The clinic in Wyoming operates on "pay-if-you-can" terms, powered by AI-assisted doctors and privacy-focused blockchain tools, aiming to reset how care should work.

TL;DR

• Charles Hoskinson calls U.S. healthcare "just f***ed," blaming its incentives for rewarding illness.

• He is investing $200 million into a clinic in Gillette, Wyoming, caring for 15,000 patients under a "pay-if-you-can" model.

• The clinic embraces AI agents for support and blockchain privacy tools like zero-knowledge proofs.

• Hoskinson's model is open-sourced, aiming for a broader policy shift in health delivery.

• He faces pushback from local hospitals slowing credentials for his doctors.

Charles Hoskinson-Cardano's founder and early Ethereum co-founder-doesn't mince words about U.S. healthcare. In a CoinDesk TV interview at the Rare Evo conference, he declared:

That blunt diagnosis is more than talk. He's putting $200 million of his own funds into a clinic designed to prove a better model is possible.

A Pay-If-You-Can Clinic in Wyoming

The clinic, located in Gillette, Wyoming, serves about 15,000 people-roughly one-third of the town's population-and operates on a model that's rare in U.S. healthcare: patients who can't afford treatment don't get billed. Hoskinson sums it up plainly: "If they can't pay, don't charge 'em."

This approach flips the usual financial incentives. Rather than rewarding high throughput, the clinic focuses on meaningful outcomes and affordability.

What's "Horrible" About the Current System?

Hoskinson's critique hits the heart of modern healthcare's problems: perverse incentives. He gives a telling example:

This encourages short visits and quick fixes rather than thoughtful diagnosis and long-term plans. In his view, it's a system designed to make people chronically sick-not get them well.

Technology to the Rescue: AI + Blockchain

Hoskinson isn't building a traditional clinic-technology is central to the vision. AI agents assist doctors by drawing from up-to-date medical knowledge and helping form care plans every morning. They flag subtle cues in patient histories, detect drug interactions, transcribe visits, and may evolve into "AI companions" that help interpret labels and medications.

On the blockchain frontier, he plans to use tools like zero-knowledge proofs and selective disclosure. That means verifying facts (like age or citizenship) without exposing sensitive data. It's privacy by design. Most importantly, all protocols and software will be open-source-free for others to use, adapt, and scale. 

More Than a Clinic-A Policy Statement

Hoskinson sees every part of this project, from its tech backbone to pricing model, as a statement on healthcare policy. He argues that insurance should function more like protection against serious health risks, not as a pre-crime obstacle for everyday care:

He's calling for a reset-for treatment that's fair, not fractured by corporate incentives. For Hoskinson, this project is deeply personal. With a lineage of physicians-father, brother, grandfather, uncle-he views this as more than an experiment; it's his family's legacy.

Final Thought

Charles Hoskinson's move is radical, not because of its boldness alone, but for addressing a problem that affects every American. He's betting $200 million that healthcare can be kinder, smarter, and more human - and proving it should not be a luxury. If his model succeeds, it won't just be a clinic in Wyoming-it could be the blueprint for care everywhere.