# On starting and scaling healthcare startup 23andMe

**Author:** Anne Wojcicki
**Type:** Video
**URL:** https://www.ycombinator.com/library/5I-on-starting-and-scaling-healthcare-startup-23andme
**YouTube ID:** zZN-3RpdjcY

---

[Anne Wojcicki](https://twitter.com/annewoj23) is the cofounder and CEO of [23andMe](https://www.23andme.com/), which
provides direct-to-consumer genetic testing. [Sam Altman](https://twitter.com/sama) interviewed Anne for a series called
How To Build The Future, which you can [check out on our YouTube
channel](https://www.youtube.com/watch?v=VAUt2j6juHU&list=PLQ-uHSnFig5MoTTcgd8EzenEADqGTQPpW).

-----

## Transcript

<span class="t-orange bt-listen" data-bt-time="0.0">Craig Cannon \[00:00\] -</span> Hey, how's it going? This is Craig
Cannon, and you're listening to Y Combinator's podcast. Today's episode is with Anne Wojcicki and Sam Altman. Anne's the
co-founder and CEO of 23andMe, and they provide direct-to-consumer genetic testing. Sam's the president of YC Group. He
interviewed Anne for a series called, How to Build the Future, and you can check it out on our YouTube channel. Alright,
here we go.

<span class="t-orange bt-listen" data-bt-time="24.088">Sam Altman \[00:24\] -</span> Today we're here with Anne
Wojcicki, co-founder and CEO of 23andMe, thank you very much.

<span class="t-orange bt-listen" data-bt-time="28.684">Anne Wojcicki \[00:28\] -</span> Hi, thank you.

<span class="t-orange bt-listen" data-bt-time="29.521">Sam Altman \[00:29\] -</span> We always like to start with how
you came up with the idea, and sort of the founding story of the company.

<span class="t-orange bt-listen" data-bt-time="33.914">Anne Wojcicki \[00:33\] -</span> I was working on Wall Street,
and--

<span class="t-orange bt-listen" data-bt-time="35.553">Sam Altman \[00:35\] -</span> That doesn't sound very fun.

<span class="t-orange bt-listen" data-bt-time="36.929">Anne Wojcicki \[00:36\] -</span> It was, actually.

<span class="t-orange bt-listen" data-bt-time="38.273">Sam Altman \[00:38\] -</span> It was fun?

<span class="t-orange bt-listen" data-bt-time="39.106">Anne Wojcicki \[00:39\] -</span> I loved it. I grew up in
academia, I always thought I'd end up being an academic. I went to a job fair right out of college, my parents made me
go, and I got this job offer to go on Wall Street. And it's one thing I always tell young people, you never really know
what's going to come your way, just take every opportunity. I very randomly got this job on Wall Street, I had no idea
what it was, but I kind of figured, I actually only took the interview cause they gave me free frequent flyer miles. I
won the flight, I won the frequent flyer miles.

<span class="t-orange bt-listen" data-bt-time="68.297">Sam Altman \[01:08\] -</span> Oh, you had to fly there, but you
got to keep the frequent flyer miles.

<span class="t-orange bt-listen" data-bt-time="71.357">Anne Wojcicki \[01:11\] -</span> Yeah, no, I was just excited. I
was like, it's a free trip, it'll be 5,000 miles, that's pretty awesome. I was on Wall Street for 10 years and I loved
it. For me it was, because it wasn't just about trading and making money and doing these things, but it was I got to
learn about companies. The one thing that is amazing on Wall Street is that you get to go deep on certain companies when
you're really interested in them, and then really broad, knowing a whole sector. I got to know small cap bio-techs and
pharma companies and hospital systems and insurance companies. I got to have a really broad landscape of health care. In
the beginning I had this eternal optimism, like, "Health care's going to totally change, there's antibodies, there's all
this new, there's technology, there's all these new discoveries coming, it's going to be so different." And then when
the bubble burst in 2000, a lot of innovation dried up and I started to see more what health care really is. And at the
end of the day, health care is an amazing business that really effectively monetizes illness. I used to always say, "If
I successfully get you to never be diabetic, no one makes money. But if you do become diabetic, there's all kinds of
ways I can make money." At the end of the day when I think about what I care about, what's in the best interest of me,
I'd rather just never be diabetic. I'd rather never be sick. There's no one in the system today that really thinks about
how to keep me healthy. After 10 years of investing,

