Data courtesy of OECD Stats, graph by Sabrina Edwards ’20
U.S. health care expenditure has increased, shown here in current USD purchasing power. This has led to booms in alternative funding.
BY SABRINA EDWARDS ’20
“He was 50 dollars short,” Ted Closson, an artist featured in a video from the Bernie Sanders campaign, said about the death of his friend Shane Patrick Boyle. “If I had known how close he was to death, I would’ve given him the whole 700 dollars.”
On Feb. 25, Senator Bernie Sanders (I-VT), a current candidate for the Democratic presidential nomination, tweeted a video slideshow of pictures of Boyle and a short summary of his story. Boyle died in February 2017, after his Go-FundMe campaign to pay for “a month’s supply of insulin” fell 50 dollars short of its 750 dollar target. Boyle was unable to afford these supplies and died as a result.
Boyle lost his health insurance after a move to help his mother with her medical issues. “He fell into whatever gap there is in the insurance market in the area that he moved to to care for his mother,” Closson said in Sanders’ video.
This lack of insurance meant that Boyle could not afford insulin, a medical necessity for those living with diabetes. He turned to GoFundMe, an online fundraising website, to fill the gap in his income and pay for the supplies, but was unable to reach his target.
We’re failing these people, lives are at stake,” Closson said. “As time goes by, I’m watching more and more tragic stories.”
These “tragic stories” are commonplace in current media — stories of people unable to meet their healthcare costs, even if they are employed, insured or surrounded by a significant social safety net. Desperate, many of these people turn to crowdfunding platforms like GoFundMe to meet rising costs.
GoFundMe was founded in 2010 by Brad Damphousse and Andrew Ballester, the founders of Paygr. Paygr allowed users to sell services as a sort of online classifieds-meets-social-media system.
GoFundMe is currently the most prolific online crowdfunding platform for any fundraiser, raising over $5 billion in nearly a decade for various fundraisers for projects, classrooms, businesses, disaster relief and medical expenses.
On Jan. 28, GoFundMe CEO Rob Solomon told CBS News that over one-third of all fundraisers on GoFundMe are for medical expenses, and healthcare campaigns have raised a combined $650 million over the last decade.
“We weren’t ever set up to be a healthcare company and we still are not,” Solomon told CBS. “But over time, people have used GoFundMe for the most important issues they are faced with.”
These “most important issues,” for many Americans, include rising healthcare costs. Healthcare in the U.S. totaled 17.9 percent of gross domestic product, compared to just five percent of GDP in 1960, according to the Centers for Medicare and Medicaid Services. This increase is significantly higher than the rate of inflation, meaning that healthcare has become even more expensive than it used to be. This is partly due to U.S. reliance on private health insurance, as well as increasing rates of chronic illnesses. According to the National Center for Biotechnology Information, healthcare costs for people with at least one chronic condition accounts for more than 85 percent of healthcare spending, overwhelming these individuals and their families.
“There’s ever-widening gaps in coverage for treatment, for prescriptions, for everything related to healthcare costs. Even patients who have insurance and supposedly decent insurance [come up short],” Solomon said to North Carolina Health News. “[GoFundMe has] become an indispensable institution, indispensable technology and indispensable platform for anyone who finds themselves needing help because there just isn’t adequate coverage or assistance.”
These gaps in coverage are what encouraged Maggie Dols ’21 to use GoFundMe to raise enough money to pay for a PTSD service dog.
“Service dogs are not covered by insurance and they can cost more than $30,000. I happen to be fortunate enough to [have] found an amazing center that offers [these services] at less than half the cost,” Dols said. “Of course, with still $9500 to go, it is a long and tiring process.”
Despite the charitable nature of many of the fundraisers on the platform, GoFundMe is a for-profit company, valued at $600 million. The company makes profit by collecting a 2.9 percent processing fee and 30 cents on each donation. There are no donation caps or minimums, but meeting or not meeting a certain donation target for a healthcare fundraiser can be the difference between life and death for users like Boyle.
Meeting these caps are, in theory, based on the efforts of the campaigner — the more content and updates the fundraisers include, the more money is supposed to flow in. GoFundMe advises that campaign managers use all of the provided tools to maximize their inflow.
However, despite all of the whirring gizmos and gadgets on the website, there are some inherent problems which prevent crowdfunding for being the “substitute for medical insurance” Solomon told CBS it could be.
According to a 2019 study by Dr. Nora Kenworthy and others at the University of Washington and Haverford College, these crowdfunding initiatives are not the answer to existing disparities in healthcare for low-income and marginalized people — in fact, these campaigns exacerbate existing gaps and inequalities.
Marginalized race and gender groups experience poorer fundraising outcomes, even if the fundraisers use all of the tools that GoFundMe pushes in order to expand “clicks” and funding potential. Rather than filling the gaps as the CEO of GoFundMe claims the service does, the platform often intensifies them.
In addition, because of the lack of oversight over the fundraisers on the part of GoFundMe, some of the “healthcare” campaigns on the site are based in unproven or dangerous “treatments.” According to research published in the Journal of the American Medical Association by researchers at the Shepherd Center and the Division of Medical Ethics at NYU School of Medicine found that there are over 1,000 crowdfunding campaigns for “scientifically unsupported, ineffective or potentially dangerous treatments.”
The funds for unproven or risky treatments, including some homeopathic remedies, totaled $27,249,487.99 in expected or sought funds and $6,799,700.01 raised. Though these treatments were only met at 24.9 percent of their goal as a group, the ramifications of promoting these remedies, as identified in the study, are concerning to healthcare professionals. Nearly 98 percent of these crowdfunding campaigns were on GoFundMe.
In the face of rising pharmaceutical costs, reduced preparedness for global health crises and growing natural disasters and injuries due to climate change, crowdfunding platforms provide temporary solutions to healthcare gaps. However, there is some cause for concern if these platforms take the pressure off of health insurance providers to cover necessary and costly medical treatments.
“I believe a medical service dog should also be covered under insurance as service dogs can be a medical necessity,” Dols said. “There are lots of organizations out there which provide grants, but they are hard to come by.”
Solomon himself wants the system to change.
“The system is terrible,” he said to North Carolina Health News. “It needs to be rethought and retooled. Politicians are failing us. Healthcare companies are failing us. ... We provide relief for a lot of people, but there are people who are not getting relief from us or from the institutions that are supposed to be there. We shouldn’t be the solution to a complex set of systemic problems.”