42 ms·
Watsi launches universal health coverage, funded by YC Research
- rsingla92 9y agoWatsi has been doing tremendous work in this area. Congratulations!
- pchristensen 9y agoThis makes my heart happy to hear!
- fillskills 9y agoWow thats cheap! That's awesome work Watsi team! What are some scaling issues you think you will face over the next few years?
- chaseadam17 9y agoThere are a lot - limited internet, different languages, technical literacy, and eventually government adoption. It feels like a lot of what we're doing is on the cusp of what's currently possible, but so far it's working, in large part because of the amazing work our team has done.
- fillskills 9y agoThose are some very big challenges. But bigger the challenges, the more fun it is to solve them. And more of a headstart you get over competition. Best wishes with the challenges. Your mission is amazing to say the least
- aheilbut 9y agoWhat exactly can be provided for $0.78 per month?
- chaseadam17 9y agoA comprehensive package of primary care benefits that includes all outpatient care at the clinic (e.g. preventive care, malaria treatment, etc.), limited in-patient care (but no surgeries), and deliveries.
- repiret 9y agoDoes the coverage premium fully pay for the cost of care, or are there additional subsidies?
- chaseadam17 9y agoThere are some additional subsidies in the form of in-kind donations that help cover immunizations, HIV/AIDS, malaria, and antenatal care.
- fgjjgutjvnu 9y agoDoesn't that kind of make "universal health care" a meaningless word? What about people who need surgeries?
- Noos 9y agoThis is for poorer african nations, and I doubt they are providing anything as opposed to giving existing efforts a convenient app to track things.
- sgpl 9y agoThis is awesome! Is there something in the works that would make it possible for 'donors' to cover the annual enrollment costs for others? Or would that defeat the purpose? And this is off-topic but that's brilliant photography - kudos to the photographer(s)!
- chaseadam17 9y agoThere's not a way to donate online to cover enrollment costs at the moment. The best way to support us is to sign up to fund a surgery for a patient every month: https://watsi.org/universal-fund https://watsi.org/universal-fund If you'd rather help cover enrollment costs for Watsi Coverage, please email connect@watsi.org and we'll respond right away. Thank you!
- ketralnis 9y agoI just wanted to echo that I'd be interested in an automatic recurring donation system. I'm sure you guys have thought about this way more than I have, but my understanding is that those kinds of donations are a significant portion of funding for other non-profits like NPR By the way, the link to "learn more" on the FAQ for "can I donate monthly?" links to http://wwww.https//watsi.org/universal-fund http://wwww.https//watsi.org/universal-fund which confuses my browser so I get a connection error
- _asummers 9y agoMy understanding is that having recurring payments gives a sense of "stable income" for the non profits, and while having massive donation campaigns is obviously helpful, it's much harder to forecast.
- toomuchtodo 9y agoI'd like Watsi to have an investment account where donations can be received but they operate off of the investment returns (similar to how Standford, Yale, etc operate financially). This would mean a gift provides for operating returns perpetually (or as long as the financial markets continue to exist). For example, a one time donation of $300 (invested) would provide for a health insurance member (at 78 cents/month) in perpetuity.
- Strom 9y agoFingerprint based system seems like an interesting choice. Don't these people do a lot of manual labor that scratches fingers? I sometimes have identifying trouble myself due to finger damage and I sit in an office.
- chaseadam17 9y agoWe're testing a few identification methods in addition to fingerprints, including cards with QR codes, name lookup, and family lookup. For fingerprints, we're using an algorithm created by Simprints out of Cambridge that's specifically for low-income settings where there's a lot of manual labor. Glancing at our data, it seems like so far we're getting good reads on more than 75% of scans. Hopefully we can improve that with some optimization. Another challenge with fingerprints is they don't work for kids under six, so regardless you need a backup identification method like a card.
- Tade0 9y agoWhy not iris identification then? It's non-invasive and has considerably more entropy than fingerprints.
- flukus 9y agoReminds me of one of the best daily WTF stories: http://thedailywtf.com/articles/Cracking-your-Fingers http://thedailywtf.com/articles/Cracking-your-Fingers
- cheeze 9y agoMy universal fund donation is the best money I spend every month. I love Watsi!
