Today we explore entrepreneurialism – the spirit that drives it, and what it takes to turn that spiritual drive into tangible action. The journey takes us to hallowed halls at Harvard and Stanford, but it starts in – perhaps – a less likely location: The Philippines.
The U.S. health care challenge is likely well known to listeners of this podcast. But the U.S. is far from the only country that struggles with access, cost, payment, coverage and more.
That’s the challenge that students and entrepreneurs Jiawen Tang and Camille Ang have taken on in an award-winning, globally-recognized way through Hive Health, a digital health insurer providing simplified, affordable, and quality healthcare to Filipino employees through a data science-powered platform. Hive Health was co-winner of the 2021 Dubilier Grand Prize at Harvard’s prestigious New Venture Competition. The Dubilier Prize was established by Clayton, Dubilier & Rice in 1998 in honor of CD&R Co-Founder, Martin Dubilier (MBA 1952), to support entrepreneurship.
This conversation not only digs into the business itself, but also, importantly, what it takes to bootstrap a new business from idea to reality. In other words, what it takes to be an entrepreneur.
About the entrepreneurs themselves: Jiawen Tang is pursuing an MPA-International Development at the Harvard Kennedy School and an MBA at the Stanford Graduate School of Business. She has worked on data science and digital development initiatives with the IMF, World Bank, and UN, and on economic development initiatives with TechnoServe Swaziland and its successor Catalyze. She also served at Oliver Wyman, where she focused on consumer financial services and digital payments.
Camille Ang is pursuing an MPA-International Development degree at the Harvard Kennedy School and an MBA at the Harvard Business School. She worked in Private Equity at Macquarie, managed insurance funds, and played critical roles in the acquisition and management of companies across South East Asia. Camille has also previously worked on public-private partnership projects in the government of the Philippines, with McKinsey, as well as the Rwandan Development Board.
Transcript: Jiawen Tang & Camille Ang, Hive Health
Chris Riback: Jiawen, Camille, thank you both for taking the time
Jiawen Tang: Thank so much for having us.
Chris Riback: Let’s start with the broad view. And Jaiwen if we could, maybe we should start with you. What is Hive Health? How does it work?
Jiawen Tang: Hive Health is a digital health insurance company for small- medium businesses in the Philippines. Through dynamic risk underwriting and our digital platform, we simplify the process and the experience of accessing quality healthcare. And our goal is to make it affordable for everyone.
Chris Riback: Affordable healthcare is something that is certainly important and in need worldwide. Why is it particularly needed in the Philippines? What’s the state of health insurance and health care in the Philippines?
Camille Ang: Yes, I guess it would be helpful to give a context compared to the U.S. which this audience is probably more familiar with. So in the Philippines, as well as a lot of emerging markets, we actually have kept monetary benefits. So when you get sick, you’re not fully insured, you simply get a subsidy. In the Philippines we do have universal healthcare. In fact, everyone is entitled to it, but in spite of that, it’s not enough. You only get a small subsidy and out of pocket costs are at more than 50% compared to 11% here in the U.S.
And I know everyone complains about health care in multiple markets, including here in the U.S. but our medical bankruptcies in terms of proportion are actually 10 times that of the U.S. and that’s very painful coming from the Philippines myself. And the reason why universal health insurance is not enough, one is, it’s just budget. Space is not there, especially with COVID, it has significantly depleted our budget. And second, there’s a lot of space for improvement in terms of having a more data driven approach to target under coverage areas, using technology to streamline processes and that’s the main reason why universal health care is not enough and supplemental, private plans are important to innovate on, and that’s where we’re entering.
Chris Riback: And I know that you both have business backgrounds. You also both have public policy interest in public policy backgrounds. When you see a challenge like this, do you see it as a business challenge? Do you see it as a public policy challenge? Is the attraction for both of you that it’s both? Jiawen, what’s your thought on that?
Jiawen Tang: That’s a great question, Chris, as a fellow alum of the HKS community.
Chris Riback: Yes, the Harvard Kennedy School, yes.
Jiawen Tang: Yes, the Harvard Kennedy School, it’s really not either/or and think the reason why Camille and I are really excited about solving health financing in this particular market is the fact that, we strongly believe a lot of the most challenging societal problems require some sort of public private partnership. It’s really not just the government or private sector or social sector that can solve it alone. And particularly in healthcare where there’s so many stakeholders involved and the need to align incentives and create a system that people can operate in a sustainable and equitable fashion. It does require a policy angle, but I think innovation is something that we’re also really interested in. I think that we’ve made a deliberate choice to pursue a business model because we think that is the best way and the most efficient way to create sustainable systematic change.
