of the world's population will

581
00:34:37,800 --> 00:34:43,400
Speaker 1: experience but has historically been largely ignored menopause. For generations,

582
00:34:43,480 --> 00:34:46,320
Speaker 1: women were told the physiological changes that come with aging

583
00:34:46,360 --> 00:34:49,560
Speaker 1: were something they should endure quietly, if they were told

584
00:34:49,600 --> 00:34:53,640
Speaker 1: anything at all. Now that silence is being broken by doctors,

585
00:34:53,880 --> 00:34:57,960
Speaker 1: celebrity influencers, startups, and investors who see menopause as one

586
00:34:58,000 --> 00:35:01,440
Speaker 1: of the next big markets in women's health. Our colleague

587
00:35:01,440 --> 00:35:06,520
Speaker 1: Scholet Foo brings us the story.

588
00:35:06,000 --> 00:35:07,440
Speaker 11: It's healthcare for half the world.

589
00:35:07,560 --> 00:35:08,439
Speaker 12: Menopause is hot.

590
00:35:08,520 --> 00:35:11,760
Speaker 13: It is a three hundred and sixty billion dollar category.

591
00:35:11,880 --> 00:35:15,719
Speaker 14: The plain wrong part was it's all over at menopause.

592
00:35:15,840 --> 00:35:18,600
Speaker 14: Go to the corner, sit in the rocking chair and

593
00:35:18,640 --> 00:35:23,040
Speaker 14: pull out your knitting needles. That's changed significantly now.

594
00:35:23,200 --> 00:35:27,080
Speaker 15: Menopause is finally getting its big business moment after decades

595
00:35:27,120 --> 00:35:32,480
Speaker 15: of being overlooked. Beauty brands, supplement makers, telehealth startups, and

596
00:35:32,520 --> 00:35:35,440
Speaker 15: investors are all racing to stake their claim on a

597
00:35:35,480 --> 00:35:39,080
Speaker 15: growing market to provide relief to women who's ovaries stop

598
00:35:39,120 --> 00:35:42,440
Speaker 15: producing estrogen. But this gold rush raises a key question

599
00:35:42,840 --> 00:35:46,480
Speaker 15: which products and services actually help versus those cashing in

600
00:35:46,560 --> 00:35:47,279
Speaker 15: on confusion.

601
00:35:47,840 --> 00:35:51,000
Speaker 11: We developed a report on the biggest domet needs in

602
00:35:51,040 --> 00:35:54,200
Speaker 11: women's health last year and established a three hundred and

603
00:35:54,280 --> 00:35:56,480
Speaker 11: sixty billion dollar ghost market.

604
00:35:56,600 --> 00:36:00,680
Speaker 15: For carly Saper. The opportunity is clear. Menopause often hits

605
00:36:00,760 --> 00:36:03,720
Speaker 15: during women's peak earning years, driving more than one hundred

606
00:36:03,760 --> 00:36:07,520
Speaker 15: and fifty billion dollars in global productivity losses and underscoring

607
00:36:07,600 --> 00:36:09,920
Speaker 15: one of the biggest white spaces in women's health.

608
00:36:10,360 --> 00:36:14,359
Speaker 11: The market for menopause is specifically a huge market. There's

609
00:36:14,520 --> 00:36:18,560
Speaker 11: seventy five million women in the US today going through menopause.

610
00:36:18,840 --> 00:36:23,000
Speaker 11: Just by comparison, there's only four hundred thousand IVF cycles

611
00:36:23,000 --> 00:36:25,520
Speaker 11: in the US today. And that doesn't mean IVF is

612
00:36:25,520 --> 00:36:28,080
Speaker 11: a bad place to invest. It just means the solutions

613
00:36:28,440 --> 00:36:31,080
Speaker 11: have to be relatively expensive for the market size to

614
00:36:31,120 --> 00:36:34,600
Speaker 11: be venture backable, whereas in menopause, even a relatively low

615
00:36:34,760 --> 00:36:37,920
Speaker 11: cost solution, if it's effective, can have a venture outcome.