<span class="t-orange bt-listen" data-bt-time="160.592">Anne Wojcicki \[02:40\] -</span> I felt like I really understood
the system and I also understood that you had all these people with the right intentions who really care but the ship's
just pointing in the wrong direction, and that no one's actually focused on keeping people healthy and that I wanted to
have a company that was, frankly, somewhat rebellious and was going to inspire people to try to really be healthier. I
felt it was, you know, again, it had sort of that, a little bit of a Robin Hood kind of mentality in the beginning of,
you can't change the system from within, so we got to do something more radical from outside.

<span class="t-orange bt-listen" data-bt-time="197.048">Sam Altman \[03:17\] -</span> One of my favorite Charlie Munger
quotes is, "Incentives are a superpower." I always believe this and this is the clear problem you just identified. How
do you think about how you design a system or a company that is incented to keep people healthy?

<span class="t-orange bt-listen" data-bt-time="210.733">Anne Wojcicki \[03:30\] -</span> Well, I realized the main thing
in health care is that you don't actually ever have a voice. Because you're not the payer in health care, you the
individual, you don't actually make decisions, it's your insurance company, your doctor, the pharmacy benefit manager,
there's all kinds of people in the back who actually make decisions and there's all this data now about... You go into
surgery and there's doctors coming into the surgery that you've never even met. For me what was transformative, what we
did to change the incentives, is to put you in the power seat. You make retail decisions that are in your best interest
because you're actually the one paying the bill. For us, what we decided to do that was frankly seen as disruptive is we
are direct to consumer.

<span class="t-orange bt-listen" data-bt-time="255.861">Sam Altman \[04:15\] -</span> I remember when you launched,
doctors, or just health care professionals in general, were saying, "Patients, this is irresponsible. You need a medical
professional to do this." I remember one quote that really stuck with me, something like, "We can't have people making
their own health care decisions, they don't know how to interpret the data."

<span class="t-orange bt-listen" data-bt-time="273.465">Anne Wojcicki \[04:33\] -</span> There were all kinds of
interesting things. Cause people would publish stuff on Facebook and then doctor would say like, "Do you have the
right?" And we'd remind people, "Yeah, it's their own information." There's always been, I'd say, a tension a little bit
with the medical system. The medical system historically there's tests like the pregnancy test. The pregnancy test when
it came out was seen as radical. How could women ever possibly learn, at home, that they're pregnant? If you look at the
literature of that era, we look at that today and we'd say it's crazy. One of my favorite papers is there's this JAMA
paper, the Journal of American Medical Association, from 1969 I think, where they ask doctors, "Would you tell your
patients that they have cancer if they had a cancer diagnosis?" Over 90% of them said no. I always put that in context,
it helps people understand. Physicians were trained in such a way, and so I don't blame the system or the individuals,
it's just that that was the culture. That was thought of what was actually in your best interest. What we do is as we
empower consumers, we are showing that people actually can be, people want to be in charge of their health, they want
the information, and they actually want to be in control.

<span class="t-orange bt-listen" data-bt-time="350.692">Sam Altman \[05:50\] -</span> I always like the model of
thinking about the world 50 or 100 years from now and looking back, what will we think was just totally ridiculous, and
this sure seems like--

<span class="t-orange bt-listen" data-bt-time="359.661">Anne Wojcicki \[05:59\] -</span> Health care that type, because
health care's really, as much as it's science and it's data-driven, it's also not. Part of what people don't necessarily
always understand is that the practice of medicine is an art. The reason why you can go to five different physicians and
get five different ways of treating cancer is because there's the practice of medicine, you can get different opinions.
One of the things that we're specifically trying to change is exactly that, is exactly to say that we're trying to get
data so that it's no longer a question of like, "Hey Sam, what's in your best interest?" There's actually data to say
exactly what you should be doing.

