November 11, 2020

How Fleri is Improving Access to Quality Healthcare Across Africa

by:
TECH TOOLS :

While enduring the challenges of rebuilding in a new country, many immigrants in high-income countries also embrace the responsibility of sending money to their family members living in low or middle-income countries. 

These peer to peer cross-border transfers are known as remittances. According to the World Bank, in Sub-Saharan Africa, global remittances reached $48B in 2019, which is more funds than aid from the top 10 donor countries and institutions.

For decades, Western Union and several other remittance service providers have controlled a lion share of the $700B remittance industry’s money flow by connecting diaspora populations with their home communities.

With limited innovation since the turn of the century, the industry is long overdue for disruption, particularly in the healthcare space, as 1 out of every $4 sent in remittances is spent on healthcare according to the UN. 

Founded earlier this year, Fleri is a health insurance marketplace on a mission to help immigrants protect the people they love. Their revolutionary business model provides an alternative to sending cash home for medical expenses. On their marketplace, immigrants can purchase health insurance policies for their loved ones for as low as $50 a month. 

Through partnerships with the best health insurers, both locally and globally, Fleri provides high quality, affordable health insurance plans.

I spoke with Sam Baddoo, Co-Founder of Fleri, about what led him to create Fleri, the launch of their recent pilot in Ghana, and what Built In Africa means to him. 

How did your journey lead you to create Fleri? 

Talking to one of my founder friends about the gravity of what we’re working on, she said, “you didn’t choose this problem to focus on; it chose you.”

If you asked me last year if I’d be building Fleri this year, I would have said no. But again, sometimes the problem chooses you, and then it becomes your mission. 

I was born in Ghana and lived there until I was 17. After high school, I got a United Nations scholarship to go to school in Morocco and spent the next five years there, learning French and Arabic prior to business school, getting to know the people, and acquainting myself with the tech community.

While there, I volunteered for Comité d’Entraide Internationale, a nonprofit that works with sub-Saharan African immigrants stranded in Morocco. Working there, I had my first real encounter with immigration as a global problem.

Since I came to Morocco for school, I didn’t see myself as an immigrant, so it was an eye-opening experience. I met real people who left their countries for different reasons, like trying to find a better life. Some of them risked their lives walking across the desert, and others endured firsthand being on a boat that capsized.

That experience has never left me. After Morocco, I moved back to Ghana and was there for the next four years, building a social enterprise with a group of friends called Heal the World and starting two other companies.

Then, I ended up moving to the US, becoming an immigrant all over again. The last six years of working multiple jobs and sending money home for various expenses, including health care for my daughters and parents, led me to Fleri. And what ignited it was the broken health care system that played a role in the loss of my uncle three years ago, my grandfather last year, and my grandmother this year. 

What value does Fleri provide to the marketplace?

Six million people die each year due to a lack of access to quality care, and millions more have fallen into poverty trying to pay for it. You begin to wonder, do we not value ourselves? No, it’s because we don’t have the means. 

Globally, lower-income and middle-income countries are receiving in excess of 590 billion dollars in global remittances. Why are we not any better for it? That speaks to a gap and inefficiency, and those of us in the diaspora can fix it. I believe we hold the key to a better Africa.

The value Fleri brings to this marketplace is simple. Insurance companies want to insure more people, but they need customers who can afford to pay. Currently, about 86% of Africans work in the informal sector, which means they have no predictable income, presenting the challenge of paying for insurance. 

With Fleri, we introduce a third person, the immigrant who has been supporting their loved ones for decades, just in a different way. The value we bring makes this experience seamless, convenient and brings choice. And most importantly, we bring peace of mind to the immigrants who are always thinking about the well-being of the people they’ve left behind. 

We’ve partnered with global and local insurance companies to make this possible. Speed to care is important. If someone has an emergency and goes to the hospital, we want to address issues immediately. And so we needed to build local partnerships with insurance companies who have insight into the local market. 

We recently launched a pilot in Ghana, where we’re working with local insurers to allow Ghanaians in the diaspora to buy health insurance for their family members.

We also partnered with global insurance companies to bring coverage to the other 53 countries we’re focused on. Also, because not everybody or every disease is treatable in our local countries, we have international plans that allow beneficiaries to travel to other countries to receive treatment.

What specific problems does Fleri address?

Accessibility to quality health care: 

For a large majority of people, the decision to go to the hospital is based on cost. If I have a headache, the thought process is I’ll go to the pharmacy first. Why? Because I don’t have the means to pay for a formal diagnosis and subsequent treatment.

I grew up in Ghana and understand how things work for the majority of people. Most recently,  I remember my mom was having trouble breathing, and she wanted to go to the pharmacy instead of the hospital. If not for my sister’s insistence, she would not have survived the mild heart attack she was experiencing. It’s unfortunate how much we defer taking care of ourselves. 

By giving a significant number of people the ability to visit a doctor, get a proper diagnosis and care, access to their medicines - all without the burden of cost and affordability, we are changing the outcome for these people while allowing the relatives abroad who support them to contribute more meaningfully to their quality of life. 

