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Fareed Zakaria GPS

Interview with Bill Gates; Interview with Nathan Myhrvold; Interview with Elizabeth Holmes. Aired 10-11:00a ET

Aired May 17, 2015 - 10:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

[10:00:00]

FAREED ZAKARIA, HOST: This is GPS, the GLOBAL PUBLIC SQUARE. Welcome to all of you in the United States and around the world. I'm Fareed Zakaria, and this is a special edition coming to you from Seattle, Washington.

(BEGIN VIDEOTAPE)

ZAKARIA: We'll begin with the city's most famous son, Bill Gates, who according to "Forbes," is the richest man in the world. In an exclusive interview, I'll talk to him about the strengths and weaknesses of the U.S. economy, education reform, innovation, and why he recently drank wastewater. With a smile on his face.

BILL GATES, CO-CHAIR, THE BILL AND MELINDA GATES FOUNDATION: It's water.

ZAKARIA: Also, the inventor, dinosaur hunter, chef and polymath extraordinaire, Nathan Merkel, on using technology to help the poor. This might be the coolest keg on earth. Literally.

Then the youngest female self-made billionaire in the world. She got there with blood, sweat and tears. Well, just one drop of blood. I'll explain.

And what the world's oldest democracy, the United States of America, can learn from some young upstarts about elections.

(END VIDEOTAPE)

ZAKARIA: But first here's my take. Here in Seattle, you can really sense the importance of the two most powerful forces that have transformed the world in recent decades. Globalization and the information revolution. These two great engines have been chugging away, integrating a share into the global system and ushering in a digital age that is now invading every corner of life.

Countries or cities that could adapt like Seattle have benefited dramatically. Those that could not like Detroit have been crippled. But either way, the train has kept on rolling.

(BEGIN VIDEO CLIP)

SEN. HARRY REID (D), MINORITY LEADER: I've been very clear, Mr. President, I'm not a fan of fast track.

(END VIDEO CLIP)

ZAKARIA: Democratic opposition to fast track trade authority for President Obama is blind to the fundamental reality of this era. You can't turn off the machine. You can't stop China from growing and trading. You can't prevent Africa from deepening its integration into the global system. These forces are already at work, powerfully entrenched and will keep moving.

The potential trade deal with Asia, the Transpacific Partnership, could, however, shape these trends in a direction that is compatible with American interests and ideas. That's why congressional, mainly Democratic, opposition has been so misguided.

For those who worry that after TPP America would have to compete against low-wage countries, it's too late. It's been too late for decades. As Zachary Karabell notes, we are already living in a free trade world.

The average tariff in the developed world is now about 3 percent. That's it. And in the past three decades, developing countries have cut their tariffs substantially as well. China's average tariff is less than 10 percent today. Down from around 40 percent in 1985.

The United States has one of the world's most open economies. Any trade deal like the TPP is going to open other economies like those of Japan or Vietnam far more than it will America. And the nature of the opening and the new rules will reflect American interests and ideas.

In an essay in foreign affairs in 1993 on NAFTA, a young and then relatively obscure economist, Paul Krugman, explained that NAFTA wasn't going to have much of an impact on the vast American economy one way or the other. It was really about foreign policy.

The economic effects of NAFTA have been heavily debated, but the foreign policy consequences are clear. And clearly positive. We forget now but only three decades ago, Mexico was one of the more anti-American countries in the world. Today, Mexico is a country transformed. Unambiguously allied with the United States. Its president is totally comfortable being described as a close ally of the United States.

Mexico has become a core component of a closely intertwined North American economy that is the world's most vibrant regional bloc.

[10:05:09] Many factors led to this transformation, but NAFTA was chief among them. If something similar would have happened with TPP in Asia, the effects would be global. The world we live in is one of rising nations but declining global norms. The struggle is on to write new norms, new rules for trade, cybersecurity, intellectual property and much more.

Let's hope we don't look back 20 years from now when new rules have been written by China and wish we had been more active and assertive when we had a chance. For more, go to CNN.com/fareed and read my "Washington Post" column

this week. And let's get started.

Joining me now, Bill Gates.

Bill, pleasure to have you on.

GATES: Great to be here.

