We started with the short-term belief that we wanted to democratize access to the world's best concierge medicine. I remember when we launched, we had this manifesto and it opened with something like: healthcare is broken. 80% of Americans are metabolically unhealthy. There are thousands of toxins in the natural environment. Male fertility is declining. Women's fertility is declining. Our longevity is going down. Chronic disease is going up. And that emotional narrative in a post-COVID world was really resonant.
There shouldn't be a question of whether I go to a human doctor or an AI doctor. Everyone will have to go to an AI doctor because it will be far better than any human can ever be.
Welcome to Subversive, a podcast dedicated to sharing stories from the best consumer subscription apps in the world. We'll bring you lessons for how to grow your consumer subscription business, including insights and inflection points that led to exponential growth from leaders at category-defining companies and innovative startups. Let's get into the show.
My guest today is Max Marchione, the co-founder and president of Superpower, a startup that is reinventing digital health to help people live longer and better lives. In this episode, I talked to Max about how his personal health struggles as a teenager later inspired him to start Superpower in 2023, about how the company managed to build a waitlist of over 100,000 people before launching publicly, and about the many ways that Max expects AI to improve the quality and reduce the cost of healthcare in the coming years.
All right, welcome Max to the Subversive podcast. Super excited to have you on today to talk about Superpower, which is a relatively new startup in the digital health space. It's a product that I've used and very much enjoyed over the last year or so. And so excited to get into the story today. But before we go too far, would love to just hear a little bit more about your background and your path to launching Superpower, and then maybe you can tell us a little bit more about what Superpower is for those who don't already know.
Yeah. So I find this question interesting because the premise of these kinds of questions is that there has to be a path, and we look for linearity in stories. And typically what happens is people therefore either retroactively feed a story to solve for what they're trying to persuade someone about, or they pretend that there has to be steps in a path and you do this step and then this thing and then eventually you can do the thing you want to do. So the thing I'd instead suggest, as a more meta thing, is what happens if we enter a world where people can just choose to do the thing without actually having to take the steps to do the thing? Now, that's not the point of the question. So I will answer it.
I have been starting all sorts of things since I was quite young, around eight, just small companies. I've always liked having opinions on the world and trying to make them come to life through the act of creation, which is starting a company. Around three years ago, I was thinking about what do I want to spend the next 30, 40, 50 years of my life on, and I had just quit my job at Goldman Sachs. I was running two small companies at the time, and I realized that three things had to be true. One is that I had to work on something that was deeply personally meaningful, and for me health is one of those things. I went through a long period of misdiagnosis, surgery, told to medicate for life. No one really knew what was wrong with me, and so I had to take matters into my own hands. Basically from age 8 to 18 that happened. So health was deeply personally meaningful.
The second thing that had to be true is what was globally meaningful. What matters for the world? There are very few ideas or companies that progress human life or push humanity forward, and health is one of those things. And then the final thing is what can support at least a 100-plus billion dollar company. If you're going to work on something for 30, 40, 50 years and you want it to be important, I think that this is a really great guiding and framing question, right? It forces you to think for the long term and think about what can compound. And there were two things I was thinking through: do I start a new city or do I start a new healthcare system? And I thought that the healthcare system comes first, at least for the first 50 years. And I moved to the US, and here we are a couple of years later.
Yeah. Well, first of all, I really love the creativity and nonlinearity of that answer. I think I'm certainly somebody who at various points in my career has been guilty of being overly linear in how I think about things, and so appreciate you breaking the mold there. It sounds like while maybe professionally you've done a number of different things and there hasn't been a clear A to B to C path, you had very personal experience with misdiagnosed health issues between the ages of 8 and 18 that inspired you to come up with this vision for Superpower. So I'd love to hear a little bit more about that story, just the origin story behind Superpower and what inspired you to do it in the first place.
So yeah, the linearity thing is interesting because if I look at the way people are trained in the US, it's in fabrication. It's tell your story to get into college, right? When you start a company, you're also taught fabrication: tell the story that explains exactly why you started this company. And the way I see founders do that, they're like, 'Oh, cool, I'm working on this thing. Cool, let's work out the story now.' Like, is that actually how it came about? I want to hear how you actually thought about things. What was the actual reasoning? And now the set of all your prior experiences probably informed what you build today, and that's where I think the story can be interesting.
