Meet Watsi, Y Combinator's First Nonprofit

by pg • 13 years ago

705 168 13 years ago

This is really cool, but I'm curious how an investment in this is different than a charitable contribution. The contribution is awesome for the network it introduces Watsi to, but I can't imagine there will ever be a return on this kind of investment.

(This is not meant to sound negative. I am truly excited to see it, interested to see what the YC network can bring to it, and very curious about the investment thinking behind it.)

pg3• 13 years ago

There is no difference; it is simply a charitable contribution.

danvideo• 13 years ago

Site and mission sound great, I'm looking forward to contributing.

Hopefully it'll quickly join the ranks of the larger crowdfunding non-for-profits like Kiva.org, Donorschoose, etc...

tikhonj• 13 years ago

Will they also be going through dinners, office-hours and the like?

I could see this being a good way to help new non-profits get over the initial hump of raising awareness, getting administrative issues sorted out and so on. Certainly a service worth more than just the money provided.

andygcook• 13 years ago

If it takes off and is successful on a massive scale, I'm sure they will find a method to monetize it other than transaction fees on donations. One example that I can think of off the top of my head is to charge medical device manufacturers or pharmaceutical companies a fee to market their products the recently funded with direct messages or traditional advertising.

pinko• 13 years ago

I don't think this ("monetization", for profit) is planned -- and if it were I and many others would have a big problem with it. See pg's comment above.

clicks• 13 years ago

> The contribution is awesome for the network it introduces Watsi to, but I can't imagine there will ever be a return on this kind of investment.

The model of charityfund-operationsfunding separation is quite enticing. This kind of transparency fosters trust. If they ask for donations on the side to keep their operations running, by golly they've got access to my wallet alright.

mb2100• 13 years ago

Exactly what I was thinking. It says on Wikipedia that YC takes about 6% of the company's equity. But I suppose a nonprofit doesn't have equity. So what's the benefit to YC? Simply some good PR?

glimcat• 13 years ago

So, the really cool part is this:

"At Watsi, 100% of your donations directly fund medical treatments. Watsi.org is separately funded. They pay all their operational costs from their own funding, and none from your donations. They even eat the credit card processing fees."

This works great with Watsi's crowdfunding-style model. It probably wouldn't help with things which need legs on the ground full-time, but it would be interesting to see more nonprofits looking at an "out of channel" donor model.

P.S. If you haven't clicked through to read PG's announcement and check out Watsi, go do so. Really. This is something YC is going to look back on and be proud of being part of 20 years from now.

https://watsi.org/faq

dmoney4• 13 years ago

So, the really cool part is this:

It doesn't sound (as) cool me if the founders can only do this until they go broke. It looks like they do accept direct donations to fund their operating costs, but it seems to me that the demand (if that's the right word for the desire to donate) might not increase at the same rate as the demand to fund treatments (and therefore costs for credit card fees, hosting, staff) increases. Better to take a percentage and be transparent about what you use it for.

tptacek9• 13 years ago

HN is bad at subtext, so let me offer you a decoder ring on the subtext of the 'pg story we're commenting on:

YC is working on addressing the problem of funding Watsi's overhead. The point of the service is that end-users don't fund Watsi, they fund patients. In the same sense as you need to take it sort of on faith that Airbnb can bootstrap and maintain a two-sided market for short-term lodging, you should probably take it on faith that Watsi's model is going to work; if you want to make Watsi work well, go fund a patient with it.

There is a real 13 year old girl on Watsi right now who is unable to walk because of a correctible congenital condition. Who cares about the Watsi founders? Go help the girl! :)

chaseadam1723• 13 years ago

Very good point. We certainly don't want to go broke!

However, we feel very strongly that Watsi should be run like a successful startup, and not like a traditional non-profit.

Sustainability is extremely important to us. I'm a terrible fundraiser, and I want nothing more than for us to cover our own overhead.

However, it just doesn't make sense to implement revenue generating features (e.g. take a cut of donations, which to be clear we will never do) until we hit scale. Right now, we're entirely focused on improving our product, speaking with donors, and maximizing our impact.

However, just like any successful startup, there will (hopefully) come a time when the costs associated with scale begin to outstrip the seed-support we've so generously received from people like pg and Jessica. When that happens, we will implement features that generate revenue for our organization, and we'll have a user base large enough to make those features viable.

Without going into too much detail, those features will include things like asking donors for an optional "tip" to Watsi when giving to a patient (expected to net 6-8%), cause marketing products (already a few companies interested), white label, etc.

We will never abandon the 100% model, and I'm completely confident that for as long as there is demand for the service we're offering, we'll find a way to cover our overhead.

kevinconroy2• 13 years ago

Contrary to what you may think, overhead in a non-profit is intrinsically bad. It's a sign of a functional, well-run organization.

Why? Fundraising to cover your overhead costs when you're small is relatively easy but comes increasing harder year after year as you grow.

The reason most non-profits take a portion of donations for overhead costs is so that they can keep the lights on and (hopefully) become better at providing their services more efficiently. Moderate overhead percentages are not a bad thing for non-profits. As a donor you should want the organization that you're supporting to have a way to pay their bills, investing in productivity improvements, and build scale.

I applaud Watsi's commitment to passing 100% of donations onto patients and I'm cheering them on to find a sustainable funding model over the long run.

dbaupp2• 13 years ago

Although it is a good sign, it's not that cool. The operating overhead of a charity should be largely irrelevant to working out if it is a good charity.

