Jul 18, 2026 · 1h 29m · news
We Built Our Own Salesforce in Months. Here's Why We're Cancelling the $600K Contract | Curative CEO
Clips from this episode (6)
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Curative co-founder and CEO Fred Turner joins Harry Stebbings on 20VC to detail his extraordinary journey from scaling a $5 billion COVID-19 testing operation to pivoting into a $1.3 billion AI-native health insurance provider. He discusses replacing traditional enterprise SaaS with custom AI agents, navigating US healthcare economics, and launching a fail-safe nuclear energy startup.
How this conversation actually went
Every chapter scored 0–10 on four independent dynamics. Hover any point for the reasoning behind the score. Harry holds 16.9% of the talking time here. How this is scored →
Harry as informed peer 5.0 Guest teaching 5.9 Guest disagreement 1.9 Harry pushing back 2.5
speaking balance: gold is Harry, purple is the guest (3 minute bins)
Sharpest disagreement ▶ 45:40 Vibe coding vs SaaS vendors
Fred emphatically dismisses conventional SaaS infrastructure, asserting that an internally vibe-coded CRM completely eliminated their need for a $600K Salesforce contract.
Hardest push from Harry ▶ 46:15 Harry challenges vibe-coded CRM maintenanceHarry pushes back directly on whether the engineering overhead and maintenance of in-house vibe-coded software outweighs paying SaaS enterprise vendors.
Biggest teaching moment ▶ 44:00 Single-use Python generation over universal parsersFred explains how they bypassed years of failed universal data parsers by having LLMs generate, execute, and immediately discard custom Python scripts for every incoming file.
Harry holds his own ▶ 1:25:15 Harry calculating developer salary token ratiosHarry cites Benioff's developer spend metrics on Anthropic to press Fred on what percentage of developer salary AI token consumption will realistically represent in three years.
the scores for every segment, with the reasoning behind each
| Chapter | Topic | Harry as informed peer | Guest teaching | Guest disagreement | Harry pushing back | Why |
|---|---|---|---|---|---|---|
| Founder Mindset: Thrill of Winning vs. Fear of Losing | 4 | 3 | 1 | 2 | Harry opens with questions on founder psychology and contrasts UK vs US venture ecosystems. Fred shares his perspective on why the UK's credential-focused risk aversion hindered early fundraising. | |
| Early Startup Journey: Cattle Genetics & Milk Yield | 3 | 5 | 1 | 1 | Fred recounts starting TL Biolabs sequencing cows for muscle and milk yield traits, detailing his unexpected path into YC. Harry mostly listens with amused curiosity at the bizarre founder journey. | |
| Pivoting to Human Diagnostics: Sepsis & STD Testing | 4 | 6 | 2 | 2 | Fred breaks down the math behind moving from cattle genomics to human diagnostics like STDs and sepsis, educating Harry on sepsis biology and mortality dynamics. | |
| The Downfall of Shield & Lessons in Failure | 4 | 4 | 1 | 2 | Fred explains how Shield failed after a strategic pulled out of a Series B, leading to the fire-sale of their lab license for $150K right before COVID made it worth millions. | |
| The Birth of Curative & Pivoting to COVID-19 Testing | 4 | 6 | 1 | 2 | Fred describes founding Curative for sepsis care before pivoting into COVID-19 testing, buying a $27M lab JV via customer cash flows, and landing the LA City contract from a single tweet. | |
| Hypergrowth: Scaling to $5B Revenue and 7,000 Employees | 5 | 7 | 2 | 2 | Fred explains how Curative scaled to $5B revenue and 7,000 employees using an orthogonal supply chain that avoided conventional lab bottlenecks. | |
| Vaccine Rollout & Searching for the Next Big Market | 5 | 6 | 2 | 2 | Fred breaks down why vaccinations were an unprofitable service business and walks through their methodical search for a multi-hundred-billion-dollar TAM, settling on health insurance. | |
| The Structural Problems in US Healthcare | 5 | 7 | 2 | 3 | Fred analyzes hospital consolidation, asymmetric rate negotiation, and market distortion in the US healthcare system. | |
| Pivoting into Health Insurance Before the AI Wave | 4 | 7 | 1 | 1 | Fred explains how LLMs fundamentally altered health insurance operations, detailing an in-house Claude agent that replaced the credentialing department and slashed turnaround from months to hours. | |
| Streamlining Claims Processing and Data Ingestion with Code Generation | 5 | 7 | 2 | 2 | Fred details Curative's novel use of single-use disposable Python code generation to clean and standardize chaotic incoming spreadsheets and PDFs in 15 minutes. | |
| Cancelling a $600K Salesforce Contract for a Vibe-Coded Internal CRM | 6 | 6 | 4 | 4 | Harry challenges Fred on whether vibe-coding internal tools justifies maintenance overhead. Fred defends cancelling a $600K Salesforce contract and cutting 80% of SaaS spend. | |