And if I look at that for me, part of why I've been really, really obsessed with health and believe that something has to change is what you're saying, which is the challenging health experiences. Basically from age 8 to 18, I had a host of health problems: chronic migraines. It would take me three hours to get to sleep every night. I slept through half of my high school classes. I used to sprint and play soccer semi-professionally; I'd be asleep like 10 minutes before a race. Had chronic sinusitis, had surgery, was told to medicate for life, saw over a dozen doctors, and no one knew what was wrong with me. And when that happens, you start to be like, well, I have to do something. So you start to research. That's what I did. I remember wearing a big Gen One Oura ring back in 2016. And people thought that was crazy back in 2016 to track sleep. They used to make fun of me, and then I pulled out the blue light blocking glasses and mouth tape, and they thought I was fully psychopathic by that point.
And because I was trying so many things and testing so many things, I became interested in investing in those companies. So I'd keep a long list of all the companies that I was seeing and I'd try to invest in them all. I invested in my first one; it was a longevity biosciences company when I was 17 years old. And again, I didn't really know what I was doing. I was like, 'This seems cool and interesting.' And I think that set of experiences exposed me to the world of self-learning, of health, and of the gap between mainstream health — what your doctor says — and the best of health, right? The kind of healthcare Jeff Bezos might have. And I ended up solving my health problem by finding a genius doctor who connected all the dots, who tested my whole body, and made me realize that there's a big gap between the best of healthcare and what most people have. And one articulation of Superpower is in response to that gap, right? We fundamentally believe that gap should not exist. And for as long as it exists, it's on us to close it.
And so you all came together — it was you and your co-founders in 2023 — and launched Superpower. And my understanding is that there was this waitlist that got built up in part because it sounds like you've had experiences with the shortcomings of the medical system. I've certainly had experiences with that. I think many of us have. So what did those early days look like in terms of developing the MVP, and when did you know that you were ready for public launch?
We started with the short-term belief that we wanted to democratize access to the world's best concierge medicine. And in the early days, the manifestation of that belief was: let's start with a $10,000 membership, and then a $2,000, and then a $799, to take high-quality medicine and then productize it bit by bit more and more over time.
That sounded sensible. I guess like the Tesla approach.
I think it was actually a bad decision. The reality is that if you start at a $10,000 price point, you end up making decisions for that price point rather than for the democratic $4.99 or $1.99 or $99 solution.
So the mistake was launching that which was too service-led, too high-touch, set too many expectations, and the correction was actually scoping down to closer to where we want to be in the limit, which is a $499 membership, which forces us to make decisions commensurate to building something which the majority of people can own. And we launched several months ago. I guess we announced the company mid last year and then properly launched several months ago with that price point and with that offering. And for us, launch was defined by having a product that we really loved, that we were happy with, that we would want for our friends or family. And to get there takes a lot of testing, bringing a lot of people through early, a lot of learnings, a lot of hacking away, and we eventually got there.
Yeah. And you mentioned that obviously you had friends and family members as early adopters, but there's so much testing that goes into the crucible of building an MVP and getting it ready for launch. How did you identify and recruit some of your other early adopters? I know you built this — ultimately you had a waitlist of over 100,000 people who are excited to use this product. How did you identify those people, and how did you get them excited about Superpower?
Initially it started as people we knew. The very first customers were friends, acquaintances, family members, people who would give us lots of feedback, who would test with us, and then we started growing by word of mouth. Most of the almost 200,000-person waitlist, the bulk of it, was word of mouth — people posting on Twitter organically. We did a few different viral marketing drops that tried to define and create culture and create awareness.
I think having really strong and stable brand foundations helped primarily — at the level of our beliefs that underpin the religion, our strategic identity as a synonym for beliefs, and then also at the level of how do we look, how do we show up? We are an orange healthcare company; that didn't exist. Every health company was blue. So we were distinct at the level of the visual identity as well. So the way this was organic: build a good product, word of mouth, have a very resonant strategic and visual brand, and then do interesting marketing drops to capture attention on the internet.
Was there — I mean, that approach makes a lot of sense. Much easier said than done, but you guys managed to be very successful with it. You mentioned some of these marketing drops. Were there any particular points that really resonated with people? We talked a little bit earlier about the frustration people have with the medical system, particularly in the United States. What were the key messages that were really resonating with people?
