Spark of Ages

How to Finance a Law That Saves Women's Lives/Bhairavi Parikh, Richard Arney - 2%, WHIC, Voter Initiative ~ Spark of Ages Ep 48

• Rajiv Parikh • Season 1 • Episode 48

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We map the data, policy, and funding failures that created the women’s health gap and lay out a California-led plan to fix it with research built for women, agile AI governance, and voter-backed capital. The goal: better outcomes, lower costs, and a template to repair healthcare at large.

• two percent venture funding and underpowered trials
• AI amplifying bias without sex-specific datasets
• misdiagnosis, adverse drug reactions, and cost burden
• why subgroup analysis must be mandated
• ballot initiatives as a research funding engine
• learning from California’s stem cell model
• WHIC’s scope: basic science to real‑world translation
• agile governance for AI and data privacy
• workforce constraints versus knowledge deficits
• value‑based care’s attribution math problem
• women’s health as a system-wide blueprint
• tangible moonshot: closing the measured gap

If anyone is out there is interested in becoming the part of future healthcare for women in California, we welcome your input. We welcome your views, your time, and your treasure to be part of this campaign that's going to change the course of history for women's health in California, if not the United States.  Please reach out to Bhairavi or Rick on Linkedin

The numbers are brutal: women receive a fraction of research attention, a sliver of venture funding, and face later diagnoses with higher adverse drug reactions—then AI threatens to accelerate the bias baked into that history. We take this on head‑first with Bhairavi Parikh, a serial medtech founder behind the proposed Women’s Health Institute of California (WHIC), and Rick Arney, co-author of California’s landmark privacy laws and a strategist who knows how to turn public will into policy.

We unpack why clinical trials still fail to power for sex differences, how underrepresentation turns into misdiagnosis and higher costs, and what it will take to build datasets and decision tools that actually work for women. From agile AI governance to rigorous privacy protections, we explore how to enable research without sacrificing trust, and why California’s ballot initiative model—proven in the state’s stem cell program—offers a practical way to fund the missing science and speed real-world translation.
 

Bhairavi Parikh: https://www.linkedin.com/in/bhairavi-parikh-9732071/

Founder of the Women’s Health Institute of California (WHIC), a proposed statewide research initiative which we’ll be discussing in depth today.  She is also the Founder and CEO of Clarity Health Alliance.  Previously Bhairavi served as COO at Health Rhythms and Wildflower Health. As a serial founder, Bhairavi has built multiple med tech companies, including CellScape and Apieron, collectively raising over $75 million


Richard Arney: https://www.linkedin.com/in/richard-arney-3a23731a/

A recognized authority on privacy, having co-authored the California Consumer Privacy Act (CCPA) and the California Privacy Rights Act (CPRA). Rick previously served as BlackRock’s Global Head of Alternatives Distribution and led BlackRock’s hedge fund product strategy and served as Head of Investment Strategy for the Global Market Strategies Group, which managed BlackRock’s largest ($10B AUM) hedge fund.  

Website: https://www.position2.com/podcast/

Rajiv Parikh: https://www.linkedin.com/in/rajivparikh/

Sandeep Parikh: https://www.instagram.com/sandeepparikh/

Email us with any feedback for the show: sparkofages.podcast@position2.com

Bhairavi Parikh:

Women already receive, as you mentioned, about two percent of venture funding for women's health and only a fraction of federal research dollars. We compound that with clinical trials that excluded women until the nineties, and even today, only 30% of participants are women.

Richard Arney:

All those statistics that Bairobi put together are unacceptable. I mean, they're they're dark. The idea that you have women there leaving hospitals, being misdiagnosed, given the wrong medications is frankly outrageous. The moonshot is that doesn't happen anymore.

Bhairavi Parikh:

If we pursue things the traditional way, the traditional playbook for kind of company by company, indication by indication, startup by startup, the research will go too slow, we'll never get there. And so we really needed a massive influx of capital and a different way of pursuing innovation in healthcare.

Rajiv Parikh:

Welcome to the Spark of Ages podcast. I have a really amazing episode today where we're going to talk about women's health and how we can use our own initiative to solve the problem or take shots at the problem. I care about this because I've seen my family members, especially my mother-in-law, deal with all sorts of medicines that she's been prescribed that help her or don't really help her, but because they're poorly studied, it takes a long time to get to resolution in a way that I see male members of my family get answers to quickly. So this is a world where the US spends $1.5 trillion annually on healthcare. It's about 18% of our GDP. And what's amazing about this is that we have this reality that our healthcare system was built without women in mind. We'll explore the monumental shift that's happening to correct the disparities with some amazing innovators working to close them with bold policy initiatives aiming to fund science, especially as these health gaps is projected to generate a 3x return on economic growth. Our guests today are Bhairavi Parik and Rick Arney. Bhairavi is a founder of the Women's Health Institute of California, WHIC, a proposed statewide research initiative, which we'll be discussing in depth today. She's also the founder and CEO of Clarity Health Alliance. Previously, Bhairavi served as COO of Health Rhythms and Wildflower Health. As a serial founder, Bhairavi has built multiple MedTech companies, including Cellscape and Apieron, collectively raising over $70 million from venture capital. Bhairavi earned her PhD in biomedical engineering from the UMass Medical Center and Worcester Polytech with a master's in science in biomedical engineering from the University of Connecticut. Rick Arney is a recognized authority on privacy. He's co-authored the California Consumer Privacy Act or CCPA and the California Privacy Rights Act, CPRA, which was done as a citizen's initiative on the ballot. Prior to his current role, Rick served as BlackRock's global head of alternative distribution and led BlackRock's hedge fund product strategy. He served as the head of investment strategy for the Global Market Strategies Group, where he managed BlackRock's largest $10 billion hedge fund. Rick is a Fulbright scholar with an undergrad degree from Stanford in economics and an MBA from Harvard Business School. Welcome to the Spark of Ages.

Richard Arney:

Thank you.

Rajiv Parikh:

Well, I'm very excited to have both of you here today. This is a really important subject. So I know both of you and to me as well. I'm very fortunate to have a wonderful wife and two daughters, now another one through marriage. And so the whole topic of women's health, we talked about in a previous episode with Joanna Strober at MIDI Health. And now we get to talk to you about one of the biggest problems in women's health today, as well as understand how it can be appropriately funded, guided, and enabled. So I want to start with Bhairavi on this question, but please both of you can jump in. Women's health receives only 2% of venture funding. And you've warned Bhairavi of a proliferation of AI trained on biased data that will exacerbate this crisis. So for our listeners, can you paint a picture of what happens in the next decade if this gen AI divide isn't bridged? What does that world look like for the health of our mothers, sisters, and daughters?

