Y Combinator’s first nonprofit; recipient of YC Research funding directed by Sam Altman for a “universal healthcare” study; Paul Graham’s first and only board seat; healthcare crowdfunding for developing countries that generates patient-level data. The benign precedent for the internal funding loop that becomes the central finding when OpenResearch grants $1 million to TrialSpark.
Watsi, Inc. (EIN: 45-3236734) is a 501(c)(3) nonprofit healthcare crowdfunding platform that enables individual donors to directly fund medical care for people in developing countries who cannot afford treatment. Founded in 2011 by Chase Adam, Grace Garey, Jesse Cooke, and Howard Glenn, the organization was inspired by an experience during Adam’s Peace Corps service in Costa Rica, when a woman boarded a bus with her son’s medical records asking passengers for money to pay for his treatment. The town was called Watsi [1] [2].
Watsi was the first nonprofit funded and accelerated by Y Combinator (Winter 2013 batch). Paul Graham, YC’s co-founder, discovered the organization through a Hacker News post and accepted a seat on Watsi’s board — his first board seat ever. Graham described it as the project he’d “never been so excited” to fund [3] [4]. As of 2024, Watsi has funded treatments for over 33,000 patients across 34 countries, totaling nearly $20 million. The organization maintains top ratings from Charity Navigator and GuideStar. It operates with 5 employees and 4 volunteers [5].
Chase Adam was recognized by the Obama White House as a “Champion of Change” for his work in crowdfunded healthcare. He later transitioned to venture capital, currently serving as a General Partner at Grove. Grace Garey previously worked at Kiva, the pioneering microfinance crowdfunding platform [6] [7].
The YC Research Grant and “Keeping It All in the Family”
On February 7, 2017, Sam Altman announced on the YC blog that YC Research — Y Combinator’s research arm, which Altman directed — was funding a Watsi project to study “the use of technology to improve the quality and reduce the cost of healthcare.” The specific funding amount was not publicly disclosed, though prior sessions identified approximately $500,000. Altman wrote that “for the initial project, Watsi will fund primary healthcare for a community in the developing world and build a platform to run the system transparently. Once the platform is in place, Watsi will start to experiment with improving the quality of care and reducing the cost” [8] [9].
Chase Adam told VentureBeat that his team “pitched Altman the study” because it seemed like “a good alignment of missions.” He added: “One of the most surprising things we’ve learned at Watsi is how much technology can improve health financing. Funding individual patients encourages more people to donate, but it also results in patient-level data that makes it easier to identify fraud, evaluate the quality of care, measure health outcomes, etc.” [9].
VentureBeat explicitly raised the structural concern: “There may be some that question whether YC Research should have invested in other nonprofits and could look at backing Watsi as a play to ‘keep it all in the family.’” The article acknowledged that “based on performance, Watsi appears to have the necessary qualifications” but the concern was about the structural pattern, not the specific recipient [9].
This structural concern is the reason Watsi appears in this investigation. The YC Research → Watsi funding loop — a research entity directed by Altman funding a nonprofit that went through Altman’s accelerator — is the benign precedent for the pattern that becomes the central finding elsewhere in the Altman nonprofit ecosystem. When OpenResearch (Altman’s nonprofit, funded by his personal $14M credit line) grants $1 million to TrialSpark (a for-profit company in Altman’s personal investment portfolio), that is the same “family” funding dynamic, except the recipient is a for-profit company in which the funder has a direct financial stake. The Watsi grant established that YC Research could fund YC alumni organizations, and the TrialSpark grant extended that precedent to a for-profit company that personally benefited the director.
The Operations Round: Conway, Graham, Tencent
In November 2015, Watsi raised $3.5 million in an operations round — structured as donations, not investments — from 12 funders including Paul Graham, Ron Conway, Tencent, and the Pershing Square Foundation (Bill Ackman’s charitable vehicle). 100% of donor contributions to patient care go directly to patients; this $3.5 million funded Watsi’s platform, engineering, and operations separately [10].