There was strong disenfranchisement with the health system post-COVID. There was this sense that the health system had failed people. I remember when we launched, we had this manifesto and it opened with something like: healthcare is broken. 80% of Americans are metabolically unhealthy. There are thousands of toxins in the natural environment. Male fertility is declining. Women's fertility is declining. Longevity is going down. Chronic disease is going up. We made this statement that here is the brokenness of the system — a system that misses red flags and reacts too late and doesn't see the full picture. And that emotional narrative in a post-COVID world was really resonant.
And when we initially announced the company, we had hundreds of people who messaged us saying this is so special and meaningful, I wish that more companies like this existed. They messaged us with stories, and we have a big Notion page of hundreds of stories that people sent us, emphasizing why they believed this had to exist in the world. So some of that messaging resonated.
Are there one or two stories — obviously anonymously — but one or two stories you could share? And this has personal relevance for me because I've had friends and family members go through some of this stuff recently, and it can be very painful. So I'm just curious about some of the more interesting stories you heard in the process of launching the company.
There were many stories of misdiagnosis — people who had things that were missed. There were many of our members who discovered things that were missed. I discovered I had pre-diabetes. I discovered I had mold toxicity. And I wasn't a lone story. Many of our members discovered very similar things, with mold or plastic exposure, or hormones that were out of balance, or a high genetic risk of heart disease as seen through LPA. So there were many of those things that were quite common across many members. Because a one-off is a story, and then in the aggregate it's like, well, this is actually really interesting data, and it starts to suggest that having access to this information about your body via a blood test as a starting point is actually really helpful for a lot of people.
Yeah. Well, and as somebody who started using the product at the beginning of this year, I can attest to some of this. I mean, I'm somebody who runs four or five days a week, generally tries to eat healthy, considers myself to be a fairly healthy person, and my results were solid, but there were certainly opportunities for improvement. And so I found it really compelling to have all your health data in a single place and to be able to diagnose where you might be able to do a little bit better, whether it's on sleep or nutrition or fitness. So why don't we take this opportunity to talk a little bit about what Superpower is today — the online health platform, the access to clinicians, the marketplace for purchasing supplements and other services. And then I'm curious to hear, to the extent you're open to sharing, where you see the company going over the next three to five years, and we can talk a bit more about the strategy for how you get there.
Today we're an annual membership: $42 a month, $499 a year. There are a few parts. One is we'll give someone twice-annual 100-plus blood biomarker tests. We'll pull all of someone's data into one place, pulling in their past medical records, integrating their wearables, allowing for data upload. We'll connect the dots across all of this data and build someone this big report — and people, like someone gets the report and they're typically like, 'Whoa, this is really special and really game-changing. I hadn't realized a lot of this stuff about my health.'
And then we make it easy for someone to take action. So at any time someone can pull out their phone and send a text message to their medical team. They have a concierge team in their pocket that will also proactively reach out. They will understand their data, and they can order all sorts of follow-up things. So if you need follow-up diagnostics, that's through us. It's not within the $499; some of those diagnostics can get expensive. If you need health products, pharmaceuticals, supplements, referrals, that can be done through us — all cheaper than anywhere else, and higher quality, and more convenient. The belief is that care within the ecosystem when you're a Superpower member is better, cheaper, and more accessible than anywhere else. That's the fundamental belief. So that's where we are today: an annual health membership focused on prevention and human performance.
And our belief is, let's keep — in the future, let's just keep adding to that membership, similar to how Amazon Prime has made Amazon Prime more and more valuable over time. How can we make this membership so valuable that the majority of people should own it? How do we reduce costs? How do we add services? How do we add software? How do we do more on the AI side, such that we get to a point where, just as 150 million Americans own an Amazon Prime membership, 150 million Americans own a Superpower membership? And this is what you do if you want to be healthy. And in that world, I believe everyone has a super app on their phone with an AI doctor on it, and that actually becomes the first place people turn to access care, before going to Google, ChatGPT, or their primary care doctor.