For example, given charities X and Y both distributing anti-malaria pills (or something). X and Y are identical except X has operating overheads of 80%, and distributes 50 pills per dollar donated and Y has no operating overhead, but only manage 20 pills per dollar donated.

Clearly X is the better charity, since it moves more pills, even though only 20% of the donations it receives get through.

What I'm trying to say is: operating overhead is a poor metric for comparing charities, since the thing that matters is the final outcome given a certain donation amount.

(That said having a high overhead is probably a sign that a charity could improve, and so do more good per dollar.)

dmoney4• 13 years ago

Why can Y distribute fewer pills if they have no overhead?

eduardordm• 13 years ago

pg,

I wrote this minutes ago in a thread about the 3rd world. If you ever come across a startup that solves this please fund them:

"The biggest problems right now involve education and health. Example: 60-80% health problems follow the same pattern: you see a doctor, he asks for blood/urine tests, you get the results, go back to the doctor for a prescription. Build something that the poor can explain their symptoms and do those tests without going physically to a doctor and become a semi-god here. That would involve a website (or phone call) and portable blood testers. (Specially for things like malaria, E. coli, colera, dengue fever, typhoid fever, etc)"

dreamdu5t• 13 years ago

This would be illegal in the US AFAIK. The law and the US government are the biggest barriers to medical innovation right now.

tnorthcutt• 13 years ago

Isn't eduardordm specifically talking about 3rd world countries, e.g. not the U.S?

dataisfun• 13 years ago

What's illegal about it?

sethbannon• 13 years ago

Very happy to see this. At the very least, it's great news for the nonprofit world, which needs desperately to learn some of the basic the lessons of the startup world: fail fast, iterate, focus on your users, and more.

jk49304• 13 years ago

Would be interesting to observe how the established nonprofits react to this. Many of them do the following: Make their target audience (who they claim to care for) more dependent (i.e., don't solve the problem, just give some temporal ease) and take money from third parties (state, private donors) that don't control them.

My guess is that they would come up with many arguments against this startup-ish approach and would lobby for legal barriers.

tptacek9• 13 years ago

Watsi is already working with huge names in this space. PIH, one of the best known, funds on-the-ground medical care in places like Haiti and Subsaharan Africa. I don't think anyone in these places cares how "dependent" they are on PIH; their kids are living with broken femurs, infected bones, cataracts, and hernias.

Charities are not going to lobby against Watsi.

kevinconroy2• 13 years ago

As a member of the non-profit community (I help run GlobalGiving.org, one of the first non-profit crowdfunding platforms), we're actually doing the exact opposite. My first response to reading this? Sending Watsi an email letting them know that I've got 10 years of hard data on what works and what doesn't for motivating donors to give to specific projects and a standing invitation for me to share this knowledge with them.

At least within the tech non-profit world (GlobalGiving, Kiva, DonorsChoose.org, charity:water, etc) we're all very friendly and supportive of each other. We're so strapped for resources that it only makes sense for us to help each other out.

After all, we're all in this to make the world a better place and know that we can't do it alone.

So good luck Watsi and you've got my email. :)

fghh45sdfhr3• 13 years ago

How about a kick starter like nonprofit for social funding of scientific and medical research?

kt9• 13 years ago

Ask and you shall receive: https://www.microryza.com/

prawks• 13 years ago

Very cool! Thanks for the link.

diziet• 13 years ago

These guys have a lot of potential, especially the more researchers they get on board.

chaseadam1723• 13 years ago

They're one of our favorite startups!

PabloOsinaga• 13 years ago

We (masporloschicos.com) have been doing roughly the same since 2005. (instead of health we focus on malnutrition)

Note- site is in spanish - targeted to the Argentine audience

We are a bit less granular though - instead of matching against an individual, we match a specific soup kitchen. But we keep donors updated with newsletters, pictures, letters from the kids and so on.

edit: this level of udpates keeps donors engaged. we dont allow one time donations - instead we require you to subscribe.

When we built masporloschicos.com I wanted to do it more granular (individual level), but we ended up doing it a bit more aggregate because it was really hard / expensive to get to that granular level.

I wonder how is watsi tackling this problem - because ultimately you don't want to spend a lot of funds (regardless of where they come from) on the administration/bureaucracy required to provide quality 1:1 matching.

So I just wonder how are they doing it?

irollboozers• 13 years ago

The issue of administration and bureaucracy is definitely one the best questions and hardest challenges for new startups trying to tackle these kinds of peer-connected problems. There are entire systems of middle-men built up over long periods of time that up until the internet have been how systems like medical treatment, education, and research funding operate. The biggest factor of inertia in these systems is the system itself.

Sites like Watsi are now making people realize two things: which inefficiencies we can cut away, and that simple experiences like funding medical treatment can be enhanced. Those are two very big revelations that will fuel so much of peer-to-peer funding.

chaseadam1723• 13 years ago

Hablamos español and we tried to check out your site but it appears to be down (maybe because of HN traffic?). Two quick answers to your question about how we operate efficiently at a granular level:

1) We may have a slight advantage working in healthcare. Our partners already collect patient info (and sometimes even photos) for patient medical records, so requesting they send us that info isn't a big ask.

2) We leverage technology to ensure we can efficiently process and allocate donations. Look at kiva.org - they've leveraged their platform to fund individual microloans for nearly a million people, and that's a much more complex process (because of repayments, interest, currency conversion, etc.) than a one-way donation for a medical treatment.

Happy to talk more offline if there's any way I could be helpful: chase at watsi dot org.

justjimmy• 13 years ago

Previous discussions about Watsi. Good to see they're getting more exposure.

