Falling in Love and Fighting for Trans Healthcare

Hi, my name is Joseph Schneier, and I’m a serial entrepreneur.

That means I fall in love a lot. Not with new people, but with ideas.

I regularly fall in love with big, complicated, audacious problems. When a problem keeps me up at night and I find myself asking, “Why hasn’t this been solved?” over and over again, I create a business to try to solve it.

One of my mentors, Esther Dyson, told me something a few years ago that has stayed with me. She said, “I’m tired of people talking about being entrepreneurs. I want to know what problem you’re working on. What problem are you solving?”

For the past 20 years, I have had the privilege of working in technology across education, language, healthcare, workforce development, and now insurance.

I have been fortunate to work on questions like: How do you create a foreign-language company that can convince Americans they are capable of learning another language? How do you build an application that helps college students speak more honestly with their doctors about alcohol consumption? How do you help those doctors respond without shaming the students for telling the truth?

That last part was a little harder.

After my second or third company, I began to notice a through line connecting all of my work: How do you help people change a belief so they can change a behavior?

Although the problems were different, the solution was almost always the same. You have to meet people where they are rather than hoping they believe something different from what they actually believe.

When you are developing a game for the FBI to teach unconscious bias, for example, you need to understand what agents believe about crime scenes.

When we worked with people living with HIV who were not taking their medications as prescribed, we had to listen to them and respect the reasons they were not taking them.

I learned that when you approach an audience with compassion and understanding, you can take people on a journey that leads to behavioral change.

Two and a half years ago, I founded my latest company, Trusty Care. Our mission is to reduce bankruptcy among older adults caused by out-of-pocket healthcare expenses.

The good news is that, for almost every older adult, there is a way to make care more affordable.

The problem is that people are not receiving the right information at the right time to make the right choices.

What makes this challenge especially compelling to me is that we have to meet older adults where they are while also meeting our large, messy, dysfunctional healthcare system where it is, then find ways to help that system change.

One thing I know for certain is that there is no silver bullet. There is no magic solution.

Medicare is incredibly complicated and confusing. In fact, 25 percent of people enrolled in Medicare believe they cannot afford their medications and therefore do not take them as prescribed.

One of Trusty Care’s central lessons is that consumers lack access to the right information at the moment they need it to make informed decisions.

Whether you receive Medicare or insurance through an employer, there is no single source that can accurately tell you at any given time which doctors are in your network.

For consumers, this lack of reliable information is one of the leading causes of out-of-pocket healthcare expenses. It also results in surprise bills.

Last week, for example, I received a bill from my insurance company stating that a doctor my son saw five years ago was not actually covered. Now I am expected to pay the insurance company back.

Imagine that same surprise bill being sent to an older adult living on a fixed income. The financial and emotional burden can be devastating.

To reform the system, we cannot simply declare that it is wrong. We need to create incentives for accurate data to be reported throughout the system in a standardized way.

At Trusty Care, we are building the infrastructure for a system that gives people the information they need when they need it, rather than five years later.

We understand that the best way to solve the problem for older adults is to empower the people around them, including insurance brokers, financial advisors, and other professionals.

We provide those professionals with a platform that automates the process of finding appropriate solutions, helping older adults make informed decisions about their healthcare costs.

We also realized that empowering professionals through our platform gave us a strong business model.

That is an entrepreneur’s dream: identify a real problem, build a sustainable solution, and deliver it to a growing market.

Through this work, I have become fascinated by the idea that insurance navigation can become a pathway toward societal change, which admittedly is not a sentence people say very often.

My wife is a transgender woman. She is also the smartest person I know.

She is a biology professor who has nearly every minute of her day planned, from five in the morning until she goes to bed at ten at night. She spends her free time reading about ancient Greece or statistics, or trying to convince me to watch films from the 1920s and 1930s.

She also grew up extremely poor. She learned how to kill a rattlesnake when she was five years old.

Before returning to school at 25, she worked a variety of demanding jobs. She drove trucks across the country, worked as a prison guard, and spent several years as a nursing assistant in a hospital.

She can take apart your engine while beating you at chess.

Two years ago, she began pursuing gender-affirming surgery.

It took four appeals, a lawyer, a doctor, many therapists, and binders full of paperwork that she completed and repeatedly resubmitted to dozens of people at the insurance company.

The process nearly broke her. She almost gave up several times.

Had she not been that rare combination of resourceful, intelligent, and, frankly, a little desperate, I am not sure she would have succeeded.

I look at her with tremendous admiration. I also know that when someone like her can barely obtain the care she needs, the rest of us stand very little chance.

The burden of navigating the system as it exists today should not rest on individuals.

It is cruel. It is also a colossal waste of time, ambition, and energy that could be spent on the things that make life worth living: family, community, love, and doing good in the world.

As I said, I believe creating a better insurance system can be a pathway toward societal change.

For me, this is deeply personal.

Four years ago, my younger brother drove into a brick wall at 50 miles per hour.

I received that horrifying phone call in the middle of the night and rushed to the hospital. As I sat in the intensive care unit, I realized that he did not have health insurance.

No family should have to face the terror we experienced, trying to navigate potentially crippling expenses while wondering whether a loved one will even survive.

I believe that by transforming health insurance, we can move our society one enormous step closer to becoming kind and compassionate.

For me, that is a problem worth falling in love with.

I hope you’ll join me.