I will say, speaking from personal experience, both for myself and my two daughters — I have an eight- and a five-year-old — my wife and I are more and more turning to ChatGPT or other AI tools as our first line of defense for just diagnosing things that crop up day-to-day, week-to-week. And so, drawing the trend line of where that could go over the next three to five years, I can easily see a world where, yes, you're still going to see a human doctor at some point, but more and more an AI doctor could solve a lot of your problems. How do you see this evolving, say, by 2030? Like, what could a Superpower user be experiencing five years from now if your vision comes to fruition?
There shouldn't be a question of whether I go to a human doctor or an AI doctor. Everyone will have to go to an AI doctor because it will be far better than any human can ever be. It will predict things far in advance. It will connect the dots. It will tell you exactly what to do. We'll no longer be in a world of asking, 'Should I trust this?' It should be like, well, no, obviously I trust this. It knows so much about me and so much about medicine. It knows all of my preferences and knows exactly what I'm like, that we kind of have to trust the algorithm. And that's where we get to.
A member should be able to come to us first and know that for any health question, we can solve that in the highest quality way with the holistic clinical model, and in the lowest price way, right? We should be able to navigate someone across the health ecosystem. Someone should come to us and want to research and explore and have all their data in one place. And then hopefully — and this is a little bit more far-fetched — hopefully where we get to when we have all this data in one place is that we can realize things that no human ever has. We can actually start to say there's actually a whole other world of medicine out there that we've kind of overlooked in a human-led paradigm, but now in a technology paradigm, we can discover. And that's on the diagnostic side and also on the therapeutic side. So those are some of the things that I don't think are actually that far-fetched, despite what some people might think today.
Yeah. I'm going to go off script a bit here because I have this framework I've been thinking about recently, just in terms of my own medical experience, and I'm curious if it resonates with you. Let's say as recently as 30 or 40 years ago, the majority of people — at least in the United States, I won't speak for the rest of the world — were living in smaller towns. They typically had a doctor who was taking care of them for most of their lives, starting in many cases from the time they were a child. And so they had a lot of context on who this individual was, what their living environment looked like, what their prior medical history looked like. And what that meant was they could more easily diagnose issues that fell one to two standard deviations or more outside of the mean.
I think more and more doctors have gotten better and better at diagnosing people who fall within a certain band of what's quote-unquote normal. But if you have an issue that falls too far outside of the norm, then because doctors are so hurried these days and they have so little time to really deeply understand patients and their medical histories, it can be really hard to diagnose one of these corner cases. And this is where I found AI to be so powerful, because it can pattern match across all of the information available on the internet in order to get at these needles in a haystack that sometimes crop up with human health. And so my hope is that over the next three to five years we continue to have the benefits of advancing medical technology and advancing medical expertise in the form of human doctors, but then we also get all the breadth that we used to have with family doctors through AI. Does that resonate? Is that sort of where you see things going?
Yeah, 100%. I think that what I'm hearing is, context helps with diagnosis, and medical knowledge helps with diagnosis. And humans have limited context; they don't know everything about you — all of your data, all of your medical history, all of your preferences, what's happening at any point in time. Like a doctor spends five to ten minutes with you, right? And humans have limited medical knowledge. Now, doctors lag the research by 17 years — known stat. So what AI does is it solves for context, it knows about you, and it solves for medical knowledge, it knows about all the latest medicine. A new paper is published and the AI has access to that. So I think the implication of that is that AI becomes far better than humans at computation between the database of the patient and the database of medicine. In other words, it becomes far better at diagnosis and far better at determining the optimal treatment plan.
Yeah, I can certainly believe that. Well, I want to go back to — we talked about vision. Let's talk about the strategy for realizing this vision. And I guess a place I would love to start: I really celebrate your desire to democratize this platform for as many people as possible. Right? Obviously, a $10,000 a year price point is going to be inaccessible to the vast majority of people. Even a $500 a year price point is only accessible to so many people. And so how have you managed to so quickly — and I know there's only so much you'll be able to share here — be able to offer a lot of these services at such a low cost? You mentioned that a lot of these supplements and other services are available at a lower cost than you could find anywhere else. And do you think that over time, whether due to advances in AI or other technology or for other reasons, Superpower will be able to offer these services even more cheaply than you do today?
The way we get there is three things. One is partnerships that result in us having a lower price or lower cost. The second is choosing to charge less and make less money — like we believe that healthcare is overpriced. And the third is by bundling: selling a membership alongside access to everything else, we can undercharge, similar to how Costco can own the price on anything because they have the membership, or Amazon Prime charges less because there's this Amazon Prime. The combination of these things allows us to potentially change the structure of how healthcare is priced, where today Hims makes an 80% gross margin selling a commodity.