"Thank You HN: From 30 people whose lives you saved" http://news.ycombinator.com/item?id=4815006

"Show HN - We just built a site that saves lives" http://news.ycombinator.com/item?id=4424081

josh2600• 13 years ago

This is awesome.

I think this model of achieving more direct distribution through technology could profitably be applied to a number of for-profit and non-profit endeavors.

This seems like it could also be a better way of addressing hunger, contributing food to individuals but using a managed distribution system.

What a cool idea :).

kalvin2• 13 years ago

Watsi is awesome. Kiva and donorschoose made "direct" p2p lending/giving popular long ago, but Watsi is the first that feels like, well, a YC startup (just from the site-- product, team, mentality).

Also be sure to check out givewell.org for very HN-friendly (rational/research-driven) tips on how you might think about giving in general.

abraininavat• 13 years ago

Really great project. Some thoughts: 1. In the interest of 100% transparency, what do you think about being 100% transparent with your tech? Would it make sense to open-source your technology stack?

2. I really wish you had the ability to donate on behalf of someone else, either to fund Watsi or to fund medical treatment. On Amazon I set up a wishlist that people can easily access for ideas of what to buy me on Christmas or my birthday. If I could set up something like that on Watsi instead, I probably would. And if your tech was open source, I might even implement the feature myself!

tptacek9• 13 years ago

This is great. I did what you asked and used the site and it is indeed extraordinarily compelling. I might suggest a move away from Paypal (only because the Paypal checkout experience is more intrusive and annoying than the state of the art).

Our annual all-hands summit is next week, and we'll look for ways to work this into our charity match programs. Many people on HN have companies with employees; we were told about running charity matches by other friends who have companies and let me pass the message along: they work really well. Match programs have generated more goodwill for us than bonus programs. Start a match program!

I have a question:

The big charity in this space is Partners In Health, which has an extremely positive reputation (their cofounder is also now the President of the World Bank), spends 94% of their funding on program expenses, and has a CEO who makes less than 6 figures. (PIH is apparently a medical partner for Watsi).

Is the advantage of Watsi over PIH that 100% of funds go to program expenses, rather than 94%? Or is it that fine-grained funding is more compelling and will thus elicit more donations?

chaseadam1723• 13 years ago

All of the treatments funded on Watsi are provided by our partner organizations (names listed on the patient profiles) and our first partner, Nyaya Health, is a Partners in Health clinic in Nepal.

So in short, the benefit of Watsi is both of those you described. 1) 100% of funds directly fund treatments and 2) those treatments are performed by great organizations like Nyaya.

tptacek9• 13 years ago

Is there a kind of care I'd be funding using Watsi that I wouldn't be funding as effectively if I routed contributions directly to PIH?

Or is the big advantage to Watsi (from a 1000ft view) that it creates an especially compelling way to get people to contribute on-the-ground operating funds to places like PIH?

The latter is certainly a huge big deal, in case I sound skeptical. I'm just trying to refine my understanding of how all this stuff works.

Congratulations on all of this.

seeingfurther• 13 years ago

One could think of this non-profit funding as YC's own charity donation. I like this type of donation much more than just hard cash. YC is committing what it does best, building great organizations around amazing teams. I wish more people, companies and orgs took this approach to donations.

kevinalexbrown• 13 years ago

Aside from the human connection mentioned in the post, by far the most compelling aspect to me is the "fixed" attribute. There's something so satisfying about isolating a problem, then fixing it.

Many charities feel like an investment. This feels like a transaction.

Edit: Here by transaction, I mean it's something that has a very high chance that it's working out. When I order a shirt online, there's a high probability it will get to me. When I fund a new t-shirt company on Kickstarter, it's less certain.

dm8• 13 years ago

I agree on the point of transaction vs investment part of non-profit. CRY (http://america.cry.org/site/index.html) has been doing it for years for educating children and they are quite successful (what I've heard).

volandovengo• 13 years ago

I work with http://www.vittana.org, which has also found success with this model.

Overall our customer research has found that people find it a lot more compelling to give money to the individual than to hand money to an anonymous institution, even though on the backend it may be treated exactly the same.

febeling• 13 years ago

Go and fund someone, and observe how a couple of minutes later you get the notification email that the funding is complete. This is a very powerful new thing.

suchow• 13 years ago

This is a neat idea.

I have an unimportant question. PG's post says "They even eat the credit card processing fees", but Watsi's FAQ says, "As part of the cost of the treatment, we have included PayPal credit card processing fees (2.9% + $0.30 per transaction). These PayPal fees are unavoidable, and no portion of the fees go to Watsi."

Who is right?

bdcs• 13 years ago

Good question. Also, PayPal fees are only unavoidable at PayPal. Would it be a conflict of interest, on pg's part, to include donations via bitcoins using Coinbase? If so, what if a competitor, such as BitPay, was used?

chaseadam1723• 13 years ago

We're switching over to Stripe and they've been kind enough to hook us up with a better deal than PayPal (we'll be paying cost which is something like 2.4% flat, inclusive of Amex and international transactions, which constitute more than 30% of our total donations).

chaseadam1723• 13 years ago

Sorry! This is our (Watsi's) fault. Everything pg said is entirely true.

When we first launched Watsi we had absolutely no operating budget and because of that we had to include credit card processing fees in the cost of treatment. We are now paying the credit card processing fees out of our own operating budget (see our Transparency Document for more info: https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...).

Thanks for catching this. We've updated our FAQ to reflect this change.

jtchang• 13 years ago

This is amazing. I love how they are moving so fast they simply publish results to a Google Doc spreadsheet.

