Tim O'Reilly discusses the concept of 'unicorns,' defined as startups valued over a billion dollars, and argues that real unicorns should profoundly impact the world and change people's lives. He reflects on past innovations that transformed society, emphasizing the need for 21st-century tech to address significant issues, such as healthcare and energy. O'Reilly urges the community to focus on creating value for society rather than just for entrepreneurs and investors.