| Competitive Margins and Structural Hurdles in Legacy Insurance | 6 | 7 | 2 | 3 | Fred describes how Gwen, an autonomous contracting agent, scales provider network acquisition from 100/week to 100/day by relentlessly negotiating and redlining contracts over email. | |
| The Economics of Token Consumption and Displacing Back-Office Labor | 6 | 6 | 3 | 4 | Harry presses on token economics and whether price hikes would crush agent margins. Fred explains that LLM costs are dramatically cheaper than human labour even if prices 5x. | |
| The Future Value of AI Labs and Relentless Sales Automation | 6 | 5 | 2 | 3 | Harry and Fred discuss AI lab valuations and how relentless email follow-ups allow tiny teams to perform at unprecedented scales. | |
| Data Ingestion Realities and the Rise of the Agent Supervisor | 5 | 7 | 2 | 3 | Fred explains why messy data is no longer a bottleneck for AI and introduces the concept of the 'Agent Supervisor' as the most critical emerging job role. | |
| Preparing for Superhuman AI, Labor Shift, and Universal Basic Income | 5 | 5 | 2 | 3 | Fred and Harry discuss rapid model advancement, the inevitability of Universal Basic Income, and societal transitions away from mundane back-office labor. | |
| Delegating Authority to AI Agents and Macro Economic Impact | 5 | 6 | 1 | 2 | Fred highlights the psychological barrier of allowing AI agents legal authority to sign contracts, while noting regulated industries remain insulated from direct Big Tech competition. | |
| Curative’s $1.3B Valuation and Angel Investment Strategy | 6 | 6 | 2 | 3 | Fred reveals Curative returned a 10x dividend to investors post-COVID while letting them keep their shares, then outlines his nuclear startup Subcritical, which he co-founded with his wife. | |
| Nuclear Energy Supply Chains and AI-Driven Hardware CAD Design | 5 | 7 | 2 | 2 | Fred explains subcritical nuclear physics and how AI code-gen is revolutionizing hardware and CAD design for nuclear power plants. | |
| Balancing Dual Founder Roles, Early Believers, and Seeking Diverse Perspectives | 6 | 5 | 2 | 3 | Harry conducts a quick-fire round covering AI budget expansion, European regulation, Josh Buckley's early backing, and the leadership necessity of gathering diverse viewpoints. |
Statements from this episode (54)
Curative Grew Headcount From Seven To 7,000 In Nine Months
“And the company went from about seven to 7000 employees in, in those first nine months.”
Curative Is Cutting 80% Of Its Enterprise SaaS Spend This Year
“We're cutting about 80% of our SaaS spend this year.”
UK VCs Refused Meetings When Fred Turner Was 18
“Like when I found, I tried to raise a venture around in the UK and I couldn't even get meetings. This was when I was like, I was 18. I was in like first year of college and I was doing this startup on the side. I couldn't even get meetings with, I think I got …”
a16z Seeded Fred Turner's Startup With $1.65M Without A TAM Calculation
“Their bio fund did our seed round right out of YC, and I don't think they did the TAM calculation. They were like, oh, this sounds interesting, and then they did the round. It was a small round, it was like, 1.65 million.”
A $1.5B Total Market Is Too Small To Raise A Series A
“And there's about a hundred million cows in the US. If you're doing well, you could charge 15 to 20 dollars per test. So even if you assume you could test every cow every year, you'd be at 1.5 billion, like total market, which is not enough to do a series A of…”
Every Hour Sepsis Treatment Is Delayed Increases Mortality By 12%
“Because with sepsis, basically every hour that you don't treat somebody is about a 12% increase in mortality.”
Strategic Investor Pulling Series B Term Sheet Caused Shield's Collapse
“Ended up getting a term sheet from a strategic, large public diagnostic company. Signed the term sheet, did three weeks of work on docs. We were in the second round of docs, and then their CEO killed it because it was too competitive with their core products. …”
Curative Wouldn't Have Pivoted To COVID Testing If Shield Survived
“No, no, because I don't think we would have pivoted as hard into COVID when COVID hit.”
Fred Turner Sold CLIA License For $150K, Re-Bought Same For $27M
“And then in December of 2019, as part of the wind down, I sold that license to a company in San Diego for 150,000 dollars to pay some of the creditors. And then five months later, acquired a company in Southern California to get the same license for twenty sev…”
Justin Mateen Invested $125K At A $3M Valuation As Curative's First Check
“Put in, I think, a 125,000 dollars at a three million dollar valuation.”