This foreshadows an era where non-profits must aggressively publish their spending and compete on how lean they become. My guess is there are going to be a lot of niche sites that perform exactly like Watsi.

jmcgough• 13 years ago

I really like the transparency - with a lot of nonprofits, I feel like I need to look into their expenditures to see where my donation is really going and to figure out if it's worthwhile. Watsi feels a lot more like kickstarter but directly targeted at helping individual people. Very cool idea.

How do they pay for operations costs - is there a separate donations channel?

wave• 13 years ago

The only suggestion I have is that it would be nice to see the patient's profiles get updated after being funded and treatment was given. We all like to see how our donations are making noticeable difference in people's lives.

I really like what Watsi is doing. They even "eat the credit card processing fees"

chaseadam1723• 13 years ago

Working on this! After Stripe integration, it's one of our top priorities. In the meantime, you can view every patient update on our transparency document (see the last column):https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...

jkuria• 13 years ago

This is really great to see. I am just curious, how do they ensure that the funds are actually used for the intended person's health issues? How do you prevent scammers and posers who just want to get money? I have a bit of experience here and would say it is a non trivial problem if you do not have an operation on the ground. You could donate to organizations that you trust but then you get back to the same old problem: Distance from the human face and actual life you are impacting.

For those of you who want to donate to non health related issues there is also SeeYourImpact.org founded by Scott Oki, one of Microsoft's early execs. They also ensure 100% of the donation goes to the person and absorb all the overhead expenses.

Shameless plug: For our Hacker News Clone for African startus, business and technology we will be running ads for SeeYourImpact.org but strictly for educational needs. Check out the site here: http://AfriTech.org/about.htm Actual news stories on front page: http://AfriTech.org

chaseadam1723• 13 years ago

We prevent scammers by going through trusted organizations. The funds go directly to the organization that is providing treatment (i.e. the hospital or clinic), and never into the hands of the patient.

As well, patients aren't able to solicit Watsi funding. In fact, they don't even know we exist until a doctor at one of our partner organizations has identified them as a candidate and presents them with the opportunity to have their care funded by Watsi. You can think of us as an "Emergency Fund" for on-the-ground healthcare providers.

gruseom• 13 years ago

This is all tremendously innovative and exciting, and you are doing a superb job of articulating it.

maxharris• 13 years ago

Is there any chance of expanding this to include Americans? Or even better - people that live near me, such as my zip code + the surrounding zip codes.

That way, there's at least a chance that I'd see the person that I helped someday.

chaseadam1723• 13 years ago

You should check out giveforward.com.

tptacek9• 13 years ago

Worth mentioning that patients in the US, and particularly children, are guaranteed medical care regardless of ability to pay. Medical care funding can bankrupt you in the US, but it cannot prevent you from having a broken femur fixed. States also run "CHIP" programs to provide health insurance coverage to children.

The same is not true in Haiti or Malawi. Without the funds to pay for care, a child can live for years --- their entire life, even --- with easily correctible medical conditions.

loceng5• 13 years ago

"guaranteed medical care" - of what quality, with what results? And the value of medical care being covered is that it doesn't destroy the rest of your life. It's actually kind of pointless to help someone just get to the point of surviving, and then leave them to fend for themself.

corin_3• 13 years ago

I'm personally not a fan of the concept of donating to help a specific person, rather than a cause, but am unsure whether I'm a rare exception or whether many people have the same view as me - hopefully a few replies could help answer this?

When I say not a fan of the concept, I absolutely don't mean I disapprove. I don't have any problem with organisations raising money this way, nor with people choosing to donate money this way - I simply don't like donating myself.

Trying to chose between fighting HIV or starvation, cancer or... etc. etc. is hard enough. Looking at Watsi's homepage, does Chimwemwe from Malawi deserve my money more than Kirshan from Nepal? What about Lidiya from Malawi? I can see the point of view that it's nice to know your money has definitely made an impact on somebody's life, but personally I don't enjoy the burden of making that decision. I'd far rather be 0.0000000001% of a big solution than 100% of a small one when it comes to charitable donations.

All that said, the fact that I dislike it doesn't take anything away from my thinking that Watsi looks like a great site, my opinion doesn't change the fact that anyone raising money for good causes is great and if the method used here helps that then no complaints from me.

chaseadam1723• 13 years ago

Great point. It's all about personal opinion. There are currently tons of organizations that enable people to fund a cause, but nearly none that let you fund something as specific as an individual treatment. We're providing a new, more direct and transparent, alternative.

Oftentimes there is institutional support for specific "mainstream" conditions (e.g. HIV, TB, etc.) and as a result, some patients who are in unique situations (e.g. have a rare condition, need a slightly expensive treatment, need referral care, etc.) often fall through the cracks. Watsi provides an opportunity to those patients by enabling them to tap into the crowd.

While there are pros and cons to each approach, it's important to note that they are complementary. Charitable giving is not a zero sum game, and we're working hard to expand the pie, not take a piece of it.

corin_3• 13 years ago

I wonder if everyone who has come across both options (broad vs. specific) choses one and sticks with that, or whether some people like both and split their donations?

While you'd obviously always prefer to expand the pie rather than just take a piece, there's nothing wrong with the latter - like you said, your approach can help people who slip through the gaps, so even if the pie doesn't expand, your taking a piece of it can still be a good thing.