ZAKARIA: So give me your sense of where the American economy is these days. A lot of people say yes, we do have a recovery. Yes, compared to the rest of the world, the United States is doing well. But we're just not getting the kind of growth we used to and that something has changed. That this is the new normal. You're not going to get back to 3 percent, 4 percent, 4.5 percent.

GATES: Well, GDP growth doesn't capture massive improvements that take place, particularly digital innovation. So I -- it's not quite as negative a picture as appear GDP look will give you.

ZAKARIA: Explain that. You think that there's stuff going on that's improving quality of life that isn't being measured properly.

GATES: That's right. When you use Wikipedia, it is contributing zero dollars to GDP, whereas when you used to buy the "World Book" or "Encyclopedia Britannica," that showed up in GDP. So the fact that those services -- listening to music, finding videos -- the price deflator doesn't capture the quality of these services, particularly ones where the price goes down so quickly that it essentially doesn't get seen by that measurement.

So you wouldn't trade places -- if you made, you know, inflation and adjusted the same amount 50 years ago, your life would be way worse than it is at the current level.

ZAKARIA: But let's take that and just be very specific because a lot of people say middle-class wages have stagnated for the last 15 or 20 years depending on how you measure it. But you're saying, well, a middle-class person shouldn't trade places with somebody 20 years ago because his life or her life has immeasurably improved.

GATES: That's right. We don't capture in the numbers that the -- you'd much rather choose, say, $40,000 a year now than the equivalent 20 years ago or 30 years ago or 40 years ago. Your ability to read books, to find information, to stay in touch with your friends, that's not at all reflected in that income level.

Now there's a few things that got more expensive. The price for college education, most people look at the state university tuition. The cost of medical coverage, either paying for it or insuring against it, that's gone up. But overall, it understates how much things have improved.

It doesn't mean we shouldn't worry about middle-class incomes, but the comparisons overstate the lack of progress. The American economy is, you know, basically very strong. Ironically here, the position of our currency as a reserved currency means that the dollar is relatively stronger than it should be which holds back export growth that would be even more robust. But even despite that drag from our unique position, it's basically a fairly positive story.

ZAKARIA: What do you think about those who say, look, the economy is overtaxed, overregulated, you need big structural reform, that that's what's going to unleash productivity in this economy?

GATES: Well, the most highest economic growth decade was the 1960s. Income tax rates were 90 percent. I mean, the idea that there's some direct connection that all these innovators are on strike because tax rates are at 35 percent and on corporations, that's just such nonsense.

Corporate profit, as a percent of U.S. GDP, the tax, corporate profit tax, is 2 percent. It used to be 4 percent. That's at a time where corporate profits are at an all-time high. So yes, your nominal rate is very high, but for a variety of reasons, including overseas deferments, accelerated depreciation, what's actually being paid is way less.

[10:10:10] So the notion that changing that nominal rate will unlock something, you know, overstates how you improve things.

ZAKARIA: Right now the presidential campaign has sort of begun, and one of the big issues that you're seeing on the Republican side is the issue of the Common Core. These standards in the tests. And Jeb Bush has reiterated his support for them.

Your foundation gives an enormous amount of money and I know you've spent a lot of time looking at this issue. What do you think of the Common Core?

GATES: Well, the Common Core is a fantastic piece of work. And if you really just take that issue and say is the way they define the math progression through the grades and what the basic knowledge should be is not well done. The answer is absolutely. It's fantastically better than what came before where things were out of order. Some states didn't teach you enough to be able to take the college entrance exam. And so you were disadvantaged there.

Some states had things that were done in a different form than they appear on the college entrance exam. So you get lower scores just because the notation and the way it was taught was different.

In the past, the U.S. designed math textbooks by committee. And our textbooks are twice as big as other countries' textbooks. And what it led to is we try to teach too much every year. We don't teach it well. And so other systems are just blowing us away in math. As we switch, like in Kentucky, who was first to adopt the Common Core, they've seen substantial gains in their math learning.

So it's a very good design. It means you can go up to Web sites and look at their material and then have it match what you're learning. If your kids move, like say military families, what they'll be learning in sixth grade will be aligned so it won't be confused and different. So Common Core is an amazing piece of work.

