Giving Access To Affordable Healthcare

Sidney Haitoff Interview

Brandon Stover: [00:00:00] Hey, you welcome to evolve a show about the stories and skills of social entrepreneurs solving the world's greatest challenges. I'm your host, Brandon Stover and today's guest is Sydney Haight off founder and CEO of Mishi. go healthcare company that puts consumers in control of their care by connecting them directly with providers on the basis of transparent and affordable pricing. No insurance needed since launching in the fall of 2020, Mishi has already welcomed more than 125 providers across seven specialties to the marketplace in just three months of active recruitment and Sandy.

They are continuing to build out their provider network and plan to offer a full suite of essential medical services to their community and other major metropolitan areas across the country.

Now, starting at the ripe age of seven years old and stuffing envelopes in his dad's medical billing company, Sidney has spent his entire professional career On the business side of healthcare building and managing teams responsible for implementing and optimizing enterprise software and workflow, developing business intelligence tools and leveraging those systems to maximize physician revenue and profitability, working with thousands of healthcare providers in most clinical specialties.

His experience has given him a multifaceted perspective on how to address many of our health systems woes, and while addressing the dysfunction of the $3.5 trillion healthcare industry is no easy task. Sydney's aim is to help the millions left behind by the system. And the even greater number of people stuck footing the bill of the system's current inefficiencies today.

He shares his expertise in the medical industry, how he approached building a two-sided marketplace and the secret tool he uses to overcome challenges of being a founder. Now, let's hear from Sydney about his mission to bringing healing back to healthcare, through price, transparency, equity, and access.

Sidney Haitoff: [00:01:46] Our mission is to increase access to affordable healthcare. The us healthcare system in total is a problem. It's not affordable. It's hard to access in a number of different ways.

It is convoluted and involved and it's not. Getting access to care should be easy. It's a right that we all deserve as humans and the ability to thrive and prosper and, and Excel and, and be healthy is one that we're really passionate about. And we've seen a lot of people, in my past experiences or friends I've had, or friends of team members that have joined this journey with me, we've, we've seen an experienced, you know, a lot of pain that's resulted from the way that the industry is structured and some of the you know, misaligned incentives and frankly, a lot of the BS that's involved in accessing care And so we are taking a stand and we want to do our part to try and again, increase access and to affordable care and do so in a way that's equitable and transparent and in doing so I think we'll be able to hopefully change the world

Brandon Stover: [00:03:12] Yeah. Love that. Well, can you explain where the name Mishi comes from? I think it has a unique background  

Sidney Haitoff: [00:03:18] mushy. Yes. So Mishy is short for Misha. Bayrock, it's a prayer for healing and we are looking to bring healing to healthcare and to frankly, the us and the world. But in the U S I feel. Most of our GDP is spent on healthcare. And most people who file for bankruptcy believe that 60% of people who file for bankruptcy do so because of medical costs.

And so the hope is by addressing this very, very large problem and, and starting in a very, very focused way that we'll be able to, you're not only increase access to care, but also helps people know that's what this is all about. It, it all comes down to helping people and, and again, helping them live their best life.

And that means physically, emotionally, spiritually, and.

Brandon Stover: [00:04:12] well, essentially you guys have built a two-sided marketplace for consumers to directly access healthcare providers. And in three months you guys have already recruited, you know, 125 providers in seven specialties. So if I were getting an x-ray today, walk us through the experience for the consumer and the provider on Mishi.

Sidney Haitoff: [00:04:32] Absolutely. So for the consumer, you would access our marketplace@mishydotcomishe.co, soon to be an iOS and Android app. But for now we're we have a mobile optimized browser-based platform. And for an x-ray, I believe it's one of our top services. So you could click the x-ray link underneath our top services category, or type in x-ray into the search bar.

And I press search and the results will yield the available care options. X-ray options in your area. Right now, we're primarily in San Diego, but we've been onboarding clients in cities, major cities across the country. We have in Houston, Chicago, New York, and we're going to continue to grow. But from the search results that you would get from searching x-ray, you would see your available options, make your selection based on price or distance.

You could click into any of the service cards to see whether or not there's a specific x-ray and a specific price for a specific body part that might be available. Some facilities offer one flat rate for all body parts, other facilities and, and practices provide organizations if you will differ their price based on the body part.

And so you'd make your selection. You would add the service to the, to your car. And you would purchase the service. You would receive a care voucher. That's essentially alphanumeric code that you would use as your payment method when contacting the facility or the provider's office. And just to give you a heads up the, the email that you would receive as confirmation it would point you to your Mishy dashboard, where you would see scheduling instructions and, and you know how to reach out to the practice either by telephone or some, a lot of practices now have online scheduling portals.

We have a client who prefers to receive text messages to schedule care, which I think is very cool all in a secure way. Of course. And you again, would use the voucher as the payment method when checking in or scheduling your care. And the voucher would be, will be redeemed by the provider. Once the care is actually rendered, that's our way of confirming that the care actually occurred.

And until the voucher is redeemed, consumers have the ability to cancel care cancel their voucher and get a full refund with no, no risk involved. But once that care is rendered and the voucher is redeemed that's when the provider gets credit for the service rendered. And from the providers perspective, they would receive a check for that full amount.

The following.

Brandon Stover: [00:07:23] well, before we get deeper into Mishi, I want to highlight some of your backstory and your career in healthcare started, you know, long ago in your dad's medical billing company. What did you learn about healthcare or being an entrepreneur from your dad growing up?