- RobertoG 9y agoSame feeling here. I like the personalize touch. I think this model could make a lot of good in the future. I want to take this chance to encourage people here to give Watsi a try. For the price of two or three beers you can help somebody every month.
- spike021 9y agoThis is awesome to hear! First saw/heard about you guys at the ELEO conference in San Jose a few years back. Great work!
- moonka 9y agoIncredible work. So many times you hear people working on this that will "Change the world", but these guys are actually doing it!
- jacquesm 9y agoIt helps that Watsi is not a traditional start-up in the sense that their investors expect a return so they are much more free to actually do stuff that matters. Way too many start-ups believe their own BS when it comes to sentences like 'changing the world' when in fact all they want to do is make their own stash of FY money. Most of these are a net negative when it comes to the change they impart on the world. If you really want to change the world in a positive way a non-profit is a much better structure. Unless you plan on using your FY money to change the world afterwards, Bill Gates style.
- brucephillips 9y agoSo which is it, they believe their own BS, or all they want to do is make FY money?
- beaconstudios 9y agoYes.
- njarboe 9y agoThere are lots of different ways to change the world. I sort of like the way SpaceX, with re-usable rockets, and Tesla, with electric cars, are changing the world.
- AndrewCHM 9y agohttps://watsi.org/faq#how-does-watsi-handle-patient-privacy https://watsi.org/faq#how-does-watsi-handle-patient-privacy "how do you handle privacy?" "yes"
- aptwebapps 9y agoHere's what it says right now, "We take patient privacy very seriously. It’s important to us that every patient posted on Watsi understands what Watsi is and how it works. Our medical partners are responsible for ensuring that every patient understands Watsi and explicitly wishes to participate in the program. If a Watsi Crowdfunding patient doesn’t wish to be featured on the website, we give them the option to have their healthcare funded via our General Fund without ever appearing on the website." Is that different from when you looked at it?
- pgodzin 9y agoI think his point is that this only addresses patient consent and website publicity, and nothing about what they do to actually keep patient data secure and private.
- microcolonel 9y agoI think prettymuch anything they could do would be better than paper files sitting in unsecured rooms protected only by people's sense of individual decency; or worse, no files at all.
- tehlike 9y agoNo. I argue paper files are more secure, at least they wouldnt be target of digital breach where millions' data could be "hacked"
- Balgair 9y agoMaybe your local dentist is like this, but almost all 'large-ish' hospitals are totally digital these days. The compliance rules for patient data safety and security are really crazy too, I would not be worried. That said, paper is in fact more secure in general, as it is very difficult to just 'grep' a filing cabinet, move several of them in a few seconds, or ransom-encrypt all of them before anyone notices.
- peterwwillis 9y agoHealthcare is complicated and expensive. This startup comes out with an app, a fingerprint scanner, and some compelling images, and now people are willing to hand over their money to some brand new company claiming they will bring universal healthcare to the masses. Rather than develop a long-term set of healthcare provider alternatives, they're depending on selling a story and getting funding from people sensitive to heart-warming stories on the internet to "change the world". If any link in their public relations chain is broken, there goes the project. I really like the idea. But copying a Sally Struthers late-80s TV commercial probably isn't going to solve healthcare.
- icelancer 9y ago>>brand new company Watsi has been around since 2011. >>Healthcare is complicated and expensive Overall? Yes. Compartmentalized and decentralized, it does not have to be. That's the whole point of these types of initiatives.
- peterwwillis 9y ago> Compartmentalized and decentralized, it does not have to be. Being compartmentalized and decentralized is what the story claims is inefficient and expensive.
- grey-area 9y agoI've been giving them money for a few years with concrete specific outcomes (surgery for people who can't afford it). Best money I ever spent.
- peterwwillis 9y agoIf you think that's great, wait til you hear about this new startup called YourTaxes(TM).
- grey-area 9y agoI already happily pay taxes thanks towards healthcare where I live but the benefits stop at the arbitrary border of the country I live in. There are many countries in the world without free health service, Watsi is helping spread that around the world. I don't think supporting watsi somehow precludes or reinvents paying taxes, so your comment is unfounded.
