- Chase Adams is the founder of Watsi, a crowdfunding platform for healthcare.
- Watsi allows anyone to donate as little as $5 to fund medical care for people in need.
- Chase traveled, worked, and studied in over 20 countries before starting Watsi.
- Watsi was the first non-profit funded by Y Combinator.
- Chase shares his experience of being inspired to start Watsi after witnessing a woman asking for donations on a bus.
- He decided to start Watsi and recruited friends to join the organization.
- They worked as volunteers for a year before launching Watsi to the public.
- Initially, the launch didn't gain much traction, but after posting on Hacker News, Watsi received significant attention and funding.
- Watsi was later featured on TechCrunch, which was a significant milestone for the organization.

- The speaker initially believed that all companies were perfect, but soon learned that every company, including Watsi, had its challenges.
- Watsi's operations were broken, with no system for finding patients and a cumbersome process for approving profiles.
- The speaker quit their job to work on Watsi full-time and attempted to raise funds, but faced challenges in fundraising as a nonprofit.
- Watsi entered a competition and won, which caught the attention of Paul Graham from Y Combinator (YC).
- YC invested in Watsi and the team moved to Mountain View to work on the organization.
- YC taught the team to focus on one metric, that they were not alone in facing challenges, and that it was okay to do things manually in the beginning.
- Watsi successfully raised funds by setting a closing date for their round of donations and convinced notable investors to support them.
- The team aims to build a long-lasting organization and values efficiency in their operations.
- The speaker acknowledges making mistakes but believes in hiring people who are smarter and better than themselves.

- The speaker believes that hiring smart and talented people has helped build an amazing team.
- The team at Watsi has achieved significant growth and raised a large amount of money for patients.
- Challenges faced include managing unsustainable growth, dealing with limited internet access in some countries, and balancing the dynamics of a marketplace.
- The speaker explains that the motivation behind their work is the belief that everyone matters and deserves access to healthcare.
- They envision a future where everyone is connected and believes that Watsi's efforts will be worthwhile in the long run.

- Chase Adams founded Watsi, a crowdfunding platform for healthcare.
- Watsi allows donations as low as $5 for medical care.
- Chase's inspiration for Watsi came from seeing a woman asking for donations on a bus.
- Watsi faced challenges in the beginning but gained attention and funding after posting on Hacker News and being featured on TechCrunch.
- Y Combinator invested in Watsi, leading to significant growth and successful fundraising.
- Watsi aims to build an efficient and long-lasting organization, facing challenges such as managing growth and limited internet access in some countries.
- The motivation behind Watsi's work is the belief that everyone deserves access to healthcare.

Chase Adam speaks at at Startup School NY 2014

Watsi is a crowdfunding platform for healthcare that lets anyone donate as little as $5 to fund medical care for people in need.

So before starting Watsi, Chase traveled, worked, and studied in more than 20 countries.

He spent time in private sector intelligence in Washington, launched a national health program in Haiti, and served in the Peace Corps in Costa Rica.

Watsi was the first non-profit that was funded by Y Combinator, And we're very happy to have him here today.

I was just walking here and there was this really old construction worker crossing 42nd and he was walking really slowly and there was this old, I mean there was this young delivery guy in a van, he was obviously in a huge hurry and he just lays on the horn and the old construction worker just stops in the middle of the street and he looks up and he just gives the guy the finger.

And then a second or 2 later they just both break down laughing.

But that would never happen in San Francisco.

So About 3 and a half years ago, I was serving in the Peace Corps in Central America, and I was sitting in the back of a bus.

And I remember that at that point in my life, that bus was the last place in the world I wanted to be.

You know, I remember the smell of dried sweat kind of coming off the top of my shirt.

There's a black North Face duffel bag at my feet, and in that black North Face duffel is just about everything in the world I own.

And I remember the worst part is that the day before, I'd just gotten off a plane from San Francisco.

And I'd been home in San Francisco visiting friends and family for the first time in a year and a half.

And I don't know why I thought this, but I kind of expected that everyone back home would be kind of miserable.

I had spent the last 6 years of my life traveling the world, working with nonprofits, trying to do good.

