Can Smaller AI Startups Compete in the AI Race?

Summary

On with Kara Swisher: Can Smaller AI Startups Compete in the AI Race?

Podcast Information:

• Title: On with Kara Swisher
• Host: Kara Swisher, Vox Media
• Episode: Can Smaller AI Startups Compete in the AI Race?
• Release Date: May 26, 2025

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In the May 26, 2025 episode of "On with Kara Swisher," award-winning journalist Kara Swisher delves into the burgeoning landscape of artificial intelligence (AI) and the viability of smaller AI startups in an industry increasingly dominated by tech giants like OpenAI, Microsoft, and Google. Joining her are two esteemed guests: Gary Rivlin, a Pulitzer Prize-winning investigative reporter and author of AI Valley, and Christy Weiskill, Senior Advisor for Innovation and Entrepreneurship at Johns Hopkins University. Recorded live at the Johns Hopkins University Bloomberg Center, the episode offers an insightful exploration into the dynamics shaping the AI sector today.

The AI Funding Landscape

Kara Swisher kicks off the discussion by highlighting the explosive growth in AI funding. “According to PitchBook, AI and machine learning startups took home about half of the venture capital dollars in North America last year,” she states at [00:22]. However, she points out a significant concentration of funding: “In the first quarter of 2025, $40 billion went to OpenAI,” raising concerns about the accessibility of capital for smaller startups.

Gary Rivlin echoes these sentiments, explaining that the dominance of large corporations in AI funding poses a substantial barrier for emerging companies. “AI is so expensive that there's very few startups that really can afford to be playing basic stuff like text to video, text to audio, large language models,” Rivlin remarks at [05:47]. He fears that foundational AI work will increasingly be monopolized by big tech firms, limiting innovation from smaller entities.

The Role of Universities and Fundamental Research

Christy Weiskill emphasizes the critical role that universities play in the AI ecosystem. “[...] the foundations of the tech industry actually come from a lot of the work that happens at universities,” she explains at [07:49]. Weiskill underscores that institutions like Johns Hopkins are pivotal in translating academic research into marketable technologies, particularly in life sciences and healthcare.

Rivlin adds a historical perspective, noting the cyclical nature of AI funding and research: “In the 50s, 60s, it was government-funded research. [...] My big fear is, you know, the Chinese have said by 2030 they want to be dominant in AI and if we're cutting off this basic research, I think we're giving them a big advantage,” he warns at [08:58]. This highlights the geopolitical stakes tied to AI research and development.

Regional Differences: Silicon Valley vs. Baltimore

The conversation shifts to the geographic concentration of AI innovation. Christy Weiskill discusses efforts to position Baltimore as a tech hub comparable to Silicon Valley. “[...] Johns Hopkins and Baltimore will not dominate that. We already are,” she asserts at [16:36]. However, she acknowledges the challenges faced by regional startups in securing funding and scaling their innovations amidst the dominance of established tech centers like San Francisco.

Gary Rivlin concurs, pointing out the migration of venture capital to San Francisco: “[...] OpenAI anthropic. A lot of the other big AI companies are in San Francisco. The venture capitalists used to famously be all in Menlo Park. They now have outposts in San Francisco,” he notes at [12:03]. This centralization further marginalizes smaller startups outside these primary hubs.

AI's Impact on Life Sciences and Healthcare

A significant portion of the discussion centers on the intersection of AI and life sciences, where AI holds transformative potential. Weiskill highlights specific applications such as early cancer detection and predictive diagnostics: “Imagine a world where you could just, with a simple algorithm, detect pancreatic cancer,” she illustrates at [24:35]. These advancements promise not only improved quality of life but also life-saving medical interventions.

Rivlin acknowledges the optimism surrounding AI in healthcare but cautions against overhyping its capabilities. “I am totally with both you that AI and healthcare is gonna be extraordinary for humanity. But why do you have to say it's gonna wipe out cancer in 10 years?” he questions at [21:17]. This balance between potential and realism is crucial in shaping public and investor expectations.

The Hype and Reality of AI

Kara Swisher and her guests address the pervasive hype surrounding AI, particularly the exaggerated claims made by techno-optimists. Rivlin criticizes the overpromising narratives, stating, “It's like this is where Silicon Valley, the tech bros get themselves in trouble. They're overhyping and AI has a problem,” at [21:18]. He argues that such hyperbole can lead to unrealistic expectations and potential backlash against AI technologies.

Moreover, Rivlin expresses concerns about public perception and regulatory lag, “Pew did a poll. The majority of people are fearful of AI,” he notes at [22:04]. He emphasizes the need for regulated and transparent AI development to align technological advancements with societal norms and safety.

Future Prospects and Policy Recommendations

As the episode nears its conclusion, the focus shifts to the future trajectory of AI and the policies needed to foster a healthy innovation ecosystem. Both Rivlin and Weiskill advocate for strategic government support and thoughtful regulation to sustain fundamental research and prevent the monopolization of AI advancements by a few large corporations.

Rivlin stresses the importance of regulatory frameworks that ensure AI development is both responsible and inclusive: “We could put in some pretty modest regulations that make sure that the general public is there with these AI companies,” he suggests at [37:09]. Weiskill complements this by highlighting the necessity of maintaining robust federal funding for university research, which is the bedrock of sustained AI innovation.