<span class="t-orange bt-listen" data-bt-time="398.537">Sam Altman \[06:38\] -</span> How do you think the medical
system, the health care system overall, will eventually get to a place where we don't have this misalignment of
incentives you talked about and we have data and we have people in control of their own health care? If you could wave a
magic wand and say, "I'm going to fix the health care system," what needs to happen?

<span class="t-orange bt-listen" data-bt-time="415.676">Anne Wojcicki \[06:55\] -</span> The reality is what needs to
happen is never going to happen, which is like you have a universal payment system. Single-coverage, like the reality
is, who cares about keeping you healthy today? Because you could be overweight and you could eat poorly and you could
never exercise, and you won't see the consequences of that for the next, let's say, 20 years. The reality is, who's
going to benefit from that? The reality is, it's society, and it's you personally, and it's somebody who's willing to
invest in you in the long run, and for a single-payer health care system or like a country, they care about actually
trying to keep you healthy for as long as possible. Second, people, we don't want, we saw that communism doesn't support
the system that we all want. People have to be willing to spend money and they have to step up. The same way you see
people stepping up with yoga and vitamins and weight loss studies and all kinds of different alternative care, people at
some point have to stop and say, "Your health is also your responsibility." The more that we can give people
personalized information about themselves, the more that they are going to be willing to execute on taking care of
themselves.

<span class="t-orange bt-listen" data-bt-time="495.119">Sam Altman \[08:15\] -</span> Speaking of that, you could have
started so many different companies in the health care space. How did you decide this was, this was not an obvious
choice at the time.

<span class="t-orange bt-listen" data-bt-time="503.021">Anne Wojcicki \[08:23\] -</span> For me it was totally obvious.
For me there's a couple things that were happening. One, I always loved genetics. It was my first investment in 1996. In
some ways it was my first and it was my last. The genetic revolution was happening. Right when I started investing there
was the race of getting the cost of the genome down. It was super exciting, and I started looking at those investments
again and realizing that you're going to be able to buy essentially a scan of your entire genome pretty inexpensively.
That was the first nugget of, okay wow, you can actually start to get huge amounts of genetic information. And second
was seeing this world of social networking. That social networking was happening and you don't actually need the old
guard to get things to happen, I could crowdsource. It gave me this idea that wow, if I just empowered everyone with
their genetic information and I crowdsourced all this information. If I have the world's health information, what could
I do? And people were like, "Well, you could cure, you could save, you'd know a lot." The idea really was, well, we
should do that. Instead of relying on Stanford or Harvard or Pfizer to go and solve a disease or how to be healthy, we
the people, we can do it. In some ways, having grown up in this Google environment and knowing the social networking
world that was coming up, it was piecing those things together that was like combine the technology and science with the
platform that is really emerging.

<span class="t-orange bt-listen" data-bt-time="591.085">Sam Altman \[09:51\] -</span> I've noticed that many of the most
transformative companies come because the founder sees an intersection of two pretty different but really important
trends a few years before everybody else does. This is clearly one of those. It's the fact that crowdsourcing works is
still amazing to me.

<span class="t-orange bt-listen" data-bt-time="607.542">Anne Wojcicki \[10:07\] -</span> Totally, well, it's also when a
founder really wants something personally.

<span class="t-orange bt-listen" data-bt-time="611.793">Sam Altman \[10:11\] -</span> Did you really want this
personally?

<span class="t-orange bt-listen" data-bt-time="612.791">Anne Wojcicki \[10:12\] -</span> Oh yeah, to me it was like the
whole beauty for me of genes, of genetics is like gene by environment. And I will always love people debating, "But is
it your genes or your environment?" I'm like, "No, the whole beauty of it, is that it's both\!" You might be genetically
high risk for diabetes, but there's your environment.

<span class="t-orange bt-listen" data-bt-time="628.724">Sam Altman \[10:28\] -</span> You can do things about it.

<span class="t-orange bt-listen" data-bt-time="629.918">Anne Wojcicki \[10:29\] -</span> What can I do? So very few
genetic ailments are a 100% deterministic, meaning 100% liklihood that you're going to get it. That means there's an
environmental component where you can potentially do something. So let's go figure out what you can do and then tell
people.

