Scott Horton Show – Just the Interviews
Episode: Andy Schoonover on Fixing the Healthcare System Without Waiting for Politicians
Date: March 5, 2026

Overview

In this episode, Scott Horton sits down with Andy Schoonover, CEO and founder of Crowd Health, to discuss practical solutions for America’s failing healthcare system—without waiting for government intervention or policy changes. Schoonover details his company’s peer-to-peer health funding model as an alternative to traditional insurance and highlights the cost-saving advantages and decentralized structure that appeals particularly to libertarians. The conversation explores the failures of current insurance, the economics driving price inflation, and why decentralization can outperform top-down bureaucracy. This is both an introduction to a new show sponsor and a rare deep dive into healthcare market alternatives.

Key Discussion Points & Insights

1. Andy’s Backstory and Why Crowd Health Exists (03:20 – 06:03)

• Andy Schoonover recounts how frustration with the traditional insurance model, particularly when his daughter’s necessary procedure was denied coverage, led to the creation of Crowd Health.
  • Notable quote:
    “I had to stroke an $8,000 check to get this procedure paid for. And I had health insurance. And at that point I was like, screw this... And so ultimately we started paying directly for our bills... People were giving us ridiculous, you know, discounts by paying them directly…” – Andy (04:40)
• Realization that direct payment to providers can be radically cheaper than going through insurance.
• Idea: Pooling individuals together, paying for each other directly, pre-dates modern insurance and can reduce unnecessary bureaucracy and costs.

2. How Crowd Health Works and Its Philosophical Roots (06:03 – 08:52)

• Scott asks if this is just insurance by another name; Andy explains that it's more akin to mutual aid societies before insurance became a corporatized, government-parasitized sector.
  • Notable quote:
    “It’s kind of like insurance back before the 1970s... The difference between us and insurance now is that ultimately Scott and Andy are paying the bill, the insurance company is not… we are taking advantage of ripping out the intermediaries and getting way better prices.” – Andy (06:21)
• Members pay each other, not a corporation; removal of intermediaries brings down costs.
• Over 35,000 bills funded; prices achieved are ~50% better than UnitedHealthcare.
• The insurance market is structured so both buyers and sellers want prices to increase, with government rules incentivizing inflation.

3. The Mechanics of Crowd Health (10:01 – 13:42)

• Real-world example: ACL surgery negotiated from $24,000 (via hospital) to $12,000 (direct payment to surgeon).
• Crowd Health distributes the bill amongst community members—each is asked (no more than once per month) to contribute, with a capped ask (e.g., $140 max per month).
  • Notable quote:
    “So Crowd Health goes to 120 people in our community and says, hey, this woman needs $100. So you send $100 to this woman... At the end of the day, this woman's going to have $12,000 in her account so that she can go and then pay that orthopedic surgeon directly at the point of care, getting that really, really good rate.” – Andy (10:27)
• Members can opt in or out of supporting each case, but refusal can affect future requests for help.

4. Guarantees, Catastrophic Illness, and Game Theory (13:42 – 18:46)

• Crowd Health does not formally guarantee payment (since members are not contractually bound), but historical success is extremely high: 99.9% of bills (35,000+ cases) have been funded.
  • Notable quotes:
    • “To date, 99.9% of them have gotten funded... Health insurance plans are paying out about 80%.” – Andy (14:11)
    • “If they say no, they have to understand that... when they go and ask the community to get help, the community will know that they said no.” – Andy (14:44)
• The underlying incentive is reciprocity: if you help others, you get helped.
• Community is now big enough (25,000 members) to handle catastrophic cases (million-dollar emergencies have been funded).
  • Anecdote: Man suffered a gunshot injury while fishing; his million-dollar bill was fully funded and negotiated.

