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How crowdfunding is a digital age answer for medical costs
02012018 LETTER

As health care costs grow and the number of uninsured Americans rises again with the uncertainty of the Affordable Care Act, more people are turning to “crowdfunding” websites to pay for medical bills and associated travel expenses to treat their conditions.

It’s a phenomenon ripe for the digital age, where a compelling story can go viral and attract the attention of strangers worldwide who are happy to chip in.

Laura Colbert
“We’ve certainly been aware of it ... the popularity as a strategy for helping cover medical or related bills,” said Laura Colbert, executive director of Georgians for a Healthy Future, a nonprofit consumer health advocacy organization. “I do think it indicates that we haven’t gone far enough in providing people with accessible, affordable care that’s close to home.”

According to the Centers for Disease Control and Prevention’s National Health Interview Survey, an estimated 29.3 million Americans were uninsured last year, an increase of 700,000 from 2016. 

The uninsured rate in Georgia, meanwhile, grew to 13.4 percent in 2017, according to the U.S. Census Bureau, the fourth-highest rate in the nation.

Colbert said rising health care costs mean more employers and insurers are shifting the burden to employees and consumers, which may also play a role in the rise of crowdfunding.

GoFundMe, one of the largest crowdfunding channels on the Internet, reports that 1 in 3  fundraising campaigns on its site at any given time is related to medical expenses. Moreover, the website reports that it hosts more than 250,000 medical fundraising campaigns annually, generating more than $650 million each year.

A recent keyword search for “breast cancer” on the GoFundMe site produced 245,844 related campaigns looking to raise tens of thousands and even hundreds of thousands of dollars.

The CEO of GoFundMe has confirmed that 1 out of every 3 GoFundMe campaigns running right now is to pay medical bills, which makes the site one of the biggest insurers in the country. 

GoFundMe’s website reports that it is the leader in online medical fundraising, showcasing more than 250,000 campaigns per year, and raising more than $650 million per year.

There are other websites that have launched in recent years that deal exclusively with medical expense campaigns.

The dependence many Americans now have on crowdfunding their medical expenses may not be surprising when the amount of charity care the Northeast Georgia Health System provides is taken into account. Across its three hospitals, the health system gave more than $40.2 million in charity care for the 2017 fiscal year.

Patients who receive care at the health system’s physician offices may also receive charity care if they are uninsured. 

NGHS also donated nearly $500,000 to help Good News Clinics provide care to indigent patients whose income is at or below the poverty line, as well as more than $1 million to provide primary care services at the public health department in Gainesville.

Good News Clinics reports that it’s 2017 fiscal year budget of 1.46 million provided nearly $24 million in free health care services for low-income patients with the support of partnerships, resource donations and volunteers.

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Mimi Collins, CEO of The Longstreet Clinic
The Longstreet Clinic in Gainesville also provides charity care to the tune of about $7.5 million to $8 million annually, according Mimi Collins, chief executive officer. 

For example, Longstreet physicians partner with Good News Clinics and participate in a health access initiative that connects low-income patients with specialty care.

Collins also is on the board of directors of Glory, Hope & Life, a local organization that provides support services for cancer patients, from respite and vacation to wigs and prosthetics.

And the clinic’s patient navigators are focused on reducing barriers and improving the quality of life of its cancer patients, specifically, for example, by helping pay power bills, rent, transportation and some prescription drug costs. 

Collins said the rise of crowdfunding is a symptom of three problems: rising health care costs, the growing number of uninsured Americans, and the vast number of “underinsured” patients.

“I struggle a little bit with it,” Collins said of the crowdfunding rage. “Certainly, people need help and need resources.”

But it’s a dilemma where “there’s limited checks and balances to make sure it’s a valid request,” Collins said.

Indeed, crowdfunding may be a new spin on traditional charity care, but it “raises a constellation of ethical and legal hurdles for patients, clinicians, institutions, and society,” according to a recent article in the Journal of the American Medical Association.

Authors from Harvard Medical School wrote that crowdfunding can redirect medical services from patients most in need to those whose campaigns are “more vocal, photogenic or emotionally appealing.”

Crowdfunding also runs the risk of exposing sensitive, personal medical information, and it’s predisposed to fraud and exploitation. There have been many examples of crowdfunded campaigns raising large sums of money for bogus causes.

But the need for crowdfunding may outweigh its potential downsides. Insurance frequently doesn’t cover all consumer medical expenses, some treatments may not be covered at all, and travel-related costs are commonly associated with severe conditions like breast cancer.

In 2015, the United States spent three times more on health care, according to the Organization for Economic Cooperation and Development, than 35 other countries with advanced economies, but doesn’t perform better in measures like life expectancy at birth.

“Our society tends to be pretty income-segregated,” Colbert said.

And while crowdfunding may assist in shrinking that gap, “You’ve got to be pretty well connected and computer literate” to make it work for you, she added.