Sidney Haitoff: [00:07:38] For as long as I can remember being an entrepreneur was something that I aspired to because of my dad, you know, he's my, my biggest role model growing up. And it was always kind of taught to think in  an analytical way about businesses, you know, as early as I can remember, I would be challenged to come up with business ideas and he would usually shut them down pretty swiftly, but over time I got better and the ideas got better and it got easier for me to identify opportunities in different areas.

I, I feel like I've had so many ideas over the last 10, 15 years that have that I've watched, turned into technologies that are used widely today and solutions the same. And so I'm very happy to be taking the steps towards and, and really can push them for the solution that I feel will solve a lot of our healthcare systems woes.

And in terms of healthcare I was working in my dad's building office at seven. You know, work ethic was a big thing with my parents. Both who came from nothing pretty much. My dad is Eastern. Yeah. European Jew from Brooklyn. My mom is a black from New York. Both well to do and put themselves up by their bootstraps.

My mom went to Yale and graduated with a physics degree. My dad didn't go to college, but was a hustler and worked his way up in the ranks of at and T is a sales rep. And then eventually I got the opportunity to start to zone a billing company, but yeah, I've been involved to a very limited extent, I would say in healthcare since I was a kid.

I learned a lot about healthcare, about the industry in my time with the billing company. And I was very grateful to get exposure to all of the different facets of the physician revenue cycle.

You know, it's a, they call it revenue cycle management is the formal term for billing. Billing is really only a piece of, you know, the full revenue cycle. And I was, had the ability to, and, and frankly, they got a lot of benefit from me going in and kind of digging into the different facets of the revenue cycle and identifying opportunities for improvement and efficiency.

And and a lot of instances I was given the ability to kind of affect change and a lot of instances I wasn't, and it was very frustrating. But that also helped me. To formulate my approach for what my solutions would look like when I had my own business, I was frequently checked with the, you could do it your way when you start your own company.

Brandon Stover: [00:10:21] sure.

Sidney Haitoff: [00:10:21] that was very encouraging, frustrating, but motivating.

Brandon Stover: [00:10:26] Yeah. Well, explain  going through some of these records, explain to our listeners, the discrepancy between, you know, a bill charge that doctor send on an invoice to insurance companies and the contracted rate that they actually accept as payment from those insurance covers.

Sidney Haitoff: [00:10:41] that is the number one problem. I would say in, in my opinion with overall health care system, is that correct? The vast discrepancy between the bill charge, the charge that you'd see on a surprise bill and the news, the charge that puts people into bankruptcy that charge that results in so much pain and anguish and, and unfair treatment is so different than, and so much greater.

And so inflated when compared to the quote unquote negotiated rate it's called, it's referred to as the negotiated rate, the contracted rate, the discounted rate, the allowed amount, the expected rate, that, that there are a number of different ways or names given to what I call the true cost of care depending on the context.

And so the contracted rate,  that's the rate that the providers. So, you know , that rate that the bill goes out with is  far greater, I, in some instances I've seen the contracted rate, the 2015, 20% of the bill charge.

that contracted rate is what the doctors paid by the insurance carrier. It's called the contractor grade because the physician doctors and medical providers contract with the insurance carrier For that rate. So the doctor says I will accept as it's called the accepted rate, the expected rate, I will accept and expect that rate for this service. And when I say this service, it could be any number of the thousands of CPT codes, CBT sensor, current procedural terminology, any one of those thousands of codes that essentially index each of the procedures that are available in our healthcare system.

And so, the contracted rate that a provider would accept is discounts. When compared to the full fee that billed charge. So it's also called the discounted rate. The discount is because, or in return for the demand that insurance carriers drive to a provider's office As for as long as I could remember.

And even before people turn to their insurance carriers and their networks for when determining who to go to for care know before the advent of the internet the, those middlemen, the insurance carriers were essentially the agents for for care for insurance carriers and for providers, they were the ones to pay the providers and still are, they were the ones to direct consumers to those providers.

But with the advent of the internet I would say increasingly over the last 10 plus years, that's where we saw consumers and patients acting like consumers and starting to seek out care from providers that.

Were increasingly outside of their networks, outside of their insurance carrier networks because they saw that provider online and that provider got good reviews or might've written an article or posted a video.

So from the providers perspective, they're trading a discounted rate for increased demand.

And for the consumer's perspective That contracted rate is essentially a ceiling for how much a provider can charge a consumer and how much a consumer could ultimately be responsible for for the care that is rendered. And I say the ceiling because the concept of balanced billing is one where the provider will balance billed the consumer, the patient for the balance between the contracted rate and the build rate.

And that is illegal no, no for contracted providers, because you are essentially you are going outside the bounds of your contract and, and trying to collect additional funds and, and interfering with the relationship that consumers have with.

Brandon Stover: [00:14:34] So essentially, you know, as somebody that's maybe uninsured or, you know, a gig worker or, you know, an entrepreneur that often doesn't have a healthcare we can come to a platform like Mishi and to get that lower cost, the. That's not built to an insurance company, we're getting direct amounts. So it's a lot cheaper for us.

And instead of going through an insurance company, we're dealing directly with that provider.

Sidney Haitoff: [00:15:02] Exactly. that was the goal and the sod and the impetus behind creating the marketplace and creating mushy was to give people who either don't have insurance or have insurance, but for whatever reason might want to engage in a relationship outside of their participating network give them an option to access care.

Having insurance and coverage covers a consumer, a person from massive, massive bills, but it doesn't cover them from deductibles that have increased over exponentially over the last five to 10 years. And so the thought is that, okay there, if the doctors are getting paid a certain rate and they'll accept that rate with, or without insurance, and frankly it's, it's even better for them without insurance because they don't have to pay the 30 cents on the dollar.

