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a16zHow Truemed Is Incentivizing Americans to Invest in Prevention
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At a glance
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 ideasHealth 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 quotesWhen 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
SPEAKERS
Justin Mares
guestFounder of Truemed; previously grew Kettle & Fire and focuses on prevention, nutrition, and enabling HSA/FSA spend on lifestyle interventions.
Erik Torenberg
hostHost at a16z who interviews founders and operators about technology, business, and emerging trends.
High quality AI-generated summary created from speaker-labeled transcript.