ZAKARIA: When we come back, more with Bill Gates. I'm going to ask him why he drank water that was made from human waste. When we come back.

(COMMERCIAL BREAK)

[10:16:47] ZAKARIA: And we are back with Bill Gates.

Bill, you recently did something very strange. You drank a glass of water that had been produced from human feces. Why?

GATES: Well, sanitation is very important. It's very important for health. It's very important for quality of living. And the way sanitation is done in richer countries is very expensive. We have piping from water in, we make dirty and then we pipe it back out and we do complex processing.

That's not likely to be affordable, say, in all of India. And so if we could take some process and take human waste and get rid of its smell and make sure that it couldn't cause disease, then it would be just like normal garbage. And for very low cost that could be moved out of the household, or we could just burn it as some part of reinvented toilet.

So the R and D to figure out how do you get CalTech, MIT, all these top universities to look at the chemistry, the physics and build this, the foundation has funded that type of advanced research. And we're seeing really good progress.

ZAKARIA: And the way it worked, as I understand it, is that the waste is taken. It's essentially heated to a high level. The water evaporates. You can then separate the liquids from the solid. That water is then distilled and purified. And then you drank it.

GATES: Exactly. All the water we drink has been in lots and lots of different places. The key is it's been purified right before we have to drink it. And in this plant, it is a very, very pure output. In fact, you know, it's a valuable output.

ZAKARIA: Did you -- could you tell anything from the waste?

GATES: Absolutely not. Once water is boiled and filtered very effectively, it's --

ZAKARIA: Where it --

GATES: It's nice, wonderful water. I had a bottle of this stuff in my car, and my kids would pick it up and say, "Really, dad?" And so they found it fascinating. But in fact, what we have to think about is that most people don't have sanitation. In fact, Modi in India has some great campaign to say let's get toilets, let's clean the (INAUDIBLE), so a lot of energy has been brought to this area that really isn't often discussed. And it can be improved.

ZAKARIA: When you look at this issue of water, does this have an applicability to rich countries? We are reading all about droughts in California. Is there a way -- I mean, we have lots of water on earth. Is that the solution? Is that going to be the technological fix to the problem of drought in California?

GATES: Yes, over time, you'll use energy to do desalinization. And so water shortage is about the cost of energy.

ZAKARIA: Because the problem with desalination, it's just very expensive and very energy intense.

GATES: It just uses energy. Like many of the things of modern life, energy is a prime input. So if we could have breakthroughs in energy, that would help us a lot to both desalinate the water and transport it to where we need it.

[10:20:17] ZAKARIA: Where do you think we are in the sort of green revolution? Solar costs have plummeted, but the price of oil has also plummeted. Where does that leave us?

GATES: Well, solar prices are still not competitive with, say, natural gas, electricity production. Now in a narrow sense, they will be competitive. That is during the middle of the day when the sun is shining, but when you buy power, what you're really buying is reliability. You want 24-hour a day, even if it's been cloudy for four or five days, you want your hospital to have electricity. You want somebody in an apartment building not to freeze to death.

And so taking these intermittent sources and adding them in means that we either need peakers, things that come in supplementing, or we need massive storage. And so we do not have an economic way of converting the energy system to a zero CO2 system. Only through big innovation in storage and so getting the costs down will we have that. That's what we need. And it could come from solar. It could come from nuclear.

There's a variety of technologies that might provide that solution. We need to fund thousands of entrepreneurs to drive those costs down because otherwise middle-income countries aren't going to pay some huge premium for their energy.

ZAKARIA: And do you feel like we are at the cusp of an energy revolution?

GATES: Well, I'm hopeful. I keep encouraging governments to raise their energy R and D budgets. And it's disappointing, given the importance of energy for the poorest in the world and this imperative that we get zero CO2 emission, that the R and D budgets haven't gone up more.

I'm funding some new work in nuclear. There's a lot being funded in storage. I'm involved in some of those. The solar space has gotten lots and lots of funding. So there's good things happening, but I think we should be trying to accelerate that because rather than subsidize this stuff when it's not economic, funding the R and D to get it be economic, that is the only real solution.

ZAKARIA: Bill Gates, always a pleasure.