In billing costs that I'm all too familiar with from my industry to collect on their revenue and they get that payment upfront in full. So it's better for them, you know, outside of insurance, frankly, but for the consumers who don't have that protection, there's no reason for them not to be able to.

Care at that same rate. And so what we do is you know, part of our offering we're technically software as a service company. And part of our offering is we help providers establish their cash pay rates and, and help them mimic those off of the contracted rates that they that they have with major medical insurance companies.

Brandon Stover: [00:16:35] Hm. Well, you mentioned it took, you know, 10 years to really put these ideas into motion was ever a point where you initially denied or refuse to solve this problem because it was too large.

Sidney Haitoff: [00:16:46] Was there ever a point yet? It was 10 years. I don't know that I would say I had denied or refused, but I was scared, you know, it's a, it's a big, big, big undertaking. And now having been full-time at it for about four months, It's bigger than it ever has been. You know, the deeper you get the, the bigger becomes, but I couldn't be happier to be tackling the issue.

But yeah, it's a scary thing. I think entrepreneurship in general is a scary thing. I just spoke with a friend who I was catching up with, about machine and some of the things that reach working on. And he was saying that he respects the entrepreneur journey. And frankly, so do I,  I grew up respecting it, but now having watched, you know, some of the tech Titans over the last 10 years really kind of changed the landscape of the world.

And, and do so with just a, an initial idea, definitely something that I grown to Revere, but I think at the same time, you know, that reverence is also intimidating and it makes it. Yeah, it makes it scarier. And so I would say in that regard for anyone who's scared by their idea or scared of the work that's going to come you know, you're not alone.

Absolutely not. It's good to be scared because that means   thinking about something that's worthwhile and big. And I would say that the biggest thing is to just take small steps. It would just take a single step forward. I know it sounds very cliche and trust me, I, I checked myself all the time when, when I give advice and I'm still at the very, very beginning, but I do feel like I've learned quite a bit and like to kind of share that with people and maybe not even just entrepreneurs, but I think with any big problem that people are trying to solve all consensus, taking the first step.

And the first step turns into to for instance, a five and 10

Brandon Stover: [00:18:39] yeah. Well, during our pre-interview you also mentioned one of the skills that you had to develop was asking for help along the way, who are the mentors that you asked for help as you were getting started and what did they teach you that really impacted your business?

Sidney Haitoff: [00:18:53] So just want to say thank you to everyone who has assisted me on, on this journey so far. I couldn't, I couldn't do it without you guys. You know who you are, I'm not going to call people out by name, but there's been a number of people. I it's another thing I would say, definitely leverage your network.

you'd be surprised with how many people want to help and assist. And, and even if you don't have a, you know, a large network and put yourself out there, I mean, again, that's something that you and I spoke about. I think now with social media and the social tools that we have and forums it's easier than ever to kind of get connected with people that you definitely wouldn't have otherwise.

you know, I have a few friends that I was in school with who are successful founders.

And so they were the first people that I went to with this idea and, and, and as I started to kind of go down the road with it and, get some traction so. A couple of my initial bigger moves or shifts changes in perspective, came from them. And it really kind of set the stage for the last three to four months in a, in a big way.

And so definitely if anyone, anyone listening has any founders or anyone that started a business, any entrepreneur in their network definitely reach out. They would love to help. I I'm confident in that.

And also. Speak to, you know, not even just entrepreneurs in your network, I guess that's the initial circle, but then, you know, branch out, start to tell people what you're doing.

It helps keep you accountable for yourself. But it also, you know, people want to know, especially if you're doing something that's worthwhile and, and that will help. You never know who the people that you might not even know or might not have experience with what you're doing, who they could introduce you to.

So it's that second and third you know, removed connection. That might be a huge one. And frankly, that that's exactly what it's been for me. You know, a couple of the, those initial advisors I'll call them helped me make some, some pretty impactful first moves. But it's been through some of the advisors that I've met through friends and even friends of friends that have really kind of helped me tweak and optimize and perfect our message and our offering.

Learning from other people is, is a quick and relatively straightforward way of of improving your skill set and knowledge about, you know, whether it's entrepreneurship or intricacies of the solution that you're trying to solve, or the subset, a subcategory of the solution that you're trying to solve. You know, reach out people are, people are more willing to help than you would think.  Well, speaking of the first moves that you started taking with Mishi obviously you had a background with deep insight into the market and you helped healthcare providers before to set pay rates. So how did you decide a pond, the marketplace model for you? Right.

So I had a client, a few clients reach out to me. would say maybe eight, nine years ago. First two years of, of my tenure in healthcare administration and revenue cycle, they reached out and asked for help crafting cash pay fee schedules. They call them, or essentially a menu of services for patients coming into their office without insurance, those  administrators knew that the discrepancy between the bill charge and what they were actually receiving from insurance companies was a Bastien and that they wanted to make the cash pay rate more.

Attainable and affordable. And so we used some of the prevailing pricing methodology in the industry, which is usually contracts are based on a percentage of Medicare insurance carriers for out of network providers. You know, those providers that are essentially able to build whatever they want to the insurance carrier.

A lot of insurance carriers will have a fee schedule. That is 250% of Medicare by default or 175% of Medicare by default. And, The Abner providers, it's that out of network fee schedule, which is essentially, you know, all, all uninsured patients, uninsured, consumers anyone that's coming in off the street and wanting to pay cash, pay rates, they're all technically out of network.

Right? So that you know, the, these insurance carriers is interesting that they have those standards. And so we helped our clients craft, you know, rates schedules that were similar to those similar to the expected rates that they would receive from insurance carriers or similar to, you know, those defaults out of network rates.