Chris Riback: So let’s talk about the business model and maybe even backing up a little bit from there, and in terms of how you got to a business model. How did you know the business opportunity existed? Just because there’s a problem doesn’t necessarily mean that there’s a business opportunity. How did you connect those to?
Camille Ang: Yes, maybe we can talk about quick, briefly the problem and then the opportunity.
Chris Riback: Please.
Camille Ang: For the problem, we both actually grew up in developing countries, myself, the Philippines and Jiawen in China and we’ve heard countless times stories from family and friends who basically had to wipe out their savings going into debt, just because of health shocks. And for both of us, we think there must be a better way who should live and who shouldn’t dictated by your wealth. And here in the U.S., we see a lot of innovations in healthcare, and we think there’s a lot that the emerging markets can learn from that space.
But secondly, in terms of opportunities. So I mentioned there’s a lot of innovations in this space that still needs to reach the emerging markets world. But on top of that, I think we all know COVID has changed our lives. And because of COVID, there has been an acute awareness of the need for quality health insurance amongst the average Filipino. And there has been an insane increase in digitization of services, being able to avail of basic services, such as healthcare. And with a large middle class that’s growing, digitization and COVID, there is a clear opportunity here to disrupt the market. And we’re very excited to be entering the space.
Chris Riback: Did I see one of your statistics, is there 90% mobile penetration in the Philippines?
Camille Ang: That’s correct.
Chris Riback: Yes. That combined with a rising middle-class, that’s pretty remarkable. So that translated then in your minds to the business opportunity. You’re entrepreneurs, was there a light bulb that went off?
Jiawen Tang: Yes, it’s funny. When I imagine entrepreneurship, I always thought, there’d be a light bulb that went off and I think I waited for quite a long time for the light bulbs go off and it, and it didn’t.
Chris Riback: Well, that makes the rest of us feel a lot better. Thank you. Thanks for doing that.
Jiawen Tang: But I think what helps there are definitely key points when I reflect on the journey. So I think one of the first is, meeting Camille, we were classmates at HKS and as well as business school students. We’re from very different backgrounds, but we share the same values and the same drive to build something new and as we discussed, and then in terms of specific catalyst, I would say we actually really utilize the resources that we had our respective schools, including a free Stanford incubator program that we participated in. And through that program, we spent a summer kind of ideating and going through lots of different ideas. And I think we’ve pivoted at least three or four times before we settled on this one. And so it wasn’t really a light bulb going off, but it was this slow iterative wandering process. And this is one of the ideas that kind of stuck, but it’s by no means a linear process.
Chris Riback: That’s very helpful and reassuring for the rest of us who are sitting and waiting for that light bulb to go off. And it doesn’t always happen. And what were the reactions within the marketplace? Your clients are, it’s a B2B2C offering, yes. So your clients are Philippine employers. But what was the reaction from the Philippine employers?
Camille Ang: A quote that I always remember is, well from the employee side, how they call what we’re trying to do a game changer, generally, there’s a large excitement that, “hey, someone’s entering the market and innovating a very sleepy space that is just like ripe for disruption.” But from the employer side, they know that employees are not only tired of confusing limited health plans, there is a large demand because of COVID, really have quality healthcare. So from the employer side, if they want to track quality talent, retain talent and keep people productive, it’s almost necessary already even if you’re a small, medium business.
Chris Riback: And so explain it. So, literally, how does it work? Literally, what does Hive Health offer? What do the employers see? What do employees see? How is it helping the experience from end to end?
Jiawen Tang: I think that the simplest way to explain it is, we offer employer based health plans to small medium businesses. And so the way that our model works is, the employer actually has a choice in terms of whether funding the full amount or partial contributions from employees. And it’s similar to U.S., it’s an annual health plan that provides them access to a national wide network of doctors, hospitals, clinics.
Chris Riback: Does the digitization, and does the kind of, data science portion of it, is that helpful on the employer side in terms of identifying the health plans or is it helpful on the employee side in terms of identifying point of care solutions and where does the data science play in?
Jiawen Tang: Sure. I would say it’s all of the above. There’s a health education awareness piece when they’re making the purchasing decision about which health benefits, which plans, to pick right now, it’s very confusing to figure out, what is actually in your plan, what’s actually covered. It’s also in the actual patient member experience of availing care. So understanding where to go, understanding how exactly to file for reimbursements, to track what you’ve utilized. And from the employer side, figuring out how to manage the employee health plan in terms of employees leaving or joining.
Camille Ang: And compared to what the status quo is previously, you have traditional insurers who have confusing and limited health plan. So, we simplify that, so that people clearly understand what is part of their health plan, they’re able to easily avail of it because it’s not confusing. And our philosophy is we don’t want to prevent you from utilizing your plan so we can get more profit. Our theory is we want to make it very accessible. So when people are able to take care of themselves in the long-term, that’s also better for us.
