It should be obvious as a fundamental principle that in a civilized country, crowdfunding for direct medical expenses should be utterly unnecessary. You get sick or injured, your medical care should be covered by the community at large.
Yet public appeals by families or individuals for help paying basic medical bills seem to be on the rise in the United States. Crowdfunding websites such as GoFundMe.com report that medical expenses rank as their largest single category of appeals; other sites such as HelpHopeLive have sprung up specifically for medical expense appeals.
A quick trot through current appeals on GoFundMe reveals campaigns for a network sports cameraman experiencing an unspecified “very serious health issue,” a California toddler with “a fatal, progressive, neurodegenerative storage disorder,” a 33-year-old rugby player with chronic heart problems and a young man, “one of the most caring and loving individuals that you will ever meet,” who suffered brain and physical complications from a cardiac arrest.
Medical resources for crowdfunding campaigns are largely distributed according to personal appeal, sensationalism, one’s social position, or luck.
No one can say that these people aren’t deserving, but one can say that their stories point to a crisis in the American health care system in two ways, neither of which is solved by crowdfunding.
One involves the gaps and other problems with U.S. health care that make crowdfunding campaigns necessary in the first place. Lawmakers who support policies that drive people to expose their personal lives in order to obtain desperately needed care should be ashamed of themselves. (We’re looking at you, congressional Republicans.)
“This way of raising money addresses only the symptoms of these problems,” observes Jeremy Snyder of Simon Fraser University in British Columbia. “If the popularity of medical crowdfunding shifts attention away from these problems … then crowdfunding could delay or prevent reforms that would benefit the vast majority of people.” In other words, beware of the impression that crowdfunding can be a substitute for broad health care reform.
The idea that appeals for individual assistance can supplant solid public programs is cherished by American conservatives. In 2014, Michael Cannon of the Cato Institute listed reliance on “friends, family, or the kindness of strangers” as a possible alternative to the Affordable Care Act. A similar notion was at the core of President George H.W. Bush’s “thousand points of light” doctrine, which was aimed at paring federal responsibility for the needy. None of these options can muster the resources to replace government programs, crowdfunding least of all.
The other crisis underscored by the rise of crowdfunding concerns the ethical issues raised by public appeals for medical care itself. Those are addressed in a new article in the Journal of the American Medical Association by Michael Young and Ethan Scheinberg of Harvard Medical School. Medical crowdfunding, they write, “raises a constellation of ethical and legal hurdles for patients, clinicians, institutions, and society.”
Not all crowdfunding needs could be eradicated by universal health care. Even Canada, which has a well-developed single-payer system, has seen a rise in crowdfunding appeals for treatments that aren’t covered by the government system or costs that aren’t strictly medical — the need to take up temporary residence near a treatment center, for example. A medical crisis can destroy a family’s financial stability in countless ways that aren’t addressed by a national safety net, including the loss of a paycheck when a breadwinner is unable to work.