I figured that everyone back home was, you know, living the office space life, working 9 to fives for big corporations.

I remember being really surprised when I got back to San Francisco and realized that most people were working for companies or starting companies or building products that they really believed in.

It seemed like a lot of people had found a way to do good and do well.

And in contrast, a lot of the work I had done abroad with nonprofits, it felt really small.

It felt really slow, and it felt really bureaucratic when compared with the scale and speed with which things were happening in San Francisco.

And so I remember saying to everyone I saw, and this is a direct quote, I said, fuck nonprofits.

And I want to make it clear that I believed then and still do that non-profits are incredibly important.

There are certain problems that markets and government just do not solve.

Imagine a 10-year-old girl in Somalia needs $1,000 for a life-saving surgery, and her family earns less than a dollar a day.

The local government doesn't have the resources to provide an adequate social safety net, and the market just hasn't found a way to create profitable businesses that provide surgeries to people that can't afford to pay for it.

Nonprofit will come in, they'll fund her health care, she'll live to see her 11th birthday, she'll go to school, get a quality education, get a job, contribute to her local economy, pay taxes, and hopefully in the future if she has children and they get sick, hopefully either she or her family or the government will be able to cover the cost of her medical care.

So when I said that I was done with this, it wasn't because I thought non-profits were important.

It was Because, from my perspective, the most important problems in the world were being solved so slowly.

So there I am, sitting in the back of this bus, in the most beautiful place on earth, during the most exciting time of my life, and I'm somehow jaded beyond belief, And a woman gets on the bus, and she starts asking all of the local passengers for donations to pay for her son's medical treatment.

And I'm embarrassed in retrospect, but I just reflexively tuned her out.

People would get on the bus every day and ask for money, and almost no 1 would ever give.

So I look back up a few minutes later, and I see that almost all of the local passengers are giving her donations.

And I cannot for the life of me figure out why all of these local people trust this woman when they had never trusted all the women that got on the bus before her.

And it turns out they trusted this woman because she had her son's medical record with her.

It was in a red folder, she was passing it around the bus, people were looking through it, asking her questions, and through that process she seemed to earn their trust.

So she gets to the back of the bus, I make a donation, almost everyone around me makes a donation, she gets off, and I get goosebumps, and I think, why on earth is there not a website where you can fund medical care for individual people that need it.

Why is there not a global crowdfunding platform for healthcare?

So I decided to start Watsi and decided to name it after the town I was traveling through at the time.

To go back to my house, this is where I lived in the Peace Corps, recruited my 2 best friends, Mark and Howard, to join the organization.

We spent our last 6 months working on the business plan for Watsi.

And I'll never forget that a few weeks before the Peace Corps ended, all the volunteers decided to rent a house on the beach and celebrate by having a party.

And at this point in Watsi's history, my primary objective was to find a developer who could build the website, because none of us knew how to code.

So we're at the party, it's last night, everyone's on the beach, drinking, having a good time, and I decide to start showing people mock-ups I had done of the Watsi website.

And so if you think people's startup ideas are annoying in San Francisco or in New York, here I was on the beach at a party in my bathing suit holding my $200 netbook in my hands, going around to every single person I could find, shoving my computer in their face, making them look at my absolutely horrific mock-ups for an organization website that didn't even exist, and asking if they knew any developers that would be interested in joining the organization.

And by some absolute miracle, the next morning, it wasn't even that night, the next morning, this girl Chamise offered to introduce us to Jesse, her ex-boyfriend, a developer who lived in Portland.

And after basically convincing him that Watsi was a hell of a lot more established than we really were, he agreed to join the organization.

We decided to do Watsi part-time as volunteers.

Mark went and got a job with a startup in LA, Howard went to get his MBA, I was working in finance in the city, and we just built this amazing team of part-time volunteers.

Grace joined to help with marketing, Sally joined to help with medicine, etc., etc., And we would jump on a Hangout every single Tuesday and talk about our progress.

At 1 point, we were 8 volunteers across 4 continents and 6 time zones, all working on Watsi.