- jnardiello 9y agoState-sponsored universal coverage: "that's for commies! Not acceptable!" Silicon Valley VC-based universal coverage sponsored with crowdfunding: "wooooho that's super great! I love technology" I would laugh if It wasn't for the milions not being able to afford basic healthcare.
- brucephillips 9y agoI don't agree with it, be the counter-argument would be that state-sponsored coverage involves taking money from people without their consent (taxes), whereas charity doesn't. You should always address the strongest version of the argument you're refuting.
- forapurpose 9y agoI fully consent to paying my taxes, even when the money goes to things that I don't want my government to do. Everyone consents to the rules of democracy: Debate it, take a vote, majority wins. Sometimes I'll win, sometimes I'll lose, but I fully support the outcome every time (even if when I'm trying to change it for next time).
- pitaj 9y agoNot everybody consents to those rules. The founding fathers thought those rules were fundamentally broken which is why they encoded a stringent restrictive constitution including checks and balances and the bill of rights.
- wildrhythms 9y agoIn what way do you think the Bill of Rights is restrictive?
- pitaj 9y agoIt restricts the power of the government to do things it otherwise would have the power to do.
- sriram_sun 9y agoFTA:"193 of the world's governments share a goal to achieve universal health coverage by 2030." What does this mean? Aren't governments always paying lip service to some form of "universal coverage"? Isn't that one of the goals of any good government?
- stevenwoo 9y agoIt has never been the stated goal of the USA government and is not the goal of the party in power now, in the Obamacare repeal process they have repeatedly argued that letting people choose how much or how much not to pay (either no insurance or emergency only type healthplans that are not available in most healthcare markets now) and to whom to pay for healthcare is more important, if one is not wealthy enough to pay, their argument is one needs to get more money. The GOP was in favor of Obamacare when Mitt Romney implemented it as governor and when it was initially proposed by a conservative thinktank.
- ams6110 9y ago> if one is not wealthy enough to pay, their argument is one needs to get more money Please cite the proposal introduced by any conservative senator or congressman that contains this argument.
- ghostly_s 9y agoIs this argument not implicit in any plan which precludes coverage for the insufficiently wealthy? Several of which the GOP has proposed in the past months?
- deleted 9y ago[deleted]
- stevenwoo 9y agoThe most famous example from memory is the congressman who said people need to stop buying iphones so they can buy insurance instead. As if one - two months of insurance is more than a temporary salve. http://www.cnn.com/videos/politics/2017/03/07/jason-chaffetz-invest-in-healthcare-instead-of-phones-sot-newday.cnn http://www.cnn.com/videos/politics/2017/03/07/jason-chaffetz... The other famous quote is people will choose to not buy insurance because it's not important enough. https://www.yahoo.com/news/gops-cornyn-defends-americans-freedom-skip-health-insurance-165433159.html https://www.yahoo.com/news/gops-cornyn-defends-americans-fre... If I had time to watch CSPAN I could probably come up with an example from every GOP congressman/White House spokesman/conservative think tank to match these with video, since they all use the same talking points they use in public for the Obamacare repeal. I guess you could interpret what they are saying to not mean what I think they mean.
- gault8121 9y agoCongratulations Chase and the team, it's incredible to see such a complex product built in such a quick time period. How many folks from the dev team were in Uganda? And is this tool open source?
- danreed07 9y agoThis is an incredible accomplishment. Congratz guys.
- dalbasal 9y agoA feel like I'm hearing the middle of a conversatoin The language used to describe this program seems to land it in the US' medical system debate. EG enrolling in health coverage. A lot of the comments here are focusing on that debate. I imagine the situation is different enough (industry, patients, funding, etc.) to make the comparison something of an analogy. In any case, I'd like to hear a bit more about watsi's role and goals. Is this a medical insurance/bureaucracy infrastructure governments can adopt? An alternative way to raise/use donor aid, funding insurance instead of clinics? Are "crowdfunding" and "coverage" separate initiatives?
