Watsi has this Impact page where you can see every person you've helped — their photo, their story, the country. I visit it more often than I'd like to admit.
I have been building a startup since the last couple of years and as we all know it is relentless. There are weeks where nothing seems to work, where you question every decision. In those moments, pulling up that page and seeing real people whose lives changed because of a few dollars a month — it resets something. It reminds me why building things that matter is worth the grind.
Thank you to everyone at Watsi for creating something that gives back to donors just as much as it gives to patients.
I couldn't remember when I joined, but it turns out 2014 too. From that date and dang's comment below, I found the HN submission that motivated me to join:
Also, fun fact: 619 of our current "Universal Fund" monthly donors first made a donation 10 or more years ago, and I'm pretty sure many of those were/are Hacker News readers.
I've long played around with the thought of what would happen if someone started something like the universal-fund you mentioned, but had it snowball like a sovereign fund? (ie, instead of spending the in flow, invest it and only spend the profits from the investments, for example) ...
Particularly for basic needs like housing,food,clothes... Like what if instead of giving a charity $100 we created 41c per month? of UBI (roughly the cashflow from investing that same $100). Yes it would seem too little today, but in time it would be massive because it would never dissipate.
IDK, just my musing while claude takes, err does, my job.
Plenty of those have existed, but in the end they always get stolen and given to the dogs trust.
There’s nothing people hate more than lasting charitable foundations. They take them to court so that they can crack them open and wank away the entire fund in 6 months.
There was one which was supposed to pay off the entire national debt. They cracked and spaffed it.
Another was supposed to end piracy. Cracked and spaffed.
You could save a million people a year, but that won’t save you from being cracked and spaffed. They’re already rubbing their trotters at the thought.
I remember Watsi being posted years ago. I was a recent graduate then and didn’t really have the funds but I do now so I just donated to Philip’s cause! Thank you!
I made the biggest donations in my life via Watsi. Thank you for building this site. I love you guys have an API as well. I thought of building an app on top of your API but never got round to complete it. If you are curious, I can share; I think there may be an opportunity to capture value in free giveaways and turn it into charity. Many people try to give away their things quickly on fb marketplace or letgo, ...what if they could ask for a donation to a charity? I know there are challenges like, what if they want to return. But there has to be a way to solve this with an escrow service or something. A similar model already works in used, 2nd stores that work for charities.
Thank you for the incredibly inspiring work! At a time when 99% of the founders and VCs just want to bank on the next big hype cycle and accumulate power and wealth, it’s good to be reminded that actual life changing work with direct impact on people is still possible.
I don't comment on Hacker News very much -- in fact, extremely rarely, but I do remember this more than a decade ago and its awesome that you've stuck with this for this long.
Congratulations to you and all the work that you've done and the impact that you've had. That's pretty cool and something I think many of us aspire to. Cheers Chase!
You should be unbelievably proud of what you've achieved, and it's lovely to be reminded of the amazing things people can accomplish amongst the backdrop of almost deafeningly negative sentiment going around.
Thanks for doing what you do and for sharing your story!
Thank you :) Watsi is lucky to have an incredible team and medical partners, who work in some of the most challenging environments to provide care to patients.
I was an early donor and had forgotten about Watsi — thank you for the reminder and congratulations! You should be super proud. Plus, the experience you got here will serve you in good stead if you decide to do a commercial venture — scaling a non profit is much, much harder than a commercial company with some compounding finances.
That said, I have a pitch for you on Watsi - I continue to think Donor Advised Funds are underutilized financial tech in the US today. Watsi could set up a DAF that takes your cohort’s startup stock, gives them a tax deduction, mandates a 2-5% annual disbursement to the general fund if not otherwise allocated, and privilege the Watsi general fund. My team did a bunch of research on these a few years ago including some legal work, and I’d be happy to share if you think you might be interested in taking another crack at getting Watsi a large fund to back what it’s doing.
I’m a fan of DAFs and agree they are underutilized. Getting ppl to donate stock might be hard but I’ll chat with Mackinnon, Watsi’s ED, about it and let you know if we have any questions. Appreciate the offer to help share research!
“we have to sell everything we get in when we get it” -> not true, managed by disclosures
“Our job is managing volatility of the donated assets, so getting volatile assets would be bad for the fund, or possibly not allowed” -> not true, managed by disclosures
“DAFs are disliked because of asset stuffing, and on the down” -> true as to the first part. On and off legislative pushes centeraround getting 2-ish% a year as a mandatory donation, so you could be ahead of the curve on an ‘ethics’ basis with this as a rule.
“It’s impossible to value illiquid stock so we can’t get a proper deduction” -> not true, you can get an outside valuation, or see below on the secondaries
The scheme I’d suggest on a call would just be: find a friend who did well from your cohort, or pitch some of your VC allies that have helped on the board, see if anyone is willing to give it a try in the 10mm or so range. You’ll then need to find someone who wants this stock in the secondary market; this would be either the key partnership or the key staff you hire, and another reason to bring in the VCs here. You’d be able to accept any donor with stock that has a value in the secondary market.