<span class="t-orange bt-listen" data-bt-time="645.99">Sam Altman \[10:45\] -</span> What was the reaction when you
first announced that you were going to do this? What was it like inside the building?

<span class="t-orange bt-listen" data-bt-time="652.886">Anne Wojcicki \[10:52\] -</span> Startups are so fun because you
get a bunch of people who are really passionate and people were excited and people knew that there would be controversy.
In some ways, we attract people who have all experienced the health care system in their own way and realize it has its
limitations. There's people who are excited about 23andme because of the mission and they're looking to contribute in
some way, to helping change the system. There was enthusiasm. We had like videos. We were also.. We were super excited
to launch and we thought there was going to be this big coming, like everyone and we had tons. We had spit parties. We
were on the cover of--

<span class="t-orange bt-listen" data-bt-time="697.65">Sam Altman \[11:37\] -</span> I went to one\!

<span class="t-orange bt-listen" data-bt-time="698.483">Anne Wojcicki \[11:38\] -</span> I know\! We had the cover of
the style section. We had the spit party in the building. But I have to say, we sold a lot the first day. And then it
was slow.

<span class="t-orange bt-listen" data-bt-time="708.883">Sam Altman \[11:48\] -</span> That happens.

<span class="t-orange bt-listen" data-bt-time="711.21">Anne Wojcicki \[11:51\] -</span> We were probably selling 15
to 25 kits a day. Which is not a lot.

<span class="t-orange bt-listen" data-bt-time="718.502">Sam Altman \[11:58\] -</span> How do you, well I guess two
questions. One, how did you eventually fix that? And how do you as a leader keep momentum in the building when you have
this great launch, the first day is always awesome, and then you have a week called the trough of sorrow and people get
pretty demotivated.

<span class="t-orange bt-listen" data-bt-time="735.586">Anne Wojcicki \[12:15\] -</span> There's always a trough of
sorrow and it's important to not let people be totally... hoping for immediate success and then to be overly distracted
by the trough of sorrow. That actually happens, not just in launches but every time you come up with a product. You have
no idea how well it's going to go. I remember when my sister first launched AdSense, and she's like, "I don't know,
we'll see how it goes. It's kind of, it's an experiment, we have no idea." And then clearly it went on, but part of it
is cause you work hard at it. I feel like for us, and that trough of sorrow, we recognized more, we focused on the long
term. What do we need to do to get to this point. As a leader, for me one of the most important things is not to wallow
on today, but to wallow on like, okay in two years, this is what it's going to look like and these are the steps I need
to do to get there. People love a vision and people love a plan. You just need to outline, this is where we're going.
When we saw that sales were slow, we're like, "People don't understand genetics." Some basic market research could have
told us that, but people don't know why they want their genetics. And that was like, "Okay, great. Now we actually need
to educate the population about why you would want your genetic information."

<span class="t-orange bt-listen" data-bt-time="811.724">Sam Altman \[13:31\] -</span> And how did you do that?

<span class="t-orange bt-listen" data-bt-time="813.964">Anne Wojcicki \[13:33\] -</span> I started changing my talks. I
would speak a ton. In the early days, you gave me a conference invite, and I took it.

<span class="t-orange bt-listen" data-bt-time="822.083">Sam Altman \[13:42\] -</span> I remember that. I remember that
for myself too.

<span class="t-orange bt-listen" data-bt-time="824.762">Anne Wojcicki \[13:44\] -</span> Yeah, exactly. Any talk, part
of it is constant feedback. Again, for the people who want to be entrepreneurs, you're constantly learning something in
the feedback. I would change my talks. I never gave the same talk twice. When I look at my inventory of all my talks,
it's like, there's like 500 of them because each one was slightly different. I remember, specifically, getting the
feedback. People questioned what is the value proposition in what you're doing and I was like, "Great, I can answer that
question." Over 50% of my customers get a medically meaningful result. And then I started shifting the conversion. Part
of it was getting real time feedback and part of it was helping us define what is it that we have to do to show the
value. It was clear people need to understand genetics. They didn't understand the basics. They need to know what is the
medical utility of this. Then also, people need to know that they're not the only one, that's not weird. Like, "Oh this
is weird I did it." We need to drive social acceptance and part of it also was medical acceptance. We did a ton... It's
one thing I always advise science companies, is you can't speak, I can't just tell you, "Oh we're great, we have great
science." No one believes that. What you need to do is you need to publish. I never even argue with scientists, I just
hand over my publications. Like, here you go. Because that's the reality, you speak with your data. I can make all kinds
of claims, but here's my data to actually support it.

