How Truemed Is Incentivizing Americans to Invest in Prevention

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. Timestamps: 00:00 — Introduction 0:44 — The Environment That Makes Us Sick 04:19 — What Went Wrong in the 1970s 6:10 — The Subsidy Problem 8:49 — Universal Ozempic Won't Save Us 12:21 — Building Truemed 15:59 — The Zoo Animal Theory of Human Health 18:33 — The Chronic Disease Crisis as National Security 27:52 — Psychedelics as Mental Health Therapy 35:49 — Why Peptides Will Disrupt Pharma Resources: Follow Justin Mares on X: https://x.com/jwmares Follow Truemed on X: https://x.com/truemed Stay Updated: If you enjoyed this episode, be sure to like, subscribe, and share with your friends! Find a16z on X: https://twitter.com/a16z Find a16z on LinkedIn: https://www.linkedin.com/company/a16z Listen to the a16z Podcast on Spotify: https://open.spotify.com/show/5bC65RDvs3oxnLyqqvkUYX Listen to the a16z Podcast on Apple Podcasts: https://podcasts.apple.com/us/podcast/a16z-podcast/id842818711 Follow our host: https://x.com/eriktorenberg Please note that the content here is for informational purposes only; should NOT be taken as legal, business, tax, or investment advice or be used to evaluate any investment or security; and is not directed at any investors or potential investors in any a16z fund. a16z and its affiliates may maintain investments in the companies discussed. For more details please see http://a16z.com/disclosures.

Justin MaresguestErik Torenberghost

Feb 3, 202640mWatch on YouTube ↗

WHAT IT’S REALLY ABOUT

Truemed aims to financially reward prevention amid America’s chronic disease crisis

Mares frames America’s chronic disease surge as an environmental mismatch problem driven by ultra-processed food, sedentary lifestyles, and constant phone use rather than individual moral failure.
He traces a key inflection point to the 1970s, when shareholder incentives and ingredient substitutions (e.g., HFCS, seed oils, flavorings) accelerated ultra-processing and worsened health outcomes.
He identifies U.S. crop subsidies (corn/soy/wheat) and permissive chemical regulation (e.g., GRAS) as major upstream policy levers that make unhealthy inputs cheap and ubiquitous.
He argues GLP-1 drugs like Ozempic can help but won’t “solve” chronic disease without fixing nutrition quality, micronutrients, and the broader food environment.
He presents Truemed as a practical mechanism to redirect spending toward prevention by enabling qualified users to buy lifestyle interventions (sleep, fitness, supplements) with tax-advantaged HSA/FSA dollars via letters of medical necessity.

IDEAS WORTH REMEMBERING

5 ideas

Health outcomes are increasingly “designed” by the environment, not willpower.

Mares argues modern defaults—ultra-processed diets, low outdoor time, doomscrolling—systematically produce poor health, similar to how zoo environments produce abnormal illness patterns vs animals in the wild.

The 1970s marked a meaningful acceleration in U.S. metabolic decline.

He attributes rising obesity and chronic disease to corporate optimization for earnings that replaced real ingredients with cheaper substitutes (HFCS, soybean oil, flavorings) over decades.

Subsidies quietly shape national diets by making unhealthy inputs the cheapest option.

By subsidizing corn/soy/wheat, the U.S. drives down the cost of HFCS and seed oils that become pervasive in packaged foods, pushing consumption patterns even without explicit consumer demand.

“Universal Ozempic” is a partial tool, not an upstream fix.

GLP-1s may jumpstart weight loss at population scale, but if people simply eat less of nutrient-poor food, they risk protein/micronutrient deficits and unresolved root causes.

Prevention isn’t funded because lifestyle interventions aren’t treated like reimbursable care.

The system readily pays for catastrophic treatment after a heart attack, but rarely finances exercise, nutrition, sleep, or supplements that could reduce risk beforehand—creating perverse incentives.

WORDS WORTH SAVING

5 quotes

When you look at our food system today, the majority of what people are eating is ultra-processed crap.

— Justin Mares

Things started to get much worse in the 1970s.

— Justin Mares

I think now the problem is, like, we're feeding our kids poison, and, like, all of them are sick.

— Justin Mares

The health of an animal is basically a reflection of the health of an animal's environment.

— Justin Mares

If for example, like China or one of our adversaries deployed a bioweapon that made 75% of our population obese or overweight... everyone in America would be up in arms and trying to figure out, like, how do we solve this as an existential crisis.

— Justin Mares

Environmental mismatch (“zoo animal” theory)1970s rise of ultra-processed foods and obesityCrop subsidies and ingredient economics (corn/soy/wheat)Chemical regulation gaps (GRAS vs EU-style approval)Limits of GLP-1s as a universal solutionTruemed: LMNs + HSA/FSA payment rails for lifestyle interventionsMental health, psychedelics, metabolic psychiatry, and peptides

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