Bhairavi Parikh:

The next decade would look a lot like our past, but just worse. Women already receive, as you mentioned, about 2% of venture funding or women's health and only a fraction of federal research dollars. We compound that with clinical trials that excluded women until the 90s, and even today, only 30% of participants are women. And we still have no requirement for subgroup analysis. So what that means for us is that the majority of medical technologies and treatments that we have available today were built for the male body, not for the female body. So now if you add AI into that mix, you know, it learns from existing data. And so if you start with a biased data set, the bias multiplies. It doesn't go down. And so the end result is that outcomes get worse and costs skyrocket. And largely because you don't know how to keep women healthy, you miss diagnoses, you have ineffective treatments, it's all expensive. So, you know, the bottom line is if we don't course correct now, we'll see a widening gap where women continue to be underserved by innovation, and AI will accelerate that inequity instead of closing it.

Richard Arney:

Yeah, Bhairavi's right. I mean, you have a situation here built up over years where there has been essentially a bias in healthcare, which has led to less access, less quick access, misdiagnoses, which has all led to outcomes that are less favorable quantitatively, whether it be mortality rates or how easily someone is served with the medicine they need or the medical care they need. And this has been built up over time, and it's it's very clear as you add AI to that, it'll accelerate it in ways that are just not favorable. And the most interesting thing here is that this is just very costly at the end of the day. I mean, people can talk about access and things like that is fine, but really, you know, this ends up being quite costly for society as large and the state, and that's something that we're very concerned about.

Rajiv Parikh:

So I think like when you're talking about the difference today, right? So the problem statement of this is that because women's health has not been funded or has not been studied differentially, there's a big difference in adverse outcomes, right? There's a big difference in mortality rates. Maybe you can highlight some of that?

Bhairavi Parikh:

Yeah, for sure. I mean, uh, there's a difference across the board, right? We get diagnosed on average four years later. We get for chronic conditions 21 days later for acute conditions. In terms of outcomes, we suffer, as you were mentioning, or asking about the adverse reaction rate to medications. We suffer at twice the rate of adverse reactions to medications than men. The result is that we spent about 500 more days of our lives in poor health than we should. We shoulder 15 billion more in out-of-pocket costs every year. We have 34% higher health care spending, even after you adjust for women-specific conditions that don't adjust in men's. So, you know, across the board from well-being to health care costs, there's just disproportionate spend that really affects quality of life and our ability to contribute to society.

Richard Arney:

I'll just add here that historically the approach has been almost treat everyone equally. When in fact, in much of medicine, there is a differential approach and a differential outcome is that that's needed. One of the major problems that we've highlighted and that we've discovered is that part of the reason that's happened is just the lack of differential research. So you have a situation where the research has been a little bit of, at least from the women-men perspective, sort of one size fits all. And with that comes, you know, an approach and outcome, whether it be medication or treatment, that is less efficient when you place it on top of the separation of men and women. So that leads to these outcomes that are not favorable. And what's really causing it is a lack of research into what the differential approach should be so that you have less misdiagnoses, less treatment that's inappropriate, and more quick identification of specific problems that from a medical perspective the women might be facing. So if if you have better research up front, these things won't happen as frequently as they currently obviously do, and the stats are showing that.

Rajiv Parikh:

This is really helpful. So like women weren't included in research until the 1990s. So why haven't things improved since then? Oh boy, that's a really take us through it. I think it's really helpful for people to understand.

Bhairavi Parikh:

There's a lot of different reasons, but I would say the two that kind of pop up to the top of the pyramid are one is that there's no regulation that insists that there be a subgroup analysis. And so in scientific speak, it means that you just don't power your studies to be able to know the specific effects on women versus a whole population that's predominantly men. The second reason is that when clinical personnel are recruiting women, what they find is that women want to know more and more difficult to recruit. And so you preferentially try to recruit men into those studies. And so again, because there's no regulation that insists that there be parity in the number of women and men and that a subgroup analysis be conducted because it'll push trial sizes higher and things will get more expensive. You get left with a situation in which the clinical trial participants are lopsided towards men.

Richard Arney:

If you can imagine that bias flowing through a huge portion of studies, the studies may be seen as complete and successful. However, the data that comes from them and then the corresponding treatments aren't necessarily as well done with respect to women. So it may appear that things are flowing through just fine. There's a lot of research throughput, there's a lot of things that are approved, but in fact, it's not actually meeting the needs of women.

Rajiv Parikh:

Okay, so Bhairavi, you have a successful track record founding VC-backed med tech companies. So with the Women's Health Initiative, you're pursuing a significant public funding model through a voter initiative. That's I think that's one of the reasons you've paired up with Rick. What was the spark that led you to pivot from the traditional, hey, I'll just raise money from VCs and go build a company and change the world?

Bhairavi Parikh:

I'm smiling because the because it was Rick is the bottom line, but it was because my husband forced me to go to a Diwali party. And he really, I don't know if we like argued about politics the first time we met, or if I just kind of spat at you this whole problem with women's health and made you listen. But Rick, he really opened my eyes when he helped me dig into and understand kind of the story of the California Institute of Regenerative Medicine, which is the initiative which was funded by a ballot initiative where we created a $3 billion fund that transformed kind of stem cell research on the heels of the federal government not funding those research activities anymore. So really what it did is it kind of showed me that public will, kind of not just venture capital and federal grants, can drive breakthrough science at scale. At the same time, it was kind of obvious that if we pursue things the traditional way, the traditional playbook for kind of company by company, indication by indication, startup by startup, the research will go too slow, we'll never get there. And so we really needed a massive influx of capital and a different way of pursuing innovation in healthcare. And so really I hand that credit to Rick.

Richard Arney:

Too kind. It is true, a lot of things happen by serendipity. And one of the things I've noticed in my career is that oftentimes the market for capital, whether it be venture capital or private equity or just major corporations, some things do fall through the cracks. And it is often incumbent for not always, for government to step in and think about ways to solve problems that aren't being solved. And sometimes those problems can't even be solved by the legislature. It has to be solved by the people. And in this state where we are in California, that's exactly what we have. We have a situation where the legislature is there to solve problems. Occasionally it can't seem to get that done. And so then the people have an option in this state, which is not available in all states, where we can decide to write a law. Anyone can. This is kind of a surprising thing for a lot of people I talk to. You don't need to be an attorney, you can just be an average person. You can write a law, and as long as you collect, you know, the requisite signatures, right now it's 1.6 million signatures, you can put a law on the ballot. And if 50% plus one vote yes on it, it becomes a law, equivalent to a law passed by the legislature. And so, as Bairave, you mentioned, a while ago, the Stem Cell Institute came up as an idea. There was not enough research money being spent on stem cells. The federal government stepped out of it because there was some overlap with the abortion issue. And so a group of people in Silicon Valley actually decided, you know what, it's time we fill that gap. And they did exactly the process I just outlined, which is write an initiative that says we're going to raise this money through bonds, general obligation bonds, to fund research and stem cells. And they put it on the ballot and it passed.