<span class="t-orange bt-listen" data-bt-time="911.624">Sam Altman \[15:11\] -</span> Can you talk about the best
decisions you made in the early days? People always ask about the worst, which we can talk about if you want. But I'm
curious if you look back, things like that where you learn, "I need to interact with the scientific community in this
way." Are there a few decisions you made, that looking back, had been critical to success?

<span class="t-orange bt-listen" data-bt-time="927.542">Anne Wojcicki \[15:27\] -</span> Fhe first two hires, the two
founding scientists, Just like, Brian and Serge were amazing. In some ways, hiring the right, for me it was such a
critical part of the company was the scientific integrity of what we were going to do and it set a bar of the talent
that we were going to hire going forward. In some ways, having the right people.

<span class="t-orange bt-listen" data-bt-time="950.39">Sam Altman \[15:50\] -</span> We've noticed that it is almost
impossible to, you can make a lot of mistakes as a company, but if you screw up the first five, seven hires, it's almost
impossible to get through that.

<span class="t-orange bt-listen" data-bt-time="961.064">Anne Wojcicki \[16:01\] -</span> There's a good number of, when
I look at the first 15 people, there's a good, a number of them are still here. The others who have left, we're still
very close to.

<span class="t-orange bt-listen" data-bt-time="974.817">Sam Altman \[16:14\] -</span> How did you find those first two
scientists?

<span class="t-orange bt-listen" data-bt-time="976.884">Anne Wojcicki \[16:16\] -</span> We found them through a friend
of a friend of a friend. They had a similar idea so it was a good, it worked as a partnership. It's hard, I would say
hiring is one of the hardest things. One of the things that we've tried really hard here in the company. There are a lot
of smart people who have humility and there's a lot of smart people who want to tell you how smart they are. And we have
opted for the humility. It's really important to have people who are constantly open to feedback and constantly open to
constructive criticism and learning about other areas. That's actually one of the things that did make us successful.
Which allowed us to grow and attract other people because it's a group of people who are really eager to learn from
others and to keep learning.

<span class="t-orange bt-listen" data-bt-time="1027.972">Sam Altman \[17:07\] -</span> I've noticed, looking back at my
own career that the big hire mistakes I've made are people who are really smart, but just awful to work with because
they want to tell you how smart they are. The framework that I've finally figured out, is you have to look at the net
output that has a person has on the organization as a whole.

<span class="t-orange bt-listen" data-bt-time="1045.975">Anne Wojcicki \[17:25\] -</span> Correct.

<span class="t-orange bt-listen" data-bt-time="1046.808">Sam Altman \[17:26\] -</span> Even if they do a lot themselves,
if they make everybody else miserable.

<span class="t-orange bt-listen" data-bt-time="1049.207">Anne Wojcicki \[17:29\] -</span> It's one of the things, hiring
is always really hard. And I think especially in leadership roles, if you have the wrong person, I just recently watched
one of the old documentaries about Steve Jobs and Bill Gates. Jobs' talking about how disastrous it was when Scully
came. I kind of forgotten about some of these stories and I realized, I was like yeah, if you hire the wrong senior
leadership--

<span class="t-orange bt-listen" data-bt-time="1072.492">Sam Altman \[17:52\] -</span> And you don't fix it very
quickly, it can sink you.

<span class="t-orange bt-listen" data-bt-time="1073.972">Anne Wojcicki \[17:53\] -</span> It can sink you.

<span class="t-orange bt-listen" data-bt-time="1075.186">Sam Altman \[17:55\] -</span> Yeah. What's it like being in a
regulated industry? One thing that a lot of people say when they think about, they want to do this really ambitious
startup, like genetic testing, but they are afraid because it's regulated.