Secondly, historically there have been multiple long approvals. We’ve heard stories where they would have to wait six hours just to get a preapproval bill health care. So we want to thrive in that. And lastly, in terms of customer service, there’s a lot of stories on unreliable customer service, where you call them and even for the full day, you aren’t able to reach them. So we want to break that status quo and basically make health insurance more accessible to the population.
Chris Riback: You have also gotten very, very positive reaction in some venture competition. Tell me about Harvard’s new venture competition in particular, what made you decide to enter it? What was the competition like? And did you think you had a chance to win?
Camille Ang: Yes, I guess in terms of what made us decide to enter, coming from Southeast Asia myself, I always looked up to HBS NVC because of companies like Grab where they came out of HBS one, the NVC, and really made a difference in the lives of people in emerging markets. But also we thought it was a great platform to test out ideas and get feedback. In terms of what the competition was like, we thought it was just to be honest, one shot feedback, but it was several rounds, multiple feedback from founders and investors that we look up to. And that really allowed us to refine our pitch and even our business mode go-to-market. And I thought that was very helpful. Jiawen, did you want to talk about if we had a chance to win?
Jiawen Tang: Yes, I think the answer is yes and no. I think obviously there was a non-zero probability or else people would have entered. But I do think sometimes when we do apply to these things, it’s a very daunting thing to, and scary to apply. But one thing that Camille and I always say to ourselves is “you make 0% of the shots you don’t try for”. And so I think we were hoping to at least make it to the semifinals or the finals as a way to practice and get as much feedback as Camille said, but we weren’t expecting to win the grand prize by any means.
Chris Riback: And what a great lesson that by, of course, the Gretzky line and “not making 0% of =the shots you don’t take”, but also the learning that by simply going through the competition you made… It sounds like, you felt that you were able to make your business better. You got questions that made you think differently, or create different opportunities and solutions. And that’s a terrific lesson as well. For any entrepreneurs listening to this, what is your advice maybe more broadly? I mean, what does it take maybe even spiritually, intellectually energy-wise besides of course, the fact that you just need to be able to live on no sleep at all. What does it take to be an entrepreneur?
Jiawen Tang: So I don’t think there’s any one way to do it and Camille and I are, one or two data points in this process. So, maybe three things to think about. And the first thing and probably the most important is to work on something you actually really care about solving. You’re going to spend a lot of time trying to work on the solution. You’re going to be spending a lot of time talking to people, working through the trenches of it. And so it’s really important to find a north star or something. Something, someone, and a problem that you really care about, because that’s going to help you get through the tough times.
The second is to really, to dive in, as I said, there’s not going to be a light bulb going off moment. And for me, there was a lot of inertia to try to get started. It was really scary to make the jump. And I think part of entrepreneurship is to just take a leap of faith and know that there’s going to be a lot of rejections. There’s going to be a ton of no’s, but there might be someone or something that will indicate that “yes, it is possible”. And so you’re not going to know until you try it.
And then third, you mentioned this about ‘no sleep’. I do think it’s… One thing we were really surprised by is how much of an emotional roller coaster, being an entrepreneur can be. It can be really lonely and really draining. And that’s why, Camille and I are so grateful to have found each other. And I really recommend having a co-founder to be on this crazy journey with you and to actively communicate with each other. I think there’s going to be tensions and conflict and working through it and not letting it, be hidden under the rug is really important. And then finally, to take care of yourself, both mentally and physically. You do need sleep, because it’s a marathon, not a sprint.
Chris Riback: Camille, anything that you wanted to add on that front, maybe a big thumbs up for sleep. Anything else that you wanted to add on that front?
Camille Ang: I think Jiawen pretty much summed it up pretty well.
Chris Riback: Good, good. I felt that way as well. Other feedback: I don’t know, to what extent you have investors already, so where are you on that stage or do you see this as a pure bootstrap, run a business, that type of thing.
Camille Ang: Yes. The funny thing is we actually launched our pilot purely bootstrap, but we’re also very lucky to have YC support us in our-
Chris Riback: Y Combinator
Camille Ang: Y Combinator, including some angels, mainly like family, friends, and mentors. So we are trying to be disciplined as well. We only are, took on what we need for a pilot, and then we will see things from there. And in terms of the people behind us, Y Combinator, angels, I think they were very helpful in terms of not just giving us advice, but specifically for Y Combinator, they were able to give an environment of multiple founders going through the same process, having an incredibly motivating and supportive community of early stage startups going through similar challenges. I think a lot of entrepreneurship is about managing yourself, your emotions and on top of the business and having that support system has been incredible.