And that's where the idea for the marketplace came from because the thought was okay, if people are coming into the office, And looking for these rates we're looking for care and are getting these discounted rates and they don't have insurance. No. Why not make that option available to everyone?

And I had also been privy to the difference between those contractors you know, from one provider to the next, even within the same specialty it all comes down to purchasing power and, and utilization, and there are a bunch of different metrics involved when negotiating with an insurance carrier.

That dynamic is what led me to You kind of come up with the marketplace model is why not give everyone access to those rates without having to go through insurance without having to deal with the uncertainty of the billing process?

You know, a lot of claims I saw a statistic that said one in four claims are denied first pass, and frankly I've seen it,

Brandon Stover: [00:24:43] Geez

Sidney Haitoff: [00:24:44] You know, for no reason other than, well, I mean, the carriers will, will say that there are reasons,

Brandon Stover: [00:24:51] justify a reason.

Sidney Haitoff: [00:24:52] yeah, exactly. But there are, I mean, I've, I've heard from, from you know, insiders that their edits that they have in place, essentially these rules that will kick out, you know, a, a number of Glen just by default.

And and when I say kick out, I mean, deny, and if a provider doesn't have the. Wherewithal or the resources to address those in the appropriate way, then they won't get paid. And so insurance companies kind of prey.

Brandon Stover: [00:25:16] How does this marketplace model help solve problems for the provider?

Sidney Haitoff: [00:25:19] Yeah, the homography his model of the goal of that was to provide people with simple access to the true cost of care, to give providers that same revenue and, and allow them to essentially dictate the price that they want.

Because again, the, they do have some, a bit of difficulty in some instances in negotiating the rates that they, that they prefer with insurance carriers. And, and that's why you see complaints of a lot of downward pricing pressure from insurance carriers against providers and you know, providers try to offset that with increased utilization and it results in burnout.

And so the goal was to reduce burnout essentially and give providers more autonomy. And freedom and deliver care in the way that they want. I want giving consumers the ability to access care based on transparent price. That's another huge problem in the industry is price transparency.

And it's great that it's been given a lot of focus over the last few years. The, the prior administration put an order or implemented an order that required hospitals effective January 1st, 2021 required requires hospitals to post publicly on their website, their negotiated rates and,

Brandon Stover: [00:26:34] Oh, amazing.

Sidney Haitoff: [00:26:35] pay rates for for the care that they render for 300 shoppable services, but they call them which represent about.

Let's think about a fifth of all medical procedures that contributes to, to our GDP. But it's unfortunate that a lot of hospitals have not come to the table and have not complied with that requirement. The concern being that they would lose leverage with insurance carriers in doing you know, in publishing their, their cash pay rates

and to the, to their defense, you know, a lot of billing arms revenue cycle, arms, and hospitals and practices in general, just don't have the resources or don't know what that average cash pay rate should be, whether it's because they are utilizing antiquated systems that don't have the reporting capability to do so, or they don't have the  attention towards this kind of option that you know, that the public deserves.

And so I think that's part of the issue is price transparency in general, and it's been nice to see the the industry or that concept get a lot more attention and that's kind of paved the way for for us and our offering to be a little bit more Well received. Well, I mean, it's still a little taboo and providers I've seen in hospitals and providers increasingly are a little concerned about the ramifications of public publishing their cash pay rates.

And when I hear provider, you know, voice those concerns, I direct them to our clients and I direct them to other bigger providers in different markets that are already taking that, that forward thinking approach of, you know, publishing their rates so that people who want to and need to access care outside of the insurance model, you can know what they're going to be paying upfront.

And I commend those providers for taking that step and would love to get them on the platform.

Brandon Stover: [00:28:36] which side of the marketplace, when you started building it, did you decide to go after first? Obviously when you're building a marketplace, you know, you have two user groups, so did you get the consumers of the healthcare or the providers first?

Sidney Haitoff: [00:28:47] So providers and the thought is that we want to be able to offer a full suite of care to consumers, to access the platform, still building out our provider networks in San Diego and in New York and Los Angeles, Chicago and Houston. But the goal is to develop a wide array of providers and services that would mimic the offering and the coverage that someone would, receive through insurance.

Again, on average, most people don't spend more than a thousand dollars out of pocket towards healthcare. I Believe that it's 50% of healthcare costs could be attributed to 5% of the population.

so the value proposition is very different for both sides of the market. Providers were able to offer increased demand and through visibility and accessibility to their services, by putting it on the marketplace, as you would see in any other industry that has the marketplace.

I like to look at the door dash scenario or Airbnb, where you're getting directed to, you know, local businesses that have been offering the services. They're just now getting increased visibility to those services. And also we're, taking out a lot of the overhead that's involved in collecting payment for services rendered.

And so  that value proposition is very different from what we're able to provide to consumers, which is ease of access, affordability, price, transparency And soon the ability to split payments up, we're going to be integrating a buy now pay later solution to increase further increase, access to care.

There are some people who have pursued this model, you know, whether it's providers, there's a growing trend of direct primary care, which is essentially concierge or subscription healthcare where it's outside of the insurance based model, you're paying a monthly fee for unlimited care or, or a certain criteria of or bundle of care. But usually the providers are available to you, you know, 24 7, which I think is great. And, and it does kind of show that there is support for consuming care outside of the insurance model.

The same with consumers. I, I speak to a lot of consumers who if they have a high deductible and when they're given. The an order for an MRI. They, I have it inside their head that, okay. I don't want to go through insurance cause I'm scared of how much it's going to cost because of all these war stories that I've heard and air seen in publications.

And so I just had actually a good friend of mine texted me the other day, asking how much should an MRI costs. And so I, I replied with a link to our MRI search query on the platform. I thought that was really cool, but you know, people are doing. Are, pursuing this type of consumer forward shopping experience already.

