Watsi (YC W13) and the Future of Patronage

One related thing I would recommend, if you're interested in charity & philanthropy, is to check out GiveWell (http://givewell.org). They have very well-studied recommendations of charities, and they recommend them on the basis of "most good for your dollar". Some of the most efficient treatments on Watsi are on the order of thousands of dollars per child's life saved. That's pretty damn good as "good for your dollar" goes, but GiveWell's recommendations are often a factor of 2-10 better, and the evidence base to support their recommendations is quite strong.

The problem with conventional charities is that if they're successful, they put themselves out of business. Even if a funder supports that idea, it's entirely possible the organization will become an "institution" in its own right, and find other problems to solve -- and when you have a huge pool of money looking for problems to solve, there's no incentive for it to be efficient at all.

Charities, especially in Africa and other parts of the developing world, have institutional biases toward ongoing involvement -- the people involved don't want to create dependency, but the pressures on the organization lead it in that direction.

I prefer preventive medicine and economic development to paying for medical treatments (more effective for each dollar invested), but I support Watsi's methods, and if they can use those same methods of transparency and direct, small-dollar donor involvement to solve other problems (or, better, if other organizations copy their methods to solve other problems), they will dwarf the impact of any other YC company to date.

Yes, I know that 100% of their "fundraising" will go to their charitable activity. But that is "fundraising" in the Groupon sense--it is a redefinition of a commonly used term that excludes their fundraising activities that actually support their non-charitable operations. Small donors may not care much about that, but for institutional donors (i.e., foundations), operational costs are a significant factor in the grant-making decision process.

I don't know what these kinds of projects will do to the "future of patronage" but it gets people aware of the problems, gets them involved and brings in real results, with little effort. That can't be a bad thing.