616
00:36:39,000 --> 00:36:42,520
Speaker 15: For Nailmi Watts, that market gap started as something very personal.

617
00:36:42,840 --> 00:36:45,680
Speaker 15: At the age of thirty six, the Oscar nominated actress

618
00:36:45,760 --> 00:36:48,480
Speaker 15: was at the precipice of fame, starring in films like

619
00:36:48,560 --> 00:36:49,319
Speaker 15: Mulholland Drive.

620
00:36:49,360 --> 00:36:50,319
Speaker 14: I can't believe it.

621
00:36:52,000 --> 00:36:55,600
Speaker 15: I'm just so excited to be here, the Ring in

622
00:36:55,680 --> 00:36:59,200
Speaker 15: King Kong. Then she received an unexpected diagnosis.

623
00:36:59,320 --> 00:37:02,520
Speaker 14: I wasn't getting pregnant, and so I a friend said,

624
00:37:02,560 --> 00:37:04,319
Speaker 14: why didn't you go to your doctor and get a

625
00:37:04,360 --> 00:37:07,040
Speaker 14: blood panel? And I was like, what's a blood pine panel?

626
00:37:07,120 --> 00:37:08,600
Speaker 13: I really was so clueless.

627
00:37:09,680 --> 00:37:13,040
Speaker 14: She said, check your hormones, and I'm like, okay. So

628
00:37:13,160 --> 00:37:17,719
Speaker 14: my guynecologist did exactly that, and he then told me

629
00:37:17,760 --> 00:37:20,640
Speaker 14: the results were looking like I was close to menopause.

630
00:37:21,239 --> 00:37:24,360
Speaker 15: That diagnosis collided with an industry that has often treated

631
00:37:24,400 --> 00:37:26,080
Speaker 15: aging women as expendable.

632
00:37:26,520 --> 00:37:28,839
Speaker 14: There are many times you are told that you know,

633
00:37:28,880 --> 00:37:32,120
Speaker 14: you get to a certain age and you're not sexy anymore.

634
00:37:32,680 --> 00:37:35,839
Speaker 14: And this was told to me I started my career late,

635
00:37:36,080 --> 00:37:39,320
Speaker 14: and they said, you better get your skates on, because

636
00:37:39,560 --> 00:37:41,440
Speaker 14: you know you haven't got many years left. I said,

637
00:37:41,480 --> 00:37:44,239
Speaker 14: what do you mean why and they said, well, you

638
00:37:44,280 --> 00:37:48,959
Speaker 14: know it sort of all finishes at forty Why. Well,

639
00:37:49,000 --> 00:37:54,040
Speaker 14: because you're not sexy after that? Why I'm getting angrier

640
00:37:54,120 --> 00:37:56,880
Speaker 14: by the second, because you're and you might need to

641
00:37:56,880 --> 00:37:58,920
Speaker 14: bleep this unvaluable.

642
00:37:59,480 --> 00:38:02,160
Speaker 15: It would take years for Wats to speak openly about

643
00:38:02,160 --> 00:38:03,200
Speaker 15: what she was going through.

644
00:38:03,680 --> 00:38:06,840
Speaker 14: I spent a lot of time feeling the fear and

645
00:38:06,920 --> 00:38:11,000
Speaker 14: shame and panic about it, and very lonely. I tried

646
00:38:11,000 --> 00:38:15,080
Speaker 14: to connect with other women and they would sort of

647
00:38:15,160 --> 00:38:16,879
Speaker 14: laugh it off and say, oh, don't be silly, You're

648
00:38:16,920 --> 00:38:20,560
Speaker 14: not in menopause. You're far too young. So the more

649
00:38:20,600 --> 00:38:24,520
Speaker 14: I sort of tried to connect with people and not

650
00:38:24,560 --> 00:38:28,160
Speaker 14: get the reaction that I wanted, which was compassion and comfort,

651
00:38:28,360 --> 00:38:30,960
Speaker 14: it just sort of made me retreat further. It really

652
00:38:31,440 --> 00:38:35,000
Speaker 14: took ten years and probably entering into my fifties for

653
00:38:35,160 --> 00:38:38,040
Speaker 14: me to own that and say I'm in menopause.