Rajiv Parikh:

So it passed, right? And the cool part about it is it passed, but the purpose of it wasn't necessarily to fund companies and their products, was it?

Richard Arney:

That's correct. It was to fund basic research in the idea of stem cells. And you can write a law however you want. What they did is they said, let's get together and raise this money with bonds and then allocate it in a grant form to major universities and research groups in California to close the gap in research and stem cells. So it was a brilliant idea that had just been sitting there. I describe it as a finance person. There was like a billion dollar idea sitting in the road, and they grabbed it. They said, you know what? We think the voters would be aligned with this. And they got it on the ballot and it passed. And that became a research institute that has really closed the gap in stem cells. Now, it was so successful that they effectively started running out of money and they went back to the voters and just raised more money. This is the model that we would like to pursue with respect to women's health.

Rajiv Parikh:

So, yeah, so you're seeing something similar, right? There's a big gap that you guys see. And I think you guys should really talk about it. Like there's a gap the way the research is being done. And it's not to fund someone's company per se to go commercialize something. Your issue is there's just a gap in basic research.

Richard Arney:

Totally. And in fact, that gap is widening. As we all know, the federal government is more recently just decided to step out of essentially the big basic research industry. I mean, and somebody's going to have to fill that gap. Historically, the federal government has been the major funder of that. There's no reason why the state can't step in. We are the home of innovation. We know where this gap is. And so then the issue becomes okay, let's use our resources as a state to fund the gap of research that's very important. And like I said, it's like a billion-dollar bill in the roadway. We have lots of women in this state that are not being served appropriately from a healthcare perspective. And we already have the model with the Stem Silence suit. It's already been approved essentially by the voters twice. Now we want to direct the attention to women's health care. And the case is very compelling. And the research dollars are drying up.

Rajiv Parikh:

Yeah, so this is the interesting one. So the feds have pulled back on basic research, but were they actually funding women's health at all originally?

Bhairavi Parikh:

So across the board, there's been at the federal level a decrease in funding of all healthcare-related research. And so it will theoretically apply to women's health in the same way that it applies to general health. And so, you know, if we were receiving 10% of funding in the past, we would expect that we would still receive 10% of funding moving forward. Where it gets exacerbated is in funding of other things like Medicaid programs, which disproportionately affects women and children. But that's on the care delivery side and not necessarily on the research side. So we expect, and we don't have enough information yet, that while it will disproportionately hit women and their outcomes, it'll be for different reasons, not the defunding of basic science research.

Rajiv Parikh:

Interesting. So they're not necessarily cutting back on just women's research, they're just cutting back across the board. That's right. And because the differential already is there, it's worse. That's right. I think you you would have done this anyways.

Bhairavi Parikh:

Well, right, because as we stated right up front, right, we get less than 2% of venture dollars. There's less than 10% of federal grant monies that go to studying women's specific conditions. And then when you compound that with lack of participation in clinical trials and gender bias in the delivery of medicine, you know, you get left with this big hole. You don't really understand women and or their bodies. And so that equation doesn't change.

Richard Arney:

I'll just add it could not be a better time to do this because you have the bias is built up, the outcomes are not good, that's clear, and the research is being cut. So it's it's actually literally, I think, uh the most prime time to address this problem that's been built up over years. And now we're having a situation where the research dollars, which have not been dedicated to women in the first place, are going away. It causes a total rethink in terms of what the state should be doing from its research perspective.

Rajiv Parikh:

Awesome. So then what's the secret sauce, Rick, for convincing voters to publicly fund a significant scientific endeavor like this?

Richard Arney:

So when you do a state initiative in California, the core question is are the voters with you or not? I mean, it really it's a question that anybody who's a voter can ask themselves if you put some on the ballot, is it gonna get 50% plus one? And there's a lot of rules in the initiative world. There's not many people that do these things. There are about a hundred people in the state that wake up in the morning and decide they want to make laws. And so, you know, it comes down to is it clear? Is it already in the minds of the voter? Let's be clear, let me take a step back here. It's very hard to get people's attention in California. Everyone is on their devices, it's a barrage of things that they're concerned about in their life, their job, their children, their family, they're on TikTok, and there's all this stuff going on. So imagine a world where you have to sell something to about nine million people, okay? And you got to get them to say yes to something that may have an impact on, say, their taxes or their rights or something that happens in their life. That's really the core question. So you have to craft something that they know is a problem. They know that the legislature hasn't really acted. It's it's it's been shown in the research that if there's something you put on the ballot that people really think the legislature should be doing, they're gonna vote no for it. Also, another sort of rule is if you put something on the ballot that's confusing, people vote no on it. So in this situation, we almost have free advertising. Every time you read the news, there's something about research being cut. Okay, it's sort of the attacks on research. So, in that sense, you don't have to spend money on the creation of the problem that's already the voters are already primed for this. Also, the data is very compelling. When you tell a voter, like, hey, look at these outcomes here, they're not favorable, they're clearly not designed for women. Then you have a voter that's kind of primed with it. We also have voters that have already voted on the stem cell initiative. Those are all very positive things when running a statewide initiative. It's not a new issue, it's not some out-of-left field issue. It's something they already are kind of primed for. And then what you do is you deliver something to them that looks reasonably familiar and isn't too crazy and too expensive. And that's why when we began scoping this, you know, we want to make sure this is very focused. It has outcomes that are tested, that it's something that a voter can say, yeah, that's worthwhile to spend money on. And we're not going crazy. We're not saying this is going to be a hundred billion dollar adventure. We've scoped it out at 750 million of bonded indebtedness. It doesn't even break a billion. I know these numbers are very high, but in statewide finance, it's not considered a major league spend.

Rajiv Parikh:

It's the state of 40 million people, fourth largest economy in the world. It's a multi-trillion dollar economy. So $200 plus billion dollar yearly budget.

Richard Arney:

Yeah, and one of the things that happens with initiatives is I I've actually gone around the state and interviewed a lot of people that have done initiatives because I I continually want to learn about it. And one of the things that happens with initiatives is people get greedy. It's very hard to get something in front of the voters. It's very hard to get something to the legislature. So when you are imminently going to do that, you get approached by a lot of people that want to say, Hey, can you just put this in there? Yeah, let's, you know, I want to get my idea in there. And oftentimes that happens, and people say yes, and then the thing gets so larded up that when it hits the ballot, voters are like, What is this thing? It's kind of like a hydra-headed mess. You don't want other people's problems to become your problem when doing an initiative. It has to be very clear what you're trying to do and get that done that way. And that's what I've done in the case of privacy. You know, it was very clear there was an issue in privacy. And by the way, surprisingly enough, it happened just the same way I met my Ravi at a cocktail party. A friend of mine, our kids go to school together, we decided at a party there's this problem with privacy, and that was the beginning of the campaign where we drafted things, you do focus groups, you do polls, you create drafts of what the initiative should look like, and then you run to it and get the signatures, and then you do a campaign. And this, to me, fits perfectly the time we're in. It's something that needs to be done, and everyone knows about it. Everyone knows there's a real problem. Not bringing to somebody a problem they don't know exists. Okay.