Conclusion

Kara Swisher wraps up the episode by reiterating the critical balance needed between fostering innovation and managing the consolidation of power within the AI industry. “On with Kara Swisher is produced by Christian Castor, Russell, Kateri Yocomb, Dave Shaw, Megan Burney, Megan Cunane and Kaitlyn Lynch,” she concludes, emphasizing the collective effort to navigate the promise and peril of AI.

Key Takeaways:

• Funding Concentration: A significant portion of AI venture capital is being funneled into large players like OpenAI, potentially stifling smaller startups.
• Foundation of Research: Universities remain pivotal in AI innovation through foundational research, especially in life sciences and healthcare.
• Geographical Hubs: Efforts to establish regional tech hubs outside Silicon Valley, such as Baltimore, face challenges amid centralized venture capital dynamics.
• Realistic Optimism: While AI holds transformative potential, especially in healthcare, overhyping its capabilities can lead to public distrust and unrealistic expectations.
• Policy and Regulation: Thoughtful government policies and sustained funding for research are essential to ensure balanced and inclusive AI development.

This episode provides a comprehensive overview of the current state of the AI industry, highlighting both the immense opportunities and the significant challenges faced by smaller startups in a landscape increasingly dominated by established tech giants. By integrating expert insights from industry veterans and academic leaders, Kara Swisher effectively captures the multifaceted nature of the AI race and its implications for future innovation.

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Notable Quotes:

• Gary Rivlin on AI funding concentration: “AI is so expensive that there's very few startups that really can afford to be playing basic stuff like text to video, text to audio, large language models.” [05:47]

• Christy Weiskill on the role of universities: “The foundations of the tech industry actually come from a lot of the work that happens at universities.” [07:49]

• Gary Rivlin on overhyping AI: “They’re overhyping and AI has a problem.” [21:18]

• Christy Weiskill on AI’s potential in healthcare: “Imagine a world where you could just, with a simple algorithm, detect pancreatic cancer.” [24:35]

• Gary Rivlin on the importance of regulation: “We could put in some pretty modest regulations that make sure that the general public is there with these AI companies.” [37:09]

Transcript

[Kara Swisher]

I just heard a really good joke. I have to tell it. TechPro stands for technically Broken. You like that Gary?

[Gary Rivlin]

I do.

[Kara Swisher]

Hi everyone from New York Magazine and the Vox Media Podcast network. This is on with Kara Swisher. And I'm Kara Swisher. As we talked about on the show last week, the AI boom hasn't slowed down. According to PitchBook, AI and machine learning startups took home about half of the venture capital dollars in North America last year. Globally it was about a third. It add up to more than $131 billion so far this year. AI is still the top sector for venture funding, but a huge chunk of the VC funding in the first quarter of 2025, $40 billion went to OpenAI. So the question is, is there still room for smaller, more focused startups in this AI gold rush, or is everyone just placing their bets on the big guys? My guests today are two people who've been following the story on the ground, so to speak. Gary Rivlin is a Pulitzer Prize winning investigative reporter who has been writing about technology since the mid-1990s. He has written 11 books including his latest AI Valley, Microsoft, Google and the Trillion Dollar Race to Cash in on Artificial Intelligence. It follows the rise of inflection AI and why, despite deep pocketed funding, much of the team, including leadership, was eventually assimilated into Microsoft. My second guest, Christy Weiskill, is the Senior Advisor to the President of Johns Hopkins University for Innovation and Entrepreneurship. She oversees Johns Hopkins Technology Ventures where she helps students and researchers launch their academic discoveries to the private sector through industry partnerships, technology licensing and startup company incubation. Our live interview was recorded on April 28 at the Johns Hopkins University Bloomberg center as part of their inaugural Discovery series. It was a great conversation, says a lot about the state of the industry today and where it's going tomorrow. Have a listen.

[Gary Rivlin]

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[Kara Swisher]

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[Kara Swisher]

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[Christy Weiskill]

Support for the show comes from the aclu. The Trump administration is pushing a dangerous and sweeping agenda to control our bodies, our families and our lives. President Trump has sign far reaching executive orders that target transgender people their rights and their healthcare. But the ACLU and their partners are in court fighting back. Meanwhile, the ACLU is also at the Supreme Court fighting for the future of transgender people's freedom and bodily autonomy for all. US V. Scormetti centers on a Tennessee law restricting healthcare access for trans youth. Tennessee has asked the Supreme Court to expand the ruling that overturned Roe vs. Wade to allow it. The fights for abortion and trans healthcare are connected. Learn [e-mail] autonomy avoiding your unfinished home projects because you're not sure where to start.

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[Kara Swisher]

It is on Christy, I just met you, but Gary and I go back before we had kids and everything else. At the dawn of the Internet age.

[Gary Rivlin]

He wrote a book, the Plot to Get Bill Gates.

[Kara Swisher]

The Plot to Get Bill Gates. We were on a book tour with Poe Bronson, who wrote Nudists on the Late Shift, and I had the paper rack version of aol.com and it was literally the dawn of the information age. And John Karp, who's now running Simon and Schuster at the time, had this genius idea to send us on a tour around the country called the Bleeding Edge Tour.