654
00:38:38,560 --> 00:38:40,919
Speaker 15: I need help. Why do you think menopause has become

655
00:38:40,960 --> 00:38:44,720
Speaker 15: a consumer category now in the mid twenty twenties.

656
00:38:44,840 --> 00:38:47,000
Speaker 13: I think it's in large part thanks to women like

657
00:38:47,120 --> 00:38:50,200
Speaker 13: Naomi who have kind of come out of the shadows

658
00:38:50,280 --> 00:38:52,839
Speaker 13: and shouted from the rooftop and said no more.

659
00:38:53,239 --> 00:38:57,000
Speaker 15: Wells eventually turned her experience into Stripes, a wellness platform

660
00:38:57,040 --> 00:39:00,399
Speaker 15: aimed at women in perimenopause and menopause where I came

661
00:39:00,440 --> 00:39:03,319
Speaker 15: inev is the CEO of Stripes. How to build a

662
00:39:03,520 --> 00:39:08,800
Speaker 15: women's wellness brand that empowers women without monetizing on everything

663
00:39:08,840 --> 00:39:09,960
Speaker 15: that they might be feeling.

664
00:39:10,239 --> 00:39:12,040
Speaker 13: This is a pro aging brand and it was born

665
00:39:12,080 --> 00:39:16,000
Speaker 13: that way. It wasn't changed to be that because it

666
00:39:16,040 --> 00:39:18,920
Speaker 13: became trendy. This was born out of like a very

667
00:39:19,160 --> 00:39:23,439
Speaker 13: personal moment of like I need care, I'm not getting care.

668
00:39:24,120 --> 00:39:26,760
Speaker 13: And at the same time, we don't want to change

669
00:39:26,760 --> 00:39:28,839
Speaker 13: who women are and we don't want to lie to them.

670
00:39:28,960 --> 00:39:31,320
Speaker 13: We do see a lot of kind of legacy brands

671
00:39:31,360 --> 00:39:34,840
Speaker 13: in the industry who are changing tune. You know, for years,

672
00:39:34,880 --> 00:39:38,520
Speaker 13: all of the products said erase time, turn back the cloth.

673
00:39:38,840 --> 00:39:41,719
Speaker 13: They call these age spots or the ads had you know,

674
00:39:41,760 --> 00:39:44,520
Speaker 13: twenty five year old women and they were purporting to

675
00:39:44,800 --> 00:39:47,719
Speaker 13: erase twenty five years of time, and it was just ridiculous.

676
00:39:47,880 --> 00:39:51,440
Speaker 13: That's never really been the Stripe's proposition It's about feeling

677
00:39:51,440 --> 00:39:54,120
Speaker 13: the best that you can feel, embracing where you're at,

678
00:39:54,160 --> 00:39:58,120
Speaker 13: but improving what you can, and being comfortable and confident

679
00:39:58,160 --> 00:39:59,320
Speaker 13: and happy and supported.

680
00:40:00,000 --> 00:40:02,319
Speaker 15: This is just one company in a menopause market that

681
00:40:02,400 --> 00:40:05,400
Speaker 15: is getting more crowded by the day. Even so, investment

682
00:40:05,440 --> 00:40:08,640
Speaker 15: dollars in women's health barely register. Of the almost two

683
00:40:08,680 --> 00:40:11,759
Speaker 15: point nine trillion dollars in funding that investors plowed into

684
00:40:11,800 --> 00:40:14,239
Speaker 15: the healthcare sector in the first half of the decade,

685
00:40:14,480 --> 00:40:17,800
Speaker 15: women's health companies received less than one percent of the total.