I would say it's still a small trend, but it's a growing trend. You know, people are fed up with the, the massive size of the bills that they get. And to some extent, they know that there, there has to be a better way.  We are bringing it to the mainstream and we're supporting it with, a tech forward consumer forward solutions and features that help consumers, access care, help providers get, increased visibility and accessibility to their services.

And we cut out a lot of the intermediary. I don't want to say nonsense, but kind of nonsense

Brandon Stover: [00:32:20] Yeah, the hurdles and the hoops that you got to jump through.

Sidney Haitoff: [00:32:23] And so we want to take out some of that some of those burdens and some of that overhead and, and move from delays and denials to equity and access.

You know, you shouldn't have to have insurance to have access to care,  and because of the discrepancy between the bill charge and the, the contracted rate and the fact that self-pay patients cash pay patients in the past were increasingly build that full fee.

That bill charge that you would see in the new. That's what has kind of caused I would say people to believe that you need insurance to access those discounted rates. And that's, that's just not the case.

Brandon Stover: [00:33:07] Yeah. You know, as you continue to build out your provider network and plan to offer a full suite of different medical services you know, and expanding to other metropolitan areas, what strategies are you implementing to help grow me?

Sidney Haitoff: [00:33:23] So high level, I would say we're iterating a lot. We're trying new things and experimenting you know, pulled from some of what I've learned from the lean startup methodology and one of them being marketing, because we have to educate both consumers and providers on this new model of care pays you go healthcare,  so marketing is a huge tool for us, and there are so many different strategies that one can employ in marketing.

It's incredible. I was a, a double major in college marketing was one of them finances.  The landscape has completely changed over the last 10 years. There are so many different options and strategic ways to get your message out there and to engage with the community that we've been testing. So social media engagement through organic content and social media, whether it's Facebook, Instagram, LinkedIn in a tick tock, give everything a shot. We have been in, it's been working very nicely. I would say a good mix between organic and paid advertising is helpful in, in establishing the brand and building that trust and, and kind of setting the stage for who you are as a company and, and who, you know, any leader is and their kind of style, frankly.

I like to kind of I haven't done it so much, but will be as letting my, my own style kind of bleed into a little bit more of our content as I start to get more involved in that process. Because it, isn't the brainless. Approach of, okay, let's just throw money at Facebook advertising and hope that we convert. And there is a bit more involved in not only from the education perspective, but just in terms of the relationship that we're looking to establish.

And the trust that we're looking to build with our consumers and our providers you know, it requires that more personal touch. And that's why I love doing interviews like this so that people can get a sense for who I am and why we're doing this. And hopefully get a sense for a better sense for the brand and what we're looking to accomplish and the security that we're looking to to bring to people and, and the public.

Brandon Stover: [00:35:36] Yeah. Well speaking a little bit about you and showing who you are as a person. What does the phrase, nobody cares work harder, meaning.

Sidney Haitoff: [00:35:44] It means everything. I would say that's a phrase, a that embodies my work ethic and how I was raised. You know, life is hard and, and doing things that are worthwhile is hard

Brandon Stover: [00:36:00] Yeah.

Sidney Haitoff: [00:36:01] and doing things that you're passionate about is hard. Whether it's starting a business or being an athlete or an artist, or, you know, doing, pursuing any passion that you have is difficult.

but you owe it to yourself. to pursue it because it's something that you want to do and, taking control of your destiny and, and I don't mean to be on a soap box, because again, it took me 10 years to get to that point, but I would encourage you to take anyone to take that first step.

And I guess the, the point in me saying all of this is that at the end of the day, You're responsible for your passion and your vision and no one is going to give that to you. And so in terms of what it takes to get to that end point, if there ever is an end point, which I think for a lot of people there, isn't it probably for myself as well.

But you know, in terms of what it takes, no one cares like you, you know, this, this takes hard work. You speak to anyone who's done started anything, pursue their passion in any way. And I feel that, you know, they'll, everyone will tell you that it's took hard work . And at the end of the day, it all comes down to what you're willing to do for yourself and  the lengths that you're going willing to go to, to honor yourself and your desires.

So the nobody cares where Carter  is a phrase that I really, aligned with. And it was super hyped to see.

more Jackson said that and I thought that it was huge and would love to thank him for publicizing that maybe not so popular view, but it's cause it's a hard truth. But it's one that I think it's helpful and one that I definitely definitely associated with.

Brandon Stover: [00:37:52] Obviously it's helped you, you know, get started on your journey and continue long, but do you have like an S a specific example of maybe a difficult challenge along on this journey that you had, where this mindset really helped you get over that?

Sidney Haitoff: [00:38:05] Designing the site was really tough. I'm not a designer. I'm not a programmer. Thankfully I have a good amount of. UI UX UX experience, really more of UX experience and not from a design perspective, but just from a use perspective, I tried to use as many technologies as I can.

I'm an early adopter with everything I try to be at least, and specifically with regards to healthcare and healthcare software. You know, I was, I rode the wave of EHR implementation and adoption from the very beginning of the high-tech act, when, you know, the millions of dollars were pumped into the EHR industry.

And so I had a thankfully a lot of exposure into implementing and configuring and optimizing those systems and also the databases that were the backend and that ran them. And so, although I did have some idea for how I wanted the data to. Travel and, and move and be stored and, and how I wanted the front end to look.

It was so tough to conceptualize that and to, get it in, in a format that could be built and created the journey from idea to what you see@visier.co took the better part of a year. And you know, I was working nights and weekends along with my more than full-time jobs at the time, and it designing, it took so long.