Keep up the good work.

pixelphantom• 13 years ago

I'm the exact opposite, which is why I love Watsi and have donated even though I've never been a donating kind of person. I don't like giving money to something that feels abstract, where I don't really know how the money is being used for. I think what makes Watsi compelling is that we are supporting individual, specific people; solving a concrete, easily solvable problem (as opposed to, say, hunger, which requires more long term support); and lastly, the solution is low-cost, as opposed to hundreds of thousands or millions of dollars. The combination of these three factors is what I think makes Watsi a winning recipe that will entice people like myself who have always wanted to give but never felt comfortable with the current options of donation.

jk49304• 13 years ago

You don't really have to make a decision. Those you don't donate to receive donations from other people. Nothing to worry about I guess.

corin_3• 13 years ago

If you use the logic that it doesn't matter because other people will donate, that leaves me clear of ever donating to charity, safe in the knowledge that other people have got it covered. What a relief!

jango• 13 years ago

In Slovakia (a small EU country) we have a non-profit called "Dobry anjel" (Good angel) which helps families of children sick with cancer and other serious diseases. It is also collects donations, is separately funded and distributes all the donations "up to the last cent". Two possibly interesting tidbits: 1) The organization has re-distributed almost 17 million euros since its inception in 2006 (this is 23 mil. USD, over half a million USD in the last month alone -- our population is about the same as Minnesota), 2) Its co-founder Andrej Kiska is planning to run for president of Slovakia next year.

EDIT: Note on transparency: all the donors have their own website login information ("angel ID") to track every donation and see exactly how much was sent to whom. The stories of recipient families are provided, along with their address + telephone number. The donors have an option to remain anonymous or reveal their contact information. I never contacted any recipients or revealed my name to them but I have heard stories where the donors and families in distress got in touch and supported each other with prayers, encouragements, etc.. "Good angel" also makes it possible to keep sending donations to the same families if you choose to (otherwise the families will be chosen at random, which is the default choice -- or at least was the default for me when I signed up in 2007).

tsycho• 13 years ago

On one hand, I love it that I was able to donate to a person, and Watsi didn't require a login, email etc. (though I guess they have my email from the Paypal payment).

But this is one of the sites where a login would probably be a good idea, so that I can keep track of my donations and particularly the status/health updates of those whom I am helping, and also potentially for tax purposes.

Another site on these lines which I like a lot is Kiva.org (no affiliation, just a user). It's micro-finance, not donations, but all 3 people whom I lent to on Kiva, have paid me back so their enterprise has presumably succeeded. It feels great to be able to help some poor villager in Africa buy some fertilizers or a cow, and I like how Kiva makes it easy to keep track of them :)

Update: Watsi just emailed me a receipt that I can use for tax purposes, and promised to send me a email when the person I donated to receives treatment. So I take back my minor complaint above!

chaseadam1723• 13 years ago

This is a great suggestion. We do send updates to all donors, but as soon as we integrate Stripe we're going to enable optional user accounts. These accounts will enable us to create new features like one-click donation checkout, recurring donations, and a donation history so you can easily view all the patients you've helped support. If you have any other ideas, please let us know!

nsomniact• 13 years ago

I lost a bet to a friend. I just used Watsi to fulfill it.

brezina• 13 years ago

Congrats @pg and team! I love seeing YC used for so much good. The impact continues

alpb• 13 years ago

Kiva is a similar organization http://kiva.org where people can lend money to people in poor countries for their needs. I wish the same help for Kiva.

namank• 13 years ago

I'm glad.

Not because of the non-profit nature of this startup but the endorsement YC has now given to non-traditional and perhaps massively big ideas.

pratikjhaveri• 13 years ago

Just donated. What an awesome cause and an amazing effort by the team. I'm asking other organizations that I donate to, to follow Watsi's example in transparency.

tadruj• 13 years ago

A great site for millionaires to visit when they're bored or have lost their purpose.

Golobulus• 13 years ago

Will there be some kind of illness directory? Or a way I could keep track of or sign up for notices of new listings? What about a widget that I could embed on my site for specific kinds of illnesses that readers/users might be interested in donating to? Congratulations on all of this, really great idea/implementation.

got2surf• 13 years ago

After spending the past week thinking about monetizing ads, the next social/local/mobile app, etc... that all seems so minor compared to Watsi. It's awesome to see people doing so much social good - best of luck and amazing job!

dasht• 13 years ago

Paul Graham, or anyone "in the know", may we please hear a bit about what the equivalent of a term sheet looks like for a Y Combinator non-profit investment? Is Y Combinator giving a grant? Is Watsi issuing debt to Y Combinator? What's the financing model here?

pg3• 13 years ago

It's just a donation.

robg• 13 years ago

Have you considered ycombinator.org? Call it a program-related investment and mirror the .com?

zopticity• 13 years ago

Wow, I'm really taken away the fact that you're using PayPal. First of all, you're in YC, where's the brotherly support of using other YC companies? You got WePay and Stripe, and you're not using either.

FrojoS• 13 years ago

One step after the other. I just donated, despite ever having used PayPal before, and with a non-american credit card. And - it worked within a few minutes. I have my objections to PayPal, too, and would like to see alternatives but that doesn't have to be the focus right now.

h2s• 13 years ago

You're right, and I understand your point, but I would also like to add my voice to those pressuring Watsi for a PayPal alternative. Personally I had pressed "Fund Treatment" and was 100% committed to converting until PayPal loaded. I don't have a PayPal account any more and I won't reopen it for anybody, not even Watsi.

chaseadam1723• 13 years ago

We're switching to stripe.

xfax• 13 years ago

Really cool concept, makes donating very compelling. In fact, I just donated to help fund Esther's treatment.

