Birthing Instincts · Dr. Stuart Fischbein + Midwife Blyss Young

#440: Thrive Again With Crowdheath CEO Andy Schoonover

November 19, 2025·1 hr 26 min·6 clips

Andy Schoonover's health insurance denied his daughter's $8,000 ear surgery, calling it medically unnecessary.

1. Birthing Instincts episode 440 examines the US health insurance system and CrowdHealth's crowdfunding alternative with founder and CEO Andy Schoonover. 2. Dr. Stuart Fishbein and co-host Bliss Young conduct the interview; Andy Schoonover is the founder and CEO of CrowdHealth, which he describes as a community-based alternative to traditional insurance where members crowdfund each other's medical expenses. 3. The episode's central thesis is that health insurance is structurally designed to obscure costs, deny claims, and ultimately serve insurer profits rather than patient health — and that direct-pay community funding can replace it. 4. Andy's origin story begins with selling his first healthcare company, losing employer-sponsored insurance, and signing up for an ACA plan at approximately $1,100-$1,200 per month for his family of four. 5. When his one-year-old daughter needed a 15-minute ear procedure for a confirmed eardrum hole, Andy's insurer sent a denial citing 'medical necessity' — and after two rounds of appeals the family paid $8,000 out of pocket. 6. Andy's subsequent discovery that paying doctors directly in cash yielded better rates than large insurers could negotiate prompted him to research the economics, finding that doctors spend 16 to 18 hours per week on insurance administration rather than seeing patients. 7. He founded CrowdHealth in 2021 with the model that a community of people willing to fund each other's large medical expenses could replace the insurer middleman; the platform has grown to nearly 15,000-20,000 members and processed 25,000 bills, saving members approximately $50 million. 8. Dr. Stu describes his own EOB: a retinal injection billed at over $4,000 from which Medicare paid $1,400, while his 20-minute wellness visit was billed at $120 and the physician received $64. 9. Andy recounts an industry insider project in which a technology company translated insurance EOB codes into plain English for a major health plan, only to have the plan reverse the project when members found errors in 80% of bills — including a female newborn charged for a circumcision. 10. Andy cites Kaiser Family Foundation data showing that 18% of ACA claims in 2024 were denied outright, and that 250,000 families go bankrupt each year from medical expenses despite having insurance. 11. He explains that ACA deductibles of $16,000-$18,000 mean most insured families cannot actually use their coverage, stating: 'if you don't have enough cash in the bank to pay your deductible, you're paying for something you can't actually use.' 12. The structural incentive argument Andy presents: ACA rules cap insurer profit at 15% of premiums, so insurers must raise premiums to grow profits — aligning their financial interest with hospital systems that also want higher prices. 13. In the short term, Andy explains, when medical costs climb toward 85% of premiums, insurers deny more claims to protect their margin, creating a perverse situation where claim denial is a profit mechanism. 14. Dr. Stu adds that insurance billers in his former obstetric practice were routinely offered a choice between accepting 40% less immediately or waiting six or more weeks for full payment — a form of financial coercion he likens to extortion. 15. Andy notes that pharmaceutical companies and insurers are among the most powerful lobbying forces in Washington, and that politicians who campaign against insurance companies often vote differently once in office. 16. The conversation touches on homeowners insurance parallels — Dr. Stu describes a California fair plan deductible over $100,000 that made coverage essentially useless for anything short of total loss. 17. Andy distinguishes CrowdHealth from Christian health-sharing ministries like Christian Sharing Ministries and Liberty Health Share, noting similarities in community funding but differences in structure and secular eligibility. 18. A Montana member story involves a man fishing in bear country whose holstered firearm discharged when it hit a rock, with the bullet passing through his calf, thigh, chest, and back — illustrating a large catastrophic expense the community funded. 19. The interview is conversational and data-driven, with Dr. Stu frequently interjecting personal anecdotes; the tone is consistently anti-establishment and skeptical of government-regulated healthcare. 20. Best for self-employed individuals, uninsured or underinsured Americans, and healthcare freedom advocates; less suited to listeners looking for clinical birth content.

As heard by us

A birth and healthcare conversation that looks past the clinic and at the machinery behind the bill.

Birthing Instincts brings in Andy Schoonover of CrowdHealth to talk through birth, health insurance, and the incentives that shape medical costs.

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Why you'd press play

If you want a conversational birth episode that also digs into why healthcare costs rise, start here.

Read the full recommendation in PlayNext →

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