Better health care financing:

Africa has the highest percentages of out-of-pocket health care costs. In Nigeria, the average out-of-pocket cost is over 78%, and in Ghana, it’s 48%. While in places like Europe and the US, it’s below 26%.  

This means that the poorest people in the world pay more for health care than the wealthiest people do; it doesn’t add up. But that’s the power of modern health care financing. It reduces the percentage of the health care cost that comes directly from your pocket.

Our health insurance partners exist to pay claims. By combining the risk of high healthcare costs across a large number of people, their relatives abroad can pay a premium based on the average cost of medical care for the group. Thus, health insurance makes the cost of health care affordable for most people.

Grow the Insurance industry:

Currently, insurance penetration in most emerging African countries hover between 2% and 3%. We want to see a healthier, better insurance industry. And the way we’re doing that is bifurcating the consumers of the insurance from the payer. It works for life insurance all the time, so why can’t we do the same for health insurance?  

We already have people sending $300 to $400 every month to their families, 25% of which is going to health care expenses. Is it not more efficient for us to have a dedicated way to solve those health care needs?

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What were some of the challenges you’ve faced building Fleri? 

Regulatory landscape: 

Every country in Africa is different, so we spent a ton of time learning and working to understand the different regulatory requirements. It’s important to know that just because something works in one place doesn’t mean it will work in another. 

New Industry:

Our business model is new and unique. We’re first through the wall. People have tried different approaches, but not quite like this, which requires flexibility and us continuing to improve each iteration and make changes as we learn. 


What were some of the things you’ve enjoyed about doing business in Africa?

People are super, super flexible in a lot of ways that you don’t see here. It is very much a people’s first operation. And so talking to people gets things done in ways that contracts and negotiations cannot. 

Also, the female talent that I’ve met working around the continent is mind-blowing. It is no surprise that Ghana has the highest level of female entrepreneurship anywhere in the world. I’ve met some great thinkers and highly capable doers. I was also really impressed to see all the women who are driving the insurance industry to the next stage.

How do you see Fleri evolving in the next 3-5 years, and what impact do you hope to make?

Our focal point is the immigrant. How do we solve problems for them as it relates to the people they love and care about. This means that as a company, we’re evolving with the immigrants’ needs.

Eventually, we’ll most likely become our own insurance company at some point in time because I genuinely believe that there is value in addressing the health challenges on the continent in a creative way. 

Also, the remittance space is ripe for modification and disruption. We believe that the way we do remittances has to change to communicate better value to the immigrant who sits at the center. 

Impact

People typically ask how is Fleri fundamentally changing the healthcare system. What we’re building will start the flywheel that brings about change. 

Insurance companies exist to pay claims. If hospitals received more payments from claims, it’s better financed, which means the hospital can hire more doctors and nurses and buy more equipment. 

The general well-being of the citizens in that country will also improve. Greater outcomes for the health care provider translates to greater outcomes for anybody who goes there. Also, when hospitals have more people, the doctor-patient ratio reduces, which is better for everybody, even those without family in the diaspora. 

We’ve already seen what a fractured system produces. We’ve been sending remittances for decades. Couldn’t it be done better, and isn’t it worth experimenting? 

That’s why we try to stress that it’s a journey of a thousand miles that we’re starting now. What it looks like ten years from now, hopefully, is a much better place than today. 


Tips to other entrepreneurs considering tapping into Africa’s tech ecosystem?  

Don’t go in with the assumption that it’s going to be easy or the same. I have the benefit of living there before moving here, but it is challenging work. Nobody’s just sitting down waiting to write you a check for your idea, so the hustle is real. 

Knowing that will help you prepare psychologically for the grind. It’s going to be very frustrating. You’ll have a lot of tough days. Times where you’ll think, how do they not get it? But over time, your efforts will compound, and you’ll start to see more traction. This is not meant to discourage anyone but instead help people understand what it’s like to build a business in Africa. 

Built In Africa. What does that mean to you?

It means built for the future and describes people who see past today. 

You have to be extremely optimistic and super passionate to be bullish on Africa. There’s a lot of skepticism. And a lot to make you shake and worry. On the flip side, there’s also much opportunity. 

The challenges we have are all bankable challenges: health care, finance, education, agriculture, and logistics. Pick any one of them. It will be hard, but if you persist, it will work out. 

Nonetheless, when I hear Built In Africa, I hear someone building for a better future.

Closing words:

We need fewer experts and more passionate doers who are willing to put in the work. I think it’s very easy to be a cynic, skeptical, or say I don’t want anything to do with the continent. When I talk to people back home, they ask, “why the hell do you want to move back? You must be out of your mind. Why don’t you sit where you are and enjoy life?”

For anyone that I might be able to influence or inspire, I want you to look at me and say, he did it, so can I. I’m not the brightest person in the world, but I’m committed to building Africa’s future.

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