Rajiv Parikh:

Right. I mean, half the population can just stand up and say, Yeah, this is a problem. I see that other you know, men seem to get you know diagnosed faster. Yeah, they seem to have fewer issues with drugs, right? So this is something people can see. They can see and feel.

Richard Arney:

A lot of people have sisters, daughters, mothers, and a lot of people are taxpayers. They don't want their money wasted. So there's a lot of good things that can come from this. And we're very enthused about it because with initiatives, you gotta have timing is very important. You have to have kind of people that say, I'm ready for this. And the good news, we already have advertisements coming out of Washington, DC in the form of cuts. So it's already freaking people out.

Rajiv Parikh:

That's a great description, Rick. So, of how this whole thing works. And so, Bhairavi, how will the Women's Health Initiative of California fundamentally change the kind of research it plans to pursue versus what we've seen in the past? And just as importantly, how will it package and deliver its findings to truly empower women to make better, more informed decisions for themselves and their families? Or am I conflating two different things?

Bhairavi Parikh:

No, I don't I don't think you are. So today, women's health is it's treated in silos like most of medicine. You'll have a clinic for menopause, you'll have a program for an app for pregnancy, you'll have a startup that's tackling new diagnostics for breast cancer. Most importantly, like the it doesn't really address the many conditions that women share with men. So cardiovascular disease, for instance, where outcomes are dramatically worse for women. So, like just pulling on that thread for a second, like if you take heart disease as an example, women are 50% more likely to be misdiagnosed during a heart attack. We're half as likely to be prescribed painkillers after bypass surgery. We are seven times more likely to be discharged while still in the middle of a heart attack. And that's not, it's not biology, that's bias and a lack of data. And I think most people don't even understand that it's the number one cause of death for women. And so the Women's Health Institute is really designed to change that. We'll fund research that well, it spans the full arc of women's health across all of the conditions, across the diversity of populations that we have, not just women-specific issues. I think just as importantly, we'll invest in research that not only funds basic science and discovery, but will allow us to develop the tools and the policies that we need to align payers, providers, and patients so that when we're aligned, it will allow us to rapidly collect the data that we want, translate them into insights, and deliver them to a clinical setting so that women can benefit from better science today and not 10 or 100 years from now.

Rajiv Parikh:

That's great. So that's a very different approach than simply publishing studies that you hope industry will just pick up and go run with.

Bhairavi Parikh:

Well, I mean, for sure we need basic science research, but we also need to know how to translate that effectively and quit rapidly to a real world environment. And so you have to figure out how to do those things.

Rajiv Parikh:

So now this is for both of you. If the Women's Health Institute of California is wildly successful, what is the moonshot outcome 20 years from now? Rick.

Richard Arney:

Yeah, I think that's a great question. All those statistics that Bhairavi put together are unacceptable. I mean, they're they're dark. The idea that you have women that are leaving hospitals being misdiagnosed, given the wrong medications is frankly outrageous. The moonshot is that doesn't happen anymore. It's equivalent. They get the care that they need when they need it, accurately prescribed, accurate treatments, that we don't have stats like that. And look at those stats, it's crazy. I mean, why would you have a situation where half the population has completely different outcomes? The moonshot is that we don't have a need for this institute anymore. That's really the moonshot, is where people up front say, yeah, when we do research, we have to have the right clinical trials populated by the right participants, that we have the right intellectual disposition to look at this and say, there might be a different outcome here, and we got to make sure that happens. That's the moonshot that we're shooting for with the Women's Health Institute.

Bhairavi Parikh:

Yeah, and just to add to what Rick was just describing is that if we try to put a number around it, we want 500 more days of our lives in good health. And if you think about that, the ripple effect is just, it's kind of enormous, right? You get families and communities will be stronger. Women are pillars of their families and their communities, healthcare costs will fall. And as I don't remember, maybe Rick was talking about this earlier, but you expect for every dollar invested a 3x return and a financial return. And so you'll gain billions from women being able to fully contribute their talents and their energy from a societal level. And so my personal definition of the moonshot is that we finally close the gender health gap and women get the healthy lives that they deserve.

Rajiv Parikh:

I love that vision. It's uh amazing that we can get there. Now, that's 20 years from now. What are we doing right now to get this initiative off the ground? Is this something I'm gonna be able to vote on this year, next year, a couple years later? How does this work?

Richard Arney:

It's a great question. So, where are we now and where does this go? So, initiatives in California have to be done in general elections. Okay, so the the general election that we will be able to put this on is 2028. It used to be in history that you could do initiatives in primary elections, but now it's limited just to general elections. And the way it works is we are now in the mode of drafting this initiative. In other words, what does it actually look like on paper? So, exactly what is the structure of it, what exactly how much money is going to be raised. It's really the beginning of our campaign. And so we are talking to lots of different people, they're leaders in the women's health movement, and we're talking to people that are could be interested in helping fund this. Initiatives are not free, the state doesn't pay for them. So, what that means is when you do a campaign, you have to think about two things draft or three things drafting the initiative, collecting the signatures, and then once you get it on the ballot, actually campaigning for it.

Rajiv Parikh:

Yeah, you said 1.6 million signatures. That doesn't happen overnight.

Richard Arney:

No, it doesn't happen overnight, and you generally need to raise money to do it. There's very few initiatives that have been done solely on volunteer effort, unfortunately. The last one I'm aware of is the ban on hunting mountain lions in California. That was done all by people in the 80s. I haven't heard one since then, so you do have to raise money. And in California, you may see this. You'll see people at Costco or Target or wherever that are collecting signatures. That's what we're going to be doing. And, you know, I've done that actually myself. I've stood in front of stores and do it. And it's one way to get the message out. But the first thing is to, you know, we're putting the team together. We're talking about people that are in the research movement that see the need here. And then we're talking about people that want to join up and become part of this, whether it be with their time or resources, to actually get this important effort done. The main things, again, are drafting it, raising money, collecting signatures, and then getting out and campaigning for it. And we we think we will be successful doing that.

Rajiv Parikh:

How do they go and find you?

Richard Arney:

So we are going to be launching a website for sure. We're not there yet. We just we're in the process of doing that. You can find us both of us on LinkedIn. It's Rick Arney on LinkedIn. Certainly send a message or by Bhairavi as well. If anyone is out there is interested in becoming the part of future healthcare for women in California, we welcome your input. We welcome your views, your time, and your treasure to be part of this campaign that's going to change the course of history for women's health in California, if not the United States.

