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The a16z Show

Why America’s Health Crisis Is an Incentive Problem

The a16z Show

a16z

Culture, Business, Science, Disruption, Technology, Software Eating The World, Entrepreneurship, Innovation

4.21.2K Ratings

🗓️ 4 February 2026

⏱️ 42 minutes

🧾️ Download transcript

Summary

a16z general partner Erik Torenberg speaks with Justin Mares, founder and CEO of Truemed. They discuss why American health outcomes are so poor compared to the rest of the developed world, how crop subsidies created a food system that "systematically outputs unhealthy people," and what it would take to treat the chronic disease crisis as a national security issue. Mares explains how TrueMed allows people to spend tax-free HSA and FSA dollars on lifestyle interventions like gym memberships, sleep aids, and healthier food—and why he believes this could redirect hundreds of billions of dollars toward prevention. They also explore the case for psychedelics as mental health therapy and why peptides could disrupt the pharmaceutical industry.

Transcript

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0:00.0

You look at our food system today, majority of what people are eating is ultra-processed crap. The average child spent less time outside than a maximum security prison that people are spending P plus hours on phone. We are in the midst of one of the biggest problems in the country. If we don't fix this, like America is going to have even more serious problem. The environment that we exist in is just structurally, just hard to be healthy, which is why you see the default health outcomes in the U.S. being so poor. Why not just universal basic ozempic?

0:24.3

Why doesn't that solve the problem? I think now the problem is we're feeding our kids poison and like all of them are sick. I think many of our problems are downstream of the fact that the majority of the country is just sick. No matter if we get rich or whatever, if most of the country is sick, it's kind of like, what is the point? What if the chronic disease crisis isn't a health care problem, but an environmental one? Justin Mears has spent 15 years building companies around a single idea that what you eat, how you move, and where you live matter more than the pills you take. His great-grandmother lived to 95 without ever shopping organic or

0:55.3

asking for no seed oils. She didn't have to. She grew up in an environment that wasn't actively

1:00.3

making her sick. Today, the average American child spends less time outside than a maximum security

1:05.8

prisoner. 70% of their diet is ultra-processed food, almost 80% of adults are overweight or obese,

1:12.2

and the health care system will pay hundreds of thousands or millions of dollars to manage a heart

1:16.0

attack, but nothing to prevent one.

1:18.5

TrueMed is trying to change that math.

1:20.7

The company allows people to spend tax-free HSA and FSA dollars on lifestyle interventions,

1:25.8

gym memberships, better food, sleep aids that treat,

1:29.0

reverse, or prevent chronic disease. The idea is simple. If we're going to fix American health care,

1:34.6

we have to make prevention as easy to pay for us treatment. I speak with TrueMed founder and CEO

1:39.6

Justin about why the 1970s were the turning point for American health, how crop subsidies created a poisonous food system,

1:46.3

and why peptide might be the most disruptive thing to hit health care in decades.

1:52.4

You've been on a quest for the last few years to uncover and make a dent in solving our food crisis,

2:00.0

our health crisis, our disease crisis.

2:01.9

Why don't you trace your journey a little bit into how you became obsessed with this,

2:06.1

and then we'll get into what we're up to.

2:07.5

Yeah, so Peter Steele has this idea of like a secret,

2:10.2

and I feel like the idea that what you eat, your lifestyle, all these things,

2:16.2

they impact your health outcomes,

2:17.7

they impact your energy, they impact how you feel.

...

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