[Gary Rivlin]

The Silicon Valley Bleeding Edge Tour.

[Kara Swisher]

Right. And so I was there to say this was a great moment and huge fortunes would be created. It turns out I was right. He was there to be sort of the contrarian. Right. Is that.

[Gary Rivlin]

Sure. I'd point out that a lot of fortunes were lost and then eventually a few people made big fortunes. Right?

[Kara Swisher]

That's correct. So. And then Po Bronson was there to be super earnest and we had the best time and we went all around the country talking about this new Internet and it was so weird to think about what's happened since. In any case, we were young then and so naive, but not really. He was never naive. He was sort of a pain in the ass everywhere we went. But anyway, it was.

[Gary Rivlin]

But the feeling was mutual, and I think it was.

[Kara Swisher]

You were doubtful. Yes, exactly. So anyway, you've come out with a book about the current makers of money around the AI sector. You're one of many. I've just been delivered three or four, mostly about OpenAI. Actually. Yours is called AI, Microsoft, Google, and the Trillion Dollar raise to cash in on artificial intelligence. Well timed. Christy, you oversee Johns Hopkins Technology Ventures, which means you're responsible for shepherding university from the lab to the private sector, including in AI. Both of you had a front row seat to the growing sector and a broadcast of characters. Researchers, founders, entrepreneurs, incubators, VCs, and also these big tech billionaires. A lot of drama. So to start off, can you describe the interplay between these characters and the relationships, this new field? Where's the most tension, affinity? Who do you relate to the most? Why don't you start, Gary?

[Gary Rivlin]

So, you know, it's interesting. I've always loved startups, venture capital startups, the gambling, that whole ecosystem. So when end of 2022, I said, wow, this AI thing is going to be a big deal. So I wonder what startups are figuring out how to cash in on this moment. And so I wanted to go find what's the next Google, what's the next Facebook. And unfortunately what I found is the next Google is probably Google when it comes to AI. And the next Facebook or Meta is going to be meta that there's still all this opportunity to create nice in quotes, modest businesses, tens of millions, hundreds of millions of dollars. But the next Google foundational companies that will be eventually worth a trillion dollars. AI is so expensive that there's very few startups that really can afford to be playing, you know, basic stuff like text to video, text to audio, large language models. I really fear is going to be the stuff of the large corporate. Yes.

[Kara Swisher]

Which is something I've talked about a lot. This is a sphere of mine, is that this is not the same thing that when you and I were first, these were a lot of startups you never heard of, never heard of Uber, you never heard of Instagram. They were real groundbreakers in this case. It's too costly. And also these companies have so much sway over compute that it's hard. Chris.

[Gary Rivlin]

And the data. And the data, they have access to the data, which is the new gold, right?

[Unnamed Guest]

Yeah. Well, I love talking about startups. I was an investor and entrepreneur for a long time and we spin out about 10 new companies out of Hopkins research every year. But I think what people don't necessarily realize is that the foundations of the tech industry actually come from a lot of the work that happens at universities that's not acknowledged. Think about how many of you actually got here by typing something into Google Maps or Apple Maps today, or your Uber or Lyft or whatever that foundational research of gps. People don't necessarily Realize or acknowledge that actually came from Hopkins researchers understanding Doppler satellite data 50 years ago and eventually in the 80s was allowed in the public domain and here we are using it every day. And so the origins of so many of these tech companies come from what we're doing before.

[Kara Swisher]

Before, meaning the early tech. Yes, Stanford or whatever, but it's less and less. So that's been.

[Unnamed Guest]

I disagree. I think if you think about where so much of the technology continues to. Not like when OpenAI was founded 10 years ago that Sam and Elon woke up and magically thought of AI, that was over decades and decades of research. And I think you're continuing to see that the types of faculty and students that are learning and training at places like Hopkins, but all over they are bringing those nest technologies to market whatever the next GPS is in the next decade.

[Gary Rivlin]

I think what you were trying to say is what's scary to so many of us, what must be scary to Silicon Valley, even if the leaders are being quiet about it, is cutting off basic research to universities. Research for foundational exploratory research is so short sighted. That's our magic formula in this country. That's our secret sauce. You know, AI in the 50s, the 60s, the 70s, the 80s, it was government funded research. And you know, my big fear is, you know, the Chinese have said by 2030 they want to be dominant in AI and if we're cutting off this basic research, I think we're giving them a big advantage.

[Unnamed Guest]

Yeah, Christy, look, I agree. I think that to quote my former colleague David Singer, who just had an article this week, he's in the New York Times. In the New York Times said drawing a causal link between federal investment and basic science research and the rise of VC industry is about as difficult as reading a map. And so those connections are happening then, now and in the future. And Whether it's the AI winter that you described in your book from the 70s and 80s, when governments stopped funding research into AI, the research stopped. The same thing could happen now. And it's just really important for us to acknowledge that.

[Kara Swisher]

Right, so talk a little bit. Chris, you play actually some of these roles, as you said, investment analysts in the 2010s, you co founded your own biotech startups and 12 years ago you started this. Now a lot of universities have these. What was it like to start that a dozen years ago? Because Stanford was already pretty active. Certain universities had already moved in that way. Stanford probably is the most famous. It's gearing up.

