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This Entrepreneur Wants to Help the Uninsured and Underinsured Find Affordable Medical Care More Easily

The co-founder and CEO of Sesame shares how his platform is helping people who don't have insurance or are facing high deductibles.

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Long-time entertainment executive David Goldhill wants his new venture, Sesame, to be America's first healthcare superstore. He sat down with Jessica Abo to discuss how Sesame works and why he’s on a mission to help the uninsured and people facing high deductibles.

Jessica Abo: What made you transition from television and film to healthcare reform?

David Goldhill: My interest in healthcare started with the death of my father from an infection he acquired in the hospital. I think finding out how common those infections were, how common such tragic results were and how so many of the infections were regarded as preventable, really got me thinking about the ways in which healthcare differed from so much of what we see in the rest of our lives. In a lot of healthcare, we've designed big organizations, insurers and Medicare and Medicaid to help us and protect us, but I've seen how the complexity they create, how making the whole thing just so confusing and so bureaucratic has frequently done the opposite. Sesame is our effort to attack part of that problem. We're reestablishing a direct relationship between patients and doctors. We like to call it, “radically normal healthcare.” Procuring care should be no more difficult than a trip to the dry cleaner or ordering to-go from your favorite coffee house.

Right now, we're at a time where more and more of us are paying for our care out-of-pocket, even if we're insured. Obviously, a lot of us are still uninsured and pay for all of our care out of pocket, but most of us now have the experience that a large amount, sometimes all of our care in any given year, we're the ones paying for it, not the insurer or the government. And that should have changed things in healthcare more than it has.

How does Sesame work?

Sesame's a very simple idea. Doctors list their services on, like the online marketplaces we've seen in almost every other industry, and patients buy their care directly at fixed prices. There's no paperwork, no complications, the records are kept on the patient's own private Sesame account. On our site, the doctors will have lengthy biographies and explanations of what they specialize in, and we'll see doctor ratings as to what other patients have felt about their services, and you'll make healthcare choices the way you do about anything else.

What are some examples of services that someone might see?

Sesame's goal as a superstore is to provide pretty much everything you might need in healthcare. That means consultations for urgent care, telemedicine and same-day appointments, to time spent with a range of specialists — whether it's an MRI, blood work or another specialty service. Direct-to-patient care is terrific for the patient, but it's also great for the provider. It's a way of avoiding all the complexity and costs and administration and paperwork and collections issues, even, around insurance and government payment. And that simplicity not only makes it easier for a provider to practice, but also gives them more time to spend with patients. And providers interested in that have been flocking to Sesame.

Why do you think this matters right now?

Very large numbers of Americans are essentially disenfranchised from the current system, either because they don't have insurance or even more commonly, they have insurance, but have very high deductibles. They're left in a position where they're paying for a lot of their care out-of-pocket, they have a hard time finding providers who will serve them. They have a hard time finding the price of the services, fixing the price of the services. They have a hard time accessing their records. They have a hard time navigating the journey — should you go from an initial consultation to a specialist or a test? And these are the patients who are most vulnerable in our system and these are the ones for whom there is no solution.

What is your advice for other entrepreneurs who are interested in healthcare?

A lot of us are working on trying to improve healthcare and that's wonderful. Healthcare has a lot of opportunities to be improved, but it also has a lot of ways to be gamed. A lot of ways to build a successful business are just about adding a layer of complexity or landing another intermediary, something between the patient in care. I think the entrepreneurs I spend most of my time with are trying not just to build businesses to take advantage of the system, but businesses that genuinely improve the patient experience. That means making it easier for the patient, making it less costly for the patient, giving the patient much greater autonomy and much greater choice and a much greater ability to follow up on whatever care they receive. All of those elements are what's essential to make healthcare better for the patient. And as far as I'm concerned, that's what we as entrepreneurs should be doing.


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