Welcome back to Startup Health. Now, I'm Logan Plaster. I think it's fair to say that when people think of Startup Health, they think about entrepreneurs and founders. Over the last 12 or 13 years, we've supported more than 500 health tech startups, nearly a thousand founders, many of whom have been featured on this show. Perhaps less well-known is what happens behind the scenes at Startup Health. This episode, I wanted to pull back that curtain a little bit, particularly as it pertains to our impact board. You see, we've got this advisory team of about 17 or so amazing individuals across multiple disciplines. Folks like Toby Cosgrove, former head of the Cleveland Clinic, and Chuck Henderson, the CEO of the American Diabetes Association, Sue Siegel, the former head of GE Ventures, just to name three. You can see the whole amazing impact board at startuphealth.com. Recently, we brought together our impact board in real life at the Lake Nona Impact Forum in Florida. Not only did the team get to learn from luminaries like Jeff Bezos, David Feinberg, and Peter Lee, but they got to go deeper on ideas with one another. So, in the spirit of encouraging a more radically collaborative impact board, we decided to flip the script a bit and have members of our board interview one another for this podcast. The hope was that this would lead to some unexpected lines of questioning and some uniquely candid moments, and they did not disappoint. The first conversation in this series is between Esther Dyson, legendary angel investor and founder of Wellville, and Roger Jansen, the Chief Innovation and Digital Health Officer at Michigan State University Healthcare. The conversation was just as wide-ranging and unstructured as I hoped it would be, but touched on some incredibly powerful topics. I hope you enjoy.
So Roger, yes, tell me what you're up to right now as we sit here in lovely Lake Nona.
Well Esther, the things that I'm focused on right now are shifting a little bit. One of the things at Michigan State University we've been made aware of is the extreme pain our employer partners are finding with healthcare costs right now. And what we've done is we've actually formed a group of employer companies around the state to come talk to us about what can we do to not just improve clinical outcomes, but if people can't afford to use the healthcare where they can actually get a clinical outcome, it's almost as if you don't have any healthcare whatsoever. And many people may not know, but this is the first year in US history that people with health insurance carry the most medical debt versus those who are uninsured. And so we've hit a milestone here where people have insurance but they're effectively underinsured. And as a result, Michigan State's taken a real role in how do we go about and tackle lowering not just healthcare costs, but how do we change the business model for delivering healthcare, because ultimately that's what we need to do.
Well, part of what's going on also is we keep talking about health literacy, these people need to do the right thing, and they need to follow our directions. But the reality, I think, is the healthcare system and the clinicians need life literacy to understand the reality of people's lives.
100%. You're not competing. It's not one drug versus another. It's one drug versus I got to pay for the car, or I need to take my kid to school, or I can't get to the doctor. And those are the choices they're making every day.
Right. And as one of the panels discussed this morning, the reality is probably the biggest thing AI can do is understand long-term impacts, understand the counterfactuals. Investing this 50 million right now in reducing obesity or in maternal health, probably most importantly, has impacts 20 years on, and that's been shown. So one part of me says, well, people just aren't paying attention to the data. But as AI becomes more prevalent, more believable, and you can apply it locally, this notion that you can actually see the impact early of the money you're spending rather than waiting 20 years for the outcomes.
Yeah, absolutely. But someone has to pay for that, and it should be the government. And they're unwilling to pay for anything more than two or three years out.
And you add on top of it, our entire business model in healthcare is based upon illness and injury. It's not based upon keeping people healthy and well. And you have a real conundrum because, you know, I challenged our group and said, who do we call if we want to stay healthy? Nobody knows. There's nobody to call. And so we have it backwards, I think, in this country where we're spending the dollars. We're spending 4.6 trillion in healthcare. We're not spending anything that I can tangibly figure out in actual health improvement or health wellness maintenance.
Maintenance, yeah, exactly. The guy, you know, this website RealAge, which is... yes, yeah, okay. Charlie Silver. He sold his company to H&R Block. Do you know who he sold his previous company to?
No. Oh wow. Yes. Maintenance. He got it. And then he said, why are we fixing our cars, but I mean, why are we maintaining our cars and not getting our bodies?
Yeah, yeah, yeah. I don't understand that. And you've been working in this space for a long time with Wellville. What are some of the lessons you take away that you think you could apply at scale to the problems?
Well, that's what we are hoping to do. And I'm going to write a book called 'Don't Rent Your Community's Health from an Absentee Landlord.' The trick is, it's not a nice white lady coming in and telling people what to do, and it's not even handing out fish. It's helping the community to build its own sustainable fishing schools. People get addicted to drugs and to short-term relief, whether it's I'm going to go buy the skirt today because it gives me more pleasure than that stupid med. Community organizations get addicted to short-term grants because they have to stay alive and they have people to pay. And so not only do they become short-term oriented, they start competing with other community organizations instead of working together. And then at the other end, the VCs and private equity get addicted not to sustainable businesses but to exits. So the challenge is how do you... we're very focused on helping them build their own community fabric versus fancy structures, whether they're big philanthropies or... and somehow the good parts spread.
So did the bad parts. Try to find the ones that are successful because they will help the other ones.
Yeah. So you're really talking about putting an infrastructure in place.
The old social... yeah, right. Teach somebody to fish versus, you know, give them a fish.
Well, not even. Again, we ask questions and help them discover their own answers. Because teaching people to do the right things... it's like with your kid, don't bribe them to do their homework. Help them discover the beauty of math. Show them how to use math to do baseball scores.
Yeah. Or when I was six, I started counting my chickenpox.