[Unnamed Guest]

Yeah, Stanford, MIT, a number of universities have a 50 year head start, basically to what? This is when the Dean of engineering at Stanford looked out at Palo Alto and said, there's a field, we should probably put a research park there. And some of the first inhabitants of that research park were Mr. Hewlett and Mr. Packard. Right. They have the head start. Hopkins has always been around the foundational basic research. But I was hired to be a bit of a disruptor 12 years ago to come in and think about how could we commercialize the incredible things that come out of Johns Hopkins. So that's the mission. I wake up every day and do that.

[Kara Swisher]

So, Gary, in your book, you write about the early iterations. You and I have talked about this many times as Silicon Valley. Obviously Stanford is the unique role in that area. Noted. Google began also as a graduate student project there. Talk about sort of early research and incubator programs.

[Gary Rivlin]

Right. So dating back to the 50s, 60s, it was the students on the campuses, it was the professors who were giving rise to these companies. So in the 1980s, there were all these companies blooming around Stanford, MIT, few other universities that were doing cutting edge AI research. And actually a few of them went public. They didn't last. There was a second AI winter after that, and that one was a little bit different because in the 80s it was companies and it was venture capitalists that temporarily got into it. They were burned. And then it really wouldn't be until 2015, 2018, where the pioneering VCs were finally daring to put money into AI. Back then it would have been autonomous vehicles. But that's, that's the Silicon Valley way. That's what I love about Silicon Valley. You say Stanford, to me, it's just a startup machine. The whole place is almost built to create startups. You've got Stanford, which gives rise. You've got UC Berkeley, which gives rise. But the venture capital is out there and there's this whole ecosystem of startups.

[Kara Swisher]

To venture capitalists, to wealth to try and.

[Gary Rivlin]

Right, right. And you know, there's almost like this mindset, like, why aren't you starting a company? They're hiring people from a Google or.

[Kara Swisher]

Meta and it's extinct still today. That's the case, yeah. I mean, yeah, well, in AI, it certainly is. It's in San Francisco now.

[Gary Rivlin]

Right. So one big difference between the 90s, when we were starting off reporting and today is the center of gravity has moved from Silicon Valley to San Francisco. It's not a coincidence. OpenAI anthropic. A lot of the other big AI companies are in San Francisco. The venture capitalists used to famously be all in Menlo Park. They now have outposts in San Francisco. And again, I don't want to give the wrong idea. There's going to be a gazillion startups that have nice returns for venture capital capitalist, nice returns for the founders. It's more that stuff that's the innovation, the real innovation, the stuff underneath. So there'll be apps on top of these foundational models, the basic stuff. But I really do fear that maybe OpenAI will break in, maybe Anthropic will break in. That's Claude the LLM. But I actually think there's a pretty good chance, given how much money they still have to raise long before they'll ever show profit, that they'll just get bought up by a giant. And by the way, what's interesting is Google could lose like Gemini. Their chatbot doesn't win, but they've invested billions of dollars in Anthropic. Microsoft and their copilot could lose, but they put what, 15 billion or so into OpenAI. So even if they lose, they win.

[Kara Swisher]

Correct? We'll be back in a minute.

[Christy Weiskill]

Support for the show comes from the aclu. The Trump administration is pushing a dangerous and sweeping agenda to control our bodies, our famil families and our lives. President Trump has signed far reaching executive orders that target transgender people, their rights and their healthcare. But the ACLU and their partners are in court fighting back. Meanwhile, the ACLU is also at the Supreme Court fighting for the future of transgender people's freedom and bodily autonomy for all. US V. Scormetti centers on a Tennessee law restricting health care access for trans youth. Tennessee has asked the Supreme Court to expand the ruling that overturned Roe vs. Wade to allow it. The fights for abortion and trans healthcare are connected. Learn [e-mail] autonomy support for this podcast.

[Gary Rivlin]

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[Kara Swisher]

So, Christy, part of your mission is to make Baltimore itself a tech hub. And like Silicon Valley or Boston, it's really Silicon Valley and everybody else goes down pretty far. As Gary writes in the book, Silicon Valley is both a place and idea. Baltimore was one of the 31 federal tech hubs. It was skipped over in the first two funding rounds. Who knows what's gonna happen now? But talk about this idea. You know, when they had Silicon beach, they had Silicon Prairie, they had Silicon Holler. I would be like, no, this is not happening in any of these places. So talk a little bit about trying to do that in a. Because place does matter. Even in a digital world, place does matter.

[Unnamed Guest]

Yeah. No, I think it does. And look at Johns Hopkins, one of the things that we are known for is biomedical research. A lot of the basic foundation models. You can look back to Bert Vogelstein, who several decades ago discovered the genetic basis for cancer. And since then, we have built on all sorts of therapies and diagnosis. What is the future of drug discovery? It's going to be AI. And we're making a huge bet. As you probably know, Kara, in AI at Johns Hopkins, the State of Science Institute, over 100 faculty, hundreds of students, who is going to train the people that are gonna work at those companies? It's going to be places like Hopkins. And so I think the types of companies that we spin out are those that are good for the world. We're not creating the seventh dog walking app. We're actually creating.

