GoFundMe Exposes Just How Broken US Health Care Is
The sadder your story, the more cash you bring in.
It’s not controversial to say that medicine in America is fundamentally broken. We pay more for services than almost any developed nation, and the care we get is certainly not scaling to that high price. Drug companies, for-profit hospitals and insurance brokers collude to keep costs high and pass as much suffering as possible on to the consumer.
President Obama took office on a populist promise to reform that system, to make health care fair and affordable for everybody in America.
Drug companies, for-profit hospitals and insurance brokers collude to keep costs high and pass as much suffering as possible on to the consumer.
The Affordable Care Act did some amazing things, including expanding Medicaid coverage to hundreds of thousands of low-income families, but it was just a Band-aid on the existing system and kept insurance companies in control.
It doesn’t look like President Trump’s promised plan is going to do much better, with analysts estimating that an additional 24 million Americans will go uninsured if it takes effect. Insurance, as we’ll soon see, isn’t a real solution.
All over the country, people are finding themselves unable to pay for the cost of medical care, despite having insurance. Massive deductibles, the insane costs of procedures and aggressively-priced medications all conspire to drive ordinary people into poverty. The leading cause of bankruptcy in the United States is medical debt. Obviously something’s still not working.
One of the most visible symptoms of this sickness can be seen on Facebook pages and forwarded emails. Thousands of people, unable to pay for life-saving treatment, are turning to the kindness of strangers on the internet to raise money to pay their medical expenses.
The leading cause of bankruptcy in the United States is medical debt.
I spoke to a man named Arthur Baker, who was diagnosed in early 2016 with stage 4 esophageal cancer and turned to GoFundMe to help pay his medical bills. He was gainfully employed and insured, but simply couldn’t afford the deductibles, coinsurances and copays on his $13.15 an hour salary. GoFundMe enabled him to do so, but the process made him painfully aware of how rigged the medical industry is.
“Not only is the US healthcare system irreparably broken, but our social safety net is largely a lie,” he said. “I only got certified for Social Security as a disabled person due to a loophole for my specific type of cancer. I learned that I can’t get Medicare until I’ve been disabled for two years?—?a period I’m very unlikely to live to see.”
GoFundMe was launched in 2010 with the intention of letting people raise funds for non-commercial needs?—?school tuition, housing and, yes, health care. They take 5% of every donation plus a credit card processing fee, so it’s not necessarily a charitable enterprise.
If you go to the site, a panorama of misery spreads before your eyes. An English teacher with Guillain-Barre syndrome. A 2-year-old girl with pre-B cell lymphoblastic leukemia. A disabled veteran who was savagely beaten trying to save a turtle. All of them unable to pay for the treatment they need to heal, even with government-mandated health insurance.
So they log on, they post photographs, they write a few paragraphs and set a fundraising goal. $15,000. $50,000. $100,000. Post to Facebook. Post to Twitter. And donations start coming in.
The media loves GoFundMe success stories. It’s a cheap and easy way to make their audience feel good about themselves. Look, people still care about each other! They’ll part with money?—?precious, precious money?—?to help the sick! We’re all going to be OK.
But we’re not. GoFundMe isn’t an institutional solution. Paying for an individual’s treatment doesn’t do anything to make the American healthcare system more fair or compassionate. It’s sticking a finger into a dam that’s already broken. And, worse, the people who succeed in raising money for their medical expenses aren’t always the ones who need the most help.
Fundraising campaigns rely on internet access, the ability to take good photographs and write compelling text and reach over social networks. Some of the people in the greatest need don’t have the ability to do those things. For every GoFundMe success story, there are hundreds of others who never meet their goals. And thousands more?—?people in poverty, people who don’t speak English?—?don’t have access to the platform at all.
This is health care in the viral age: the more compelling your story, the more cash you can bring in. That encourages patients and relatives to exaggerate, and sometimes even to lie. While GoFundMe tries hard to screen campaigns for scams, they’re endemic on the platform.
This is health care in the viral age: the more compelling your story, the more cash you can bring in.
In 2015, a man made off with the funds for his godson’s heart transplant. A woman in Oklahoma ran multiple campaigns to pay for her daughter’s fictitious cancer treatments. The company guarantees that if you donate to a fraudulent cause, you can get your money back, but that’s just spurred scammers to up their game.
Over $3 billion has been raised on GoFundMe since the site launched, netting the company an enviable $150 million in income. They’re doing very well on the failings of the American health care system, and I have no doubt they will continue to do so.
But what would have happened if that $3 billion hadn’t been spent on helping individual cases, but instead on reforming the system that made their misery possible? What would happen if GoFundMe took even a small percentage of its profits and worked to make health care accessible and affordable for everybody, not just photogenic white families who can write a shareable paragraph?
But obviously, the company has no interest in doing that. Why should it? Things are working just fine for GoFundMe. It’s in the company’s best interest to keep the system exactly the way it is.
Using GoFundMe for health care is a classic Silicon Valley “disruption,” where tech wonks take a basic human need and strip out the infrastructure that makes it accessible for everybody. Sure, Ubers are cheap and convenient, but without a cell phone, a credit card and a data plan, you’re not hailing one. And it takes ridership away from public transit, which desperately needs the money to continue running. The people who don’t have the social reach to run a funding campaign deserve to get help just as much as the ones who do.
GoFundMe is a classic Silicon Valley “disruption,” where tech wonks take a basic human need and strip out the infrastructure that makes it accessible for everybody.
I’m not making the argument that we should shut GoFundMe down, or stop helping people in need. I spoke to numerous people while writing this article who told me the service literally saved their lives. But even they could agree that, without a health care system that is fundamentally broken at its core, they wouldn’t have had to turn to the site in the first place.
It is criminal that we live in a nation that treats healthcare as a luxury and leaves its neediest people out in the cold. The fact that Silicon Valley has disrupted the system to let some survive the burden isn’t a positive thing. It’s a Band-aid on a fatal wound.