The power of compounding is widely understood. What’s underappreciated is when the value is actually created.
Compounding is continuous, but when you look at it in decade blocks, the pattern becomes obvious. Even moderate differences in the annual compounding rate are severely amplified over time. For instance, starting with $1:
At 15% annual compounding
10 years: $4.05
20 years: $16.37
30 years: $66.21
Last decade: 75.3% of the total value
At 20% annual compounding
10 years: $6.19
20 years: $38.34
30 years: $237.38
Last decade: 83.8% of the total value
At 25% annual compounding
10 years: $9.31
20 years: $86.74
30 years: $807.79
Last decade: 89.3% of the total value
At 30% annual compounding
30 years: $2,618
Last decade: 92.8% of the total value
A 2× difference in the rate (15% vs 30%) becomes nearly a 40× difference in outcomes over 30 years.
Compounding doesn’t add. It multiplies the entire base.
The first decade is impressive.
The second decade is extraordinary.
The last decade is unfathomable.
That’s when fortunes are made.
That’s why the ceiling matters. If the market size caps you early, compounding dies early. You need a category large enough to let it run for decades.
Once you see compounding this way, it permanently changes how you choose markets.
Health insurance, for instance, is roughly a $1.7T TAM in the U.S. alone. It may not be the sexiest space, but that’s one of the reasons I’m so excited about Curative Health long term.
What business today has a ceiling high enough to compound until 2056?
Can’t believe it’s been 6 years since that call! Forever grateful to you Justin for making the bet on me a Curative and then doubling down again!
We’ve only scratched the surface of what needs to be done to rebuild healthcare to focus on prevention, actually keeping people healthy and providing health insurance people actually love to use - and we’ve already passed $1B ARR. So much more work to be done to grow this to the first $1T healthcare company but I’m more excited than ever to double down on solving this problem!
This day six years ago.
On New Year’s Eve going into 2020, I was on my honeymoon, hiding in the bathroom to take a call from a stressed 25 year old founder telling me the company I’d backed had just collapsed.
I had no idea I was witnessing the start of one of the greatest comebacks, and possibly one of the greatest tech investments, quietly taking shape.
I offered him one month of runway. Just $175K. One more shot.
Today, Curative, his health insurance business has crossed $1B ARR and is on a path to disrupt the industry and become a $100B+ company.
Answer the call.
Sometimes one conversation changes a life.
Be like @FredTurnerBio … rise after you fall.
Five years ago he was 25 and left with nothing after his first company failed.
Today he’s built two different $1B+ businesses inside the same company, yet almost nobody knows his name.
His name is Fred Turner. The company is Curative. The insurance business just crossed $1B ARR.
I first backed Fred at 21. He was building a genetic testing company for cows. Years later, everything collapsed overnight when a term sheet was pulled. Lab gone. Debt provider took over. Brutal ending for a young founder.
On New Year’s Eve 2019, while I was on my honeymoon, he called asking for my lawyer to sue the investor who walked. I took the call hiding in the bathroom. I told him not to waste years on a lawsuit and that winning is the sweetest revenge.
I offered him a month of runway. He said the lender would seize it.
So I told him that if he ever started something new, I’d back him again.
Six weeks later he called. Ready to try again. No deck. No hype. Just a founder who’d been knocked down and wanted to get back up.
His idea was sepsis diagnostics. He told me 285k people die from it every year in the U.S., often without knowing because results take too long.
I thought “coronavirus” was already in the U.S. and asked if he could test for it. He said it would take a new lab 4–6 months to get licensed.
I joked that if coronavirus were a startup, I’d make a massive bet on it.
I backed him anyway at a ~$3M valuation. I didn’t know if it would be the best investment of my life or just a donation to humanity, but it felt right.
Two weeks later he said he found a lab and would have to move to LA. Turns out the “LA lab” was actually in San Dimas. I told him I had no idea where that was, but he should move anyway. He did.
Then the world shut down.
Fred built Curative’s first business, COVID diagnostics, from $0 → $1.4B in 9 months. Millions of tests. Lives saved. My first check returned ~80× within a year, and a majority of the profits stayed in the company.