And in retrospect, not raising money and starting Watsi as volunteers was 1 of the best decisions we made.

And it was good because there was really no downside.

The only downside was that it just took us a lot longer to launch.

But that didn't matter because we had no users who were waiting on us.

We had no funders who were expecting results.

And we all had jobs, so we could support ourselves.

The upside was that we were beholden to no 1, which meant that we could take risks and make decisions that we otherwise probably wouldn't have been able to.

So we made 3 decisions during that year as volunteers that I believe shaped the future of WOTC.

The first was that we decided that 100% of every single donation would directly fund medical care.

We decided that we'd be completely transparent.

We'd go through the extra effort to put all of our financials and operations on the website.

And that instead of just focusing on top-line growth, like a lot of non-profits and start-ups, that what was actually most important to us was the ratio of how much money we spent in our operations compared to how much value we were creating for patients.

So after working on Wattsy for a year as volunteers, we were ready to launch to the public.

We sent out an email, we did the Facebook post, all the things, and I remember thinking, okay, it's just gonna explode now.

My mom donated, Grace's mom donated, Jesse's friends and family donated, and then it just died.

Was terrified of all the comments that were just going to destroy me.

And so I create a user account, post on Hacker News.

And I don't tell the team, because in the event the post flopped, I was just gonna pretend like it never happened.

So posts on Hacker News, and within what feels like minutes, we're in the number-one spot.

We funded every single medical treatment we had in our pipeline for the next 6 months in a matter of hours.

So completely exhausted, spent the entire week trying to do my job and also doing Watsi.

And a week later, I remember sitting in bed and getting a Google alert that Watsi had been featured on TechCrunch.

And another embarrassing moment in retrospect, but it was hard for me to actually hold back the tears.

TechCrunch, you have to understand, TechCrunch and Hacker News, for me and the team, was the entirety of our startup education.

We hadn't missed a post in the last few years and to be featured on both Prominently over the course of a week was more than we actually ever thought was possible for Watsi So I remember reading the post a few minutes later after kind of like the emotion died down I remember turning to my girlfriend at the time and asking, you know, do you think that all the startups that TechCrunch writes about are secretly as crappy as we are?

And I figured, you know, I was like reading about Wattsie and TechCrunch.

I saw us on Hacker News, and I figured there's probably at least 1 human being in the world that thinks we're like a real organization.

But in reality on the inside everything was broken.

And at this point in my life, I was still naive enough to think that all of the companies were perfect.

I actually had this image in my mind of employees at Google and Facebook just playing ping pong all day.

Like, I just thought that's what people at startups do, is just play ping pong because everything was automated, computers did everything, nothing was broken, and all the graphs would just magically always go up into the right.

I've learned that pretty much every company, probably at any startup, you always kind of feel like you're standing on a house of cards.

And I imagine that the more successful you are, the larger that House of Cards feels.

But at Watsi, that House of Cards was really about to come tumbling down.

I mean, to give you an idea of how broken our operations were, we had never in a million years expected that we would fund all the treatments we had in our pipeline.

So we had no idea how we were going to find more patients.

There are thousands of people going with nothing to do.

We call them both frantically saying, we need more patients, we need more patients.

So they go out, they're trying to find patients.

They go through all this work, and then they compile this information, and they put it into a Word document.

And the Word document would go to Mark, and Mark would make sure all the privacy waiver was there, all the information, everything was signed.

And Sally was doing her residency in emergency medicine at UCSF, which basically meant she was working 24-7 as a doctor.

So we would text message Sally like 15 times in 1 night.

Sally, you've got to approve this patient.

Sally would sneak into the corner of the emergency room and basically approve the Watsi profile from her phone.

And Grace was responsible for editing the content and publishing it on the website.

But Grace had been working on Watsi so much from her day job in New York that she was having to sneak into the bathroom to edit and publish Watsi profiles from her phone.

So it became clear pretty quickly that we needed at least 1 full-time employee if Watsi was not gonna implode.

And so I decided to quit my job and work on Watsi full-time.

And I only had 3 months of savings in the bank.

So my objective was to go out and to raise enough money to cover at least my own salary, then hopefully the salary of a few other people.