City Of Los Angeles Paid Curative Daily On Net-One Payment Terms
“The best thing we could get with the city of LA, because they have obviously, you know, There's a city, there's certain restrictions, is that they would pay after delivery, but they would pay net one on the invoice, and so we would deliver the tests for a day,…”
Curative Won A Multi-Hundred-Million-Dollar Florida Contract For Nursing Home Testing
“Probably one of the Florida contracts was maybe the largest, so we did a contract with the state of Florida for all of their nursing home testing. I forget what the dollar figure was, but it was, you know, in the hundreds of millions of dollars. They put it ou…”
Curative Scaled To Peak 206,000 COVID Tests Daily Within Eight Months
“Our peak day was 206,000 people tested in a single day. And that was December of 2020. So that was within eight months from zero, zero to 206,000.”
Curative Generated $5 Billion In Revenue Over Three Years
“I think the total revenue ended up being about five billion over a three-year period.”
Curative Was The Largest U.S. COVID Testing Provider Outside Quest And LabCorp
“We were, yeah, we were the largest, like, non-LabCorp and Quest testing company.”
Curative's Dodger Stadium Site Tested 10,000 People Daily At Peak
“So if you went to a drive-through testing site, like the biggest one was the Dodgers Stadium site in LA. It was seven lanes of traffic, seven a.m. To seven p.m., seven days a week. So they were testing at the peak, about 10,000 people a day coming through thei…”
Curative Invested $500M Of COVID Testing Profits Into Health Insurance
“So after all was said and done, the money that we basically put forward into the insurance business, the health insurance company, was about five hundred million that we invested into the health insurance business.”
Curative Administered 2.5M COVID Vaccines At A Loss
“We did two and a half million vaccinations. That was another service we did. We also lost a ton of money on that. That was a terrible business.”
Total Market Cap Replacing LabCorp And Quest Is $30 Billion
“But even if you say, okay, I'm going to displace all of LabCorp and Quest, that's about thirty billion of market cap. So that's like the largest company you could possibly build is about thirty billion.”
Payers Ultimately Drive All Behavior In US Healthcare
“Everything sort of ends up coming back to the payer. Like, the payer is the one that drives behavior in the US healthcare system. If you are providing the dollars, people will go where the dollars aren't. If you say I'm going to pay for this service, people wi…”
Hospital-Affiliated Primary Care Doctors Get Double Independent Doctor Reimbursement
“If we look at how much we pay a primary care doctor who's independent compared to a primary care doctor affiliated with a system, they get paid an average double.”
U.S. Is Unequivocally The Best Place To Receive Medical Treatment
“Yes, definitely. Yeah. The U.S. Has the access to, by far, the most cutting edge techniques and facilities and drugs. Than the rest of the world. And they are willing to spend a lot more in order to preserve life.”
Curative Reduced Physician Credentialing Time To 12 Hours Using Claude
“And that used to take us two to three months on average, and cost about 50 dollars. We have now built in-house an agent that runs on, on Claude, that does this end-to-end, and it goes to the website, it verifies the license, it goes and reads the transcripts, …”
AI Agents Parse Messy Files Best Via Throwaway Python Generation
“What we found works amazingly is literally to give the files to an agent, tell it to write Python to get these files into a standardized format, because they're not very good at parsing files, but they're incredibly good at code gen, and so you can tell it to …”
Curative Canceled $600K Salesforce Contract For An Internally Vibe-Coded CRM
“We just recently canceled our Salesforce contract because we have an internal CRM that was vibe coded, that is working better, that is managing our process better, is more integrated into what we're doing. We run our agents inside of it, and no one was using S…”
Curative Built An In-House Claims Platform And Will Abandon Legacy Software
“We've built our own claim system Completely from scratch, in-house. It's now, we've migrated most of the workflows off. We'll be fully off in July.”
Big Insurers Will Take 10 Years To Adopt AI Due To Inertia
“I think some of the biggest insurers will struggle. They will not be able to keep up from a margin standpoint with where we can get to with agents. I think some of them do have Technical expertise. It's more operational and kind of people ops. If you've built …”
Curative's Anthropic API Spend Grew 6x Monthly Into Millions
“Our anthropic cost over the last six or seven months has six X'd every month from, you know, a base of, you know, a couple of tens of thousands of dollars now up to millions of dollars a month.”
Curative's AI agent Gwen signs contracts with the CEO's signature, 100 a day up from 100 a week
“So she now signs the agreements with my signature. She'll open up the DocuSign link and then click the button, and it's my signature on that agreement. And so this has taken us from doing about a hundred contracts a week to about a hundred contracts a day.”