An idea to get more people to give more - make it competitive. For example, it'll be cool if I could create a group for my school and then get people to 'tag' their donations with the group ID. Would love to see which school can get the most donations!

st0p• 13 years ago

I just donated some euro's, and I truely believe those euro's will be well spend. But it feels wierd (and somehow wrong) to crowdfund someone's health. I'm not questioning watsi, they are in it for the right reasons. But is crowdfunding something important as health for poor people the solution?

I think everyone is trying to do good here, but nobody is solving the real problems.

chaseadam1723• 13 years ago

Thanks for the donation, the patient (and we) really appreciate it.

You bring up a really interesting point. Is crowdfunding a sustainable solution for healthcare? It's something we think about a lot as a team.

Right now, there are people dying for lack of available and relatively cheap medical treatments, simply because they can't afford them. We think the only moral thing to do is fund their treatments.

However, is this sustainable? I'd argue that it is for two reasons.

First, the organizations we partner with are all working towards fairly obvious sustainable solutions. Some establish public-private partnerships, others cross-subsidize, and others have a very strong focus on training local doctors (some do all three - we require at least one).

Second, and without getting into a really deep discussion here, only about 40 out of 200 countries in the world have a formal healthcare system. And those systems that work best are, for the most part, universal healthcare systems financed by the government (i.e. the costs are crowdfunded via taxes). However, with the world becoming smaller by the second, is it too crazy to think that Watsi might one day be the first truly universal healthcare system?

What if instead of a mandatory tax, of which a % is allocated to national healthcare, human compassion was enough to fuel a global healthcare system? For the first time in history, the internet is making this feasible. The only question that remains is whether human compassion is enough to solve one of the world's greatest challenges.

callmeed• 13 years ago

I'm curious if there's a reason Watsi couldn't or shouldn't be a for-profit company?

I like the fact they're not taking a transaction fee. But, it seems to me that they're also a benefit to healthcare providers, insurance companies, and big pharma (after all, the money raised is going to end up in their pockets). Aren't there ways Watsi could make money from these companies?

chaseadam1723• 13 years ago

Great suggestion. We hopefully will make money from them! As a non-profit, we're able to earn money just as a for-profit would. The only difference is that we are required by law to invest any profit back into the organization to ensure we're never personally profiting off of the generosity of others.

cdcarter• 13 years ago

Not-for-profit companies aren't prevented from making a profit, and are in fact encouraged to (how else would they sustain!?). All the not-for-profit distinction means, business wise, is that the profits must be reinvested in the organization and not distributed to the owners.

This is a common misconception about not-for-profits. They are expected to make money, and overhead is important.

woodhull• 13 years ago

I'm pretty sure that GiveWell (whom I adore) wouldn't like Watsi very much.

It doesn't maximize the utility of donations to spend lots of money saving the lives of a handful of people vs. other interventions that can save the lives of many more people suffering from diseases like malaria at a much lower cost per patient than the interventions that Watsi is promoting.

I think Watsi donors will feel good about helping specific people, but I'm personally interested in my donations actually being maximally impactful. If you want to save the most lives per dollar, the sort of extraordinary treatments that Watsi funds are not a great way to do it.

chaseadam1723• 13 years ago

Charitable giving isn't a zero sum game. Instead of taking a piece of the charitable pie, we're expanding it by offering donors and patients a new opportunity.

If Watsi didn't exist, many of the patients on our site would have likely died. How do you quantify that impact? How do you prove that all the donations made via Watsi would have been allocated to some other cause had we not existed?

Also, I'd like to say that we really respect GiveWell's work. Quantifying social impact is a really tough challenge, and it's great to see such an intelligent team working on the problem.

Furthermore, we actually think they'd be big fans of donations made on Watsi, at least those made to patients at Nyaya Health, which was rated one of GiveWell's "Standout Organizations" last year.

philh• 13 years ago

> If Watsi didn't exist, many of the patients on our site would have likely died. How do you quantify that impact?

Roughly, by comparing it to the number of people who die in other hypothetical scenarios. You can't get exact numbers, but you can do a damn sight better than saying "it can't be done".

> How do you prove that all the donations made via Watsi would have been allocated to some other cause had we not existed?

Of course they wouldn't. But what if, instead of creating Watsi, you had put the same effort into advocating for more efficient charities? (This is a serious question. I actually wouldn't be completely shocked if it turns out that that would have been less effective.)

> Nyaya Health, which was rated one of GiveWell's "Standout Organizations" last year.

However, they didn't estimate its cost-effectiveness. And on that metric... I go to your website and see that $1000 can stop someone from maybe becoming infertile, and that just doesn't seem like it can possibly win against malaria nets. (Looking deeper, that seems like one of the lowest value treatments available, but I don't expect the others to win either.)

Don't get me wrong, I'm glad you guys are doing this. I'm not convinced you're doing the best you possibly could, but you're doing far better than me. I absolutely think your impact on the world is massively positive. But I don't anticipate donating to you myself any time soon.

vegasje• 13 years ago

I'm really glad to see that Watsi got some more attention after their original HN debut (here: http://news.ycombinator.com/item?id=4424081). These guys are making it so easy to help people in need.

chunsaker• 13 years ago

Way to go, Chase and team. This has tremendous vision and I hope you come out of YC with a ton of velocity.

DannyBee• 13 years ago

I'm really glad this is happening. A lot of the traditional funding mechanisms for non-profits seem badly broken, incentive wise. Then again, i've been in DC, where I guess almost everything is badly broken.