<span class="t-orange bt-listen" data-bt-time="1089.921">Anne Wojcicki \[18:09\] -</span> Regulation, in some ways
there's pros and cons. In some ways, when you're regulated, it means there's rules. There's guidelines and you can
figure out exactly what that means. In some ways, there's more of a path about actually how you have to execute. It
definitely also means that it's more expensive. There's rules. If you don't always agree with all those rules, and when
we went from an unregulated company to a regulated company, there was definitely a pretty major transition for us
because we were used to, you hire smart people. What do smart people like to do? They like to question and they like to
argue\! We would question all the time like, "Ugh, well why do you need that test? Or why do you need this study? Why
did you need that number of samples?" We would question all the time. One of the things, I think, in a regulated
environment, again, it's like the DMV, there's rules and you follow. There's a level of obedience. I'd like to encourage
people, it's not so overwhelming to be regulated. That said, it requires a lot of communication. And in some ways it
requires a communication style that's not prevalent in Silicon Valley.

<span class="t-orange bt-listen" data-bt-time="1159.86">Sam Altman \[19:19\] -</span> Right, yes that is hard. There is
an opinions mismatch there.

<span class="t-orange bt-listen" data-bt-time="1166.215">Anne Wojcicki \[19:26\] -</span> We always said... I'd look at
some of my old communication and I'm like, "Oh wow, that's embarrassing now." The way we thought we were communicating
appropriately and how it really wasn't. There's a style and there's a form and there's ways. There is actually, there is
a path and there's rule. It's not terribly clear. The regulatory world can do a better job of helping outline. One thing
I do appreciate from, now having been regulated for a number of years, is that there is a bigger picture that they see.
People who work at the FDA or people who work in government, it's a public servant job. They care, they care about
public safety. At the FDA, they care about public safety. There's so many companies, we can all see them. There are so
many companies trying to dupe the consumer and their job, they are there to keep us safe. I have a lot of respect for
what they do. The onus is on us as the startup and the new company. All these people want to do things in a new way, the
onus is on us a little bit to explain how we're doing it, how that works, and the way they speak, just like I mentioned
about scientists, they speak in data. You can't just say, "Oh no, no no. Trust me, I'm the good guy." You have to show
the data and you have to show the data in lots of ways. In that capacity, I don't really mind because they do know, they
know a bigger picture story. Some of the people we worked with there have been there for 20 years and were amazing. They
have a depth, a breadth of knowledge that I'm never going to have.

<span class="t-orange bt-listen" data-bt-time="1270.679">Anne Wojcicki \[21:10\] -</span> So learning, there's input to
genuinely take.

<span class="t-orange bt-listen" data-bt-time="1274.522">Sam Altman \[21:14\] -</span> As you look back, your vision on
the day you signed the incorporation paperwork to now, how much has this all played out like you thought it would?

<span class="t-orange bt-listen" data-bt-time="1285.662">Anne Wojcicki \[21:25\] -</span> It was remarkable. I have this
picture of the day we signed and I always look at it and I'm like, one, I really dressed in a very different way than I
do today. But two, our series A documents... and our OKRs from 2007 are remarkably similar to what they are today.

<span class="t-orange bt-listen" data-bt-time="1307.57">Sam Altman \[21:47\] -</span> That's always--

<span class="t-orange bt-listen" data-bt-time="1308.515">Anne Wojcicki \[21:48\] -</span> We're unusual. One of our
investors, he has said, "What's amazing, I look back on everything, you're a broken record." In some ways that's also
why it's so easy to do speaking engagements cause I've said the same thing now for a decade. We have a mission. We have
a drive. I know where we're going. We've been continuously executing on it.

<span class="t-orange bt-listen" data-bt-time="1332.311">Sam Altman \[22:12\] -</span> The best companies are remarkably
steadfast in that. It's hard to do cause entrepreneurs sort of by definition like to start doing new things.

<span class="t-orange bt-listen" data-bt-time="1338.857">Anne Wojcicki \[22:18\] -</span> Right, so one of the hardest
things for entrepreneurs, and again going back to the era, I forget what you called it, the era of sorrow.

<span class="t-orange bt-listen" data-bt-time="1345.314">Sam Altman \[22:25\] -</span> The trough of sorrow.