686
00:40:18,960 --> 00:40:22,719
Speaker 15: As the metopause economy expands with new products and increased visibility,

687
00:40:23,120 --> 00:40:25,720
Speaker 15: who is setting the standard for what actually works?

688
00:40:27,280 --> 00:40:30,239
Speaker 16: It should be American physicians in the medical community and

689
00:40:30,320 --> 00:40:33,520
Speaker 16: number two, the FDA, which has a very distinct role

690
00:40:34,040 --> 00:40:38,200
Speaker 16: mandated by Congress to ensure that if a product makes

691
00:40:38,239 --> 00:40:42,360
Speaker 16: a medical claim about improving your health, that that claim

692
00:40:42,400 --> 00:40:43,640
Speaker 16: has to be supported by data.

693
00:40:44,000 --> 00:40:47,200
Speaker 15: Marty McCarey served as FDA Commissioner from March twenty twenty

694
00:40:47,200 --> 00:40:50,080
Speaker 15: five to May twenty twenty six. The former surgeon and

695
00:40:50,120 --> 00:40:53,640
Speaker 15: professor began his tenure at the FDA intent on reversing

696
00:40:53,760 --> 00:40:57,600
Speaker 15: long held medical dogma around the risks of hormone replacement therapy.

697
00:40:57,800 --> 00:41:01,799
Speaker 15: That reversal became official last Novemas. I'm curious about the

698
00:41:01,840 --> 00:41:05,640
Speaker 15: overall history of HRT. What were the early days of HRT?

699
00:41:05,960 --> 00:41:11,279
Speaker 16: Like it was extremely popular. Women were experiencing the life

700
00:41:11,440 --> 00:41:15,879
Speaker 16: changing benefits in terms of their health, living longer, and

701
00:41:15,920 --> 00:41:18,320
Speaker 16: feeling better with hormone replacement therapy.

702
00:41:18,600 --> 00:41:20,840
Speaker 11: In two thousand and two, a study came out linking

703
00:41:21,080 --> 00:41:26,240
Speaker 11: HRT to breast cancer, stroke, and blood clots. The number,

704
00:41:26,280 --> 00:41:28,960
Speaker 11: of course, fell from forty percent of women using HRT

705
00:41:29,440 --> 00:41:32,280
Speaker 11: down to about four percent in the mid twenty tens.

706
00:41:32,600 --> 00:41:34,600
Speaker 16: As long as I've been in medicine, I've heard this

707
00:41:35,080 --> 00:41:38,320
Speaker 16: dog by this dictum that women should avoid hormone replacement

708
00:41:38,360 --> 00:41:42,400
Speaker 16: therapy after they go through menopause. Researchers said that a

709
00:41:42,440 --> 00:41:46,440
Speaker 16: study claimed that there was an increased risk of breast cancer,

710
00:41:46,920 --> 00:41:49,600
Speaker 16: suggesting that a woman had an increased risk of dying

711
00:41:49,600 --> 00:41:53,319
Speaker 16: of breast cancer. Turns out the study didn't really represent

712
00:41:53,719 --> 00:41:56,840
Speaker 16: the opportunity that women have to benefit from hormone therapy.

713
00:41:57,160 --> 00:42:00,920
Speaker 16: But regardless, the FDA piled on with some skin warnings

714
00:42:00,960 --> 00:42:04,080
Speaker 16: in two thousand and three, and so for the last

715
00:42:04,120 --> 00:42:07,440
Speaker 16: twenty two years before we tackled this at the FDA.

