Crowdfunding first started as way to launch an indie music album or tour, a company or service that had great potential but was shunned by investors, or perhaps fund a documentary with a cutting-edge theme. But as health care costs continue to increase, with more Americans perilously close to financial ruin, sites such as GoFundMe, GiveForward, Fundly and FundRazr are seeing medical fundraisers dominate the various fundraising stories on their sites. Facebook has recently entered this space, so now these appeals can be made even more directly.
The result is a rising cottage industry as appeals for financial assistance can generate companies like GoFundMe tidy profits. Some analysts, however, worry about the lack of oversight in this sector. The boost in popularity of these services raises concerns over issues such as privacy. While opponents of the current health care system say public programs should be replaced by individual responsibility, the evidence suggests that mounting health care costs make such a system unsustainable.
If the Affordable Care Act (ACA) ends up repealed, watch for more even more appeals to be posted online as health care costs keep spiraling upward. As countless news outlets have shown, despite the guarantees the ACA has supposedly enacted, including ending coverage exclusions for pre-existing conditions, a rare disease or medical procedure can wreck a family’s finances if they end up having to pay close to their maximum annual deductible. The winners, in such a system, are those who post that compelling picture, write that perfect narrative, or, pardon the oxymoron, score some luck and go viral with their illness. “Lawmakers who support policies that drive people to expose their personal lives in order to obtain desperately needed care should be ashamed of themselves,” wrote Michael Hiltzik in the Los Angeles Times.
Add Americans’ growing dependence on the sharing economy, or actually, the gig economy, and watch for these harrowing stories to surge in numbers and appear increasingly on your social media feeds. One study in 2015 suggested that 47 percent of Americans do not have even as much as $400 stashed away to cope with an emergency. And studies have shown that the poorer the person, the less likely he or she has a strong social network – and most funds for these medical care appeals come from friends, and then friends of friends.
Another problem is that as with any fundraising pitch, one needs both marketing savvy and have a compelling story in order to stand out. Otherwise, the reality is that an online audience already tiring of these incessant appeals for help means that few people who are in dire need will actually come anywhere near their fundraising goals. As Bloomberg noted earlier this week, the vast majority of medical crowdfunding campaigns fall far short of their goals; rare is the million-dollar windfall for a story of a woman’s cancer reappearing after she had quadruplets, or a celebrity cutting a check for a girl with leukemia.
For many fundraisers, being in the right place at the right time, or having a strong social network, makes all the difference. Buzzfeed, for example, highlighted the case of an Arkansas woman who struggled at first to meet the fundraising goals she said she needed in order to stay at her home – and even, as she argued, stay alive. Then Kati McFarland confronted Senator Tom Cotton at town hall in February, the clips went viral, and the slow trickle of donations turned into $50,000 of her $63,000 goal.
But as a University of Washington Bothell study concluded, on average such campaigns only generate 40 percent of what they originally sought. Plus, there is always the risk that stories are embellished, which if revealed, can further sour an already jaded public.
“Crowdfunding narratives also distract from crises of healthcare funding and gaping holes in the social safety net,” concluded this study, “by encouraging hyper-individualized accounts of suffering on media platforms where precarity is portrayed as the result of inadequate self-marketing, rather than the inevitable consequences of structural conditions of austerity.”
The result is that there is an opening for businesses, whether or not they are in the health care sector, to find more creative ways to help society cope with healthcare scares. After all, insurance and pharmaceutical companies that come even close to appearing to profit excessively off of Americans’ misery will be subject to risks such as unrestrained outrage on social media as well as a tarnished brand reputation.
But so far, such business efforts have been spotty. CVS, for example, is working with a pharmaceutical company to help make insulin more affordable. The health insurer Aetna is partnering with a non-profit to help provide public health services to at-risk kids. At best, these services do not come close anywhere to filling the gaps in health care coverage and services; crowdfunding may be effective in providing hope, but the numbers suggest it is hardly an effective long-term solution. All of these efforts do well at alleviating some symptoms of our health care system’s problems; none offer a real solution.
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