- kbart 9y agoWhat I don't get about USA mentality is that Americans collectively pay >600B/year to fund military[0], trillions worth of pointless wars[1] via taxes and are happy about that, but when it comes to paying some extra to fund their own and fellow citizens healthcare (which costs nearly twice less than military spending[2]), suddenly it's somehow against free market and "American spirit". Is it a paramount of government brainwashing, lobbying or something else? 0. https://www.cnbc.com/2017/05/02/how-us-defense-spending-stacks-up-against-the-rest-of-the-world.html https://www.cnbc.com/2017/05/02/how-us-defense-spending-stac... 1. https://www.reuters.com/article/us-iraq-usa-funding/u-s-cbo-estimates-2-4-trillion-long-term-war-costs-idUSN2450753720071024 https://www.reuters.com/article/us-iraq-usa-funding/u-s-cbo-... 2. https://en.wikipedia.org/wiki/Health_care_in_the_United_States https://en.wikipedia.org/wiki/Health_care_in_the_United_Stat...
- edraferi 9y agoThis attitude is even more stark in the Justice system. It's way cheaper to buy a homeless person a sandwich than to jail them for 5 years after they steal one. (A real situation, per a DA friend of mine, thanks to mandatory minimums and 3 strike laws.) You see the same thing with drugs: we prefer lengthy, expensive jail sentences to lengthy, expensive treatment. Why are people more willing to fund punitive programs than assistance programs that could preempt crimes? I have several theories: 1. Post hoc measures are more inherently more certain. You know that the treatment is being applied in the specific cases you want. With prevention it's impossible to know if any given intervention accomplished something, and very difficult to assess if the overall program is effective. 2. The USA specifically has a strong individualist streak. This has roots in a combination of (1) the cowboy myth / fronteir legacy of relatively infinite living space, (2) Protestant Christianity, (3) capitalism, especially post WW2 consumerism. I recently heard a talk that argued that Regan synthesized these very effectively, pushing us forward from the Great Society era, which was more collectivist. The emphasis on individualism created contrast with the communist Soviet Union.
- mrunkel 9y agoEven more insane, Americans ALREADY pay for all the uninsured through their insurance fees, as the cost of healthcare for the uninsured is passed along to insurance companies by the providers in the form of higher prices. I'd only correct your post by saying that it's not about paying extra, it's about paying the same amount and/or less to someone other than a for-profit insurance company. I am in Germany and am totally blown away by the German health insurance system. It seems to work really well for all concerned.
- wslh 9y agoWhere do you apply to be funded by YC Research?
- Noos 9y agoThis isn't going to work. It looks like they are just appifying the missionariy/charity elements already going on in african nations, not providing universal healthcare. To have real universal health care would involve a lot of infrastructure building and education which would be way beyond what a small start up could do.
- narrator 9y agoIndeed, nothing really about the supply side. If they don't take care of that, spending more money on health care will just raise prices. Don't tell Americans that though. They believe, as a matter of ideology, that spending more money is the only effective solution to all problems
- lkbm 9y agoThey increased the customer base (by increasing healthcare enrollment to 98%) and made it quicker and easier to get paid for treatment provided, while also preventing unnecessary treatments. What deficiencies do you see in the supply side right now, and why don't you think this addresses them?
- narrator 9y agoNumber of available doctors. Drug production. Consumable medical supply production. I guess if you can import this stuff from China and India with minimal quality checking things are good. I am not being sarcastic about the China importing. In the U.S we have $500 bags of saline that the minimally checked bag from China would cost $5. Really you don't even need universal health care, just adequate supply and that means imports, cheaper schooling and deregulation to solve health care.
- lkbm 9y agoWe're trying to solve healthcare in Uganda. It does look like supply of doctors is an issue[0], but it also seems that delayed paychecks are a big part of that, and this seems like at least a partial solution. I'm not sure what to do about there being higher salaries for doctors in the US. Subsidizing education for medical students who promise to stay in Uganda for several years might be a good option. But it seems silly to complain that Watsi has only partially fixed healthcare in Uganda. I certainly don't see any basis for the blanket claim that "This isn't going to work." This is already working--it's just not a panacea. [0] https://www.theguardian.com/global-development/2015/feb/10/uganda-crippled-medical-brain-drain-doctors https://www.theguardian.com/global-development/2015/feb/10/u...
- knivets 9y agoDoes anyone know what is the model of the fingerprint scanner used in the article?