Next on GPS, from Seattle, how great would it be if U.S. election campaigns were shorter, had no negative TV ads, and didn't require a billion dollars to win?

We'll show you some global lessons on elections next.

(COMMERCIAL BREAK)

[10:26:52] ZAKARIA: Welcome back to a special edition of GPS from Seattle. Now for "What in the World," there are still more than 540 days until the next presidential election.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: You can see the media running behind me here to chase the Scooby Van.

(END VIDEO CLIP)

ZAKARIA: Already exhausted by the Hillary watch and the ever expanding tribe of Republican contenders? Well, then perhaps you'd be happier in Great Britain where candidates for parliament this year only campaigned officially for less than six weeks. That included the candidates running for prime minister like David Cameron and Ed Miliband.

There wasn't a single negative advertisement on television because all political ads on TV are banned by law. And each political party was allowed to spend around $30 million, just a fraction of what U.S. presidential nominees normally do.

(BEGIN VIDEO CLIP)

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: And God bless these United States.

(END VIDEO CLIP)

ZAKARIA: Britain has much stricter rules on campaign spending than the U.S. but the last time I checked, it was still a vibrant democracy. In fact, many other democracies have such spending limits.

(BEGIN VIDEO CLIP)

DAVID CAMERON, BRITISH PRIME MINISTER: That's what we believe in. That's what we will deliver.

(END VIDEO CLIP)

ZAKARIA: And it's not just campaign finance where the U.S. is an outlier. Consider voter turnout. America ranks 31st out of the 34 developed countries in the OECD according to Pew. with just over half of its voting-age population turning out in 2012. Other countries like South Korea, Denmark and Sweden have turnout rates above 80 percent. According to the International Institute for Democracy and electoral assistance, the U.S. barely beats out war-torn Afghanistan.

One reason why the U.S. lags behind in turnout might be that other countries make it a lot easier to vote. Nations like France hold elections on weekends so voters don't have to worry about missing work. America still votes on a Tuesday, thanks to a law from 1845 that catered to travelers on horseback.

It might be time for an update.

Then there's voter registration. In the U.S., only 65 percent of the voting population is registered. Much lower than other countries according to Pew. Other nations like Israel and Italy register voters automatically when they receive their I.D. cards from the government, for example, while in the U.S., citizens must register themselves.

So how about how Americans vote? Is that antiquated, too? Certainly. Estonia has had online voting since 2007 with nearly a third of its voters casting Web ballots in this year's parliamentary elections. While there have been some concerns about the system's vulnerability to hacking, it makes voting easier. Switzerland is also moving towards voting via cyberspace.

[10:30:00] But the best way to ensure voter turnout might be to require people to vote by law. Several countries including Australia, Belgium and Turkey do just that. And those nations have impressive turnout numbers, as one would expect. America is the world's oldest constitutional democracy. But it could probably learn a few best practices from some of its younger brethren across the globe.

Next on "GPS," the problem. How to keep critical medicines like vaccines cold in parts of Africa that are blistering hot where electricity is notoriously unreliable. The solution came from one of the smartest men I know. You'll meet him next.

(COMMERCIAL BREAK)

ZAKARIA: We talk a lot about innovation here on "GPS," but I'm fascinated by innovation in action.

[10:35:00]

ZAKARIA: So while in Seattle, I went to visit a man with whom I love to talk about everything. Nathan Myhrvold got his Ph.D. in physics, studied with Stephen Hawking and then for years was the chief technology officer at Microsoft. He now runs a company called Intellectual Ventures. There he gets to indulge his passions. He spent time, money and brain power on such diverse subjects as bread baking, nuclear power, and dinosaurs. His company is working on all three plus much more. One of his latest projects was spurred by a challenge from Bill Gates who asked Myhrvold to help solve a tough problem. How to keep fragile medicines cold in hot climates in developing countries where constant electricity is far from a guarantee. The team tinkered and tinkered until they found a solution.

Nathan, a pleasure to have you on again.

NATHAN MYHRVOLD, CEO, INTELLECTUAL VENTURES: Well, it's a pleasure to be here.

ZAKARIA: This sounds like a simple problem. You know, why don't you put it in a thermos. Explain why this was hard and how you solved it.