[Kara Swisher]

Why not?

[Unnamed Guest]

I mean, are the first six not good enough? I mean, really, let's.

[Kara Swisher]

Healthcare is really. Oddly enough, my next book's all about this. But the AI, its impact on healthcare is obviously one of the biggest possibilities.

[Unnamed Guest]

Yeah. My friend Alec Ross, who wrote a book, Industries of the Future, said that the last trillion dollar industry was created with the using zeros and ones. And the next trillion dollar industry will be with the four letters of DNA. And there's no reason why Johns Hopkins and Baltimore will not dominate that. We already are. We already have companies spinning out, raising billions of dollars.

[Kara Swisher]

So according to Pitchbook, just for a little fact check here, though, venture Capital investment in AI startups was up more than 50% last year over $131 billion feels bubblicious. In the first quarter of the year, they say the AI sector raised 73.1 billion. But spoiler alert, $40 billion of that went to OpenAI. Both of you talk about this, you've raised about 4.4 billion, correct? Christine?

[Unnamed Guest]

Venture capital are the total companies that have come in, Hopkins. Yeah.

[Kara Swisher]

So, Gary, first, can you talk a little bit about this fact that it's sort of coalesced around really one company, right?

[Gary Rivlin]

Well, a few. So Xai, that's Elon Musk's company, they're out there trying to raise, I think, 20 billion. So 40 billion would be. Is the largest raise ever in venture history. 20 billion would be the second largest. You know, we covered the dot com boom and bust and we're seeing some of the same things. So Ilya Sutskever, famous co founder of OpenAI, famous for initiating a coup that it lasted five days at OpenAI, but.

[Kara Swisher]

After it's called a coupet.

[Gary Rivlin]

So after he left, started his own company, Safe Superintelligence, and they raised $2 billion at paper worth of $30 billion. They don't have a product yet, but that's venture capital, right? They slap down bets really fast. Some company writes a memo, two or three promising founders write a memo, a week later, they've raised tens of millions of dollars at 100 million valuation. It's really just rolling the dice. But that's the venture capital business. Most of these will not work, but a few of them will, and when they do, they'll show extraordinary returns.

[Kara Swisher]

So, Christy, you said with these investments you're making, you co founded Upsurge Baltimore network of entrepreneurs and startups to facilitate the fundraising. Talk about that environment, because a lot of people definitely feel that there's an over investment in infrastructure and over investment in the valuations. And this isn't like the Internet because it was just an overinvestment in companies. It wasn't infrastructure, it wasn't. The costs were quite low actually here they're very high, whether it's energy or infrastructure or whatever. So the bits are slightly bigger in that regard. Not just the money, the figures. So talk a little bit about that.

[Unnamed Guest]

Yeah, I mean, 80% of what we do is in the life sciences. Again, there's a heavy overlay now with drug discovery and AI on that, but it's been a bit of a Biotech winter since 2021. So it's a little bit different. And it's also not necessarily kara about the cult of personality. It's much more about the research and what's behind it. And I would say those valuations and the money flowing there are much more down to earth. It reminds me a little bit you had Josh Johnson on your podcast. Because I'm a huge fan.

[Kara Swisher]

The famous AI researcher and comedian anyway.

[Unnamed Guest]

But he had it. He actually made a really, I thought just was really poignant about the idea that so much of our world today, the foundation of that was people who. We'll never know their names, we'll have forgotten that some of the things that we take for granted. And I feel like that's so much of the research that happens at places like Hopkins are not necessarily going to get the same hype of a big AI startup in California, but there's the level of impact that one would have. So you can get ROI and you can bring great things to market, but it doesn't necessarily have to raise 30 billion and be on the front page.

[Kara Swisher]

To do that or have to deal with egos and things like that.

[Unnamed Guest]

Hopkins is a very low ego place. I get to deal with some of the smartest, most earnest folks in the world. And at the end of the day, what they care about is the impact, not their name in the headlines.

[Kara Swisher]

Silicon Valley's got you covered for that. So still. Still after all this time, especially. Especially really. It's gotten worse, hasn't it?

[Gary Rivlin]

It's gotten much worse. Yeah, it really has.

[Kara Swisher]

Yeah, yeah. Every human growth hormone they take, it's gotten worse anyway.

[Gary Rivlin]

Allegedly. They take other stuff too. I've read, I've read.

[Kara Swisher]

Yeah, no, they say it doesn't matter. So I want to get deeper into AI, specifically the intersection of life sciences and this. Gary, you point out in your book, healthcare is the area the techno optimists and that's the term they use for people who are pro AI versus they're gonna kill us tomorrow. They often use the proof point to bolster their position that AI will change lives for the better. In a recent 60 Minutes interview, Google DeepMind CEO and Nobel laureate Demis Hababas said he believes AI has the ability to cure all diseases within the next. This is something they go on.

[Gary Rivlin]

This is the problem.

[Kara Swisher]

Okay, all right, okay, wait, okay, okay, sorry. Do you think. Talk about this. Go ahead, go ahead, go ahead, rant away. I'm sorry, allow you to rant?