Rajiv Parikh:

I love it. All right. What we're going to do now is this is really helpful, Bhairavi and Rick. We're going to now go into opinions about the American healthcare system. So we're going to get your points of view. So in this episode, we're tackling a topic that affects every American, the U.S. healthcare system. It's a multi-trillion dollar machine that's both a marvel of innovation and a source of profound frustration. When Bhairavi and I started a Apieron, US healthcare spending as a percentage of GDP was 11%. 20 plus years later, it is now 18%. And we wonder, are we getting a lot of value from it? So despite all this massive spending, health outcomes are worsening and systematic gaps like those in women's health are more apparent than ever. So we've compiled some opinions designed to spark a debate that goes beyond the usual talking points. So here we go. The obsession with patient data privacy is a major obstacle to medical progress. The ability to aggregate vast de-identified data sets is far more valuable to public health and research than the individual's right to keep their medical information entirely separate from the larger system. All right, Rick, you're the data guy. What's your opinion?

Richard Arney:

Okay, so this is a very important debate to have because people's information, whether it be their employment, their net wealth, or most importantly, their health care and their health status, has always been at the forefront of privacy. And the question becomes how do you set this up such that people do not get discriminated against, their privacy is not violated, and yet we use the data for research. Historically, that has not been done well from my perspective. You have situations where people are vulnerable because of their health conditions for discrimination for the provision of services like insurance or even employment. We have laws against those things. You can't discriminate against somebody because of their health condition. But the problem is a lot of that data has been very discoverable and it's been hoovered up by a lot of companies and sold in a very sort of fig leaf de identified way, where eventually people do figure out okay. Okay, here's a list of people that have these conditions. Let's not sell insurance to them or charge them too much for their insurance and let's make sure they don't get employed. So, in the law that we wrote, we wrote exemptions for research. HIPAA is the major law governing healthcare information. Many of you are familiar with this. When you go to doctors, you have to sign a HIPAA release. These things have not worked extraordinarily well. And going forward, it's going to be very critical, particularly as Bhairavi mentioned, the usage of AI, machine learning, very quick decision making, that we have to be very careful that we strike the balance between being able to do research that moves forward better outcomes, which, as you've mentioned, Rajiv, the outcomes are going down, not going up, but while at the same time doesn't lead to any type of discrimination based on someone's pre-existing condition or their health status.

Rajiv Parikh:

Okay, Bhairavi, your point of view.

Bhairavi Parikh:

I think I actually share Rick's point of view. I mean, I think I would frame it a little bit differently, right? Patient privacy, it's not an obstacle to progress. It's kind of the foundation of it. And so if women and or just consumers in general don't trust that their data will be protected, they won't share it, and then we kind of all lose. And so the question is like, how do we develop systems that protect the individual while kind of unlocking the collective good? And we have some of those systems in place, rigorous de-identification, kind of transparency in how we govern those data, giving patients visibility into how their data is being used, which doesn't happen today. I think if we can build a foundation of trust where patients can see that their information is safe and that sharing it will help us make progress and closing the gaps that we've been talking about, they'd be more willing to participate. And so I'm not the one to talk about, you know, the nefarious use of the data, but I think the foundation is right and we have to build the trust that allows us to access those data.

Rajiv Parikh:

Are there a few like entities that do it well? Is it like the VA does it well? Does Kaiser do it well? Does certain countries do it well? I'll just answer that.

Richard Arney:

I think we're in very early days, and Bhairavi, you set this up perfectly, is that in history for information, we as Californians and elsewhere have just decided give up your information, don't worry about it. I mean, it's like if you interview people, which I've done on privacy, you ask people, what do you think of privacy? And it's like, well, I really like it. It's important. And then you say to them, Would you spend a dollar to enhance your privacy? A lot of people are like, Yeah, I'm not so sure about that. So it's it's one of these things that it's a it's a developing right. It's a right we've had before. California is one of the only states that has in its state constitution the right to privacy. So we're very early days in how people think about their information. In the past, people just kind of let it go. Now we've given people tools to bring it back and actually respect that information. Businesses are showing more respect for the information as opposed to hoovering up and figuring out what to do with it later and not securing it. So we're in early days, and the good news is people are waking up to it. It's become more popular for businesses and people to say, What are you doing with my information? And people are willing to give up their information if they think it's being used appropriately. And in this case, people do want research to be done. They just don't want them to be discriminated or to be used inappropriately in the past. So this is a developing right. You know, there's a lot of rights that are very developed: free speech, assembly, those types of religion, a lot of stuff that's very developed their time. Privacy is not one of those. And so we're in the early days where now people are showing respect for their information, they're questioning what happens to it. But I think they're very open to healthcare information being used to advance science. That's an area where people don't have a problem with as long as it's being done securely and anonymously.

Rajiv Parikh:

I think, you know, as a company that works in data to help companies find their customer, I think it's actually a good idea to have clear regulation for data. CPRA has not damaged our ability to help marketers find their customer and market to them more effectively. It just we still want to present the same information. We don't want to put a wall behind it. In the end, the company still wants to get information to people. So you've got to be clever about it. And you got to ask them for permission. And I think that's completely fair.

Richard Arney:

One thing I'll add to that is what we found is that people really do, when they decide to do business with somebody or a company, they're fine with the transfer of information. As long as that company can be trusted, isn't selling it, and isn't transferring on, they're actually fine with that. So, Rajiv, you're right. I I don't think this is an extreme thing where people like don't use my info, but the relationship they have with a company is changing and it can be used well as long as everyone's responsible about it.

Rajiv Parikh:

Absolutely. All right, next one. Any attempt to preemptively regulate AI in healthcare is a colossal mistake. So our favorite subject, AI. The market through competition and the imperative for companies to demonstrate safety and efficacy will be a more effective and faster regulator than any government body could ever be. Over regulation will only stifle the very innovation needed to address the healthcare crisis.

Bhairavi Parikh:

Take a shot. Okay. So I actually like and believe in regulation. I'm just going to put it out there. I would not go so far as to say that regulation is a colossal mistake. But I do think that if you prematurely regulate, it risks kind of locking us into outdated models kind of before we even see the full potential of AI in healthcare. But at the same time, you can't just assume that the market will kind of self-regulate and self-correct because the stakes are literally people's lives, right? If you start making mistakes. So the right balance here is actually agile governance, which will be new for us from a safety and efficacy perspective, right? These are the two words that we all live and die by in the healthcare space. And it's what FDA demands before bringing new technologies to market. So providing clear guardrails around safety, around efficacy, around the resulting bias of these new technologies while still kind of giving those of us that are innovating in the space the room to experiment and prove what works. That whole model needs to change and shift. And the FDA has been, quite frankly, very receptive to AI-based technologies. I believe the most recent data was that there's 700 medical devices that have been approved by FDA, kind of again in silos, largely centering around imaging-based technologies. But you're starting to see it creep into the drug development pathway, how new drugs are getting approved for use. So it sets standards, but also kind of what we need to do is we need an agile system that sets standards but still continues to evolve as we learn more.