In what industry do companies make 80% gross margin selling commodities? It doesn't happen, except in healthcare. And they earn that margin because they have to spend it all on customer acquisition every time. Now, in the world where we have people coming to us first, we don't have to spend on customer acquisition every time. And the implication is that what Hims sells at 80% can be sold lower. And that's what the structure of healthcare should look like: things priced the way they should be priced, as commodities, not priced at exorbitant prices because there are companies pretending that these things are not commodities.
Yeah, that's interesting. Well, and I feel like we don't have to get into your unit economics or trade-offs you're making in terms of growth versus short-term profitability, but I would imagine that because you have this platform, that as more and more people use it, you become the centralized point of personal health data that unlocks all sorts of adjacent opportunities to sell products and services. You're already doing it a bit with Superpower Marketplace, selling supplements, but there's all sorts of additional things that you could serve to your customers if that core platform really starts to work.
And so one of the trade-offs — you're a very unusual, atypical consumer subscription business, but ultimately you're a consumer subscription platform for health — one of the trade-offs that companies often face is: do we keep our prices low and try to grow primarily through organic word of mouth or other non-paid channels, or do we increase our prices and then just go spend the extra money on Facebook and Google to acquire users? I would imagine you're more aiming to be on the former versus the latter end of that spectrum. But how do you think about balancing short-term profitability versus just maximizing growth? Because if you get to that tipping point, then this is a very valuable business in the long run.
Right now we don't want to be losing money on the things we sell. We also believe that great consumer businesses are not built on Facebook and Google, or Meta and Google. The implication is we need to think about not how to drive growth through getting better at ads, but how do we drive growth through having a
Business model or a product which is conducive to growing. For an example, this is like a free business model. Like we don't have any plans to go to free. We're not going to do it, at least for the foreseeable future. But free products have growth baked into the business model, which is you're free, right? Things grow exponentially fast, and then the risk they're taking on is can you monetize, right? But I think then there are some companies at the opposite end of the spectrum, which is like we're going to take zero, we're going to not use the business model to grow. Instead, we're going to do what you said, which is actually just use the gross margin with a higher priced business model to grow. We're probably somewhere in between. I don't think we skew too far in either direction.
Got it. Okay. Well, and you're selling a service that's valuable enough that your LTVs, I imagine, are still going to be very, very high. It's probably too early to even know in many cases, because if your retention is high, then it's going to be years before you know your lifetime value. Yeah, and for that reason, you can afford to spend on acquisition, but you're also doing the best you can to grow organically. And it sounds like because this resonates so deeply with your customers, you are getting a lot of organic word of mouth. Has that continued since the launch?
Yes. A little bit less so now. And I think the reason for that is honestly probably that we've just done a worse job of educating our members on how they can sign others up. In the early days, we had clinicians in the loops. There was this human touch point, and that makes it possible to say, 'Oh, do you think other people should sign up? Are your parents members? Do you want to add them in?' You ask the children, whereas now we don't really have that touch point, and it's also not a focus at the moment. Like we don't have—yes, we have the referral motions, again we still have a reasonable word of mouth, but I think to drive that really effectively, yes, you need product, but it also has to be a focus. There are things you can do at the level of the product by focusing on it to make word of mouth rates higher. And we have limited resources and limited places to invest, and our job is working out how to spend limited resources on the most important things.
Yeah, makes sense. So, I think that's actually a good segue into the next section that I wanted to talk to you about, and that's sort of where you focus your limited resources in the short term to really get this flywheel going. So, you only launched—you launched the company in 2023. I believe you launched publicly about a year ago, maybe a little bit more. Which customers have you found are your strongest early adopters? Is there a particular archetype or a description of your ideal customer profile right now, and how do you think that expands over time?
We have been amazed by how broad and varied the people who have signed up are across geographies, ages, demographics, income brackets. It's been way more varied than we expected. Our focus is on targeting taste makers, because we believe that if you want to define culture and create a religion and a brand that people love and relate to, you need to start with the taste makers. And taste makers tend to be media and wellness in LA, finance and fashion in New York, and technology in SF.
