Justin Mares - The US Health Crisis - [Invest Like the Best, EP.333]

Episode Summary

Executive Summary: Patrick O’Shaughnessy interviews Justin Mares about the U.S. health crisis, arguing chronic disease is driven by subsidized, ultra-processed food, toxins, and warped incentives. The conversation also covers TrueMed’s attempt to use HSA/FSA funds for health products, plus lessons on consumer brands, talent, and repeat founders.

Main Topics: America’s chronic disease crisis (Priority: 5/5): Mares argues health has deteriorated dramatically over 50 years and now threatens national competitiveness. Food system incentives and subsidies (Priority: 5/5): He links cheap corn, soy, and wheat to processed foods and poor population health. Ultra-processed food and engineered addiction (Priority: 4/5): Big food firms optimize palatability and marketing, pushing products people overconsume. Toxins, water, and environmental exposure (Priority: 4/5): Glyphosate, PFAS, and microplastics are framed as major, underregulated health risks. TrueMed and health spending reform (Priority: 5/5): His new company helps consumers use HSA/FSA dollars for nutrition, sleep, exercise, and wellness. Building consumer brands and edge-city thinking (Priority: 3/5): He explains how he validates products, finds early signals, and spots frontier opportunities. Repeat founders and capital allocation (Priority: 4/5): The episode closes on why multi-company founders and talent clusters may increasingly dominate.

Key Arguments: Chronic disease was rare 50-60 years ago; now it's a major share of GDP and American life. Food subsidies favor corn, soy, and wheat, making unhealthy inputs artificially cheap. Big food uses research and marketing to confuse consumers, echoing cigarette-industry tactics. Obesity is a symptom of metabolic dysfunction; GLP-1s don't fix the underlying system. Mental health, fertility, and physical health are tightly linked through gut and metabolic health. TrueMed tries to let people spend HSA/FSA funds on health products that prevent or treat disease.

Data Points: Healthcare cost growth: outpacing inflation by like 200% - Mares says healthcare inflation is accelerating far faster than the broader economy. Share of GDP: almost at 20% of GDP - He argues healthcare spending is approaching an unsustainable national burden. Adult chronic illness: six in 10 adults have at least one chronic illness - Used to illustrate the scale of population health decline. Average adult medications: 17 medications are prescribed on average per adult every year - Evidence of heavy reliance on medical management. Nutrition studies: 50,000 nutrition studies in the last two years - He cites this to show the volume of confusing, often conflicted research. NIH vs big food funding: $1 for every $11 - He says NIH spending lags big food funding for nutrition research. US food subsidies: almost 210 billion - Since 1995, subsidies primarily support corn, soy, and wheat. Soybean oil calories: approaching 20% - He says soybean oil now makes up a large share of the average American diet. Cigarette subsidies: four times more government subsidies, about 2% than all fruits and vegetable crops combined - He uses this to highlight distorted agricultural incentives. USDA subsidy allocation: 80 plus percent - He says most subsidy dollars go to corn, soy, wheat, not produce. Fruit and vegetable subsidy share: 0.45% - He contrasts this with USDA guidance favoring fruits and vegetables. Diabetes in China: 10,000% - He cites this as evidence Western diets are exported globally. Male sperm count: down 50% - Used to support the claim that fertility has worsened sharply. Women with PCOS: 26% - He says PCOS is now a major infertility driver. Miscarriages: up 10% - He cites a recent decade trend in reproductive harm. Children with pre-diabetes: 25% - He uses this to argue kids are entering adulthood metabolically damaged. Kids obese or overweight: 45% - He says nearly half of children are overweight or obese. School lunch risk: risk factor for childhood diabetes - He argues school lunch quality is harming children at scale. Prevention spending: less than 3% - He says healthcare overwhelmingly pays for treatment rather than prevention. Glyphosate tolerance in US water: 700 parts per billion - He claims U.S. standards are far looser than Europe’s. Glyphosate tolerance in Europe: 0.1 part per billion - He contrasts this with the U.S. threshold. Detox Project rat study: 0.1 part per billion - He says this amount altered gene function and created severe organ damage in rats. Cereal glyphosate testing: 100% - He says all tested center-aisle cereals exceeded tap-water levels. Cheerios glyphosate level: 1,125 - He says one study found this amount in almost every Cheerios sample. Water contamination: 93% of streams - Used to argue exposure is widespread and hard to avoid. HSA/FSA market size: about $150 billion - He says these accounts are large but underused. Unused HSA cash: 91% of HSA accounts of the $100 billion that are in there are just sitting in cash - He argues the system is underutilized for health spending. Nutrition education in medical school: 80% of medical schools in the country have zero nutrition classes - He says doctors are not trained to use nutrition as treatment. Psychedelic therapy efficacy: better than SSRIs, better than almost anything - He argues psychedelics may be a superior mental-health treatment tool. Kettle and Fire validation test: $1,000 worth of Google ads - He used ads and preorders to test demand before launching. Kettle and Fire launch price: $20 a box - He says he set a high test price to see if customers would pay.

Pivotal Quotes: "the greatest mystery that people are not talking about" — Justin Mares: Describing the gap between widespread concern about health and the lack of serious attention to its causes. "our food has also been weaponized against us" — Justin Mares: On how big food engineers hyper-palatable products and shapes consumer behavior. "if exercise was a pill, everyone would get prescribed it" — Justin Mares: Explaining why lifestyle interventions should be treated like medicine.

Implications: The unresolved question is which exposures matter most; listeners are encouraged to reduce obvious risks now while better evidence and policy catch up.