Rajiv Parikh:

All right. Agile governance. Do you have a point of view on agile governance, Rick?

Richard Arney:

I do. I actually think that hits it on the head because in history, if you look at regulation of industries, at least in the US and at the state level, has been very lagging. And we've accepted that. That's not, I don't mean that pejoratively. It's like we get a new technology, we kind of see how it plays out, and then we regulate it. Other places in the world, it's different. It's like something comes up and then all of a sudden it's regulated before it actually sees the light of day. With the rapidity and how quickly AI is developing and what it can do, it does require quicker governance, or as you put it, Bhairavi, agile governance. So as the implications of the technology play out much faster, the governance has got to be quicker, but not ahead of it in the sense that it squelches it out. There's plenty of examples globally where, in fact, in you know, I've known some regulators globally, and they they literally think about okay, what is going to happen with this technology? Can we regulate it now before it happens? That's just not the disposition we've had in the US.

Rajiv Parikh:

It's a more European thing, right? Like in Europe, they're much more uh about protecting from potential overreaches or terrible outcomes that we all imagine. Where over here in the US, we're more about let's try it, let's see what happens, because we don't know what could happen. We don't know what great things could happen, right?

Richard Arney:

Yeah, that's spot on right. And the only difference now with AI, it's just a little quicker. So I'm not saying we have to squelch it out and rub it out before anything happens, but the implications is technology is coming quite quickly. So you've hit it on the head. In Europe, it's just a different approach. Here, I think we just need to accelerate the governance a little bit faster than we've had in the past.

Rajiv Parikh:

This is great. Thank you. Okay, next one. The US healthcare systems dysfunction is not a financing problem, but a supply side problem. The core issue is a systematic lack of accredited medical professionals. Until we fix the pipeline of doctors, nurses, and specialists by reducing debt and streamlining training, no amount of funding or policy reform will fix the system. Just use AI.

Bhairavi Parikh:

Yeah, I mean, I don't think there's any question that we have a work for workforce crisis in healthcare. We don't have enough doctors, nurses, and specialists all at the time where our population is increasing and getting sicker. Training pipeline is too long, it's too expensive. There's just like there's just a huge problem. But I still wouldn't say what we're talking about here today is a supply-side issue. Uh, even with more clinicians, women will still face late diagnoses, they'll still have higher adverse reactions to drugs. There's still what we've been talking about this whole time gaps in care that come from the knowledge deficit. We just don't know enough. We have to fix both. We have to understand women and their bodies. We have to bring new tools and technologies to market, and we have to have the providers to deliver that care. So where the Women's Health Institute comes in, it's like it's not just about funding basic science research, but it's also about funding the research that allows us to bring those tools and technologies to market.

Rajiv Parikh:

Rick, you have a different point of view?

Richard Arney:

Yeah, totally agree. I mean, it's it's more about you know adjusting how this research is being done to react to the problems out there. Certainly there's a supply problem with doctors and medical professionals, but that that's not the core problem here in the sense that the research hasn't produced the outcomes we need. So we need more research done more specifically for women's health. And that's what we intend to close that gap. That's really helpful.

Rajiv Parikh:

All right. Next question: the gradual incremental move towards value-based care. Oh, this is one of your favorite topics, might it be. The gradual incremental move towards value-based care is a cowardly approach. We must immediately and completely abolish the fee-for-service model in its entirety, as its perverse incentives are the single greatest cause of runaway healthcare costs and poor outcomes.

Bhairavi Parikh:

Yeah, I mean, I fundamentally like the idea of value-based care, but you can't just overnight dismantle a system that's been operating for forever. So the real challenge isn't just like getting rid of the fee-for-service environment. It's creating a value-based care model that will actually work. And right now, what we have is a healthcare system that operates in silos. You have different providers caring for different people that may or may not be connected together. They're all billing independently. And even a lot of our value-based care models are still built on the foundation of a fee-for-service model, meaning they're charging for specific services and procedures. So, really, one of the major complexities is when you have multiple providers caring for the same patient, who do you attribute the risk and the reward to? And how do you come up with that equation? And so there's like hands down, like a mathematical challenge here. And until we solve that problem, value-based care just can't deliver on its promise, even though the fundamental concept is right.

Rajiv Parikh:

Rick?

Richard Arney:

Totally agree. Yeah, I don't have any contention with that. It's a model that really needs to be examined, the math essentially. It just doesn't work. So I I completely agree with Bhairavi here.

Rajiv Parikh:

There is some bending of the cost curve, right, with Medicare cost. Originally it was supposed to, it was like a linear situation where Medicare was supposed to essentially be bankrupt by now. And it hasn't. And I think some attribute it to Obamacare, which did encourage more preventative care or it caught more people into the healthcare system. Is that because they implemented more value-based care or more preventative care?

Bhairavi Parikh:

Or was it a combination of all those things. There are bright spots all over the place. And so if you look at Obamacare and its emphasis on preventative care, you know, we as a society, we practice reactive medicine. We do not practice preventative medicine. And so we wait for something to go wrong and then we put a band-aid on it. And so the demand to accentuate or highlight preventative care does do good things. We know that if you go to your doctor's visits and you have your screening tests and you're proactively dealing with lifestyle factors, then you can bend the cost curve. And the same thing on the Medicare side. It is a model that has been shown to work from a financial perspective. But then moving that model to realize its full potential and then to have it trickle through to a commercial setting and then to a Medicaid setting, we have not yet been able to do that in a practical way.

Rajiv Parikh:

Amazing. Thank you. I got one right up your alley. Women's health isn't a niche. It's the perfect microcosm for the entire system's failure. By focusing all reform efforts on closing the gender health gap, we would be forced to address the root cause of dysfunction from misdiagnosis and lack of research to provider shortages and payment issues. And in doing so, we'll fix the entire system.

Bhairavi Parikh:

It's not a niche issue. It's just the fixed lens of how we can see how the whole system is broken. So if we can close the gender health gap, we'll have solved all of the problems that drive dysfunction everywhere. Misdiagnoses, lack of research, provider shortages. What else have we talked about that today? Like broken payment models. And so if you fix the women's health issue, it's like a template. You just kind of rinse and repeat and you apply it to all people.

Richard Arney:

Yeah, and and all that women are not a niche, right? We're talking about a niche. What you're saying is true. It was truly a niche, but we're talking about women. It's not not a niche.

