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a16z2023 Big Ideas in Technology (Part 2)
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CHAPTERS
- 0:00 – 1:12
Series Intro and Part Two Overview
Steph Smith explains that a16z asked partners for one big idea for startups to tackle in 2023, producing 40-plus ideas. Part two covers Fintech, American Dynamism, and Bio & Health, with six partners presenting.
- •a16z asked dozens of partners for a big idea for 2023 startups
- •The two-part series covers 12 of the 40-plus ideas
- •Part two spans Fintech, American Dynamism, and Bio & Health
- •Speakers are Vijay Pande, Julie Yoo, Angela Strange, Anish Acharya, Ryan McEntush, and Michelle Volz
- 1:12 – 8:20
GPT Applied to Credit Counseling
Anish Acharya pitches GPT-driven credit counseling that delivers labor at a tenth of the cost of humans. He sizes the market, including the many people he says are misscored, and answers Steph Smith's questions about the error tolerance of finance and lender incentives.
- •GPT unlocks labor supply at roughly 10X lower cost than humans
- •Credit coaching is a moderately complex expert system no UI has captured
- •Credit Karma sold for $7 billion, yet only a small subset of users saw dramatic score uplift
- •Acharya argues financial advice is a closed-domain, answerable problem
- •He disagrees that lenders profit from bad credit, saying lower default rates allow lower prices
- 8:20 – 10:31
Customer Support and Wealth Management as Low-Hanging Fruit
Anish Acharya describes where else cheap AI labor could apply in fintech in 2023. He points to customer support and wealth management, and the conversation turns to people forming relationships with AI.
- •Customer support is the most low-hanging fruit
- •Everyone could get private-bank-like interactions with their bank
- •Wealth management advice will be commoditized, though the therapist aspect is harder
- •Acharya says consumers' affection for big tech suggests adopting AI at scale isn't crazy
- 10:31 – 14:38
Compliance as a Competitive Advantage
Angela Strange argues that tech-enabled compliance will become a competitive advantage in 2023. She cites 50,000-plus regulations, the cost of compliance, and the three reasons it has become so burdensome.
- •Software has not yet taken a big enough bite out of compliance
- •Banks spend an estimated 6 to 10% of revenue on compliance, with over $250 billion in fines since 2008
- •Compliance staff at some large banks rose from 4% to 15% of employees in ten years
- •Causes: Dodd-Frank, non-modular software met with headcount, and fintech's global expansion
- 14:38 – 16:46
Coinbase's Fine and Automating KYC and AML
Using Coinbase's $100 million fine as a case study, Strange and Smith discuss how scaling strains manual systems. Strange explains how image recognition and machine learning can cut manual review and false positives in KYC and anti-money laundering.
- •Coinbase's fine concerned KYC failures, not crypto, after transactions rose 25 times
- •New companies can build compliance in from the start
- •Manual ID checks don't scale, but image recognition has improved
- •Rule-based AML alerts catch only about 3% of laundered dollars
- •ML can gather customer data and reduce false positives
- 16:46 – 23:48
Gaps in the Compliance Web and Global Opportunities
Strange outlines three opportunities: unified rather than siloed compliance, joining on-chain and off-chain compliance, and better data sharing between institutions. She also covers global compliance infrastructure and building compliance in from day one.
- •Compliance is siloed across KYC, transaction monitoring, and fraud
- •On-chain and off-chain compliance could be unified since 10% of Americans have crypto wallets
- •Data sharing between banks could improve compliance for all
- •Expanding to a new country like Brazil means learning a new regime, creating room for infrastructure providers
- •Compliance costs of 10% of revenue could fund new products
- 23:48 – 27:30
Small Modular Reactors and the Nuclear Renaissance
Michelle Volz presents SMRs as part of a nuclear renaissance. She explains how they differ from traditional plants in size, cost, and deployment, and why they could be built in years rather than decades.
- •Nuclear provides 20% of US electricity, and the IRA earmarked $30 billion in tax credits for existing reactors
- •SMRs are smaller, cheaper, and can be shipped to remote places, ships, or space
- •Traditional plants take decades, mostly in siting and approvals; SMRs could take years
- •Several startups are getting designs approved today
- 27:30 – 34:49
Nuclear Regulation, Supply Chain, and Fusion
Volz discusses the NRC as a bottleneck, how other countries are progressing, and supply-chain opportunities for founders. She says SMRs need no new scientific breakthroughs, unlike fusion, and that the biggest barrier is a national decision to invest.