I, I have documents 20, 30, 40 page documents of, you know, going into detail about functionality and different visuals of what it could look like and seeing the different iterations from. The time when it was all text to, you know, some screenshots to then, you know, working with the designer to create wire frames, to then working with, you know, product house to D to develop the, the platform that the UI and UX in the backend, you know, that progression is, is wild.

But no one seemed to really care about the struggle and, you know, the, the people that I worked with you know, my partners in the beginning they were super comforting, but it wasn't, you know, this, this was my idea. This is my vision. And only I knew how it was going to work both from, you know, again, from, from the workflow perspective and from the user experience perspective and, and the backend.

And so. Yeah. It was like, okay, who, who am I going to? Am I going to complain to, you know, who am I going to say, oh, why aren't you helping me? Like, you know what I mean? So, so that I would say was, you know, and there are plenty others, but in terms of what took me the longest and what was the most painful and, and what I am most proud of at least to this point is the design.

The, our goal was to. I go with to make it very user-friendly and seamless and straightforward. And from what I've been told and, and from your feedback and testing we, we accomplished that. There's still a lot of work to be done visually and, and you know, with regards to a little bit of content, I think we might've made it the platform a little too simple to the point where some people who are directed to the marketplace, don't exactly know what we're doing and, and the value that we bring.

And so I take responsibility for that and, and we're, we're working towards addressing that, but you know, we, we, we got it done, I got it done. And that I would say, you know, that mentality. Is what helped see that through is that, listen, this is all on you. No, one's going to help you. I mean, I did get help, but no one's going to do it for you.

No one cares at the end of the day. No one's gonna do it for you. No one cares that you want them to do it for you. Let's you want to pay someone and insane. And when I say insane amount of money, I'm talking, we did, we you know, my partners went out and tried to get estimates or they'd get estimates for what it would take to develop the platform based on my notes without visuals, without wireframes.

And the estimates that we received were more than five times, what it ended up costing after we went through the process of developing wire wireframes and kind of doing what was required and what the kind of standard is when, when developing a tool and platform like Michigan. Thankfully, I had advice from a friend who's a senior developer.

At LinkedIn. And he told me that I was silly for trying to go out and try to get estimates based on texts and notes. And then I needed the wireframe and that that's really what kind of changed everything. And that's what started us down the road. So yeah, I would say that that's definitely it.

Brandon Stover: [00:42:55] Yeah, I think that's a excellent example in such a strong mentality. Because the reality is, is you're correct. You know, you have this vision and it's your responsibility to bring it to fruition. Nobody else is going to do it otherwise they would have already done it for themselves. So excellent perspective you know, something else is providing underserved populations is, you know, very important to you, which is why Mishi is launching its fun to care initiative to, can you explain what this is and why it's so.

Sidney Haitoff: [00:43:23] Absolutely. Thanks so much for bringing that up. So we, with our fund, the care initiative, we  have started down the road towards funding care for underserved members of the communities that we're serving across the country. So we essentially are accepting donations from people in the community and, and  using those donations to fund care, that's offered on the platform. So the way that it works is we'll be hosting an application on our site. It's going to be fund the care.michigan.co. And people in the community will be able to apply for funding for the specific services.

Our initial set of services that we're going to be offering are cancer screenings you know, for cervical and breast cancer and colon cancer. And so super, super excited and honored and get pretty emotional. When I'm thinking about that. Having known people who have been afflicted by those. Those diseases and cancers fucking answer.

So very, very very thrilled to, to be able to help people identify and and intervene early on. Should they have, you know, early onset of cancer? So go onto the platform, submit your application and we'll send you a A virtual card you can use towards, and only towards the the care that you applied for on the platform.

And you'll follow the same steps as you would a paying customer. I mean, technically you are a paying customer of the care and the screening services. And so providers won't know the difference. That's, that's another thing that I've I wanted to protect against is bias against some of the underserved against the underserved population.

I've feel did Bias, even in, speaking with people about what I'm doing, you know, that I've heard people say, oh, well, you know, I don't know that this is going to work meeting Michigan in general. And, and this model in general, I don't know if this is going to work because it's only going to be the people that insurance and poor people that are going to want to pursue the care and providers don't want to do it for people. And that kills me For a number of reasons that really, really bothers me. But I would say in the context of fund the care,  the provider won't know they'll, they'll receive the request as they would any other consumer, and they will render the care as they would any other consumer and they want a different and so it removes some of that, that bias that unfortunately is there.

Brandon Stover: [00:46:03] Amazing. This feels really similar to GoFund meme, which has been used by many people you know, who can't afford a costly operations or medical care. How does  fund the care compared to GoFund me?

Sidney Haitoff: [00:46:14]  The goal is to automate the process. These are going to be the, you know, this workflow is the, the, the beginning stage of the automated process whereby we're going to essentially provide a, an automated way for people to either anonymously or publicly you know, submit requests for care that's on the platform and give the public either anonymously or publicly the ability to fund that care in a way that might look a little similar to go fund me and how the 30% of GoFundMe's balance sheet is for medical care.

And, you know, there are tons of articles that talk about how, you know, the GoFundMe and philanthropic funding is, is a huge. Trending in a way for a lot of people to access care because it's so expensive and they can't afford it. And I think that that's amazing, but on the flip side of that, you also see a lot of GoFundMe campaigns be scrutinized for fraud.

You know, people purporting needs for care or, or that they don't actually need. And so those funds don't, aren't actually used for their intended use. And so with, with Mishy, the beauty is that we're able to bring transparency, not only to the president, obviously, but to the, the kind of process. And we're we essentially.

