The member who accidentally shot himself, and how CrowdHealth costs so much less
Solving Healthcare 2
You may have heard of CrowdHealth. It’s one of the fastest-growing startups in healthcare. In Solving Healthcare Part 1, I wrote about how it works and how the incentives differ from health insurance.
I was lucky enough to join CrowdHealth as a member in 2022. It entirely replaced health insurance for me. On average, I pay $155 / month. Insurance would be more than double that just for the premium. Then there would be a high deductible and a co-pay. With CrowdHealth, my average annual expenditure is 65-75% less, and I get services that I wouldn’t get with legacy insurance plans, like find-a-doctor and unlimited telehealth.
How the heck is this even possible?
I’ve been thinking about this for over a year, and talking with Andy, the CEO and founder. He told me about a member in Montana who accidentally shot himself and how they handled the bills—more on this incident later.
Three main things allow my CrowdHealth membership to be so much lighter on my wallet:
Health of our members (the crowd)
Self-pay, cash-pay pricing
Professional shopping and negotiating
1 - Health of the Crowd
CrowdHealth strives to make members healthy and keep them healthy because they are financially incentivized to do so—and also because they are good people. I’ve talked with a bunch of CrowdHealth employees over the years, and many members in the community telegram channel. Andy and the leadership have created a culture of actually caring about people’s wellbeing.
We are paying each other's healthcare bills. Healthier members means we all pay less because healthier people have less healthcare bills on average.
In Solving Healthcare Part 1, I discussed how America stumbled into a disastrous situation where health insurance companies are financially incentivized to cultivate a chronically ill population and exorbitant healthcare pricing.
Nobody in the CrowdHealth crowd is obese or a chronic smoker. It’s not allowed. 1 Unfortunately, the American health insurance system is loaded with fat people. Most of America is fat and sick. It’s crazy. It weighs heavily on the wallets of people paying into the insurance system.
I take care of myself. I don’t smoke or eat like crap. I’d rather not pay for people’s insane medical bills because they’re doing that stuff. I want to support people who are mindful of their health and do what they can to avoid preventable chronic illness.
I’m optimistic that removing out-in-the-open corruption from regulatory bodies, and re-aligning healthcare incentives will end the 50-year health decline, and actually reverse it, returning America to our former health greatness.
Insurance, sadly, doesn’t really care about the health of customers. One reason is because for them, there’s no money in it. The average policyholder switches insurance companies every 3-5 years. And in the end, it’s the federal government footing the bill when people go on Medicare fat, sick, and loaded with pricey prescription pills. Meanwhile, the insurance companies made a fortune from premiums and pill sales. It’s the big insurance companies who own the pharmacy benefit managers (PBMs) who set the inflated drug prices. It’s dark stuff.
CrwodHealth emailed me a discount code for a DEXA scan - Dual Energy X-ray Absorptiometry. It’s fully crowd-fundable as a preventative care “quarterly special”. I went and did it and I was blown away. It was a 2-minute, full body scan that showed my distribution of fat and muscle, plus bone density.
My DEXA score was an A-.
A minus sign… I could hardly believe it.
Andy, the CEO, told me that CrowdHealth is working on implementing a system where members can submit health test results and receive discounts for having excellent health. I learned about DEXA scans, got a near-perfect score, and I’ll soon be saving money for it. That’s a triple win.
2 - Self-Pay Cash-Pay Pricing
There’s a weird thing in healthcare (doctor visits, surgeries, pharma) where they charge different prices to different people. The main variable is whether or not you have insurance.
A friend of mine, who works in healthcare, thought people get better prices from providers by having insurance. The exact opposite is true. People get way worse prices because they have insurance. The industry standard to attempt charge insurance companies an absurd price for the healthcare they are buying for the policyholder. After I tell the provider, “I don’t have insurance,” the price is lowered substantially—every time. This is crazy.
But it makes sense…
I talked to a dietician whose team uses therapeutic ketogenic diets to treat a range of conditions, mainly psychiatric disorders—something the legacy health system is largely failing to help with. She told me that if they were to accept insurance, their small business would have to hire four additional people just to do the paperwork and deal with insurance companies.