Chris Riback: Camille, Jiawen, tell me a little bit more about, both of you about your upbringing. We know that, you’re from the Philippines and from China, Camille and Jiawen, but tell me, where were you educated? What was school like there? And then after your initial education, after undergrad, you both did have some experience in professional world and I think that’s good to learn about as well. So Camille, why don’t we start with you?
Camille Ang: Yes, sure. As you mentioned, I think both Jiawen and I grew up in areas where the need for financial inclusion was really important and that’s how we ended up where we are right now. But personally growing up in the Philippines, I was always excited with the idea of solving problems at the intersection of business and government as an entrepreneur, because I think truly, truly at the space that can really impact lives of people from emerging markets like the Philippines. So for me, my undergrad was actually in engineering, but after that, I spent six years in the public private partnership space first with McKinsey, a management consulting firm and then with the Philippine government ruling out a few of the first public private partnership infrastructure projects in the country. And then before going to Harvard, was in private equity, basically doing public private partnerships across Southeast Asia. And I think somehow looking back the dots connect backwards and everything ties to what we’re doing today, which is quite fulfilling.
Chris Riback: The rest of us call that reverse engineering. But you’re the engineer. Jiawen tell me more about your background.
Jiawen Tang: Sure. So I was born in China and my family immigrated to the U.S. when I was a kid. So I grew up in Rhode Island, in the Northeast. Studied economics and political science at Columbia and growing up as a young adult, just became more aware of the inequality of access to opportunity and just thinking about my own like immigrant upbringing and comparing it to those of others in my hometown in China.
And so after college, I was really focused on trying to just learn as much about the world as possible. And my family, actually, my parents are scientists. So I had no business background at all. And so I first worked in management consulting as well and kind of fell into FinTech and consumer payments, consumer financial services, and really enjoyed learning about the way that… FinTech is really changing the way that we’re experiencing the world and then had the opportunity to work for economic development, non-profit in Southern Africa, in Swazi land. I was really energized by the problem space and where I could see myself in international development. So Camille and I both did the MPA international development at HKS where we… I think we can tell we’re both kind of just econ nerds that also care about applying theory and to actual practical applications.
And while in grad school, I had the opportunity to work on a lot of data science projects with the IMF and world bank and other development finance institutions, and kind of just similar to Camille and then having a time to reflect and kind of piecing everything together just made me think more about, “okay, if I’ve had these skills and this exposure and this expertise, is there something that we can do to be part of the shrink, the change”, as one of my professors, ambassador Samantha Power used to say to us, “it’s how do you shrink the change and make something, you have to start with something and start small” and think Camille and I, in building hive is our attempt to shrink that change and to be a small part of potentially being part of the solution.
Chris Riback: Exciting things can happen when econ nerds unite, can’t they? What’s next for the business? What is your vision now?
Jiawen Tang: I think our vision hasn’t changed. Our fundamental vision is to enable affordable and quality healthcare for all Filipinos and essentially beyond. What we really want to do is try to reimagine the future of healthcare in Southeast Asia, which is the one of the fastest growing markets in the world. And there’s definitely still a lot of need to close the, a lot of the inequality gaps here. And ultimately, right now we’re health insurance companies who really focused on reducing the out-of-pocket costs like Camille talked about and the financial burden, but ultimately our goal is to improve health outcomes and to actually build a world where the financial resources don’t dictate the life that one can have. And I think having starting in the health financing space, essentially expanding beyond as a platform solution to enable people to live the kind of life that they want to live is something that, is what we are motivated by every day.
Chris Riback: “Beyond” is a not unimportant word to you. Is it? I just heard you use it twice. And I noticed as well in something else I either read, or maybe one of the videos that you guys did that I saw in preparing for this conversation. I wrote down the quote, “We hope you’ll join us in re-imagining the future of healthcare in the Philippines and “beyond.” Beyond matters to you guys, does it,
Camille Ang: A lot of things packed into that word.
Jiawen Tang: Yes
Camille Ang: But, I think we’re heads down focused on the next 12 months first, but it’s good to see the long-term north star.
Jiawen Tang: Yes, I think we do need to have it… This is me being no more philosophical, but from a founder experience perspective, we do need to have something to guide us. And that ‘beyond’.. Beyond sure represents, different products and market segments and so forth, but it’s also a challenge ourselves and an optimism that we have that we can do something to change the status quo.
Chris Riback: Well, it seems quite obvious that ‘beyond’ if that’s where you aim to go is where we all will get to meet you both someday. Jaiwen, Camille, thank you. Thank you for your time and thank you for what you’re trying to do and doing in the healthcare space. And importantly, you just said the phrase,” around health outcomes”, because I think any of us would agree, in the end that’s the purpose. The purpose is to create an environment where individuals get improved health outcomes. Thank you for your time.
Jiawen Tang: Thanks so much, Chris.
Camille Ang: Thank you. It’s been fun.