The Ethics of Crowdfunding in Healthcare

[Not_A_Hat_Person, RN]

In light of the recent crowdfunding threads, I found this article Is It Fair to Ask the Internet to Pay Your Hospital Bill? interesting. As the mother of a child who may need a heart transplant in the future, it really hit home. I can't think of any other country where people are encouraged, or even expected, to hold fund-raisers for necessary medical care.

But the Internet's potential to relieve the burden of medical bills isn't distributed equally, said Elizabeth Yuko, a bioethicist at Fordham University's Center for Ethics Education: In order to create these profiles, you have to have access to a computer, you have to be relatively tech-savvy.”

If we use crowdsourcing for healthcare costs as a way to replace what a good healthcare system might do, then we're really creating a new health disparity,” Moon agreed. But to her, the most pressing ethical question surrounding medical crowdfunding is not the inequalities it illuminates, or how donors choose who to fund, or how sites choose who to host—it's why the practice has become necessary in the first place.

There's a concern that it will become a pop-off valve for a healthcare system that's not doing its job.” she said. If someone's raising money to cover the cost of cancer treatment, the question that raises on the other side is, why is our healthcare system not paying for necessary care?”

[toomuchbaloney]

Seriously?

You don't think that this is one of the things that makes Murika exceptional?

I am really excited about how our exceptionalism will be increased when our Congressional leaders make good on their promises and repeal the ACA, privatize Medicare, and tighten the purse strings on Medicaid.

[brandy1017, ASN, RN]

I think it is sad that people are put in the situation of having to beg friends and strangers for money to pay health bills because our govt refuses to provide fair, equal national healthcare for all. Instead we have a patchwork system where fate may decide whether you have health insurance, what it will pay and what it won't. Medicare isn't free and the people in it have been paying into it all their working lives only to access it in their old age or disability. Medicaid is free if you are poor enough, but you may find you live in a state that won't pay for transplants like Arizona has done to save money calling them experimental. Plus even if you qualify for Medicaid, many doctors refuse to take Medicaid so it is difficult to actually use it!

It reminds me of all the food pantries and appeals to donate food, while the federal govt under the republicans has cut food stamps to millions of people! Likewise nothing is done about the minimum wage when if people were paid a living wage they wouldn't need to beg for food or rely on food stamps and food pantries!

Unfortunately I don't have a solution to fix these problems. Since the govt is unwilling to act things will remain status quo and people will continue to go on begging because what other choice do they have? Give up and die? I don't think so!

[KelRN215, BSN, RN]

It doesn't happen in other countries because every other developed country in the world provides healthcare to its citizens. The child in the article should have qualified for supplemental Medicaid to cover out of pocket costs. I have never heard of such issues happening in my state even with kids with out of state Medicaid.

That said, I've seen people abuse these kinds of websites too. A girl I went to high school with posted one last year trying to get money (for herself) by using her daughter's T&A. She wrote this ridiculous sob story about how her "insurance" didn't cover the full cost blah blah blah even though everyone reading it knew she had Medicaid and no out of pocket costs. She took the site down when someone called her out on it.

[MunoRN, RN]

"Crowdfunding" healthcare has been around for awhile, that's basically what medicare and other insurance is. I think the only unethical thing about it is when it's not available to everyone, just those who can succeed in an internet popularity contest.

[Natasha A., CNA, LVN]

crowdfunding as expanded for paying for college tuition and more. Its the new scholarships and grants

[MrNurse(x2), ADN]

On the surface, the need for crowdfunding seems distasteful. Ask yourself why. We have 60 years of expecting the government to care for us, we have also lost our sense of community. There should be no welfare system in this country if we all would just have empathy, it is something that was much more abundant in the early 20th Century. We have become a selfish society, and crowdfunding has become the glimmer of humanity in a pretty dark place. Then the author decides to play the have/ have not card, so progressive of her. In my area there are constantly jars at convenience stores, raffles, auctions and bingo for those who "have no access to technology", and these efforts normally are sufficient. For those who want to fault our health care system, be aware we have single provider health care, it's called the VA, and we all know what happened in the last few years. Much more direct and efficient for community to solve a problem than government.

[NOADLS]

A local high school graduate crowdfunded new boobs for her graduation gift.

I would have recommended a nose job instead.

Ethics in crowdfunding don exits.

[jadelpn, LPN, EMT-B]

Crowd funding is not as it appears. If one is going to go on social media and ask for funds, I would be the first one to say one needs to set up a specific account for same. NOT co-mingle these funds with your primary bank account, and here's why:

There is someone that I know who, due to a large amount of "stuff" needed to obtain a car. Crowd fund page set up by a well meaning friend (not me). Response was overwhelming. Imagine, friends and neighbors and even strangers with their "name in lights" on the internet for all to see how generous they were!! Little subcultures of "can you top this" donations!! WOW!! All put directly into the recipient's bank account. Then, all heck breaks loose.

3/4 of the people have second thoughts, had no intention of going beyond their name on the donor list, gets their knickers in a twist because (at least in small communities) the person doesn't SEEM destitute--and proceed to charge back their credit card. (WHAT?!?!?! I NEVER approved that charge!!) Which not only removes the money that they "donated" from the recipient's account, but the crowd funding page then charges a fee to the recipient for the inconvenience.

This snowballs into just as many if not more money in charges then was actually donated. All then payable by the recipient. Out of $15K in donations, this person ended up, with all of the charge backs and fees with less than $1,000 and a big headache on their own account. At one point, falling into the red and almost getting their main account closed because of it. Not to mention the tax implications. And all the while, those who charged back were still on the donor list, and having their praises sung by the community on how generous they are!

The same can be said about doing fund raising events for private people's needs and the like. The recipient is put under a microscope and a "must be nice to go out to dinner on my dime" foolishness. Credit cards are charged back, checks are stopped for payment.....it is a mess.

So no matter how well intended, this becomes a mess quickly. So if someone really wants to help, I would suggest gift cards for groceries, gas, or sending a money order made out directly to utility bills or hospital in the person's name, or even the landlord or mortgage company. It would do the most direct good, and not involve bank accounts or credit cards.

[MunoRN, RN]

On the surface, the need for crowdfunding seems distasteful. Ask yourself why. We have 60 years of expecting the government to care for us, we have also lost our sense of community. There should be no welfare system in this country if we all would just have empathy, it is something that was much more abundant in the early 20th Century. We have become a selfish society, and crowdfunding has become the glimmer of humanity in a pretty dark place. Then the author decides to play the have/ have not card, so progressive of her. In my area there are constantly jars at convenience stores, raffles, auctions and bingo for those who "have no access to technology", and these efforts normally are sufficient. For those who want to fault our health care system, be aware we have single provider health care, it's called the VA, and we all know what happened in the last few years. Much more direct and efficient for community to solve a problem than government.

I would assume this isn't really what you mean, but are you really suggesting jars at convenience stores and bingo would be a viable way to pay for our health care? How would that work? When someone shows up in the ER having a heart attack, would they then have someone put a donation jar on the counter at a convenience store and wait until it can cover their heart cath or OHS?

The VA is actually a very good example of why paying what we feel like paying towards healthcare doesn't work. Unlike Medicare, the VA is not funded based on what it takes to provide healthcare to the people it covers, it's funded based on what Congress feels like paying, which is generally far less than what it costs to actually provide healthcare to everyone the VA covers, and you're right, that doesn't work very well.