One of the things we looked at was psychology on give now / give later, most founders are planning on mooning, and therefore want to give later. This lets them split the difference a little - deduction at current secondary prices, but they could hold off on selling and get more out to charity if the stock does well.
On valuation, to my mind the easiest path is finding a secondary buyer, then you’ve got an independent price.
We even ID’ed an Exec Director who wants to do this, and would be great! My contact is in my profile.
Watsi is an incredible organization doing incredible work.
Chase and Grace are both incredible people.
When I was 15 and first starting Hack Club, I went to Startup School 2013 and watched Chase’s talk. It was the first time I had ever seen a startup founder who was starting a nonprofit instead of a for-profit. Afterwards he showed me the kindness of speaking with me.
Later as the years went on, both of them always replied to emails and gave great advice.
Many nonprofit founders understandably feel very protective of their experience and relationships because nonprofits can be zero-sum in a way that for-profits aren’t, but Chase and Grace are two of the most generous people you’ll ever meet.
Thank you for starting an incredible organization and being such an inspiration.
I’ve been a monthly donor since ~the beginning when I was just an undergraduate, and I still read the stories and emails I receive. I’m glad that you opted for the steady growth path, and that you’ve made it a sustainable thing.
Your support every month in our Universal Fund means the world to us! This consistency and reliability helps us plan ahead, show up faster for patients in need, and grow to reach new hospitals and communities.
One thing I always thought of converging businesses with helping people in need.
I know a lot of people think about this in a negative way in charity circles but I’d rather like to see companies sponsor donate in return of some sort visibility.
Somehow I always thought that would be a good fit for an organization such as yours. (I did donate through you guys previously, thanks for facilitating that).
That’s such an amazing story. I ca relate to much of the emotional, time and financial commitment of a non-profit and keeping at it like you have is absolutely commendable. Seeing you succeed is an inspiration to continue doing the right thing for me and for many others!
Great work Chase! I remember meeting you back in the shared office with Teespring. You are right, we are not our startups, but there is a lot to be proud of, an impact is always the goal, for profit or non. Onward!
Thank you Chase -- I was an early Watsi supporter (and still am actually) but you just reminded me I need to donate soon haha :) Either way fantastic work and thank you!
Hey Chase! Congrats on everything you, Grace, Thomas and the rest of the team built. I know it wasn't always what you expected it to be from the inside, but from the outside nobody saw that. They just saw something amazing. Your Startup School talk is my favorite ever, and I'm lucky I got to work with you all those years ago. You built something incredible, and helped a lot of people.
Why would for profits not make the world a better place?
For-profit does not mean “shareholders and ROI over user” or something. You can do for-profit and not enshtfy and make the world better. That’s my goal at least.
The comment is a bit misguided: the operations Watsi helps perform would not have been possible without for-profit companies and for-profit innovators building the infrastructure of modern medicine. It's not one or the other: both for-profits and non-profits make the world a better place and I think they complement eachother. Sure, there are for-profits that do NOT make the world a better place, just like there are non-profits that fail in their mission to do good things. They just typically fail to do good things for different reasons.
If profit is the objective, it will turn into growth-at-all-costs machine because that's how the mathematics works.
If, however, the objective is, say, improve as many lives as possible with the constraint of being profitable, it's definitely possible to do good. You just have to make sure you understand what level of profitability is sufficient, which is rare but doable.
Ohh, thanks for the reminder! I’ve been a Universal Fund member briefly, but I’ve lost my job soon after, and have had it paused since then. I do have some stable income again now – will resume my subscription later this month. :)
One thing I didn’t like back then (IIRC) was the fact that you couldn’t opt out of receiving the patient stories with your monthly receipts. While genuinely heartwarming, I’d prefer to check these out when I’m in the mood. Any idea if there’s such an option now?
This is truly great - just joined the universal fund.
I tried to signup from the nav bar but kept getting a 500 error from the sign_up.json endpoint. I had to go through the Donate flow to be able to create an account.
This post triggered a wave of bittersweet remembrance: when Watsi was announced I signed up and was genuinely excited for what I thought a well-positioned incubator like YC could accomplish in general redistribution. I was very wrong! But to see this not being a shutdown or acquisition announcement is heartwarming. Keep linearly existing!
Grateful for your work, and sticking it out serving human beings while others hustle to secure the bag. There's nothing wrong with securing the bag, of course, but it just makes work like this even more impressive to me. Kudos!
I was part of Omaze and can definitely empathize with the amount of work charitable fund raising takes and the amount of heartache that come from seeing under needs. Thanks for your hard work!