Amazing investment, but he wasn’t done.
While running diagnostics, he saw how broken health insurance was. Instead of taking his profits and calling it a day, he bet everything again. A full restart.
Curative 2.0, a next gen health insurance company, went from $0 → $1B ARR in 2.5 years. The company becomes profitable this quarter.
To maintain Curative’s A.M. Best rating and limit dilution, the internals did a small round to strengthen reserves. Fred reinvested. Curative’s CFO, Tami, invested her own money.
I invested $47.5M between personal + JAM Fund, even though my original personal check from Feb 2020 is already up ~400×.
It’s the only time I’ve ever invested more than pro rata after a win that big.
Why? Because some founders are worth backing again and again. And with a $1.8T TAM, there’s room for another 100×.
Fred built:
• $0 → $1.4B revenue (diagnostics)
• $0 → $1B ARR (insurance)
inside the same company by age 30.
He got knocked down, started from zero, and built something world changing, twice.
Bookmark this: Fred Turner is building a $100B+ company. Almost nobody realizes it yet.
They will soon.
Ever wonder why your insurer charges a copay for statins (and other high-value meds)?
Don’t they want to prevent heart attacks, strokes, etc?
Copays never made sense to me.
In this new paper in @QJEHarvard, we show copays kill. 🧵
https://t.co/3PHeckLiZM
@nikillinit Also if you’ve spent 10 years preaching that HDHPs are the solution to everything it’s quite hard to pivot out of that. And to get rid of cost sharing it has to be complete, having some plans with and some without leads to massive selection bias between plans and wouldn’t work
@nikillinit Because going in the opposite direction, increasing cost sharing, saves money by decreasing utilization on a 12 month time frame but increases cost long term. Getting out of this has some “activation energy” that is small for a new plan but very large for United.
STAT's @bobjherman spoke to @FredTurnerBio about how #Curative pivoted from being a Covid test maker to a health insurance company. https://t.co/vkP2PyjkLi
From improving sepsis outcomes ➡️ responding to the COVID-19 pandemic ➡️ tackling one of the biggest challenges in healthcare today: health insurance.
Curative CEO and co-founder, @FredTurnerBio, is now on a mission to reinvent health insurance.
https://t.co/gdVa3517Ys
"No deductible. No co-pays. No out-of-pocket expenses. No prescription drug costs. All the health insurance benefits." No...really.
That's Curative.
As CEO @FredTurnerBio said, "The design is one big financial incentive for preventative health."
https://t.co/M3x9LgvdLK
We are pleased to announce Curative’s acquisition of @WingspanHealth, a company that shares our commitment to delivering a human-centered, technology-powered healthcare experience. By joining forces, we can deliver better health and quality care seamlessly for our patients.🤝
2 incredible challenging years, a lot of patients served, a fantastic team built at @Curative, a great company started with a tweet from @FredTurnerBio. Looking forward to Curative 2.0.
👏🏻 @FredTurnerBio won @Comparably#BestCEO for Q4 2021! 🏆 Through his leadership we were able to effectively scale to over 40+ states and deliver over 26MM+ COVID-19 tests throughout the pandemic. Read more on @BusinessInsider: https://t.co/aI77ZzLUXp #ComparablyAwards
Our Dodger Stadium testing site is BACK! As the holidays approach and demand for testing increases, we're here to help you have a safe season.
More in the news: https://t.co/ZTgRa0FD2p.
#COVID19testing#COVID19testingLA#Dodgers#DodgerStadium
Our 2020-2021 interactive #impactreport documents the work of our hardworking employees and dedicated partners to keep communities safe, healthy and informed throughout the COVID-19 pandemic.
Report: https://t.co/11w8RLgcYu
Blog: https://t.co/dEX4VBsfi2
Come work with me! Let’s build better healthcare. We’re looking for people to fill many roles including software engineers, managers, product people, data scientists, security and QA.
DM or visit https://t.co/rBzV10DvSA