While the United States does offer some of the best health care in the world, it also offers the most expensive care. What it does not offer is the sort of medical coverage for the citizens that other Western countries provide. As such, many citizens are on their own when it comes to paying for this expensive care. As of this writing, Trumpcare has not passed, but it seems likely that the final version will be essentially a tax-cut for the wealthy with a reduction in coverage and benefits for those who are not well off. In any case, healthcare is likely to grow increasingly expensive for most Americans while they have reduced abilities to meet these expenses.
Americans are a creative and generous people, so it is not surprising that many people have turned to GoFundMe to get money to meet their medical expenses. Medical bills can be ruinous and are all too often a contributing factor in personal bankruptcy. As such, successful GoFundMe campaigns can help people pay their bills, get the care they need and avoid financial ruin. Friends of mine have been forced to undertake such campaigns and I have donated to them, as have many other people. In my own case, I am lucky—I have a job that still offers insurance coverage at a price I can afford and my modest salary allows me to easily meet the normal medical expenses for a very healthy person with no pre-existing conditions. However, I know that like most Americans, I am one bad medical disaster away from financial ruin. As such, I have followed the use of GoFundMe for medical expenses with some practical interest. I have also given it some thought from a philosophical perspective.
On the one hand, the success of certain GoFundMe campaigns to cover such expenses does suggest that people are morally decent—they are willing to expend their own resources to help other people in need. While GoFundMe does profit from such donations, their take is relatively modest for the service they provide. They are not engaged in gouging people in need and exploiting medical necessity for absurdly high profits—unlike some pharmaceutical companies.
On the other hand, there is the moral concern that in such a wealthy country replete with billionaires and millionaires, many people must resort to what amounts to begging for money to meet their medical expenses. This reality points to the excessive cost of healthcare, the relatively low earnings of many Americans, and the weakness of the nation’s safety net. While those who donate out of generosity and compassion merit moral praise, the need for such donations merits moral condemnation. In a purportedly civilized nation, people should not need to go begging for money to pay for their medical care.
To anticipate an objection, I am aware that people do use GoFundMe for frivolous things and that there are no doubt scammers using fictions of medical woe to separate the kind but uncritical from their money. Obviously enough, people are under no obligation to donate to frivolous camp and such scams are to be condemned for their wickedness. My concern is with the honest campaigns that are necessary to meet medical expenses. These are the campaigns that illustrate much that is wrong with the existing health care system.
While donating to such honest campaigns is morally laudable, there are some concerns about this method of funding. One obvious problem is that it depends on the generosity of others. It is not a systematic and dependable method of funding. As such, it is certainly problematic that some people need to rely on it.
A second obvious problem is that this method depends on an effective social media campaign to succeed. Like any other crowdfunding, success depends on getting attention and then persuading people to donate. Those who have the time, resources and skills to run effective social media campaigns (or who have such people helping them) will be far more likely to succeed than people who are lacking in these areas. This is especially concerning because people who are facing serious medical expenses are often in no condition to undertake the challenges of running such a campaign. In some cases, their efforts are being devoted to not dying. This is not to criticize or condemn people who can do this or recruit others to do it for them. Rather it, is to point out that this method is obviously no substitute for a systematic and consistent approach to funding health care.
A third obvious problem is that the success of this method depends on the appeal factor of the medical condition and the person with that condition. While a rational approach to funding would be based on merit and need, there are clearly conditions and people that are much more appealing in terms of attracting donors. For example, certain diseases and conditions can be “in vogue” and generate considerable sympathy, while others are not as appealing. In the case of people, it is evident that we are not all equal in how appealing we are to others. As with the other problems, I do not condemn or criticize people for having conditions that are in vogue or being appealing. Rather, my concern is that this method rests so heavily on these factors rather than medical and financial need. Once again, this serves to illustrate how the current system has been willfully broken and does not serve the needs of most Americans. While those who have succeeded in their GoFundMe campaigns should be lauded for their effort and ingenuity, those who run the health care system should be chastised for a state of affairs in which people have to run social media campaigns to afford their health care.