MYHRVOLD: Well, you know, it turns out that when you find really hard problems in society, there's a reason why they're hard. And sometimes it's a technical reason. Often it's a mixture of technical reasons, political reasons. So as an example, if Africa had a reliable power grid, this wouldn't be a problem. They'd have refrigerators just like we do here. The trouble is Africa doesn't have that. And every year children die because they don't get the right medicines at the right time. And one of the reasons they don't get the right medicines is because the medicine went bad. The generator went out. Everything spoiled. They had to throw it out. Or it didn't reach them or something else.

And besides the cost of the lost vaccines, which is considerable in a country that has little resources, the human cost in terms of the lives of those children and others that are affected is immense. So why couldn't you solve it with some other thing? Well, people tried. They tried for a really long time. And there's a combination of the fact that the -- it's very difficult circumstances. So you can, for example, make a solar-powered refrigerator, and companies have, and that can work. The trouble is the solar panels are fragile. They might get broken in the truck getting out there. They might get stolen. They might get repurposed. The fancy solar-panel refrigerator and electronics might break, and there's nobody there to fix it.

There's all of these problems that will frustrate a purely technological solution. So we decided that the best way to solve this was to say what is the most robust thing we can possibly imagine? And that was a totally passive system. So we said, could you make something that would hold vaccines at the right temperature, just above the freezing point? For months, maybe, with no power at all.

ZAKARIA: Wow.

MYHRVOLD: Now, that sounds crazy, but of course, the thermos model does this at a small scale. The trouble is the thermos model isn't good enough. But if you go through all the equations, it turns out we thought, hey, maybe you could make a thermos model that would be good enough. And a couple years later, lots of prototypes, millions of dollars of experiments, we have one that works.

ZAKARIA: So these are the devices that hold these vaccines that kind of look like beer kegs.

MYHRVOLD: Yeah. That's the first prototype over there. And then progressively, we built more and more and different prototypes all changed in some way. They got a little better looking over time. We had to heat treat those early ones. And that's why they discolored that way. And here's one actually that we've cut in half because it failed in a test in Africa, and we wanted to find out why.

ZAKARIA: And this is, then, the final version.

MYHRVOLD: Yeah, here is the final product. So it's basically a big thermos. One person can lift it.

ZAKARIA: Wow.

MYHRVOLD: So it's easy to get around. You can strap it on the back of even a motorcycle. There's a system for doing that.

ZAKARIA: No energy at all, and no batteries, no electricity, no nothing.

MYHRVOLD: No batteries, no nothing. There's a tiny battery in here for the display, and it also has a built-in cell phone. So it will send text messages out to say I'm running low on ice! Help me! Help me!

ZAKARIA: But there's dry ice in there.

MYHRVOLD: No. Regular water ice. Regular water ice. So if we open it up, we can reach inside and pull up.

ZAKARIA: There's the vaccines.

MYHRVOLD: Vaccines.

ZAKARIA: And - I'm going to test. It is very cold.

MYHRVOLD: It's cold. Oh, for sure, it's cold.

ZAKARIA: And you could use this all over Africa, all over South Asia, parts of Latin America, anywhere where you have large rural populations that don't have access to really good power supplies.

MYHRVOLD: That's right. It's - the world has tons of people that work and live in an area that has either no power or very flaky power.

[10:40:07]

MYHRVOLD: And with flaky power, if the, you know, generator goes out, if the power lines go down, the vaccine goes bad. And it's not just that you lose the vaccine, which is very expensive. But in fact, you kill kids. Even in this country. When human organs are moved around, enormously valuable, a kidney or a heart, you have to keep it cold. Today they use little, you know, hand-held coolers to do that, which is OK unless weather grounds your plane for two days in an airport somewhere, or there's some other logistical nightmare, and then you fall back on doing these.

ZAKARIA: So you charge this with ice.

MYHRVOLD: Mm-hmm.

ZAKARIA: The capital city of an African country, and it goes out into the villages. How long can it stay cool?