716
00:42:08,120 --> 00:42:11,680
Speaker 16: Women had been talked out of it, but the mantra

717
00:42:11,840 --> 00:42:14,200
Speaker 16: that women should avoid it at all costs took on

718
00:42:14,239 --> 00:42:17,440
Speaker 16: a life of its own and sadly scared away a

719
00:42:17,600 --> 00:42:21,799
Speaker 16: generation of women. Some call it the Lost Generation, approximately

720
00:42:21,880 --> 00:42:25,880
Speaker 16: fifty million women over twenty three years who were denied,

721
00:42:26,000 --> 00:42:30,440
Speaker 16: talked out of, or never offered hormone replacement therapy because

722
00:42:30,480 --> 00:42:33,319
Speaker 16: of that dogma in the field. I consider it to

723
00:42:33,360 --> 00:42:36,799
Speaker 16: be one of the greatest mistakes of modern medicine. The

724
00:42:36,840 --> 00:42:38,320
Speaker 16: FDA is taking action.

725
00:42:38,320 --> 00:42:40,959
Speaker 15: So during his brief tenure, McCarry took a major step

726
00:42:41,000 --> 00:42:41,839
Speaker 15: towards fixing this.

727
00:42:42,280 --> 00:42:45,920
Speaker 16: I immediately convened experts and tackled this issue, and we

728
00:42:46,040 --> 00:42:50,160
Speaker 16: told women the truth nationwide. We removed black box warnings

729
00:42:50,200 --> 00:42:53,320
Speaker 16: that were not supported by the data, and we described

730
00:42:53,360 --> 00:42:57,520
Speaker 16: the profound short term and long term health benefits that

731
00:42:57,760 --> 00:42:59,680
Speaker 16: ultimately are good for public health.

732
00:43:00,080 --> 00:43:03,359
Speaker 11: There's a lot of relief because so many women who

733
00:43:03,520 --> 00:43:06,520
Speaker 11: are experiencing the symptoms are really relying on the FDA

734
00:43:06,680 --> 00:43:09,080
Speaker 11: to tell them if they should be taking HRT or

735
00:43:09,320 --> 00:43:11,720
Speaker 11: are not now going to see that they should access

736
00:43:11,840 --> 00:43:13,840
Speaker 11: HRT and have the care that they deserve.

737
00:43:13,880 --> 00:43:17,000
Speaker 15: A need under McCarey. The FDA's move helped to advance

738
00:43:17,000 --> 00:43:21,280
Speaker 15: a medical conversation stunted by stigmatization over the past two decades.

739
00:43:21,800 --> 00:43:25,759
Speaker 15: Just in the past five years, progesterone containing HRT prescriptions

740
00:43:25,760 --> 00:43:28,520
Speaker 15: for women aged forty five and older have more than

741
00:43:28,560 --> 00:43:32,080
Speaker 15: tripled and prescribing rates have increased more than nineteen percent

742
00:43:32,239 --> 00:43:33,960
Speaker 15: since the FDA's label change.

743
00:43:34,320 --> 00:43:37,040
Speaker 16: And in the past, this was a taboo topic. Women

744
00:43:37,120 --> 00:43:39,040
Speaker 16: would be embarrassed to talk about it. If they brought

745
00:43:39,040 --> 00:43:42,120
Speaker 16: it up with their doctor, they would sort of be dismissed.

746
00:43:42,600 --> 00:43:45,879
Speaker 16: And now you're seeing a national conversation emerged where very

747
00:43:45,920 --> 00:43:50,080
Speaker 16: respected leaders around the world are saying, look, when I

748
00:43:50,160 --> 00:43:52,840
Speaker 16: go through menopause in the next few years, this is

749
00:43:52,880 --> 00:43:56,200
Speaker 16: what I intend to do, or this has changed my life.

750
00:43:56,680 --> 00:43:59,080
Speaker 15: The FDA's actions may be helping to remove some of

751
00:43:59,120 --> 00:44:02,080
Speaker 15: the stigma of mentopol but the healthcare industry has to

752
00:44:02,120 --> 00:44:05,920
Speaker 15: catch up in preparing professionals to address women's changing needs.