So I read a bunch of books on nonprofit fundraising.

I have no connections in the Valley at all, and just fall completely flat on my face.

And just like with for-profits, 1 of the most challenging things about raising money initially is that no 1 wants to be first.

No 1 wants to be that first person to take the gamble and support you.

But beyond that, there are a few things that make fundraising as a nonprofit even more challenging.

The first is that as a for-profit, you have the opportunity to go to a fund and say, at least attempt to raise a $500,000 convertible note.

As a nonprofit, you usually have to go to 100 people and try and raise $5,000 from each 1.

The other thing is that there's no deadline.

You just constantly get pushed to the bottom of people's to-do lists.

And the last thing is that people are just too nice and they don't want to say no to you.

So they kind of just end up stringing you along forever, and you just kind of keep turning your wheels until you eventually give up.

So I went out, wasn't able to raise any money.

So we decide to enter this Huffington Post competition.

We make it to the finals of this Huffington Post competition.

The prize is $10,000, which at the time seemed like the largest sum of money on the planet.

I was like doing the math, I was like, I can live for a year on 10K.

We make it to the finals, and the way the finals work is that it's an online vote between us and 1 other nonprofit.

I will never do another online voting competition for as long as I live.

But it was the most stressful week of our lives.

We Facebook message every single 1 of our friends.

I get defriended by like a hundred people because I'm being so annoying.

We're stopping random people in the street asking them to vote for Watsi.

And then it's 9 p.m., the night before voting closes at midnight, and we're still like neck and neck with this other nonprofit.

And then all of a sudden we start getting a bunch of votes and I have no idea where these votes are coming from.

Like I, if I send another Facebook message, I'm not gonna have a single friend left.

And it turns out that Grace was at a bar, and she convinced this bouncer to get every single person to vote for Watsi on their phone before coming in.

So we end up taking the lead, we win the competition, and at midnight the bartender apparently rings the bell and buys shots for everyone in the bar to celebrate.

Immediately after, I'm flying down to Palm Springs to spend Thanksgiving with my dad.

I'm in the plane, the plane lands, and I start getting all these messages in my phone, and I see that I have an email from Paul Graham.

He had seen a recent post we'd put on Hacker News.

The secret reason we had posted this post on Hacker News was to get votes for the Huffington Post competition.

He had seen a post we'd done on Hacker News, and he wrote an email with just 2 sentences.

I just could not believe this was happening.

I was so excited that I got off the airplane and left all of my luggage for Thanksgiving on the airplane.

But it didn't matter, I had my phone, I remember I got to my dad's place and I had like 15 people read my 1 sentence reply to make sure there were no spelling errors or grammatical errors.

But get back, the next week Jesse flies down from Portland.

I don't think anyone at YC knows this, but that was only the second time Jesse and I had ever met in person despite working together remotely for over a year and a half.

We meet at a coffee shop, we're like, kind of playing out what we're gonna say.

We meet with PG, have an amazing meeting.

He writes us our first check and invites us to join YC.

So that's enough to convince Grace to move from New York, Jesse to move from Portland.

We rent a little apartment in Mountain View.

We convert the living room into a full-time office.

And we just work on Watsi, you know, 24 7.

I think the biggest things for us, the first 1 was just to focus on 1 metric, that it was so easy for us to just like get distracted by the million things that we had to do and what we realized that there's always a single thing that's most important.

There's always 1 thing at any point in time that's most important, and that for us it was just so valuable to focus on that 1 thing.

And for a lot of YC it was really just donations, average weekly donations, that was like all we focused on.

The second thing that we realized during YC that we learned was that we're not in this alone.

You know, I think it's so easy to think that all of the startups are perfect, and this was a time in my life where I realized that really all the other companies were facing the exact same challenges we were.

They were facing the same problems, same opportunities.

And what we learned in YC was that really the only thing separating us from success was just hard work and not giving up.

We realized that if we never quit, it's impossible for us to fail.

And the last thing we learned was that it's okay to hand crank things.

It's okay to do things manually in the beginning when you're still trying to figure out what's gonna work and what's not.