Guarantee that the money that is donated and the funds that are granted to the underserved are actually used for care and go directly to the providers of that care. So it cuts out, you know, the, the in between process and you know, we're hoping to make that the norm when it comes to philanthropic funding.

And so, yeah. I'm super excited about that. And mostly just because I want to do, there are a lot of gaps gaps with regards to coverage and gaps, even with regards to some of the public initiatives that exists to help people underserved communities, access care, they're there. Usually the, the, the.

Eligibility requirements come down to income. And it's interesting. It's the same with one's ability to access, you know, Medicaid in a lot of states all comes down to income and there are a lot of people that fall within the cracks and the gaps where they make a little bit too much money to qualify for the assistance, but they still can't afford it.

And so they end up avoiding care. Because they're one concern, either concerned about, you know, the uncertainty of the price. But with regards to fund the care there, they just don't have the funds.

And so people go without you know, some of the screening care that's recommended by the CDC. They go without that for years. And. By the time that they realize, or, or that, that the need for care is identified, it's too late. And no, I have experience with that in my family and with people that I love.

And so I'm looking to address that problem and, and address the gaps. You know, there's too many people living and operating in the margins and not getting resources that they need. And I'm hoping that with this, this approach it'll, it'll close the gap and, and increase access

Brandon Stover: [00:49:42] yeah. I mean, part of your long-term vision for me, she has to be sort of a backbone for, you know, government funded healthcare. What are your thoughts on universal health care and you know, what are the benefits of it? And maybe some of the drawbacks that people don't always see.

Sidney Haitoff: [00:49:56] So great question. Universal health care, socialized medicine, Medicare for all government funded healthcare of those. I choose government funded healthcare socialized medicine, universal medicine, Medicare for all.  We have evidence of that. Not working. Currently in our country, when you look at Medicare, which is a government funded healthcare for people above 65 it's fraught with abuse and overutilization and fraud, frankly.

When you look at Medicaid, it is fraught with abuse and fraud,  and,  the gaps that exist and, and the delay in care and the notoriously poor quality of care.  Even with the VA, you know, again, delays.  It was interesting. I was educated to the fact that, and very recently, so that the VA. Prioritizes care for veterans who have issues that resulted from combat or, or their service. And so if you go into, and I had no idea about this, you know, you hear about the stories on the news of people dying in the ER, in the ER, because they don't have the enough nurses to adequately triage people appropriately.

 Listen, I'm, I'm very grateful for the government funded approach. And I'm very grateful that these systems exist and I'm not trying to knock them.

I'm just saying that there is. A better way. And I think that you know, the public has been for that for quite some time. Your Medicare for all is I would say the has a lot of support. And I think what people, when they say Medicare for all it's government funded care and that people should be given access to care by the government in some way. Where the people who pushed back  doing show within the context of Medicare. Will cost far too much money because of how much abuse and over utilization and lack of care management and kind of, it's a little bit of a free for all exists within the confines of Medicare.

And that's why you hear a lot of politicians saying it's not realistic because  how are we going to pay for that, you know, with taxes. And so when I say that  I would love for Mishy to be the backbone for government funded care. The idea is that the government should be able to allocate money for healthcare spending to individuals and have those individuals only be able to use that money for health care. And so. That currently to some extent, health savings accounts allow people to contribute income tax free to a fund that can be used as an as and investment tool by the way, which I think is very cool.

So somewhat similar to a 401k, but allows people to contribute funds tax-free which, you know, to some, in some instances can save people tons of money towards a a fund that can only be used towards medical services.

And so my hope and vision for  for Michie's involvement and role in this type of government funded option is that the government could fund an HSA or established an agent a for people or some type financial tool  that could then be used to purchase. Care in a free market that gives people access to, you know, affordable rates and allows people to save money over time that they don't use.

Like one of my biggest gripes with the Alvin insurance industry is that you're not able to use the funds or even a portion of the funds that you don't actually utilize.

So there's no roll over benefit. Thankfully there is with HSA, but with, you know, standard coverage, there's no roll over benefit to whatever you don't use. You lose. If you contribute a $5,000 of your $6,000 deductible and the year ends starts over. So  I want to give people a way, access care. In a a transparent and kind of consumer centric way similar to how they would in any other industry and have it that care be funded by the government  and I like, and it also similar to how, you know, the government was able to send and give stimulus checks to a lot of people too.

Stimulate the economy and ensure that people didn't succumb to the economic pressures of, of the pandemic. And so if, if that was doable in a relatively short period of time, then it should be doable for the government to allocate a certain amount of funds, whether it be, you know, a certain amount of funds per year on a sliding scale from the time that you're a baby to the time that, you know you're a senior or you a flat rate each year I think that there would be that would give people access to the care that they need for the most part.

One thing I do want to say is, you know, that, that whole concept of  allocating funds  to people  each year. It already exists in. With Medicare advantage plans. And so this is something that I don't think a lot of people are aware of and a reason for why the insurance carriers and these new companies that are coming on the scene and, and providing insurance the ones that are blowing up are increasingly Medicare advantage plans.

The reason is because the government allocates $13,000 towards. Consumers who opt for a Medicare advantage plan, Medicare advantage meaning, you know, commercial sponsored Medicare coverage that is intended to give consumers slightly more benefits and freedom and less potential out-of-pocket costs Medicare by default, the co-insurance the patient responsibility is 20%.

So if you have a you know, $10,000 procedure, you're on the hook for 2000 of that. And so the government will pay pays. If you opt for Medicare advantage, the government pays the insurance carrier $13,000, and any amount under 13,000 or whatever you utilize under $13,000, they choose coming to get to keep that same way.