753
00:44:06,520 --> 00:44:10,719
Speaker 11: Only twenty percent of residency programs in the US have

754
00:44:10,880 --> 00:44:14,719
Speaker 11: a formal menopause track, so we're seeing that providers are

755
00:44:15,000 --> 00:44:18,160
Speaker 11: lacking education on how to treat women going through menopause.

756
00:44:18,560 --> 00:44:21,360
Speaker 11: This is a huge gap that allows for innovation to

757
00:44:21,400 --> 00:44:24,080
Speaker 11: come in by democratizing access to metopause care.

758
00:44:24,280 --> 00:44:27,520
Speaker 12: There are very few people trained in the science and

759
00:44:27,600 --> 00:44:31,800
Speaker 12: medicine of midlife care for women, and essentially they treat

760
00:44:31,840 --> 00:44:35,080
Speaker 12: you the wrong way. So the opportunity that I saw

761
00:44:35,360 --> 00:44:39,680
Speaker 12: was to create a company that would give great women's

762
00:44:39,719 --> 00:44:43,920
Speaker 12: health care focusing on hormones to women covered by insurance,

763
00:44:43,960 --> 00:44:45,920
Speaker 12: because it shouldn't be that you have to go to

764
00:44:45,920 --> 00:44:48,399
Speaker 12: a concierge doctor like I did and pay fifteen hundred

765
00:44:48,440 --> 00:44:49,960
Speaker 12: dollars in order to get this care.

766
00:44:50,400 --> 00:44:53,640
Speaker 15: That idea became midi Health, a telehealth company started by

767
00:44:53,719 --> 00:44:57,400
Speaker 15: Joanna Strober focused on midlife women's healthcare. It reached a

768
00:44:57,480 --> 00:45:01,000
Speaker 15: one billion dollar valuation back in February, the first menopause

769
00:45:01,000 --> 00:45:01,879
Speaker 15: company to do so.

770
00:45:02,160 --> 00:45:05,920
Speaker 12: I was around in my late forties. I was suffering

771
00:45:05,960 --> 00:45:11,240
Speaker 12: from anxiety and heart issues and gaining weight all the things.

772
00:45:11,760 --> 00:45:14,880
Speaker 12: I went to a primary care provider, and that primary

773
00:45:14,920 --> 00:45:18,400
Speaker 12: care provider sent me to therapy. They gave me a

774
00:45:18,440 --> 00:45:22,240
Speaker 12: sleep test and said that I had perhaps sleep apnea.

775
00:45:22,760 --> 00:45:27,360
Speaker 12: They also gave me an anti depression medication. So I eventually,

776
00:45:27,400 --> 00:45:31,040
Speaker 12: after about a year, found a concierge doctor who was

777
00:45:31,120 --> 00:45:34,480
Speaker 12: specialist in women's health, and within two weeks she cleared

778
00:45:34,560 --> 00:45:37,080
Speaker 12: up all of the issues that I was experiencing. We're

779
00:45:37,160 --> 00:45:39,480
Speaker 12: sending people to get colonoscopies, we're sending people to get

780
00:45:39,480 --> 00:45:43,480
Speaker 12: blood tests, but we're basically creating a care layer of

781
00:45:43,560 --> 00:45:47,040
Speaker 12: expert women's health providers. None of that requires in person.

782
00:45:47,080 --> 00:45:48,080
Speaker 12: It can all be done online.

783
00:45:48,120 --> 00:45:51,479
Speaker 15: How do you separate durable medical demand from the hype

784
00:45:51,480 --> 00:45:53,200
Speaker 15: and the excitement that surrounds menopause?