- •The NRC charges multi-million-dollar fees, has long timelines, and lacks an SMR framework
- •International coordination could ease approvals across countries
- •Opportunities span materials, transport, waste, repurposing coal plants, and software
- •Fusion could be game changing but is further away
- •The biggest barrier is humans getting in their own way
- 34:49 – 37:38
Overhauling the Space Supply Chain and Why It Matters
Ryan McEntush frames space as the measure of industrial and military power. He argues the US should lead in space and explains why satellites matter for the economy, war, climate, and long-term resources.
- •Space supremacy is framed like the Stone, Bronze, and Iron Ages
- •Satellites underpin telecom, GPS, and military intelligence, as in Ukraine
- •Earth observation helps with climate monitoring
- •Space holds nearly infinite resources for long-term growth
- 37:38 – 44:08
Space Opportunities: Mining, Manufacturing, and Orbital Servicing
McEntush identifies three immediate opportunities: midstream refining, mass manufacturing of space components, and on-orbit servicing. He also describes how startups can avoid pure moonshot risk, using Apex, Jamestown-style businesses, and military contracts.
- •Midstream refining turns mined materials into workable metals
- •Apex builds satellite buses as a step toward mass manufacturing
- •On-orbit servicing includes repairing, refueling, and de-orbiting satellites
- •Jamestown businesses serve an immediate market like Earth observation
- •Government contracts such as space domain awareness and space tugs can fund early growth
- 44:08 – 46:36
Is Space Really the Measure of Power?
Smith challenges whether land, water, and minerals are the real measure of power. McEntush answers that land battles depend on space assets, satellites would be early targets, and satellite data helps mineral discovery, while asteroids could supply materials.
- •Ukraine shows space assets supply real-time intelligence and targeting
- •Satellites would be among the first targets in a major conflict
- •Satellite imagery supports mineral discovery
- •Asteroids could hold vast nickel and iron
- •Energy-intensive industry might eventually move to space
- 46:36 – 53:29
The Biggest Company in the World Will Be Consumer Health Tech
Vijay Pande argues the biggest company will be a consumer health tech company, via a vertically integrated payvidor or a horizontal marketplace or infrastructure layer. He explains the scale of healthcare, why tech and healthcare incumbents haven't won, and responds to the objection about profiting from patient health.
- •Healthcare approaches 25% of US GDP, about 10 times the marketing budget of Google and Meta
- •Two paths: a vertically integrated payvidor or a horizontal marketplace/infrastructure layer
- •Tech giants and healthcare incumbents each lack the other's deep knowledge
- •Founding teams should combine tech and healthcare expertise
- •Patients often aren't the payer, so user experience has been neglected
- •Pande distinguishes value-creating growth from rent-seeking
- 53:29 – 1:02:09
The Value-Based Care Stack and Fee-for-Service Inertia
Julie Yoo presents the value-based care stack, a new set of purpose-built infrastructure for providers bearing risk. She explains fee-for-service versus value-based payment, why inertia persists, and what is changing in 2023.
- •Many value-based models transplanted fee-for-service operations and haven't delivered value
- •Fee-for-service pays per task, while value-based care pays to manage population health
- •Fee-for-service inertia includes a $150 billion claims industry
- •Government initiatives like Medicare Advantage and ACOs pushed adoption
- •Pandemic pressure and decentralized care are tailwinds, with only about 20% of payments risk-based
- 1:02:09 – 1:12:03
Next-Wave Opportunities and Firefly Health's Engagement Model
Yoo says the next wave of the stack is in clinical decision support and risk management, and that direct-to-consumer care means patient loyalty, not just out-of-pocket payment. She uses Firefly Health's 45 annual clinically meaningful encounters per patient to show how technology lowers care costs.
- •First-wave companies built billing, financial services, CRM, and admin workflows
- •Next opportunities are AI-aided clinical decisions and actuarial and risk tools
- •Direct-to-consumer care means direct patient loyalty, not necessarily out-of-pocket payment
- •Firefly Health sells to employers and offers 24/7 text-based concierge care
- •Firefly averages 45 clinically meaningful interactions per patient annually
- •Multimodal technology-enabled care reduces cost structure