Chase- thank you for what you've done in creating Watsi to impact 33,000 lives! It also made me believe in the potential for non profits to create a positive impact again.
No problem! I would absolutely help again. This is an important cause that is near to my heart. Speaking for the HN community: we are always happy to help!
We'd love to have GiveWell evaluate Watsi. They often recommend global health interventions because every dollar goes incredibly far in saving lives. In the meantime, here's what a few (independent) experts have said about investing in access to surgery:
• A review across 23 LMICs found that low-complexity surgeries (e.g., appendectomy, hernia repair) cost as little as $17 per Disability-Adjusted Life Year (DALY) averted (Mengistie et al., 2025). Overall, 89% of surgical procedures studied were cost-effective, and 76% were “very cost-effective” based on GDP thresholds (Ifeanyichi et al., 2024).
• Essential surgery often achieves costs per DALY well below standard willingness-to-pay thresholds and can be more valuable than essential drugs or vaccines on a per-DALY basis (Mengistie et al., 2025). Low-complexity surgical interventions compare favorably to—and are sometimes more cost-effective than—interventions such as HIV antiretroviral therapy, family planning, and TB vaccinations (Ifeanyichi et al., 2024).
Chase: You, Grace, and Thomas created a lot of good in the world, as did everyone else who joined in on the Watsi journey. Was really proud to see all you accomplished!
Great work. Do you have specific countries you work with? How are health partners selected? Would love to introduce some doctor friends of mine in Southern Africa. Every now and then they have some cases where we end up just pooling as friends and send to them. Again, great work!
Watsi seems to be doing great work, but the title—"you helped save 33k lives"—reads as misleading to me. I guess "helped" could be doing a lot of heavy lifting here, but I would be incredibly surprised if the counterfactual number of lives saved was more than 3000. (But don't let this dissuade you from donating; concretely improving someone's life is totally a worthwhile goal, and Watsi seems very good at effecting this)
"Counterfactual number of lives saved" is not the normal sense of the phrase "save a life". By that logic, each person's life can only be saved once, which is not how people normally use the phrase.
Your definition may be useful for cold hard utilitarian calculus, of the sort that hospital directors need to do if they've run out of fundraising opportunities. However, "effective altruism" – which I suspect you're alluding to here – isn't actually an efficient way to save lives, the way it's usually practised (ignoring second-order effects, and everything that doesn't fit on a spreadsheet).
You're right; I should've been more precise. However, we have tools for dealing with this—that's what quality-adjusted life-years are for! I don't contest that surgeries often significantly increase QALYs, and may do so pretty cost-effectively.
Yes they are surprisingly cost-effective in the countries Watsi operates in, which isn't intuitive for those of us who live in places where surgeries are very expensive.
"A review across 23 LMICs found that low-complexity surgeries (e.g., appendectomy, hernia repair) cost only about ~$17 per DALY, whereas even complex procedures were often cost-effective" (Most surgeries on Watsi are low-complexity)
"Reports from the WHO and Lancet Commission consistently emphasize that investing in surgical capacity has high value, in many cases, more than essential drugs or vaccines on a per-DALY basis"
Lol, I just care a lot about saving as many lives as I can; the most effective charities I've been able to find good evidence on save one life for $6–8k. If Watsi had a credible claim at being able to save lives 10x cheaper I would redirect my entire donation budget to them!
That said, once again, Watsi is great. I really appreciate all the hard work they've put into making this happen—this is orders of magnitude more impressive and impactful than most projects I've ever seen!
Incredible, I didn't know about Watsi, but I am glad that I do now. Direct support for something as important as healthcare seems to be one of the best ways to deploy donations to positively impact the world. Thank you for creating this!
We can't see any failed donations around this time, and we've had many successful ones, so we'd love to get more info from you to debug if you're willing. My email is in my profile. Thanks so much for the help!
So awesome to hear - thank you! Hoping others will join in on watsi.org to help too. We want giving to be a bigger and more meaningful part of our day to day lives and to do this, it helps to always know and trust the impact you are making.
That's pretty awesome what you're doing. Tough that you got to feeling responsible for all of those people. I've struggled with that weight.
The good news is God doesn't hold us responsible for them. He is sovereignly in control of the entire universe, including every life. He made us to worship and reflect Him, and love others as ourselves day by day. We're only judged for what we can actually do, more from the heart than anything.
That's a huge relief. I just help who I can. It's also awesome that, if we believe in Jesus Christ, we can pray fir them to be healed or for Him to raise up entire organizations to give people more medical care. We've seen some healings but usually exceptional, medical progress. (Some suffer or die.) On more care available, your team was one of our answered prayers. :)
If this world wasn’t run by disgusting psychopaths an organization like this wouldn’t be and shouldn’t be necessary but since it is, I applaud the work sincerely and wish you the best of luck.