[Gary Rivlin]

No, I mean this is, I would say the same about the early Internet. Like it will do extraordinary things. I am totally with both you that AI and healthcare is gonna be extraordinary for humanity. The connections it's Gonna make the vaccines, the treatments, all of that. But why do you have to say it's gonna wipe out cancer in 10 years? Which I have heard. But why do you have to say it's gonna wipe? It won't.

[Kara Swisher]

I mean, it's sort of like saying self driving is here today. Ten years ago someone said that I'm.

[Gary Rivlin]

Not going to say no, but that one I believed.

[Kara Swisher]

I really thought it's been recently unemployed from Doge, but go ahead, they're coming.

[Gary Rivlin]

No, but it's like this is where Silicon Valley, the tech bros get themselves in trouble. They're overhyping and AI has a problem. First off, they had really bad timing. AI hit at the end of 2022 when distrust among the public in big tech was at its peak. You know the terms I like to use. There's the Doomers, who are convinced that laser eyed robots are gonna take over and subjugate humanity. There's the Zoomers, who want no speed bumps. Just let us do our thing. China, China, China kind of thing.

[Kara Swisher]

They're gonna beat us.

[Gary Rivlin]

And I'm kind of more with, this is a Reid Hoffmanism, a bloomer that I think I could do extraordinary things. But let's be deliberate about it. We're way ahead of where the public is. Pew did a poll. The majority of people are fearful of AI. And you know, here we're talking about a technology where humans are going to lose their apex status. They're going to be these agents, the AI is going to be our personal assistants, these AI agents, which means they're going to know everything about us and privacy issues. Like we're getting way, way ahead. And I think the Zoomers are making a strategic error by saying, like, there should be no regulation. We should just like do everything we can to accelerate. You know, to quote our vice president, stop with the hand wringing and let's just start winning.

[Kara Swisher]

Right?

[Gary Rivlin]

And I'm just scared they're gonna get way ahead of where the public is.

[Kara Swisher]

It is interesting cause the ones who are terrified are also not so much fun at a dinner party. I was at one dinner party with a bunch of them and they were like, you need to stop Sam Altman because the human race is at risk. You need to stop him now. Kara, you're the only one. And I'm like, that's the plot of the Terminator and I am not her. Like, I have no. It was like. Like they literally were counting the plot of the Terminator to me and I had to kill him, which I didn't.

[Gary Rivlin]

I think our problem is that Hollywood is defining what we should be scared of.

[Kara Swisher]

Right.

[Gary Rivlin]

Whereas there's much more line of sight things we should, you know, AI and surveillance, AI and warfare, AI manipulating people, autonomous AI. This stuff isn't ready. Humans still have to be in the loop. That's the stuff I wish we were debating. That's the stuff I wish we were, you know, worried about and not like robots taking over.

[Kara Swisher]

Many are, but Christy, life sciences obviously is Johns Hopkins superpower. But a lot of the things I'd like to hear about them, cause they are very AI assisted tools for early detection, disease prediction. When I was with Vinod, Khosi was talking about drug interaction is something that kills a lot of people. The wrong drug interaction, obviously diagnostic tools for respiratory cancers. Where do you see the most potential?

[Unnamed Guest]

One very specific area. I can think of several. But I think within cancer diagnosis, there are 30 million CT scans done on the abdomen every single year. Imagine a world where you could just, with a simple algorithm, detect pancreatic cancer. Right? And we have researchers working on that to basically say there could be otherwise undetected pancreatic cancer. And I don't know how much you all know about that, but generally by the time it's detected, it's a death sentence. And so the idea of early detection, which again is something that a number of our researchers have been working on, because cancer develops over decades, not overnight. And so the sooner you can find it, the sooner you can treat it. Another application that we're all painful that maybe you would have appreciation of. We have a wonderful woman who's an ER doc who basically just saw parents exasperated having to bring their kids in for a strep throat test. Right?

[Kara Swisher]

So she figured out we did that yesterday. My wife did. I did not do it. My wife did it. She totally gets credit.

[Unnamed Guest]

So think about a world where you take your phone camera, take a picture of the throat and it says strep throat or not, and you get the prescription. You don't have to sit at urgent care on a Friday night, you don't have to come into the ER and wait 12 hours on a Sunday, but you basically get treated right then. So. So both of those applications, one is great quality of life, one is literally life changing, life saving. In both of those cases, those are real and happening.

[Kara Swisher]

We'll be back in a minute.

[Gary Rivlin]

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[Kara Swisher]

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[Kara Swisher]

So one of the these R and D heavy startups aren't coming just out of university is Deborah Subappos who I just mentioned co founded Isomorphic Labs. It's a division of Google spun out of DeepMind to focus on drug discovery for example. They not only have Google money, they recently raised outside VC money. This kind of internal R and D used to come from universities. Gary, what impact does it have? And Christy, how do you build them into sustainable businesses if they're destined to be bought out by tech companies or big pharma? As Acquihires, what does that look like? First you, Gary.