Mizza• 13 years ago

I used Watsi when it was first announced here. It's a truly amazing offering, a great product with great customer support and outreach, and, as a user, it truly makes you feel like you're doing something good for the world.

A few weeks after donating, I later got an email from them letting me know that the boy whose heart transplant I had funded had died. It kind of wrecked my whole day, but I was still glad I got the notification. I didn't expect to have such an emotional connection to a person I have never even interacted with before. Godspeed, Watsi.

chaseadam1723• 13 years ago

Our team was heartbroken to hear the outcome of that treatment as well. (You've now got three of our team sitting around discussing your incredibly poignant comment.)

It's certainly a bit of a dilemma, but we've made a promise to be 100% transparent, even when it hurts.

FWIW we've found ourselves even more dedicated to Watsi since receiving our first negative outcome. We always knew that what we were doing was real and important, but there's something about death that really puts the gravity of the problem we're attempting to solve into perspective.

orionblastar• 13 years ago

Well it is good for people in Nepal.

But what about the USA, especially disabled veterans, people on disability, people on no or low income, homeless people, and others who cannot afford their healthcare and got shafted by the federal government?

There are some charities, but they collect funds with Quadriga Art, that keeps the lion's share of the donations and little to no money goes to the charity or people in need. CNN has investigated this company http://www.cnn.com/2012/09/26/us/senate-charities-investigat... http://ac360.blogs.cnn.com/2012/09/24/fund-raising-company-f... http://ac360.blogs.cnn.com/2012/09/25/charities-in-debt-to-f...

This is the reason why so many charities are broke in the USA and the money never goes to the people it is supposed to help. We can reform this problem by starting up a non-profit web company to keep the costs low for raising money for these charities and making sure the people in need get the money and life saving medical treatments and surgeries that they need.

jc00ke• 13 years ago

Yes, there are people all over that need help, and that definitely includes those you mentioned in the US. However, there are existing organizations already working on that, or other organizations yet to be created that could lead the charge.

Watsi was founded on a few simple principles, and 2 that we apply to every possible treatment are "low cost, high impact". Unfortunately, health care in the US is not low cost. It's ridiculous.

I hope one day we can collaborate with an organization or 2 that will take on the challenge! Until then, there's Give Forward, which does a great job itself.

ryanmolden• 13 years ago

Congrats, this is awesome news! I contributed to a couple of patients when I first saw you announce this on HN because I like the 'direct to patient, 100% utilization' nature of it. This is a reminder for me to go back.

I see from your website you are a 501(c)(3) charity. I will submit your organization for approval for the matching program at my employer, which I like because it allows me to 'stick it to the man' by donating to all kinds of things my employer might or might not support (this doesn't fall into that category though). They also match volunteer hours by employees at $17 bucks an hour (after the first 10 hours), which can be a great way to get free work and free money.

chaseadam1723• 13 years ago

Awesome! Thank you. Please let us know if we can provide any info for the matching request: chase@watsi.org.

zhyder• 13 years ago

"I've never been so excited about anything we've funded."

That's great! I'm excited that you're excited. I imagine we'll see a lot more non-profits in YC shortly. Will 2013 be the year of many such non-profits, like 2012 was for hardware startups?

rosstamicah• 13 years ago

Next up, a YC L3C (a hybrid for and non profit)

theklub• 13 years ago

Wow this is a great idea.

aidos• 13 years ago

I just love this. It was featured a few months back and by the time I got to it everyone had already been sponsored [0]. It's brilliant to see the real stories of people who's lives you can have a positive effect on right now.

I also use Kiva [1] which is brilliant in a different way. You can loan money to people so they can fund their businesses etc.

I'm off to donate to Watsi now.

[0] http://news.ycombinator.com/item?id=4424081 [1] http://www.kiva.org/

eranation• 13 years ago

I'm so glad this was funded, I remember when it was initially posted, and the simple, brave solution, and I salute to YC for funding and mentoring this.

One small thing, although I just donated 50$ for two people, I found myself to be a bit uncomfortable with my actions,

I didn't really pay attention much to who I'm donating to, just clicked on the first picture that caught my eye without thinking, and donated 25$. Then I noticed, I'm donating to a 1 year old baby, with a cute photo. I really want to think of myself as someone who pays more attention, reads and makes a decision based on facts, medical condition, urgency, and likelihood to succeed, but no, I just clicked based on prejudice, 1 second first impression, biased decision, without noticing I did so.

Then I saw a 37 years old woman and noticed she got much less donations although her total needed amount is higher, perhaps her medical situation is less severe, but I would be naive to think that that's the only reason. So I asked myself, am I doing some sort of unconscious decision that is not really fair and unbiased? I would lie if I say I didn't.

So I donated 25$ to her as well, just so I feel a little better with myself, and then I thought, well, this is a feature request.

So to avoid the "cute baby gets more donations" bias, what would make it a little nicer to me is to donate without knowing who it goes to, I'd like a button that says - "donate to most medically severe case", or "donate to most time sensitive case" and have someone else make the decision. This will make me feel a little more in peace with myself, and actually might make such biases less common. Right now it might not have affect, but as it will hopefully grow to help more people, having such "donate to who needs it most medically" option will help prevent such gaps.

Also moving to a better payment system, Stripe or even Google checkout will make it a much nicer experience.

