Episode Details

One of us had a wicked head cold last week and ended up getting nothing planned for the week done except becoming a professional ginger tumeric peeler and tea maker. Meanwhile the other of us made up for it by programming an entire app that will power the Crusonia venture we are launching.

We decided Friday we would formally kick off the new year for the Substack with a live conversation that started as an attempt at structure and ended, predictably, somewhere between Tom Sawyer and economic theory. The most exciting part for Ellen is that she went an entire hour and a half without a sneeze. As for our ramblings, quite frankly, I think everyone expects that from us and would likely be surprised if it were different.

But here’s what matters. We don’t think 2026 will be another year of incremental change. We think it’s the year the pieces finally converge.

We’re done pre-gaming. The infrastructural forces are aligned. The question isn’t whether healthcare transforms, it’s who dives into System C transformation and what happens to the incumbents who don’t. And the same holds true for food. With GLP-1 now becoming close the cost of some cell phone monthly bills, we expect the food industry will have no choice but to pivot very quickly.

If you want the cliff notes version (Andy Beckman - hopefully you see this) - we added a section at the bottom.

The Predictions

The Gen Z Wildcard

The first prediction. At the end of 2026, we’ll look back and see that Gen Z changed the equation.

Not because they’re better or smarter than other generations. But because they have a fundamentally different relationship with healthcare, information, and self-determination. They’re also the core of pre-chronic cohort - under 40, healthy enough to opt-out of the incumbent healthcare system, tech-native enough to figure out their own solutions.

They’re not buying insurance. They’re using Mark Hyman as their doctor. They’re taking their Function Health data, throwing it into ChatGPT, and building protocols that would take a physician weeks to research. They’re microdosing GLP-1s they bought on the gray market for $25/week while Lilly charges $1,000/month to employers willing to pay the price.

Here’s what matters: They’re predictable in their unpredictability. They’ll do what’s necessary to stay alive in an affordable, manageable way. To them, this looks normal. To those of us over 50, it looks like noise. Especially those over 50 in healthcare. But noise has a way of becoming signal when enough people generate it.

The Minnesota daycare fraud story reached 100 million people, more than 10x what 60 Minutes gets on a good day. Young people moved elections that boomers can’t quite understand. They’re influencing family units upward, the typical matriarch/patriarch structure inverts when Gen Z enters because they actually might know more about navigating this new landscape than their elders.

The GLP-1 Cascade

The second prediction: 2026 is the year GLP-1s hit critical mass. They could easily hit $100 and result in a 25%+ weight loss outcome. The gray market’s already there with next-generation peptides at $25/week, functionally equivalent to what Lilly hasn’t even gotten FDA approval for yet.

This matters because it triggers a cascade:

Q1 2026: Food industry feels it first. We’re already hearing from CPG executives about sales disruption. When you’re not hungry, you buy differently. Think share of stomach instead of selling calories. When 20-30 million Americans are on semaglutide variants by year-end, the grocery cart changes at scale.

Q4 2026: Lilly (and Novo Nordisk) hit their Clayton Christensen moment. They’re losing 30% of sales to gray market peptides. The music industry had to deal with MP3s. Pharma now has to deal with the fact that people are comfortable enough to biohac