Due to the execution of a health insurance CEO, public attention is focused on health care. The United States has expensive health care, and this is working as intended to generate profits. Many Americans are uninsured or underinsured and even those who have insurance can find that their care is not covered. As has been repeatedly pointed out in the wake of the execution, there is a health care crisis in the United States and it is one that has been intentionally created.
Americans are a creative and generous people, which explains why people have turned to GoFundMe to get money for medical expenses. Medical bills can be ruinous and lead to bankruptcy for hundreds of thousands of Americans each year. A GoFundMe campaign can help a person 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 and have a job that offers insurance coverage at a price I can afford, and my modest salary allows me to meet the medical expenses for a very healthy person with no pre-existing conditions. However, I know that like most of us, I am one 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 suggests that people are morally decent and are willing to expend their own resources to help others. While GoFundMe does profit from these donations, their take is modest. They are not engaged in gouging people in need and exploiting medical necessities for absurdly high profits. That is the job of the health insurance industry.
On the other hand, there is the moral concern that in a wealthy country replete with billionaires and millionaires, many people must beg for money to meet their medical expenses. This spotlights 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. People should not need to beg for money to pay for their medical care.
To anticipate an objection, I am aware that people do use GoFundMe for frivolous things and there are scammers, but my concern is with the fact that some people do need to turn to crowdfunding to pay their bills.
While donating is morally laudable, there are concerns about this method of funding. One practical problem is that it depends on the generosity of others. It is not a systematic and dependable method of funding. As such, it is a gamble to rely on it.
A second problem is that it depends on running an effective social media campaign. Like any other crowdfunding, success depends on getting attention and persuading people to donate. Those who have the time, resources and skills to run effective social media campaigns (or who have help) are more likely to succeed. This is concerning because people facing serious medical expenses are often in no condition to undertake the challenges of running a social media campaign. This is not to criticize or condemn people who can do this or recruit others. My point is that this method is no substitute for a systematic and consistent approach to funding health care.
A third problem is that success depends on the appeal 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 more appealing in terms of attracting donors. For example, certain diseases and conditions can be “in” and generate sympathy, while others are not as appealing. In the case of people, 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” 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 in which people have to run social media campaigns to afford their health care should be condemned.