MYHRVOLD: It depends on how hot it is outside. So we test it up to about 110 degrees Fahrenheit, which is really hot. Now, most places are not 110 degrees day and night for a long time. But if it was 110 day and night, it would last for six or eight weeks. In a cooler area, it can last - actually last for months. In West Africa, these devices, a modified version, were used as the means for getting the experimental Ebola vaccines in. There was no way that they could have provisioned these experimental vaccines if they didn't have some way to keep stuff cold. And there just wasn't anything in the area that would work.

ZAKARIA: So this is the silent hero of the response to Ebola.

MYHRVOLD: There's a lot of heroes in the Ebola story. I'm not going to take full credit. But we did our part with our little thing, yes.

ZAKARIA: Thanks to Nathan Myhrvold for inviting us into his lab. We'll bring you more with him in coming weeks.

Up next, the world's youngest self-made female billionaire. How did she make her money? All from a drop of blood. I'll explain when we come back.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

BARACK OBAMA, PRESIDENT OF THE UNITED STATES OF AMERICA: I used to think of entrepreneurs as kind of old, grizzled people, and now I'm the old, grizzled person, and the entrepreneurs are all young and extraordinarily good-looking group of entrepreneurs.

(END VIDEO CLIP)

ZAKARIA: That was President Obama on Monday welcoming the newest class of presidential ambassadors for global entrepreneurship. Among the group and among the youngest of the group is my next guest, Elizabeth Holmes, the founder and CEO of a company called "Theranos". There are many striking age-related superlatives about Holmes, but perhaps the most striking is that according to "Forbes," she is the youngest self-made female billionaire in the world. How did Holmes make her money? Well, she and her team have revolutionized one of the most common medical tests in the world. You've probably gone to the doctor for what seemed to be a simple blood test only to have vial after vial of blood drawn. Well, Theranos has reduced that to just a few drops. I'll let her explain.

ELIZABETH HOLMES: People don't like big needles being stuck in their arms. And so part of our work has been ...

ZAKARIA: So, because they don't like that, they tend to not have their blood tested often enough?

HOLMES: Exactly. Exactly. ZAKARIA: I mean, your basic thesis is that if we could have much

more testing of blood, we would find out about these diseases or potential diseases much earlier.

HOLMES: Exactly.

ZAKARIA: So, why do we give so much blood? I think everyone who's ever had a blood test does wonder, why do you need so much blood to, you know, figure out your cholesterol or whatever it is?

HOLMES: The whole system has been designed around that. So since really the 1960s when the clinical lab infrastructure began to develop, we've had this infrastructure that's very similar to what you see in mainframe computing where you have highly centralized, very big analytical instruments which require that much blood. And therefore, people have had to take tubes and tubes every time they do a blood draw. Because you can't, one, the chemistries that have been designed without it.

ZAKARIA: And how did you make it, though? That you can find all this out so easily with one drop of blood?

HOLMES: We focused on four core areas. One was exactly the small sample size. One was making it incredibly inexpensive to do this testing so that any person could afford it and being transparent about our prices. And ...

ZAKARIA: What are your prices compared to Medicare reimbursement rates?

HOLMES: They start at 50 percent off of Medicare reimbursement rates, and they go down to 90 percent off of Medicare reimbursement rates. Yeah, which means people can do, you know, a cholesterol test for $2.99 or really expensive specialty tests for tens of dollars as opposed to thousands. And we made that possible through advances in technology which we have applied toward redeveloping the chemistry, redeveloping the hardware, redeveloping the software that is used in the traditional infrastructure.

ZAKARIA: And your argument would be, as I understand it, that your tests are actually more accurate than the large sample. Why?

HOLMES: Well, what we've worked to do is eliminate the error and variability that's associated with effectively human processing of samples.

[10:50:00]

HOLMES: And that today in the lab industry is the cause of 93 percent of the errors. And through technology, you can automate many of the processes and decentralize and distribute the infrastructure so that you can mitigate -- mitigate, you know, the variance that comes from human processing.

ZAKARIA: All right. You've got to show us the size of these samples.

HOLMES: Sure. So this is the little tubes that we collect the samples in. We call them the nanotainer. They're about this big.

ZAKARIA: And so that's one drop or that's -- one drop of blood would go into that? What about the rest of that box?

HOLMES: So, this is - this is a sample.

ZAKARIA: That's one single sample.

