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Click Here to Save a Life, for Real

Watsi, the crowd-funding healthcare site, proves that not every change-the-world Silicon Valley start-up is a scam.

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Adam is quick to acknowledge that having one’s access to medical care depend on how bright one’s smile is would indeed be troubling. But that’s not how Watsi works, he says.

“We believe very strongly at Watsi that donors shouldn’t be making medical decisions. All we want to do is establish a meaningful connection between donors and patients. So the way Watsi works is that we accept every single patient’s profile before the patient receives care. Just like an insurance company. We’re not retroactively approving things. We guarantee funding. We won’t take a profile down until it is fully funded. No other crowd-funding platform that I know of works this way.”

The patients we see on Watsi’s front page are preselected by local doctors and medical institutions who are best situated to know who is in critical need of care that would not otherwise be funded. The patients must fit Watsi’s criteria — the cost of medical care must be under $1,500 and there has to be a 75 percent chance that it will make a significant difference to the patient’s living standards. But once they are in, they’re in. If donors haven’t contributed in time to pay for addressing an acute crisis, Watsi will cover the out-of-pocket costs from an emergency fund.

You can question  how real the “direct connection” between donor and patient is in a system where every patient will get care regardless of how quickly donors rally to their side, but Watsi’s strategy does seem to address the ickiness factor. There’s also a good answer for why Watsi focuses on the developing world, even when there are plenty of people with acute healthcare needs right here at home in the United States,

That, says Adam, is a simple matter of economics. Watsi would love to operate in the U.S., he says, but right now, the cost of healthcare “is just prohibitively expensive here.”

“Our donors have contributed about $450,000 to $500,000,” says Adam, “and that’s like just a couple of heart surgeries in the United States. Instead, we’ve been able to use that same amount of money to do over 700 procedures around the world.”

But even so, some wonder whether person-to-person donations are the best use of such funds. In a  BBC News clip on Watsi that aired earlier this summer, Will Dow, a professor of economics at the University of California, Berkeley, questioned Watsi’s basic premise.

“If you’re relying on crowdsourcing and showcasing instances of people who have particularly heart-rending stories, then you may be funding people who seriously need help and you may be saving their lives, but with that same money could you have saved many more individuals, by investing in even more cost-effective global health efforts, for example, on prevention?”

In other words, if more lives could be saved by distributing bed nets that prevent malaria, shouldn’t Adams be fundraising for bed nets?

It’s not clear to me that Watsi’s funding model actually siphons money away from other healthcare initiatives. The whole point of crowd funding — which makes it extraordinarily easy to donate cash with a personal specificity that contributing to a large charity doesn’t offer — may well unlock contributions that would otherwise never be made in the first place.

But the prevention versus treatment tradeoff, says Adams, is a big issue for every nonprofit that works in the health domain.

“Doctors in hospitals are asked to make a very difficult decision every day,” he says. “They have a 10-year-old girl in their waiting room that has a condition that is likely to kill her unless she gets access to medical care, and treatment costs $500. And they have a community health program where they can pass out $500 worth of bed nets.”