Curative's AI Agent Executed 3,500 Contracts In Eight Weeks
“So this has taken us from doing About a hundred contracts a week to about a hundred contracts a day. Last year, as an entire team, we did 2300 contracts. So far in about the last eight weeks, the agent alone has done 3500.”
AI Agent Gwen Cuts Curative's Contract Costs From $2,000 To $70
“So it costs, with people, it costs us about 1500 to 2000 dollars on average to do a contract. The average with Gwen has been about 70 dollars.”
Fred Turner: Curative Engineers No Longer Write Or Read Raw Code
“They're not writing any code anymore. They're not even reading the code anymore.”
Curative's Smallest Employer Deal Is Worth At Least $1M
“And most of these contracts, right, most employers, even our smallest employers, it's a million dollar contract at least.”
Curative's AI Agent Signs Hundreds Of Contracts Daily Without Human Review
“We had a contract, a standard template contract that was drafted by a law firm, and then we have kind of like guard rails for what Gwen can agree to, but she just red lines it and then signs it. It doesn't go to a law firm for a review. Like, we're signing hun…”
Curative's AI Agent Gwen Sends 15,000 Custom Emails Daily
“So Gwen is sending on average 15,000 emails a day. Customized emails to providers that know about their practice, that know about their work, and one of the things we found is like that relentlessness of the follow-up is what works.”
Curative Headcount Will Shrink In Short Term Due To AI
“We're about 650 people now. In five years we'll probably be bigger. In the short term I think we're going to be quite a bit smaller.”
Enterprise Data Cleanliness Is Not A Major Barrier To AI Adoption
“I think if you approach it in the right way, then the cleanliness doesn't really matter that much because the models are so good at cleaning up the data if you give them the right context.”
Curative Used AI Agents To Migrate Dashboard Stack From Looker To Snowflake
“We moved away from Looker, right? Google's Looker product for visualizations. It's super expensive, and we moved to do it in Snowflake. And it's been a lot cheaper. It's worked really well. Part of that migration is moving all of our dashboards and all of the …”
Society Will Look Back In Disbelief At Mid-Level Administrative Jobs
“I think these are jobs that will look back and say, God, I can't believe we had people doing that kind of work.”
AI Labs Will Not Compete In Regulated Complex Industries
“I think things that have some, like, regulation around them, and are, like, complex industries, yes, they're gonna see the advantages of the models, but they're not gonna see competition from Anthropik or OpenAI.”
Curative Returned 10x Capital To Early Investors Via Post-COVID Dividend
“No, we haven't sold any secondaries. We did there was a dividend at the end of COVID. We paid out some all the investors got 10 X their money back before we started the health insurance company, and then they still have their shares today.”
Fred Turner Co-Founded Nuclear Fission Startup Subcritical With His Wife
“Yes. So there is a company that I co-founded with my wife, Subcritical, in the nuclear fission space based on an idea that I had a few years ago that we need more power and that nuclear is a really good way to do this.”
Nuclear Energy's Main Challenge Is Regulatory, Not Engineering
“That it is very safe. And that it's not a science or engineering problem. Like that was when we started looking at companies to invest in, that was for me, that the thing that I was sort of disappointed by is everybody was approaching it as if nuclear is this …”
Subcritical's Reactor Design Makes Runaway Nuclear Reactions Impossible
“So we are designed to operate at .97. So that means you never have enough neutrons to keep the reaction going. The reaction will always fizzle out. So no matter what you do, it's going to fizzle out. But normally that would mean you get no power output. What y…”
Coal Power Generation Will Mostly Disappear Over The Next Decade
“I mean, I think any power from coal will mostly go away. I think you're still going to see a lot of gas, just because, particularly in the US, it's cheap, it works, it's fast, but I think coal is going to go away, and then you're just going to see more of ever…”
AI Enables 20 Mechanical Engineers To Do Work Of 100
“And so we're seeing that you can do the design with far fewer people using AI to optimize a lot of the design parameters, where historically you might have needed a hundred mechanical engineers to design every single nut and bolt and part You can do it with 20…”
AI Creates Better CAD Models Via Python Than Direct 3D Vectors
“You can generate really good CAD models by having it write Python to make the CAD model. Like, it's not good at, necessarily good at, like, three-D space visualization or outputting a drawing Right, as vectors, but it's really, really good at generating plausi…”
Subcritical Nuclear Deployments Cost $1B Per 300MW Facility
“Each one of our deployments would be about a billion dollars of construction cost for a 300 megawatt facility.”
People Should Have Children Early Rather Than Waiting Until Late 30s
“I think, you know, like, have kids early when you have the energy and can run around and not sleep, and it's one of the best things you'll ever do. You should just get on with it.”
Current AI Models Can Perform Every Back-Office Task At Curative
“I think today, the current gen models can do every back office task we have at Curative.”