So we did YC, obviously the way YC works, at the end you have demo day where you pitch to a bunch of investors, and I start having these recurring nightmares.

We're the only nonprofit that's ever been accepted to YC, and I'm having these recurring nightmares that I'm gonna get on stage, and I'm gonna do so terribly that YC is never gonna invite another nonprofit to join.

I'm like, I'm gonna be that guy that ruins it for everyone.

So I practiced the pitch so much that I ended up losing my voice the day before demo day.

We do fine on the pitch, and it kind of kicks off our next round of fundraising.

So this time, we learned a lesson, and we decided to try and do something crazy.

We decided to raise a round of donations.

And really, all that meant was that we picked an arbitrary date, 3 months in the future, and we said the round's closing on this date, and everyone said we're stupid.

Like why would you stop raising donations?

And for whatever reason, just having that date, despite it being arbitrary, was enough to convince people to at least make a decision within those 3 months.

We went out, we had 138 meetings in 5 states over 3 months.

We ended up convincing 14 people to support our operations.

Some of the best investors and technologists and entrepreneurs in the world decided to back Watsi.

PG donated, Ron Conway donated, Vinod Khosla donated, you know, Paul Buchheit, Jeff Ralston, Tencent, just the most amazing group of people on the planet, And that's not a responsibility that we take lightly.

So in a sense, raising that round a little less than a year ago, we've been lucky enough to grow the team, and we've definitely grown the team pretty slow compared to other startups at our stage.

I think it's the right decision because, you know, to be honest, like, we're not trying to build an organization or a startup or a worst case scenario, we get acquihired in a year and a half.

That's not possible because we're a non-profit, but even if it was possible, we're not interested in that.

We're really trying to build an organization that if we do well and if we get really lucky, that we hope we'll be around for 100 years.

And what that means is that that founding, that initial team is just so important, not just from a technical perspective, but from a culture and from a mission perspective, because if we do get lucky and Watsi does exist for a long time, Hopefully the characteristics of that founding team will be compounded exponentially time and time again.

And the last thing is just efficiency that it's so tempting to just look at those top line revenue numbers and just hire more people, hire more people.

But efficiency being our core value, We found that it's actually kind of nice sometimes to just embrace the challenge and the awkwardness of not hiring, of not having enough people to do everything you need to do because it forces you to be more creative, it forces you to be more efficient, and it forces you to focus on what's ultimately most important.

I've made a ridiculous number of mistakes at WOTC.

As a team will attest to, I tend to learn just about everything the hard way.

But I think 1 thing that I fortunately did right was from the beginning only agreeing to hire people that were a hell of a lot smarter and a hell of a lot better than I was.

And as a result, I think we built 1 of the most amazing teams in the world.

We have Grace who is without a doubt the hardest working, most passionate person I've ever met.

Dan built the medical philanthropy team at Palantir.

Neta, most talented designer I've ever known.

You know, and as a result, actually every day I come into the office, you know, I think to myself, you know, I hope it's true.

I hope it's true that you end up becoming the average of the 5 people you spend the most time with.

Because if that's the case, I think I'm honestly, I'm honestly 1 of the luckiest people out there.

So as a result of the work the team did, we grew 1,007% in our first calendar year.

But the stat that I'm actually most proud of is the fact that every single team member at Watsi raised more than 10 times the amount of money for patients that they took in their own salary.

A few that we're facing right now, which are maybe of slight interest to you guys, is just the first is unsustainable growth.

That this definitely falls into the good-to-have problem camp, but 1 of the, there's like press and hype is kind of this double-edged sword, because for our first year, you know, it was really hard for us to balance resources between kind of like managing these short-term spikes in growth that you'll get from an article or a press release, and actually building features that are going to help you succeed in the long run.

You have to have patients next week whenever an article comes out.

But you also have to invest in the future.

And balancing those 2 is always challenging.

When we started at YC, we were working with hospitals in 2 countries.

We're now working with hospitals in 19 countries.

Most of those hospitals just got access to the Internet very recently, and for most of them, Internet access is spotty at best.

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Chase Adam at Startup School NY 2014