5. Medical Price Rigging and Abuse in Current System (18:46 – 22:52)

• Discussion of journalist Steven Brill’s deep-dive into the manipulation of medical pricing—different rate lists, opaque pricing, and opportunity for direct-pay deals.
  • Notable quote:
    • “It’s like going into a car dealership... ‘A Toyota Corolla is $100,000, but I’m going to give you a 75% discount and I’m gonna sell it to you for 25,000.’... That’s not a real price.” – Andy (19:41)
• Government mandates (e.g., insurance profit capped at 15% of premiums) paradoxically incentivize higher prices: more expensive coverage = more profit.
  • Notable quote:
    • “If you have a thousand dollar premium and they can only make 150, how do they grow their profit by 10%? ... Well, your premium has to go up from ... a thousand dollars to eleven hundred dollars.” – Andy (20:12)
• Kickbacks and direct treasury subsidies to insurance companies ensure continuation of the system.
• Regulatory capture: “The rich people got to keep the government in business, the government’s got to keep the rich people in business,” Scott summarizes (21:37).

6. Decentralization, Libertarian Values, and Who Benefits (23:43 – 25:21)

• Crowd Health’s natural alignment with libertarian philosophy: decentralization, market signals, direct reciprocal relationships.
  • Notable quote:
    • “It was overwhelming the number of libertarians who this resonates with. Let’s decentralize as much as is humanly possible. And a part of that is because I’m libertarian... that will give you the best possible outcome.” – Andy (23:53)
• Emphasis on member responsibility: No pre-existing conditions dropped into the pool, no entitlement mentality—market discipline.
• Libertarian members are “better customers”—less likely to abuse the system, more into fairness and reciprocity (24:30).

Notable Quotes & Moments

• On insurance companies' incentives:
  “The buyers of healthcare, the insurance companies, want the price to go up. The sellers of healthcare, the hospital systems, want the price to go up. And so if you have the buyer and the seller... wanting the price to go up, guess what, the price goes up.” – Andy (07:37)

• On cataclysmic medical events:
  “[A million dollar emergency] got fully funded by the community without a problem… those bills also take, you know, six or 12 months to play out… So you have a long period of time to pay that thing out. It's not like you need to come up with $5 million tomorrow.” – Andy (17:41)

• On regulatory capture:
  “The real libertarian wisdom is that regulatory capture is why Alexander Hamilton created this government in the first place... participatory fascism where, you know, it’s not exactly Mussolini, but it’s Woodrow Wilson...” – Scott (21:37)

• On decentralization and libertarian customers:
  “Decentralize as much as humanly possible and that will give you the best possible outcome... the libertarians... are way better customers... They're not entitled and they're like, yeah man, this is fair.” – Andy (23:53, 24:30)

Timestamps of Key Sections

• 03:20 – 06:03: Andy’s personal insurance horror story and creation of Crowd Health
• 06:03 – 08:52: Is Crowd Health just insurance? How is it really different?
• 10:01 – 13:42: Step-by-step breakdown: What actually happens when you get a medical bill
• 13:42 – 18:46: Guarantees, catastrophic claims, game theory, and the power of a large crowd
• 18:46 – 22:52: How hospitals rig prices, how insurance profits from inflation, and regulatory capture issues
• 23:43 – 25:21: Why libertarians love the model; decentralization as a moral and practical principle
• 25:26 – 26:13: Promo code info and closing thanks

Takeaways for Listeners

• Crowd Health offers a peer-to-peer, direct-pay health funding alternative that removes insurance companies and government bloat, resulting in huge cost savings and greater transparency.
• The system succeeds because of large-scale mutual aid, market discipline, game theory, and transparency—not contractual obligation—achieving higher bill funding rates than traditional insurance.
• The entrenched U.S. healthcare system is fundamentally structured to inflate prices, rewarding insurance companies and providers at the expense of ordinary people.
• Crowd Health’s values and operational mechanics are well-aligned with decentralization and libertarian economic principles.

For More

Listeners interested in learning more or joining can visit joincrowdhealth.com and use promo code “Horton” or “Scott” for a special introductory rate ($99/month for the first three months).

(This summary excludes ads, book promos, and non-content outros per instructions.)