Bhairavi Parikh:

By definition, but somehow it's been traded as one. So I think we need to coin the term men's health and start cutting that up as men's health.

Rajiv Parikh:

We don't want to go there with men's health. That's a whole point. Okay, well, thank you for that. So welcome to the Spark Tank. Today we're thrilled to have Bhairavi Parikh, a visionary who's a driving force behind Clarity Health Alliance, a mission-driven collective working to close the massive gap in women's health. She, along with Rick Arney, are both leading the women's health initiative in California. And Rick is a finance and policy strategist who's navigated the worlds of global investment and has literally helped co-author California's landmark privacy legislation. Today's challenge, Two Truths and a Lie, has a focus on women's health, healthcare policy, and the state of Massachusetts. We've all spent some time getting our education and has a very robust history and has so much well-kept records, so it was really helpful, easy for us to put together a great game for us. So I'll give you three statements that sound almost too wild to be true, but two of them absolutely are. Your mission: spot the fabrication amongst the shocking realities. Here's how it works. After each round, I'll count down three, two, one. And you'll both reveal which statement you think is a lie. Okay, here's round one. In the 1960s, Boston University students helped overturn Massachusetts law that made it a criminal offense to provide birth control or information about contraception, even for adults, unless they were married. Number two, Boston once required all licensed midwives to wear large purple hats in public so city officials could keep track of them. Boston's got a long history. Number three, Massachusetts infamous crimes against chastity law once made it illegal for anyone, married or single, to obtain contraception, an archaic public morals code struck down by the Supreme Court in Eisenstadt versus Baird. Okay, so one is the BU students overturned the Master's Law, right, about birth control or information about contraception. Number two was about midwives wearing purple hats. And number three was uh crimes against chastity. So ready? Three, two, one, two. Both of you are saying number two, and you both are correct. Two is false. While Massachusetts had strict licensing for midwives, there's never been a law requiring them to wear purple hats, even though it's very on-brand for Boston's preference for a colorful vision. Number one, birth control access for unmarried adults was banned until 1972, and BU students played a pivotal role. William Baird's talk and arrest at BU triggered the Supreme Court case Eisenstadt versus Baird, which created new rights for all Americans. And number three is true, crimes against chastity, morality, decency, and good order covered contraception and abortion. These were only officially cleaned from the books in the 2010s, even though they had been unenforceable since the 1970s. I can't believe they were even enforceable in the 1960s. But, anyways, here we go, round two. All right, you both have one. I'm very excited about this. Massachusetts archaic reproductive laws meant that by the 1970s, Boston women seeking an abortion were required to convince a panel of psychiatrists they were suicidal in order to get legal approval. Number two, in the 1940s and 1950s, Harvard affiliate researchers in Boston pioneered the use of diethylstilbesterol, or DES, a synthetic estrogen, to control pregnancy hormones in women. The drug was prescribed to countless pregnant patients even after animal studies showed it could cause cancer and birth defects. And number three, a 19th-century Boston public policy required any farm that raised chickens run by women to spend one day a year devoted to egg appreciation, led by the city's first ever egg czar. Okay, so you ready? Ready? Got your answers? Yep. Three, two, one. All right. You both came out as three. Which is false, yes. While Boston has a rich farming and policy history, there's no evidence of an egg appreciation day what eggs are in city government. But number one and two were true before Roe versus Wade, Massachusetts required women to seek dangerous and humiliating legal and medical approval, even for life-saving abortions. And number two, Olive Watkins Smith, Harvard biochemist, and her husband, a Harvard professor, pioneered the use of diethylstobesterol, or DES, at the Fearing Hospital in Boston. DES was initially heralded for pregnancy support, but later discovered to cause cancer and birth defects, leading to widespread scandal and legal changes in women's health policy. So sometimes good changes happen after bad things. Okay, round three. Number one, a tradition at Boston's Fannual Hall in the 1800s required new female physicians to recite a public health oath while standing atop a block of ice as a test of their firmness in the city's cold winters. Number two, again, this was 1800s. Number two, for decades, Massachusetts had a law making adultery punishable by up to three years in prison, and it remained on the books until it was quietly repealed as part of a women's health overhaul in 2018. Number three, in the 19th century, Massachusetts banned unmarried women from obtaining any contraceptives, and the text, woman, was not even allowed in public notices for health lectures. Okay, you ready? Three, two, one, one. Why'd you choose one?

Richard Arney:

Standing on ice.

Rajiv Parikh:

You don't think they would do that in Boston? Well, you're right. Boston is famous for both historic oaths and frigid winters, but there's no record of ice block ceremonies for women in physicians. We should just be crazy. But I guess it would be it would be a deterrent. Number two, is true, the 2018 repeal of archaic statutes as part of modernizing women's health law included formally removing a colonial era adultery law that carried a shockingly harsh penalty. Even in recent decades, the law technically mandated up to three years imprisonment for adultery. It's crazy. Three, strict bans on women's reproductive information were enforced for decades, even with public discussion strictly censored in Boston. All right, so now we're gonna go to number four. Since you both have three, this could be the tiebreaker. So we're gonna ratchet up the hardness of this. I mean, since we gave you three layups, I'll give you a real hard one. You ready? We'll see if this is really hard. Okay, number one. Boston's women-only gym controversy in the 1990s led to a lawsuit from a man who claimed he suffered emotional distress after being denied entry to a female-only health club. He briefly became a minor Boston celebrity. Number two, Massachusetts Archaic Health Code once regulated who could sell or discuss undergarments, and official corset inspectors could fine store owners for carrying unapproved supportive devices. Number three, for decades, women were routinely excluded from clinical trials nationwide, including Boston area hospitals, until a 1993 federal NIH mandate required inclusion, drastically reshaping women's medical care and research. Okay, so which one is false? Three, two, one. All right. Well, you're tied.

Richard Arney:

Tied again.

Rajiv Parikh:

What's wrong with having a corset inspector? You don't think that would happen in Boston? Haven't we spent time at various Boston bars and seen all kinds of things? Okay, you both are correct. Number two is false. Our staff was very kind to you. So while old Boston law regulated many aspects of public and private life, there's never been a state certified corset inspector. Number one, the women-only gym case hit headlines and made waves in Boston legal circles, exposing the oddities of gender discrimination law as applied to health clubs. So that was a thing. Number three was also correct, which is the NIH 1993's policy ending exclusion of women from clinical trials was a landmark moment in medical research, with Boston hospitals amongst those forced to adapt protocols and research design. And luckily, because they did it, everyone else did it too. That's why Boston's been a leader, it has the richest history, it keeps great data, and gives us something really interesting to talk about. So thank you both. You both tied for the victory, which is what I hope happens with your initiative.

Richard Arney:

Thank you.