Ron Conway is the connection through which Watsi surfaces in this investigation. Conway is one of Silicon Valley’s most prolific angel investors and a central node in the YC ecosystem. His presence in Watsi’s operations round, alongside Graham and Tencent, places the organization within the same capital network that funds the broader Altman-connected entities.
Tencent is a Chinese technology conglomerate whose participation in a healthcare crowdfunding nonprofit’s operations round is contextually notable. Tencent operates WeChat (1.3 billion users) and has its own healthcare and AI ambitions. The presence of Chinese tech capital in a developing-world healthcare data platform — even at a modest scale — is part of the broader pattern of cross-border tech investment in health data infrastructure documented across this investigation [10].
Patient-Level Data and the Transparency Model
Watsi’s model generates detailed patient-level data as a byproduct of its funding mechanism. Adam’s statement to VentureBeat is revealing: “Funding individual patients encourages more people to donate, but it also results in patient-level data that makes it easier to identify fraud, evaluate the quality of care, measure health outcomes, etc.” [9].
This data generation is presented as a feature of transparency — and within Watsi’s context, it likely is. But the observation connects to a broader pattern across the Altman network: entities that collect sensitive personal data from populations with limited power to push back, framed as benevolent services.
| Entity | Data Collected | Population | Framing |
|---|---|---|---|
| Watsi | Patient medical records, treatment outcomes | Developing world patients | Crowdfunding transparency |
| Worldcoin | Iris scans, biometric data | African/developing world populations | Financial inclusion |
| 23andMe | Genetic/DNA data | Consumers | Ancestry discovery |
| OpenResearch | Economic/survey data | Low-income UBI recipients | Research for public benefit |
| Formation Bio/Muse | Patient demographics, recruitment data | Clinical trial participants | Efficient drug development |
Watsi’s data collection is the most modest and arguably the most genuinely benevolent in this table. But the structural pattern — tech-adjacent entities generating sensitive health data from populations in developing countries, funded by overlapping Silicon Valley investors — is consistent across scales.
Nodes / Open Questions
- What were the outcomes of the YC Research–funded “universal healthcare” study? Was the platform built? Was it deployed? Where?
- How much did YC Research actually provide? The $500K figure comes from prior investigation sessions but was not publicly disclosed in the original announcement.
- Does Chase Adam (now GP at Grove VC) maintain any relationships with Altman network entities through his venture role?
- Grace Garey (co-founder) came from Kiva. Does the Kiva network intersect with any Altman-connected entities?
- Watsi’s patient-level data — who controls it? Is it shared with funders, researchers, or third parties? Is there a data governance policy for the patient records generated through the platform?
- The Pershing Square Foundation (Bill Ackman) funded Watsi’s operations round. Does Ackman have any positions in the broader Altman network?
- Watsi operates in 34 countries across the developing world. Do any of these operational geographies overlap with Worldcoin’s deployment regions?
- Watsi has maintained Charity Navigator top ratings — unlike UBI Charitable (1 star) and OpenResearch (2 stars). What governance practices does Watsi follow that the Altman-directed nonprofits do not?
Sources
- [Archive] (https://en.wikipedia.org/wiki/Watsi)
- [Archive] (https://techcrunch.com/2012/08/30/watsi)
- [Archive] (https://techcrunch.com/2013/04/19/paul-graham-watsi/amp/)
- [Archive] (https://techcrunch.com/2013/01/25/y-combinator-backs-its-first-non-profit-watsi-paul-graham-says-hes-never-been-so-excited-to-invest)
- [Archive] (https://grokipedia.com/page/watsi)
- [Archive] (https://obamawhitehouse.archives.gov/champions/crowdfunding/chase-adam-)
- [Archive] (https://www.linkedin.com/in/chaseadam17/)
- [Archive] (http://smbp.uwaterloo.ca/2017/03/watsi-revolutionizes-crowdfunded-healthcare-with-radical-transparency/)
- [Archive] (https://venturebeat.com/2017/02/07/y-combinator-and-watsi-launch-study-to-see-how-technology-can-fix-healthcare/)
- [Archive] (https://techcrunch.com/?p=1233116)