[Gary Rivlin]

Well, I mean, corporations have been investing in cutting edge research, Microsoft research. Google has a big research arm, IBM, for decades and decades. So that's always been going on. It is interesting. Some of the biggest venture capitalists in Silicon Valley right now are the tech companies. Microsoft in 2023 was the number one VC just by dollars given Nvidia. They invested in that, like 35 or so startups. So there is this. Some of it is. It's just so damn expensive. Like, you know, we're talking about a $40 billion raise. A large venture capital fund in Silicon Valley is $1 billion, and that's a tiny fraction of what they need to raise. And so, you know, what we're seeing is the large corporations, big tech companies, Amazon, Apple, Google, are taking over that role.

[Kara Swisher]

And Christy, what does that have this idea that how do you make a healthy AI industry if there's consolidation in this way or if the research comes out of here because they weren't gonna let it out. You want diversification, presumably to be healthy?

[Unnamed Guest]

Yeah, absolutely. Look, one of the cool things about my job is I get to be a bridge between these basic science researchers and industry and be that front door for Johns Hopkins. And so we have a lot of examples where we took things and worked really collaboratively with. There are actually a lot of good players out there. We have a drug that is for men's health. It's called Pilarify. It's for diagnosing prostate cancer. And one of our clinicians described as if you wanted to treat prostate cancer before this incredible technology came out, it was like watching black and white TV in the 1950s, and it's now Technicoler. And we licensed to a company in Boston called Lantheus. They sell it, we get royalties on it. So everybody wins. The patient wins, the company gets the growth and the roi. We're rewarded with those royalties as something that we discovered. So I think just being that natural bridge over and over, that does require care, though, that we get credit for what we've done. Right. So a lot of working with industry is maybe acknowledging that there were people that came before. There were people that built this foundation and what does that look like? And how can we be more collaborative?

[Kara Swisher]

But the idea of these acqui hires there was obviously Mustafa Suleiman with inflection. There were many AI companies started. Now, Microsoft essentially bought that company, although it wasn't looked at that way. They hired everybody.

[Gary Rivlin]

They hired virtually everybody there and then gave $650 million as a licensing deal to make everyone whole, make everyone happy. My big concern on this is, you know, this idea of consolidation of power in just a few big tech companies. The Silicon Valley way we've seen this forever, Kara, is that let's get a few smart guys and there are always guys in a room and we'll figure out AI is different. I mean first off, it's not just computer scientists, it's math, it's linguists, but where are the sociologists and philosophers? Where's there a diverse group of people like this stuff is powerful, it's reflecting humanity. We're gonna increasingly end up relying on it in everything for education, social life, business and all. And so. So that's my biggest worry, that that same mentality, Sam Altman and a few smart guys are gonna show up at his mansion in San Francisco and they'll figure it out. Cuz they're smart. Yes, they're smart, but it's more than just being smart.

[Kara Swisher]

Two more things before we have to go. The costs are so high, but deep sea had scared the crap out of everyone. This is a Chinese AM model trained for less than $6 million. That's questionable if that was actually. But they called it a Sputnik moment. If they're more efficient models, Christy, with more chips bring down the overall price of computing power. How would it impact small startups like you invest in?

[Unnamed Guest]

Well, I think there are a lot of parallels here to even the tech industry today because what, 15, 20 years ago you had to buy big servers and big computers and have all this infrastructure and now it's accessible. So I think in the same way these tools make the playing field a lot more level. And I think we'll be surprised with the level of disruption really across the board, not just in pure tech, but whether it's energy, whether it's life sciences, whether it's adjacents. I think there's a lot of room for innovation and I think it's great that the playing field will be much more level.

[Kara Swisher]

So I want to finish up with two things. One is this threat to research that we talked at the top. I'm going to ask you, Gary, I'd be happy to put you on the spot, Christy. The federal government is one of the biggest funders of university R and D. A lot of Johns Hopkins money comes from the National Institute of Health, for example, about $1 billion in fiscal 2024, more than any other institution in the U.S. a lot of the money has been canceled, not just at Johns Hopkins, but Elsewhere is in limbo. Why don't you talk about this, Gary? You can talk about it, Christy, but what is the impact right now on research at places like Johns Hopkins if the Trump administration doesn't reverse course on this?

[Gary Rivlin]

So it's the way it happened to me. It's like they bent over and unplugged the machine and just. So there's all this wasted stuff. And what really scares me, I was out in Silicon Valley a few weeks ago talking to people at Stanford and like, it's not like you could just, oh, okay, this was this four year period, now let's just revive it. I mean, that to me is the big worry that a new administration would come in is more foresighted, like, you know, thinking like this, we really need this. And it's not gonna be so easy to just like, oh, okay, well, we lost a few years, but now we're gonna go back right back to where we were.

[Kara Swisher]

How do you deal with it?

[Unnamed Guest]

Look, I think there are just a couple things I would say here. I think what the NIH has done over time with very competitive grant funding to universities and ultimately to the commercial sector, this incredible group of three sectors that came together have lowered the deaths of heart disease and stroke by 75% in the last 40 years. When I was growing up, HIV and AIDS was a death sentence. And now you can live a normal lifespan thanks to NIH research into universities, into the private sector. And so I think we want to continue that. My greatest fear is for this incredibly talented generation of scientists that are going to choose necessarily not to do that.

[Gary Rivlin]

We're.

[Unnamed Guest]

If their grant funding's cut off, if they're unable to continue their work, they'll go do something else. And what does that mean for the next decades of that type of progress?

