It’s Time to Build in Healthcare

Can a country be built from the internet up? Not as a metaphor or an online community, but as a system that replaces institutions we usually think of as fixed, money, law, and governance. In this conversation taken from The Network State Podcast, a16z cofounder Ben Horowitz joins Balaji Srinivasan to explore how internet native institutions are beginning to mirror and challenge traditional state structures. Drawing parallels to China’s early special economic zones, they discuss how constrained experiments like Shenzhen tested new rules without rewriting the entire system, and why similar experimentation is now happening online. The discussion examines crypto, digital identity, and network states as attempts to turn code into coordination and coordination into legitimacy, while grappling with a core tension. Code is deterministic, but societies are not. Ben and Balaji explore where these systems work, where they break, and whether network states are a curiosity or the next phase of governance.

Out-of-Pocket is a healthcare education company founded by Nikhil Krishnan that helps people understand how healthcare works and how to navigate it in practice. In this episode, a16z investing partner Jay Rughani and Nikhil discuss why health insurance is losing its role as the default way people access care. They explain how rising costs are pushing more consumers to pay out of pocket for diagnostics, preventive care, and navigation. The conversation also looks at what this shift means for startups, AI-powered tools, regulation, and access as healthcare continues to move beyond insurance.

In this episode, Jen Kha, Head of Investor Relations, and David George, General Partner, discuss how late-stage private markets are evolving as AI reshapes scale, capital intensity, and growth timelines. They explain why AI-driven companies are staying private longer, how infrastructure spending is changing return profiles, and what this moment means for durability, value creation, and long-term outcomes in private markets.

Mintlify is a documentation platform built by cofounders Han Wang and Hahnbee Lee to help teams create and maintain developer docs. In this episode, Andreessen Horowitz general partners Jennifer Li and Yoko Li speak with Han and Hahnbee about how coding agents are changing what “good docs” mean, shifting documentation from a human-only resource into infrastructure that powers AI tools, support agents, and internal knowledge workflows. They share Mintlify’s early journey, including eight pivots, the two-day prototype that landed their first customer, and the “do things that don’t scale” sales motion that helped them win early traction. The conversation also covers why docs go out of date, what “self-healing” documentation requires to actually work, and how serving fast-moving customers has shaped both their product priorities and their pace.

Inferact is a new AI infrastructure company founded by the creators and core maintainers of vLLM. Its mission is to build a universal, open-source inference layer that makes large AI models faster, cheaper, and more reliable to run across any hardware, model architecture, or deployment environment. Together, they broke down how modern AI models are actually run in production, why “inference” has quietly become one of the hardest problems in AI infrastructure, and how the open-source project vLLM emerged to solve it. The conversation also looked at why the vLLM team started Inferact and their vision for a universal inference layer that can run any model, on any chip, efficiently.