Chase Adam at Startup School NY 2014

While serving in the Peace Corps in Central America, Adam saw passengers donate to a woman seeking money for her son’s medical care. They trusted her after reviewing the medical record she carried in a red folder. The experience led him to start Watsi, a platform for funding individual patients’ healthcare.

Adam and a team of volunteers launched Watsi after a year of part-time work. They decided that all donations would go directly to medical care, that the organization would publish its financial and operational details, and that it would measure operational spending against value created for patients. After launch, a Hacker News post brought 16,000 visitors and funded the patients in their pipeline for six months.

After leaving his finance job, Adam struggled to raise money for Watsi’s operations and described how nonprofit fundraising required many small asks without a clear deadline. A Huffington Post competition prize and a meeting with Paul Graham led to Watsi’s first check and an invitation to YC. There, the team focused on average weekly donations, persisted through shared startup challenges, and handled early work manually.

Adam said Watsi aimed to build an organization that could last for 100 years, which made its founding team and mission important. He described efficiency as a core value and said that operating with a small team pushed people to prioritize and find creative solutions. Watsi grew 1,007% in its first calendar year, while each team member raised more than ten times their salary for patients.

Adam identified press-driven growth, unreliable internet at partner hospitals, and the two-sided marketplace as ongoing challenges. Watsi worked with hospitals in 19 countries, many with spotty internet access, and kept patient profiles up until they were fully funded. He tied the organization’s work to the belief that everyone matters and that access to healthcare should not depend on where someone is born or how much their family earns.