[Kara Swisher]

Irreparable harm?

[Unnamed Guest]

I don't know.

[Kara Swisher]

What they didn't invent, we don't know.

[Unnamed Guest]

Correct.

[Kara Swisher]

All right, last question. Speaking of chilling effect, Gary, at the end of the book you write, AI was of course a bubble. But bubbles are as much a part of the Valley's boom and bust economy as underaged cocksure founders. And the VCs who fund them used the past tense. So was it a bubble? Did it burst? Is there a possibility of another AI Winter that some commentators have been warning about since last year? And Christy, how do you feel about the bubble and the winter?

[Gary Rivlin]

Yeah, no, I don't think the bubble has burst. There's still tons. You just mentioned a stat 150 billion or whatever it is in venture capital going and AI. I mean, I think what we're going to see is a natural cycle where a lot of these companies are going to go out of business, but some will break through and will go on to have kind of long great lies for a company. But it's mountains and valleys. It's like it's going to peak and then there'll be a slower period. I don't agree with people in Silicon Valley who say, like, oh, we have artificial general intelligence in the next year or two. I still think we're a breakthrough or two away. They'll say they have AGI because their venture capitalists need them to say that. And it's an amorphous definition kind of thing. But no, I think we're still in the middle of a prolonged, fruitful period for AI Super.

[Unnamed Guest]

For the VCs to get their return on investment here, we need the capital markets to open up, which means we need certainty, which means we need great investments. And the moment that a number of these investments go bad, it's not going to be great. I've been part of four downturns in my career and you never know exactly when the top is. But you've got to hope that things go well, at least for a couple bellwethers.

[Kara Swisher]

Are you worried about that? What would make you worried?

[Unnamed Guest]

I mean, if companies aren't able to have exits, then it's hard for the VCs to. To tell their LPs, yeah, let's pour more money in.

[Kara Swisher]

So, last question. Let's end on a positive note. If you could do one thing to fundamentally secure innovation in the AI space for the next generation of entrepreneurs, what would it be?

[Unnamed Guest]

Look, I think there has to be a combination of thinking about the products, the returns, and also the policy. I mean, look at the center. This is where we can really be thoughtful. The companies don't necessarily have the best interest in humanity in mind. And so let's come together and figure out what the policy arguments are, what the future of that investment would be. But so I think having.

[Kara Swisher]

What would be the key policy, you'd think if you had to.

[Unnamed Guest]

I don't know, I'd have to ask our policy experts.

[Gary Rivlin]

You know, I do think there just needs to be a few ground rules that the Biden administration, I thought had, you know, a gentle policy like, hey, before you release these things, these powerful models, you know, we're going to require you to test them and share the results with us. And, you know, Silicon Valley really rebelled against that. Sam Altman was all for it. Until the Trump administration. Now he's all against it kind of thing, but I do think that we could put in some pretty modest regulations that make sure that the general public is there with these AI companies. I'm convinced there's something bad's gonna happen. I don't know what it is. A trillion dollars siphoned off from the global economic system, money system, before a human even realizes whatever it is. And then people are gonna panic and hate AI. And that's what I really wanna prevent, because I'm with you, education, healthcare, science. I think extraordinary things could happen with AI. And I'd hate for there to be another AI Winter because of the carelessness.

[Kara Swisher]

Are these the critical years right now? And who's the most important person in this?

[Gary Rivlin]

The most important person? I would say policymakers in D.C. i don't know if it's a single person. Yeah, I think these are the formative years. This is really gonna shape people's idea of AI. And again, people are mistrustful of AI and I'm scared that that's gonna really slow things down, which would be a shame.

[Kara Swisher]

Christy, most important person right now or company?

[Unnamed Guest]

Yeah, I don't know that there's any one, but I think just keeping an eye on the promise and the peril.

[Kara Swisher]

All right, on that note, thank you too.

[Gary Rivlin]

Thank you.

[Kara Swisher]

On with Kara Swisher is produced by Christian Castor, Russell, Kateri Yocomb, Dave Shaw, Megan Burney, Megan Cunane and Kaitlyn Lynch. Nishat Kurwa is Vox Media's executive producer of podcasts. Special thanks to Eric Litke. Our engineers are Rick Kwan and Fernando Arruda and our theme Music is by TrackAdemics. If you're already following the show, you are keeping an eye on the promise and peril of AI. If not, you may be technically broken. Go wherever you listen to podcasts, search for on with Kara Swisher and hit follow. Thanks for listening to on with Kara Swisher from New York Magazine, the Vox Media Podcast network and us. We'll be back on Thursday with more.

[Christy Weiskill]

Support for the show comes from the aclu. The Trump administration is pushing a dangerous and sweeping agenda to control our bodies, our families and our lives. President Trump has signed far reaching executive orders that target transgender people their rights and their health care. But the ACLU and their partners are in court fighting back. Meanwhile, the ACLU's also at the Supreme Court fighting for the future of transgender people's freedom and bodily autonomy for all. US V. Scormetti centers on a Tennessee law restricting healthcare access for trans youth. Tennessee has asked the Supreme Court to expand the ruling that overturned Roe vs. Wade to allow it. The fights for abortion and trans healthcare are connected. Learn [e-mail] autonomy.