Rajiv Parikh:

We've never had a four-to-four outcome before. So you guys can nail it. All right, let's go to these interesting things about you. So I'm going to start with Rick. What's something you're currently learning or trying to get better at that has nothing to do with advancing your career?

Richard Arney:

That's a terrific question. I used to play Badman in high school. In fact, I was Northern California's state champion Badman, and I dropped it for like 40 years, and now I'm picking it up again.

Rajiv Parikh:

Oh, there you go.

Richard Arney:

Yeah.

Rajiv Parikh:

Is it like riding a bike? Are you are you taking it?

Richard Arney:

I picked it up quickly. Yeah, I've been buying a racket and everything. I'm actually doing it again.

Rajiv Parikh:

That's awesome. That's awesome. Sounds like a lot of fun. It's a great game. It's very popular. I go to India every three months. Super bite. Super popular there. It is like the sport. Okay, for Bhairavi, when you're having a terrible day, what's your go-to thing that almost always makes you feel a little bit better?

Bhairavi Parikh:

Oh, going for a walk and talking to friends while I'm walking.

Rajiv Parikh:

Ah, okay. That's it. I thought you'd have a different answer, but I love it. I love it. That's a great answer. To going for a walk and talking to friends. And you can do that because you live in Northern California. I can do that all the time. Awesome. Okay, Rick, if you could add one subject to the high school curriculum that wasn't there when you attended, what would it be and why?

Richard Arney:

Personal finance, very clearly. Because it's something a life skill that isn't taught generally, and yet it can have huge outcome differentials for people if they just know the basics of personal finance, budgeting, investing, et cetera. It's just to me, it's the largest gap in education I could see.

Rajiv Parikh:

Crazy we have Home EC, we have sex ed.

Richard Arney:

And no money. Nothing about money. Nothing about money.

Rajiv Parikh:

We see this with a lot of college kids because our kids are college age. We see it with their friends, how smart they are, but how clueless they are about money.

Richard Arney:

Totally.

Rajiv Parikh:

It's unbelievable. Okay, for Bhairavi, what's the most useful thing you've learned from someone significantly younger than you? I'm gonna force you to choose.

Bhairavi Parikh:

Oh, how to be more carefree. Oh. And to not treat life as seriously as I as I have a habit of doing.

Rajiv Parikh:

And what got you to do that? Or kids. Do you want to say which kid? No. Was there a particular instance?

Bhairavi Parikh:

No, it was a combination of kind of all four of them, just kind of watching the way that they're leading their lives and what's important to them. It's different than the way that we are.

Rajiv Parikh:

In what way?

Bhairavi Parikh:

I know. I think their priorities are just different in a way that I appreciate. Okay.

Rajiv Parikh:

You don't want to go for other you don't want to name. Another podcast. Okay, Rick, if you could go back and witness, but not change, one ordinary day from your past, what day would you pick?

Richard Arney:

The day after I graduated from college, I'd go back to that and and think more about what I'm doing. I didn't have a job at the time. And I wish I knew better what that meant and what to do about it. I was gonna deal cards in in a casino in Reno. That's what I was gonna do. And I wish I wish I had thought a little bit more about what was going on in the world.

Rajiv Parikh:

Did you actually do that?

Richard Arney:

No. I like I got lucky. I got a job before I my cousin was dealing cards up there, and he said, I understand you don't have a job, you should come deal cards. I'm like, okay, cool. But luckily, for me at least, that change. It was gonna be a fun time, but I just didn't know what I was doing. Yeah, that's amazing.

Rajiv Parikh:

Sometimes it's who you're around.

Richard Arney:

Totally.

Rajiv Parikh:

Takes you in whatever direction you go. It's more serendipitous than just simply breaking it down from a research perspective.

Richard Arney:

Yep.

Rajiv Parikh:

All right, and the final one for Bhairavi, if you had to choose between being known for being incredibly kind or incredibly smart, which one would you pick and why?

Bhairavi Parikh:

Kind.

Rajiv Parikh:

Unequivocally. Unequivocally.

Bhairavi Parikh:

Yeah, because I mean I think kindness makes the world go around, and you can't have quality in your life and or your society without it. The rest of it is just ancillary.

Rajiv Parikh:

Well, I just want to thank you both. Those are great answers and really helps us understand what you two are about and what you're trying to create with the Women's Health Initiative in California. I think this can make a huge difference in the world. We are talking about a rather large niche, and it's a big problem that we want to address. So I really appreciate having you here and helping us tackle this huge problem in a more innovative way than we would normally talk about it. So thank you so much. Thank you.

Richard Arney:

Thank you. Terrific podcast. Thanks a lot. Appreciate it.

Rajiv Parikh:

That was a lot of fun today. We have two people I know really well, of course, one I know extremely well, join us. And I've had a chance to start my own medical device company with her back in 2001. So I know a lot more about healthcare than I ever would have. And what's interesting with what Bhairavi and Rick are talking about is that there is a massive gap that's sitting right under our nose. That for more than half our population, we have a situation where they are not getting the kind of care they need. And that's just because of a research and policy and procedure gap. We have so many smart people, so many smart people in medicine and health, and we still are lagging behind. And wow, we can make an incredible change. And we can make an incredible change in a time where research funding is being cut. And we can make a big change because in California, we have a citizens' initiative process. And it was so helpful for Bharavi and Rick to talk about, and especially Rick to talk about how the whole initiative process works in California, how you pick the right subject, how you put it together, how you get it to the voters. Because you want to find that situation where people can understand it, they can feel it, they can feel that it's unaddressed and that it can be solved. How you go about fundraising for it and getting it put together and approved. And this is because of his own work in privacy rights that became hallmark legislation that we all run by today. So it's really amazing how all this comes together. And I'd say the final thing beyond knowing so much about these two amazing people is be open. I say be ever curious, but I think part of being ever curious is being open to going to things that you may not want to go to. So it may be a cocktail party, it may be a devalue or celebratory party, it may be a Passover event, it may be a Christmas party. Sometimes it's just good to go to these things because you never know, especially here in Silicon Valley, if you may find someone of a common interest with the ability to get things done. And I think that's what we got to do when we serendipitously brought Rick and Bhairavi together. So super excited about that. All right. Thanks for listening. If you enjoyed the pod, please take a moment to rate it and comment. You can find us on Apple, Spotify, YouTube, and everywhere podcasts can be found. It makes a huge difference to us. We are a top 10% podcast, and we want your help to get to top 1%. The show is produced by Sandeep Parik and Anand Shah, production assistants by Taryn Talley, edited by Lauren Ballant. I'm your host, Rajiv Parik from Position Squared, a top-notch AI-driven growth marketing company based in Silicon Valley. My company sponsors this for your benefit, so please come visit us at Position2.com. This has been an F Funny production. We'll catch you next time. And remember, folks, be ever curious.

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