785
00:45:53,440 --> 00:45:55,520
Speaker 12: Thirty five and sixty five is one of the biggest

786
00:45:55,560 --> 00:45:58,680
Speaker 12: care gaps that we have. Essentially, there's a lot of

787
00:45:58,680 --> 00:46:01,400
Speaker 12: focus on babies and then there's a lot of focus

788
00:46:01,480 --> 00:46:04,560
Speaker 12: on geriatric care, and we have this huge gap of

789
00:46:04,640 --> 00:46:07,600
Speaker 12: care in between. And what people have realized is that

790
00:46:07,640 --> 00:46:10,840
Speaker 12: this gap of women has been dramatically underserved.

791
00:46:10,880 --> 00:46:14,600
Speaker 15: What do investors misunderstand about menopause and how do you

792
00:46:14,600 --> 00:46:17,160
Speaker 15: think that that's evolved or changed over the years.

793
00:46:17,600 --> 00:46:20,200
Speaker 12: So I think there's a perspective that menopause is a

794
00:46:20,239 --> 00:46:22,239
Speaker 12: moment and you're going to take care of people in

795
00:46:22,280 --> 00:46:26,440
Speaker 12: that moment. But we've learned that menopause care is it's

796
00:46:26,480 --> 00:46:30,240
Speaker 12: both symptoms and preventive care. For a thirty year period,

797
00:46:30,239 --> 00:46:32,560
Speaker 12: of time. So women might come to us in their

798
00:46:32,560 --> 00:46:35,160
Speaker 12: thirties having had a baby and their hair is falling

799
00:46:35,200 --> 00:46:37,719
Speaker 12: out and they're having some anxiety. They come to us

800
00:46:37,719 --> 00:46:41,120
Speaker 12: in their forties because they're having symptoms of perimenopause and menopause.

801
00:46:41,120 --> 00:46:44,640
Speaker 12: They're not sleeping, they're having anxiety. And then in their fifties,

802
00:46:44,680 --> 00:46:47,800
Speaker 12: they're worried about their bones and they're worried about cardiovascular

803
00:46:47,840 --> 00:46:50,239
Speaker 12: disease and what can I do to age healthier? So

804
00:46:50,280 --> 00:46:52,640
Speaker 12: we're finding women stir with us for one thing, and

805
00:46:52,680 --> 00:46:54,440
Speaker 12: they stay with us for many, many years.

806
00:46:54,960 --> 00:46:58,120
Speaker 15: The same conditions that make menopause a promising market also

807
00:46:58,160 --> 00:47:02,200
Speaker 15: make it a confusing one. Clinics and wellness claims multiply.

808
00:47:02,600 --> 00:47:05,080
Speaker 15: The challenge for women will be figuring out what kind

809
00:47:05,120 --> 00:47:07,880
Speaker 15: of help they can trust. There are many companies out

810
00:47:07,920 --> 00:47:11,399
Speaker 15: there claiming to treat menopause symptoms, either in the short

811
00:47:11,480 --> 00:47:13,799
Speaker 15: term or in the long term. What should women look

812
00:47:13,840 --> 00:47:17,280
Speaker 15: for in buying certain products? How do they distinguish between

813
00:47:17,320 --> 00:47:19,880
Speaker 15: something that's real versus something that just claims to do

814
00:47:19,920 --> 00:47:20,239
Speaker 15: the trick.

815
00:47:20,320 --> 00:47:22,719
Speaker 16: I think in every industry there are products out there

816
00:47:22,760 --> 00:47:26,200
Speaker 16: that just don't survive because they don't live up to

817
00:47:26,239 --> 00:47:29,440
Speaker 16: the claims. Look for the FDA brand. It's one of

818
00:47:29,440 --> 00:47:31,520
Speaker 16: the greatest brands in the world, and product does not

819
00:47:31,600 --> 00:47:33,840
Speaker 16: have that brand. I'd run it by your doctor.

820
00:47:35,600 --> 00:47:37,359
Speaker 1: That does it for us. Here at Wall Street Week,

821
00:47:37,600 --> 00:47:40,680
Speaker 1: I'm David Weston. See you next week for more stories

822
00:47:40,800 --> 00:47:55,400
Speaker 1: of capitalism.