<span class="t-orange bt-listen" data-bt-time="1346.147">Anne Wojcicki \[22:26\] -</span> The trough of sorrow\! It's
important to stick with it. One of the most important things I've learned at doing this now is the importance of
persistence. You have to stick with it. And when you stick with it, you really see a benefit. There's things that I see,
now that I've done it for over a decade. One of our missions is to tell people anyone can be a scientist. Anyone, any
age level, it's part of the reason we're direct to consumer. I believe anyone, you can be eighth grade level, and you
have the ability. I love it now when kids come to me and they're like, "Oh I saw you speak, and because of you, I
really. Even though I had, my parents didn't know anything and I didn't really have that degree, I'm now in a PhD
program at MIT." I get amazing stories and you never in some ways, it takes a long time to see the consequences of your
actions. It's one of the things I emphasize to people. If you really care about something, if you're really passionate,
it takes a decade to really see the impact.

<span class="t-orange bt-listen" data-bt-time="1407.805">Sam Altman \[23:27\] -</span> It's like compound growth. It's
always misunderstood. It always takes longer and then the magnitude and the out years is always bigger than you think.

<span class="t-orange bt-listen" data-bt-time="1415.662">Anne Wojcicki \[23:35\] -</span> Right, and I think what
happens is that people hear the WhatsApp story, they hear other stories, and the real stories, the companies that
continue to persist even if there's challenges. The WhatsApps are the rare, but you can be super consistent and that's
one thing, when I see the press about us now, it's overwhelming, we've just persisted.

<span class="t-orange bt-listen" data-bt-time="1437.657">Sam Altman \[23:57\] -</span> Yeah, that's it.

<span class="t-orange bt-listen" data-bt-time="1439.105">Anne Wojcicki \[23:59\] -</span> We don't go away.

<span class="t-orange bt-listen" data-bt-time="1440.039">Sam Altman \[24:00\] -</span> That is the secret to overnight
success is ten years of persistence.

<span class="t-orange bt-listen" data-bt-time="1442.858">Anne Wojcicki \[24:02\] -</span> Yes, the overnight success is
that ten years of persistence.

<span class="t-orange bt-listen" data-bt-time="1446.675">Sam Altman \[24:06\] -</span> You've done all the remarkable
things as a company and the one that is most remarkable, or sort of most important to the future of the world, is that I
think in the last 11 years, genetic testing, because of you has gone from something people are afraid of, to something
that is now accepted as a really important part of putting people in charge of their lives and their health. But I'd
love to hear what the next 11 years look like and if we had this conversion in 2029, what would we be talking about and
then your proudest accomplishments then?

<span class="t-orange bt-listen" data-bt-time="1477.841">Anne Wojcicki \[24:37\] -</span> I said my original mission, if
you think back to my Wall Street days, I think the system is broken, how am I going to be healthy. Success for me is I
would like to be healthy at 100. I now know, I have my genetic information. I can learn about things. I have set up this
research machine where I can collect data from all my customers. We can make discoveries. We give those discoveries back
to our customers. I have this amazing machine for discovery. Now I want to execute on the vision of I would like to be
healthy at 100. So success for me, is how do I now, I just empowered you. I have five million people empowered to learn
about themselves and they could keep coming back. We collectively as a five million person community and growing--

<span class="t-orange bt-listen" data-bt-time="1525.86">Sam Altman \[25:25\] -</span> Is that the biggest genetic
dataset in the world?

<span class="t-orange bt-listen" data-bt-time="1527.84">Anne Wojcicki \[25:27\] -</span> By far, yeah.

<span class="t-orange bt-listen" data-bt-time="1529.109">Sam Altman \[25:29\] -</span> That's awesome.

<span class="t-orange bt-listen" data-bt-time="1529.999">Anne Wojcicki \[25:29\] -</span> With health information. To
me, that's where there's a power in what we an do now to make discoveries about prevention. We have the drug discovery
arm. To me, I look at it as, we have two aspects. You're healthy today, you want to keep staying healthy. You have a
condition, you just have this. We want to have drug discovery for that. Now we'd like to keep you healthy. I think about
who, what are the partnerships I can do. What's the community I can form to actually help you make behavior changes. One
thing I see all the time when I meet people, again, all economic levels, all socioeconomic groups, people want to be
healthier. They don't necessarily know how. I see this, people don't necessarily know. Like, "Oh are the Doritos really
bad? Is soda really bad?" It's remarkable how much there's a disconnect between, you hear things, but you don't really
know what are the ways that we're going to be able to help people be healthier.

