In 2017, Shane Patrick Boyle died of diabetic ketoacidosis, a condition marked by a dangerous increase in blood sugar and the acidification of the blood, after his GoFundMe campaign for a month’s supply of insulin came up a mere $50 short [1]. From 1987 to 2017, the price of a 20-ml vial of Humulin U500 - a concentrated form of insulin used by an increasing number of patients - rose from $170 to $1,400, according to Truven Health Analytics [2]. The soaring prices have forced 1 in 4 patients to ration their insulin, which can lead to blindness, kidney failure, heart disease and stroke [3]. The practice of crowdfunding medical expenses is a symptom of a broken healthcare system, not an innovative way to raise money.
Medical expenditures are the primary reason people turn to crowdfunding websites like GoFundMe, CrowdRise, and FundRazr [4]. Nearly $1 billion has been raised through health-related fundraisers on GoFundMe alone since the site’s launch in 2010 [5]. However, 90% of fundraising campaigns do not get fully funded [4]. Regardless, most platforms profit off of users’ misfortune by taking a percentage of every donation. The crowdfunding of medical expenses not only raises several ethical concerns inherent to the practice, but more importantly, it exposes a dire, harsh, and dystopian reality in which people die simply because they cannot afford to live.
Deeply-ingrained in the crowdfunding model is the pressure to romanticize personal suffering in order to gain necessary sympathy and attention. This inevitably leads to many people’s experiences being overlooked because their stories were not compelling enough, their pictures not clear enough, or their pain not legitimate enough. Individuals who are members of socially marginalized groups or have medical needs that are associated with negative stigmas are less likely to benefit from medical crowdfunding [6]. For example, studies show that there are racial disparities in how donors choose to fund campaigns [7]. Furthermore, the practice promotes the valuation of health as a market-driven good rather than as a basic and inalienable human right.
While crowdfunding platforms have assisted many people in lessening the monetary burden of medications and medical procedures, the fact that such crowdfunding websites exist should signal the urgent need for a healthcare system that does not discriminate based on class. According to the Federal Reserve, 44 percent of Americans did not have enough savings to cover an emergency costing $400 in 2016 [8]. Moreover, studies suggest the lack of a sufficient social safety net in a given state corresponds to an increase in the reliance on crowdfunding, as fundraising campaigns are much more likely to originate in states that rejected Medicaid expansion under the Affordable Care Act [9]. While 39 percent of the population lives in these states, 54 percent of the sampled campaigns came from them [9].
The United States is the only developed country in the world that does not guarantee its people the right to healthcare. To eliminate the need for crowdfunded healthcare, eradicate medical bankruptcies, and put an end to preventable deaths, the United States should work to implement a universal healthcare system that guarantees a basic level of affordable, accessible care to all. One way to achieve universal coverage is through the expansion of Medicare, a plan popularized by Senator Bernie Sanders during his 2016 campaign for president. Currently, Medicare covers seniors over the age of 65; however, under Sanders’ plan, the required age will be incrementally lowered until it covers every American. Some proposals, such as Sanders’ Medicare for All plan, replace private insurers entirely, while others extend Medicare to those who opt-in. Medicare for All would be financed by a tax on the top 0.1% of Americans as well as an increase in estate taxes [10]. As a result, there would be no monthly premiums, no copayments, and no deductible to meet before coverage kicks in [10]. Guaranteeing healthcare as a human right will eliminate the need to turn to crowdfunding out of desperation and poverty.
References
Saini Vikas, “A Mother’s Day Message to Pharma: Lower Your Insulin Prices,” WBUR, 11 May 2018.
Harrar Sari, “Insulin Prices Still High,” OnTrack Diabetes, 28 Sep 2018.
Teare Kendall, “One in Four Patients say They’ve Skimped on Insulin Because of High Cost”, Yale News, 3 December 2018.
Smith S.E., “Crowdfunding is a Symptom of the Broken U.S. Healthcare System,” TalkPoverty, 21 November 2018.
Helhoski Anna and Victoria Simons, “Seeking Medical Debt Relief? Crowdfunding Rarely Pays off the Bills,” Nerdwallet, 2 November 2016.
Snyder Jeremy, “Crowdfunding for Medical Care: Ethical Issues in an Emerging Health Care Funding Practice,” The Hastings Center, 22 November 2016.
Rhue Lauren and Jessica Clark, “The Consequences of Authenticity: Quantifying Racial Signals and their Effects on Crowdfunding Success,” 23 July 2018.
Marche Stephen, “Go Fund Yourself,” Mother Jones, January 2018.
Hiskes Jonathan, “The Moral Failure of Crowdfunding Healthcare,” The Simpson Center at the University of Washington. 3 April 2017.
Kliff Sarah and Dylan Scott, “We Read Democrats’ 8 Proposals for Universal Healthcare. Here’s how they Work,” Vox, 19 December 2018.