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Timestamps are as accurate as they can be but may be slightly off. We encourage you to listen to the full context.
This episode features a captivating conversation between A16Z co-founder Ben Horowitz and general partner Jorge Conde at the firm's Bio and Health Build Summit. Horowitz shares profound insights on leadership, company culture, and the critical decisions that shape entire industries. The discussion explores his bestselling book "The Hard Thing About Hard Things," delves into historical leadership examples like Toussaint Louverture, and examines the unique challenges facing biotech and healthcare innovation. (01:00) Horowitz emphasizes how individual founders can change the course of history through decisive action during critical moments.
Ben Horowitz is the co-founder of Andreessen Horowitz (A16Z), one of Silicon Valley's most influential venture capital firms. He is also a bestselling author of "The Hard Thing About Hard Things" and "What You Do Is Who You Are." Prior to founding A16Z, Horowitz was CEO of Opsware (formerly Loudcloud) and worked at Netscape during the early days of the internet, where he witnessed firsthand how individual decisions shaped the open web we know today.
Jorge Conde is a general partner at Andreessen Horowitz, where he focuses on bio and health investments. He was previously a founder and CEO himself, experiencing what he calls "the struggle" for seven years before finding guidance through Horowitz's writing. Conde brings deep experience in healthcare innovation and the unique challenges facing biotech startups in navigating complex regulatory and distribution environments.
Horowitz challenges the conventional wisdom that large cultural forces drive change, arguing instead that specific individuals making crucial decisions at pivotal moments shape the world. (04:24) He illustrates this with the story of Kip Hickman at Netscape, who developed SSL encryption in just three months when tasked by Jim Clark to "secure the Internet." This single achievement enabled the open internet to defeat Microsoft's proprietary "information superhighway," which would have charged a 30% tax on all transactions. The lesson for founders: recognize that your individual effort in critical moments can literally change the world and save lives, especially in healthcare where delays mean people die while waiting for innovations.
Drawing from Samurai philosophy, Horowitz defines culture as "a set of actions, not beliefs." (14:38) He explains that culture manifests in daily behaviors: response time to emails, punctuality, choice of hotels when traveling, and how you treat partners. At A16Z, being late to an entrepreneur meeting results in a $20 fine, reinforcing their core belief that entrepreneurs' time is sacred. The practical application: define your culture through specific, measurable behaviors rather than abstract values like "integrity," which can be interpreted differently by everyone.
Horowitz distinguishes between peacetime and wartime leadership using a rap quote that captures the urgency: "You're lucky that I ain't the president because I'd push the fucking button, get it over with." (11:22) Wartime CEOs must rapidly shift their entire organization from an old strategy to a new reality without the luxury of consensus-building. This requires being "inconsistent" (abandoning previous plans) and temporarily not listening to teams who are still operating under outdated assumptions. The key insight: "It's better to be right than consistent" when market conditions demand immediate pivots.
As companies grow beyond 50 people, Horowitz emphasizes the critical need for "mandatory cultural assimilation." (21:01) New hires bring their previous company's culture, and without forced assimilation, your culture will fragment into subgroups. For example, hiring eight Google AI engineers means they'll default to Google's behaviors unless actively integrated into your culture. The solution involves daily reminders and non-negotiable behavioral standards that force new employees to adapt to your way of operating, not the other way around.
Horowitz identifies that both distribution and innovation are "dramatically more difficult" in healthcare compared to traditional tech. (28:20) Distribution is "50 times harder" due to complex regulatory environments, multiple stakeholders (doctors, hospitals, patients, regulators), and the difficulty of navigating this system before running out of cash. Simultaneously, innovation is challenging for incumbents because new technologies like AI, CRISPR, and gene therapy require completely different processes than traditional drug development. This creates unique collaboration opportunities where startups rent expertise and access while incumbents rent innovation.