- brepl 9y agoLooks like https://www.simprints.com/ https://www.simprints.com/
- EternalData 9y agoA true step to equality, in a truly global sense.
- lkbm 9y agoWhen I first read this article, I thought I'd missed something. Watsi isn't funding the coverage--they primarily provided a way to efficiently administer it. That seems a lot more sustainable than what I initially assumed. Cost savings and scalability seem to come from: * Easy to ensure treatment guidelines are being followed (so it's catch and eliminate non-administrative waste). * Avoiding more expensive interventions by providing cheaper, early intervention. * Easy to track who's enrolled (which also kills the free-rider problem). * Overall less time (=money) spent on administration in general. I'm curious if these can be teased apart. What percentage of savings is from early intervention vs. unnecessary treatments? I'm also curious why 98% of people signed up. Was it good outreach/marketing, increased trust that the system would be beneficial to them (as opposed to bureaucratic delays), or free-riders no longer getting a free ride? Did it get cheaper? More reliable? Why didn't the other 2% sign up? I'm sure these variables will all be fairly different when they go on to the next community, but they'd be interesting to look at. I'm also eager to see what this does for the medical infrastructure (and economic growth) down the line. This should make it easier for places offering medical care to get their funding efficiently and quickly, so I would expect them to scale as need grows better than they would otherwise. I hope this means also much more stable school attendance and economic stability for families and communities. Is this more cost-effective and sustainable than just buying people bed nets? Track this and find out. A lot of funding will flow to whatever can be demonstrated to be maximally effective, and it's important for us to find those interventions.
- plumeria 9y agoWhat's the brand and model of the fingerprint reader featured in the Watsi animated gif?
- Fej 9y agoWow. With my admittedly limited knowledge, it appears to me that this is one of the best efforts in our industry, changing the world for the better and directly making a dramatic difference in the lives of the most vulnerable. Watsi, and the people behind it, give me hope for our species, despite the state of politics (both in where I live, the US, and in the world in general) or whatever other cynical reason one could come up with. When we come together, we really can do great things... don't give up hope. Of course, many thanks to the Watsi team. I hope that I will have the opportunity to join you someday.
- jdiaz5513 9y agoYeah, agreed. I'm sending them my resume. My last company (RIP) had a similar idea: ruthlessly cut costs typical for the industry (banking) and pass the savings along to create a product that works for the disadvantaged.
- nicpottier 9y agoIt feels like there aren't a lot of people in this thread that have spent any time in this space, specifically health care in East Africa or the wild wild world of NGOs / aid there. This has the same breathless and "six weeks of hacking to save babies" feel to it that every other project starts out with. What exactly is different? There are a zillion mini-EMRs operating in East Africa, especially Uganda, what most lack is real integration and cooperation with the government to make them sustainable and scale. What is the story there for Watsi? Why will Watsi avoid the complexity of a real EMR like OpenMRS? Are you integrating with them? There's a slide somewhere that I think UNICEF put together of all the NGO (as in non-UG-government, not just non profit) health projects active in Uganda. It is this hilarious demonstration of the crazy amounts of bootstrapped projects exactly like this and just how much they overlap. To the founders, have you read The White Man's Burden? If not, please bump it to the top of your list. Source: I lived in neighboring Rwanda for 5 years and work in this space, including projects in Uganda. It is a fascinating space with lots of opportunity for good, but also one that requires real introspection on why you are pursuing particular strategies and whether that is being driven by ego or truly because you think it is the best for the people. Almost always the answer is that no, a new thing isn't required, but rather you should be pitching in with someone else or building upon an imperfect system to better it, because that system is government owned and managed and thus will be sustainable and gives the country and people agency. This is why aid is hard work, because most good organizations have moved past the "hey, look what we built you stage" to instead trying to build capacity and institutionalize changes. That is so much more difficult but much better tack, though my beliefs are still more in the camp of direct cash transfers these days.
- beaconstudios 9y agoI don't think it's fair to bring up the White Man's Burden in this case. It doesn't matter what background and ethnicity people come from, surely we should all be doing what we can to help those in need? Understandably it's an incredibly hard problem, especially for NGOs without government support, but if each of those NGOs can help just one local community doesn't that add up to a meaningful difference to those living in poverty in Uganda?
- 9y ago