Businesses want you to pay cash. They get the money immediately and there’s less work on their end. Self-pay cash-pay gets substantially lower prices.
Weirdly, insurance companies make more money from prices being high. I detail this in Part 1. The system is convoluted on purpose—“the margin is made in the mystery”.
With CrowdHealth, members get the self-pay cash-pay price, upload the receipt to the app, and get reimbursed by the crowd within weeks. If it’s a huge bill that is too big for a wallet or credit card, it can be pre-crowdfunded and sent directly to providers.
Unlike insurance, neither the crowd nor CrowdHealth makes more money if we pay more. CrowdHealth’s compensation is a monthly flat rate from members, to grow a healthy crowd and facilitate funding of legitimate, fair-market bills
3 - Professional Shopping and Negotiating
A big part of Crowd’s job is sourcing healthcare for members and negotiating big bills on our behalf.
One member, David, posted in Telegram that he got the discounted self-pay cash-pay price for an MRI. Then CrowdHealth got it EVEN LOWER by $700.
Boo yah, baby.
That’s less money out of my pocket. And ya know what that means? More 1 on 1 swing dancing lessons!
If there’s a big bill or an upcoming surgery, CrowdHealth sends in their pro negotiators.
They post their wins on their socials:
It’s messed up that the industry norm is for the healthcare business people to attempt to charge exorbitant prices.
These huge numbers get thrown around and contribute to the perception that health insurance is reasonably priced, and an absolute necessity, because if anything substantial happens it’ll be a million bill.
The guy who shot himself
A CrowdHealth member was fly-fishing in Montana (boo yah, baby). He got a big fish on the line. During the battle, his revolver fell from his holster, landed on a rock and shot him!
The bullet bounced around inside him, destroying his organs.
Green stuff oozed from his chest.
“Dude, I’m dead,” he said.
Sad!
But no! He didn’t die. The helicopter got him out.
He woke up from a three-day coma. They handed him a $1 million bill.
“Holy f*ck,” he said.
Just kidding, CrowdHealth handled it. The negotiating team got the bill down to $250,000.
You know what that means?
More swing dance, baby! Let’s goo!!!
Like everyone else in the crowd, the guy who shot himself paid the first $500 for his medical bills, and the crowd covered the rest.
I tell a lot of people about CrowdHealth. The most common question I get is, Can it cover a huge bill?
The answer is yes, easily.
The team estimated the man’s approximate total bill and pre-crowdfunded it over multiple months. The money was ready to go before the bill even arrived.
Boo yah, baby.
The future is here, it’s just not evenly distributed
CrowdHealth is obviously the future. It’s a better service at a way better price.
I’ve been investing in businesses for a decade, constantly looking for incredible, underappreciated products and services. This is one of those ultra-rare, once-in-a-decade companies, where an entire industry that’s been failing us for fifty bloody years is transitioning to a new system.
Realigning incentives so that regular people have more capital and more options is critical for solving the healthcare problem, and increasing swing dancing per capita.
Thanks for reading, and have a great rest of your day. Join CrowdHealth (affiliate link). My referral code is BIGWIN.
Related Readings
a wrote a story of how people in the health insurance system did their damndest to scam her. She’s fighting back, as we must, to end this nonsense and criminality.Time Magazine Story about Crowdhealth: They Hated Health Insurance. So They Started Paying For Each Other’s Care
Podcast: Ex-Pharma Rep: It's Way More Corrupt Than You Think - Brigham Buhler Chris and Brigham suggest that healthcare would be better if it wasn’t for-profit, but if the incentives are aligned, then for-profit is no longer a concern, it’s a benefit, as we see with the CrowdHealth crowdfunding model.
Links
All Outcomes Are Acceptable on Amazon
Join CrowdHealth (Affiliate link) Discount code BIGWIN
Songs
An important delineation is preventable chronic illness and pre-existing condition. So far as I know, CrowdHealth does not discriminate based on the latter.
I’ve lived in three different states while needing gov healthcare, all different rules and it was either great or terrible. There have been too many headaches along the way. I’m currently in a lucky position, but I’m so happy to read businesses like Crowdhealth are looking to reinvent health insurance. The swing dancing video is so fun too haha definitely better place to put your money.
Their absolute damndest!