They get to keep the premiums. So It's interesting that the fastest growing companies in the insurance sector are Medicare advantage companies. Given the concept that the government is funding $13,000 each year for people 65 and up who opt for this Medicare advantage coverage on top of the premiums that the insurance carriers charge for these Medicare advantage plans, which aren't as much as the standard premiums, because, you know, again, it's, it's augmented by the government, but very interesting how they're growing at such an exponential rate off of the backs of taxpayer dollars that are intended to go towards care.

So yeah It exists, government funded care, just, it just is not done in a way that has helped people. And so I would love for Mishy to be the tool and the vehicle by which people are able to access care using the funds provided by the government in a free market way that promotes innovation and that you know, yields, price equilibrium based on supply and demand and quality, and any other factors that go into the economics of price in, in any given market.

And you know, want to give people the, the ability to just be consumers like they are in any other industry and, and be able to pursue the, the best deal you know, based on quality and price and access care and an equitable.

Brandon Stover: [00:58:19] Well before I get to my last question, is there a call to action you would like to leave our listeners with.

Sidney Haitoff: [00:58:25] Yes, educate yourself on pressure and fancy and pay as you go healthcare,  I challenge you to educate yourself on the amount of money that you're contributing towards the premiums that you're paying for the coverage that you receive and tally up the care that you've utilized in the past year or a couple of years, whatever that looks like.

And. Do a comparison, see  how much care you're utilizing, what that care would cost you know, out of pocket paying cash pay rate, and you could utilize Mishy. You could utilize for, to, to research those prices you could utilize. You know, the Medicare website Medicare has a procedure lookup tool that will provide people with the Medicare price for any service.

You just have to know the CBT code, which can easily be Googled or you can find on fair health, fair health, consumer.org, I believe is URL. And it tally up those amounts and compare. for most people, I guarantee you that the discrepancy is. That, that, you know, most people who are contributing towards their premiums are spending thousands of dollars a year and are utilizing hundreds and maybe, you know, a thousand or two towards the of care utilizing a much less rate or a much lesser amount than what they're paying.

She, what alternatives might exist. I'm not going to say that you should drop your insurance. Cause I, I wouldn't advise that jobbing your insurance for Michelle, although, you know, eventually, or based on what you see, you might feel that that is a viable option. And based on your level of health and your your, your risk tolerance, that might be, you know, something that you would consider.

And trust me, I'm saying this because I've heard people, you know, heads of families say that they intend to do this based on what they learned about a pay as you go health care and, and, and what we're looking to to popularize. So get, get a sense for what those differences. Different than what the difference is and pursue, you know, maybe an alternative option maybe instead of opting for the more expensive plan with a higher premium, maybe opt for the lesser expensive plan that has a higher deductible that that still covers you above, you know, for, for catastrophic injuries or conditions, but at a lesser monthly rate than you would have to pay or they, that you might be paying currently.

And then look to see what options are available, what care options are available in your area. Which providers are offering the services for cash pay rates? I would say again, most of them, I think at this point, most providers have an idea for what their cash pay rates should be. Some of them post them publicly.

And I, I plan to be able to make that process very quick and easy for you in the next couple of months. So you get a sense for how much you could be saving depending on the different options that you choose.

And again, HSA, fully recommended look into it. Tax-free save a lot of money and you can use it as an investment vehicle.

Very similar to 401k.  And  check us out. Mishy.co we're on instagram@mishy.co on Twitter at Michigan. You know, feel free to, to reach out to me. You can reach me@infoatmishy.co or sydney@mishy.co. Our phone number is, is publicly listed. If you want to give me a call or, or shoot me a message on our, our chat bot.

It's not a chat bot, I'm actually at the other line. And we have our, our team on the other line, actually answering questions and engaging with people because again, it's all about education. But it would love to hear from, from any of the listeners who are interested and intrigued and want to learn more.

And also we'd love to hear from any of the listeners who are passionate about, you know, increasing access to affordable care and, and activism in general, and, and want to kind of do something to help the public and ha. Expertise in the areas of software development and marketing. I'm looking to build out a killer team so that we could really.

Really make a dent in the industry and I'm excited. I've started down that line and have a credited physician who is joining the team. And he's gonna have to also help get, make this message more vocal and help educate people, but looking to, to round out the team from a tech and a marketing perspective, and also we're we'll be entering our currently.

And I appreciate ground during our seed round the fundraising towards Q4. So any prospective investors, angel investors you know, feel free to reach out of, to speak with you. And especially if you have expertise in the areas of the software as a service marketplaces or direct to consumer.

Brandon Stover: [01:03:40] Awesome. Well, we will put that on the show notes for people to make it very easy to find. My last question is how can we push the world to evolve?

Sidney Haitoff: [01:03:49] I would say trust. I think a lot of conflict that exists stems from lack of trust. Lack of trust is our ourselves lack of trust in one, another lack of trust in the systems that govern the way that we conduct our lives.   You know, people who innovate and create the, the infrastructures that changed the world we're able to do so because they believed and they trusted themselves and they trusted that their message would be heard and the solution would work. And that even if it didn't work initially that they could make it work or that they could find a way to, to make it work.

Nothing's perfect.  I think that the ability. To make the world a better place, comes down to trusting who we are trusting that we're all one and that we all deserve to be treated with respect and dignity and truth.

Brandon Stover: [01:05:00] Sydney. Thank you so much for coming on the show today, sharing your story and about Mishi. Very excited to see it grow. I'll be moving to Austin, Texas in the fall. So looking forward to maybe seeing it there eventually

Sidney Haitoff: [01:05:13] absolutely. And Brandon, thank you so much for having me. I really appreciate what you're doing and I wish you the best and hopefully look forward to meeting you in person.

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