EDIT: the baby's profile was on the home page, where as the woman's profile was one click deeper, so this could be another reason, but this brings another enhancement, please automatically promote / rotate profiles that have less donations / most urgent medical conditions to the front page

Another feature I'm missing is to allow subscription, I would think many would be happy to donate 5$-20$ a month and automatically give it to those who have the least donations, or must urgent medical condition. Getting traffic is hard and critical for making this work, and not every day you get to HN front page, I would take advantage of it and offer a recurring donation as soon as possible.

DigitalJack2• 13 years ago

It sounds to me like that what you want to work with is the more traditional charity model. You don't know who your funding will support generally, you can subscribe, they have staff that steer the funding toward the most urgent needs.

So have a look at the Medical Partners that Watsi uses. See about donating there.

chaseadam1723• 13 years ago

Thanks for the feedback and the donations. We're hoping to implement all of the features you mentioned.

We're in the process of switching to Stripe, building a general fund that will auto-allocate donations to patients, and enabling recurring donations (with the option to personally allocate your credit to a patient, or have your credit auto-allocated). All in that order.

We're usually pretty hesitant to add new features to Watsi for fear of complicating things (we're big fans of simplicity). However, you hit the nail on the head with your suggestions, and all of them will be included in the coming iterations. Thanks again.

lilsunnybee• 13 years ago

It's part of human psychology that you'd do that. You shouldn't feel too bad. Hopefully Watsi can figure out how to work with that best and just more heavily promote anyone that doesn't have the cutest picture, or limit the total amount of possible recipients they show to get the most severe cases handled first.

cko• 13 years ago

You're not alone - the first person I clicked on was a "cute photo" - then I scrolled further down and was disappointed to see that another cute photo had already been fully funded (disappointed because I couldn't join in on the action). I'm only minimally uncomfortable with this, however.

kanamekun2• 13 years ago

Congrats on a great site, and the exciting news around joining YC! One quick question:

<< If Watsi didn't exist, many of the patients on our site would have likely died. >>

If a surgery isn't funding in time to save a patient's life, would you fund the remaining amount of the loan out of your own funds?

DigitalJack2• 13 years ago

Yep. Take a look at their transparency document [1]. It links to all their patients so far, and also provides information about treatments postponed, status updates, etc.

In one of the updates, the patient passed away before treatment [2]. Funding was refunded.

[1] Transparency Document: https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...

[2] Update info: http://us4.campaign-archive2.com/?u=4ee1aaad2e315a0de585af61...

chaseadam1723• 13 years ago

Yes, we guarantee funding for all patients on our site by leaving profiles posted until they are fully funded. Also, we give our partners permission to pre-treat a patient in the event they need immediate care, so long as we've already accepted the profile. We then reimburse the partner for the cost of treatment once the profile is fully funded. In the event we have more profiles than we can fund (never been the case so far) we will accept and post the lowest-cost, highest-impact profiles first. However, we can do a pretty good job of avoiding this situation by growing our partners (and thus our volume of potential patients) at a rate that corresponds with the speed at which donor demand is increasing.

kanamekun2• 13 years ago

If your doctors do "pre-treat" patients, please be very careful! If patients are regularly pre-treated, then the 1:1 connection between donor and patient could be seen as less pure (if the surgery already happened, it isn't 100% clear that the users' donations funded that specific surgery - as opposed to just being a general donation to a Medical Partner's operating budget).

A similar criticism was made of Kiva, as covered by the NYT here: http://www.nytimes.com/2009/11/09/business/global/09kiva.htm...

It's really important to disclose the date of any surgeries. And if a surgery has been performed prior to the profile being fully funded (or even prior to posting), the date of the surgery should be displayed and the profile should be labeled as pre-treated.

Just want to make sure you guys avoid some of the growing pains of Kiva! (I used to run Marketing over there for a bunch of 2010/2011.) Good luck!

raheemm• 13 years ago

Not to be cynical but how do they ensure the veracity of the patients?

macorama• 13 years ago

Great Job!

rdl2• 13 years ago

Please figure out a way to take equity eventually (there are organizations which help non profits do this).

I, and a lot of other startup founders, have limited income to donate, but potentially have equity which could be worth a lot of money someday. It is a lot easier to donate equity than current income.

It adds overhead and complicates your "transactional" model, but it might be a good way to fund your overhead, or to fund longer term projects, and could eventually be a recurring income stream to pay for some number of treatments.

chaseadam1723• 13 years ago

Yes! Great idea. We'll get on this.

white_devil• 13 years ago

Why would a venture capitalist invest in a non-profit? Does YC not want a return on their investment?

chamboo• 13 years ago

This is how all charities should be done. I will be supporting this charity, and I furthermore think it should be illegal to run a charity in any other manner than pure transparency. My hat is off to Watsi, and I feel this is a bigger deal than most people may realize. These are the types of startups we need to change the world. Not only do they do something good and useful for people, they also show the rest of the charities that operating with transparency is the only way to go. Thanks guys, this made my day.

batemanesque• 13 years ago

this could channel money away from preventative care, which is far more cost-effective than funding later-stage individual treatments. $50 given for the purchase of malaria nets would save a lot more lives than a single operation.

benrmatthews• 13 years ago

Amaingly transparent organisation too. You can see every patient they've ever funded and the outcome of their treatment in a Google spreadsheet, here:

https://docs.google.com/spreadsheet/pub?key=0Ah3wJ9CRQzyHdDZ...

toddnessa• 13 years ago

A really great idea. I have been befriended by a native pastor in Kenya. His son came down with something unexpected and had to go to the hospital. The hospital did not want to let the kid out until he was fully paid up and he couldn't pay it all . This escalated the bill even further. Something like this could have really helped.

Meet Watsi, Y Combinator's First Nonprofit

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