HOLMES: This is a single sample. So, this would contain 16 samples.

ZAKARIA: Of 16 different people, maybe.

HOLMES: Right.

ZAKARIA: Right.

HOLMES: Yes.

ZAKARIA: And the heart of this, again, is the more often you can have your blood tested, the more likely it is that you will catch variations, oddities that would signal to a doctor that you have a condition, you have a disease, you have something that can be handled much earlier than the physical symptoms?

HOLMES: Exactly. 40 to 60 percent of Americans don't even go to get their lab tests done when they're told by a physician to go do so. And physicians generally don't order lab tests unless someone is symptomatic for a given condition because to get insurance to pay for the test, they have to be able to justify it on the lab form with a code that effectively talks about what symptoms you have. So by the time a doctor orders a test, it means that you're generally at risk for something. And you're not even seeing people engage. But if we can make the testing process wonderful, we can get people to begin engaging. And the more they engage, the more you can start to see this data in a preventative context as opposed to a reactive context.

ZAKARIA: Have you had your own blood tested this way?

HOLMES: All the time. Yeah.

ZAKARIA: How often?

HOLMES: Well, I'm a little extreme, but I do it at least monthly.

ZAKARIA: Wow. Elizabeth Holmes, a pleasure to have you on.

HOLMES: Great to be here.

ZAKARIA: Next on "GPS," behind me through the rain and fog, you can hopefully make out the sprawling city of Seattle. I'll tell you why 40 years ago nobody could have, would have predicted the Seattle of today.

Plus, Bill Gates will give you a book recommendation when we get back.

(COMMERCIAL BREAK) ZAKARIA: The nonprofit women on 20s has nominated a woman they will campaign to put on the $20 bill. Harriet Tubman was selected over finalists Rosa Parks, Eleanor Roosevelt, and the Cherokee nation chief Wilma Mankiller. And a petition was submitted this week to President Obama. It brings me to my question of the week. When was the last time a portrait changed on U.S. paper currency? Was it 1812? 1865? 1929? Or 1945? Stay tuned and we'll tell you the correct answer.

For this week's "Book of the Week," we have a comic novel recommended from a very special guest star.

(BEGIN VIDEO CLIP)

BILL GATES: My book of the week recommendation is the Rosie project. It's a great story. You'll learn about dealing with people. And I found it so much fun and educational.

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ZAKARIA: Thanks, Bill. It sounds like a great read. And now for "The Last Look." In the 1970s, two men erected a billboard near Seattle that read "Will the last person leaving Seattle turn out the lights?" This city which had enjoyed a booming economy in the post- World War II era had fallen into recession like much of the country. Boeing, a huge employer in the region, had cut its workforce by more than half which greatly affected the city's economy as "The Guardian" pointed out. That billboard was only up for a short period of time, but to this day, it is invoked often in discussions about Seattle's economy. As "The Seattle Times" notes, that slogan even spread beyond Seattle to other cities, countries, even the planet. In the 1980s, Boeing was recovering, as was the economy, and today, of course, the city of Seattle is thriving. Unemployment is below the national average. Microsoft, Starbucks, Costco, T-Mobile, Nordstrom's, Amazon and other giants call the greater Seattle area home. According to the U.S. Census Bureau, Seattle has a highly educated population, 57 percent have a bachelor's degree. 18 percent of the population is foreign born. And the city often called America's gateway to Asia is seen as a truly global innovation hub. The real estate market is hot, and the minimum wage now $11 an hour will soon jump to $15 an hour. Something people hope will aid with the city's wide income gap. So the lights stayed on, and for many, the city thrived. Today a more appropriate billboard might read, "Will the next person to come to Seattle invent a way to keep the lights on without warming the planet?" They might do it right here.

The correct answer to the "GPS" challenge question is "C." although the U.S. dollar has over the years added fancy bells and whistles like 3-d security ribbons and watermarks, the U.S. treasury hasn't changed any portraits on bills since 1929 when a reshuffle landed Andrew Jackson on the $20 bill. The group women on 20s hopes to have Tubmans in their wallets by 2020, the 100th anniversary of women's suffrage.

Thanks to all of you for being part of my program this week. I will see you back in New York next week.