<span class="t-orange bt-listen" data-bt-time="1586.795">Sam Altman \[26:26\] -</span> Have you discovered anything that
is, I mean obviously the whole point of this is it's personalized, but general trends that you've discovered that apply
to a lot of people they might not already be aware of? Most people know they probably shouldn't drink so much soda.

<span class="t-orange bt-listen" data-bt-time="1600.092">Anne Wojcicki \[26:40\] -</span> No, but there's probably
people who could absorb more sugar than others. Those are the types of things. We're all pretty different. The beauty of
humanity is that you're meant to survive. You can look at it from the perception of viruses. You have the 1918 flu, lots
of people died. Some people survived, some people are immune. The same thing, foods, some people can just eat a lot of
sugar. Some people can't. That's why we are still around on the planet today. The main thing that I would say take away
is that there's a lot of variability. 100% you shouldn't smoke, you should exercise more, you should eat better, but the
reality is there's some people who can smoke and never get cancer. There's some people who can eat a lot and never get
overweight. Some people, exercise doesn't really matter.

<span class="t-orange bt-listen" data-bt-time="1645.31">Sam Altman \[27:25\] -</span> How far away are we from someone
being able to spit in a tube and you tell them, here's what you need to do to have a good shot at living to 100?

<span class="t-orange bt-listen" data-bt-time="1652.073">Anne Wojcicki \[27:32\] -</span> That's one of the things
that's most exciting. What we can do by having a community of people who are all engaged. We're starting to do what we
call these intervention studies. We did our first one on weight loss. We had 70,000 people doing a six arm weight loss
study. That's the first time we're doing it in that kind of scale, specifically to see based on your DNA, are there
differences in weight loss? I'm also, I'm personally motivated in Parkinson's space. So people who are genetically high
risk. Are there behaviors that can lower your risk? And how much then can you lower your risk? We're starting to do
those types of studies specifically because that's what our customers want. Our customers specifically want to know
exactly what you just asked.

<span class="t-orange bt-listen" data-bt-time="1698.24">Sam Altman \[28:18\] -</span> Tell me what to do.

<span class="t-orange bt-listen" data-bt-time="1699.073">Anne Wojcicki \[28:19\] -</span> Tell me what to do. When you
say, again, success for me, is at the end of this decade, I will tell you what to do.

<span class="t-orange bt-listen" data-bt-time="1704.904">Sam Altman \[28:24\] -</span> At the end of, by 2020?

<span class="t-orange bt-listen" data-bt-time="1707.064">Anne Wojcicki \[28:27\] -</span> Well I look at it as--

<span class="t-orange bt-listen" data-bt-time="1708.662">Sam Altman \[28:28\] -</span> 2030?

<span class="t-orange bt-listen" data-bt-time="1710.303">Anne Wojcicki \[28:30\] -</span> The next ten years of the
company. I'm already 10 and 12 years in, so give me another eight years.

<span class="t-orange bt-listen" data-bt-time="1716.266">Sam Altman \[28:36\] -</span> That's pretty exciting.

<span class="t-orange bt-listen" data-bt-time="1717.114">Anne Wojcicki \[28:37\] -</span> I'm on it, I'm on it, Sam.

<span class="t-orange bt-listen" data-bt-time="1719.209">Sam Altman \[28:39\] -</span> I will follow the instructions to
the letter. Thank you very much for taking the time.

<span class="t-orange bt-listen" data-bt-time="1722.129">Anne Wojcicki \[28:42\] -</span> Oh you're welcome. Any time.

<span class="t-orange bt-listen" data-bt-time="1723.795">Sam Altman \[28:43\] -</span> This was really fun.

<span class="t-orange bt-listen" data-bt-time="1724.628">Anne Wojcicki \[28:44\] -</span> Super fun.

