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America’s Health-Care Crisis Is a Gold Mine for Crowdfunding
- subverter 9y agoWoah, woah – you're telling me people voluntarily help each other pay their medical expenses without the government forcing them to?!
- jaggi1 9y agoLet me run a crowdfunding for c-section of my aunt's 7th baby or drug overdose treatment for the junkie across the street! We need government coercion for that.
- michaelchisari 9y agoCrowdsourcing medical expenses is a point of national and economic embarrassment, not pride.
- maxxxxx 9y agoI always find it sad that people have to raise money for for surgeries or serious health issues. It's great that people donate but this should simply not be necessary in an advanced society.
- ahallock 9y agoThis is not an argument.
- michaelchisari 9y agoIf not, then neither is the post I'm responding to.
- sp332 9y agoYou're telling me that a representative government would help people afford healthcare, even if it cost money? But the AHCA currently has a 17% approval rating and will get passed anyway? http://www.businessinsider.com/quinnipiac-poll-shows-17-percent-of-american-support-trumpcare-ahca-2017-3 http://www.businessinsider.com/quinnipiac-poll-shows-17-perc...
- pcwalton 9y agoNobody is arguing that charity care doesn't exist. The question is whether charity care substitutes for a functioning health system.
- yequalsx 9y agoYou might be interested in reading about the free rider problem. This is a well known phenomenon in economics. Also consider that there are no instances of charities providing for the basic needs of a nation's poor. It was with government programs that things like universal education and healthcare became a reality.
- ohazi 9y agoDon't be silly. Sardonic libertarians don't believe in the free rider problem!
- davidw 9y agoWell, some of them - the popular ones, or ones with friends with money - get help. It's kind of like high school, but some of the losers die!
- adamnemecek 9y agoWhat about those that don't have many friends?
- michaelchisari 9y agoOr what about our own proven biases? Pretty versus ugly, young versus old, white versus black, man versus woman, overweight vs average weight, high school dropout versus university graduate, religious versus non-believer, etc., etc., the ability to look past all of these things and donate purely based on need is not something crowds have ever been good at doing.
- aphexbr 9y agoSome people voluntarily help some other people with some costs. There's a lot of people who don't get the care they need for whatever reason, even in a system where there's a lot of volunteers. To get the best deal for everybody, governments in most countries step in to create a system where everybody pays in and the best deal for everybody is made (with the option for extra private care if you can afford it). You get a basic guaranteed level of healthcare in return for your taxes, as part of your participation in society. Corporations are prevented from deciding they need to charge you more than your annual income for the medication keeping you alive, while you're free to change jobs and start businesses when you wish, because you're not trapped in an insurance plan that you'll lost the moment you do something else. Only in America is this seen as wrong. Everywhere else gets cheaper bills with zero chance of personal bankruptcy just because you got the wrong disease/got ill before/etc.
- ryguytilidie 9y agoAs someone said below, we should be embarassed we live in a society where someone needs to raise funds or go broke for medical treatment. I'm starting my own business and the cost of health insurance is absolutely insane. If we come to the conclusion that we want our fellow countrymen to die or go broke versus live healthy, I think we should just shut it all down and call it a day.
- hippich 9y agoCost of insurance is just a reflection of cost of medical care. Nothing current government does affect cost of medical care. If anything, they suppress flow of cheap money to medical providers which only inflates its costs even more.
- bdamm 9y agoNot true; the government has an enormous impact on the cost of health care. The American health care system is enormously inefficient, costing almost twice as much for less effective care than most other developed nations. How can this be other than because of the government? One source: https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_systems_in_Canada_and_the_United_States https://en.wikipedia.org/wiki/Comparison_of_the_healthcare_s...
- hippich 9y agoHigher expenditure can be due less efficiency (btw, what we are going to do with all the inefficient people, pay them welfare?) or due more money spent on more procedures. Is it bad or good - I am not going to say.
- sp332 9y agoCost of insurance is so unrelated to the cost of healthcare, that when my grandfather recently went in for a procedure, no one at the hospital could tell him how much it would cost. They just take the amount that was negotiated with his particular insurance company. Different people get charged different amounts, and there is no way to get a "quote" ahead of time!
- johnwatson11218 9y agoI am about half way through this book https://www.amazon.com/dp/B00957T4QK/ref=cm_sw_r_cp_awdb_CEVqzb6T0MXJH https://www.amazon.com/dp/B00957T4QK/ref=cm_sw_r_cp_awdb_CEV... And I think it makes many good points about our health care system. Thinking about why I don't use geico insurance for routine maintenance on my car was a very interesting thought experiment.
- TuringNYC 9y agoI see what you are getting at (i.e., health insurance should be for catastrophic events rather than routine visits.) The problem is that in the US, routine visit costs are wildly inflated. Try going in to get a vaccine or a cold and you get wildly dispersed and large quotes. This is because the insurance system is two things in one: a real insurance plan + a negotiated ratecard. When you go for routine/preventative care with insurance, you get fairly reasonable values on the rate card -- without it, they can (and usually do) charge you anything, and often you don't even know the cost until afterwards. Until there are realistic rates for simple/routine/preventative needs, I don't see how insurance can be restricted to catastrophic cases only.
- michaelchisari 9y agohealth insurance should be for catastrophic events rather than routine visits But routine visits often severely reduce the rate of catastrophic events. Catching cancers early, assessing risk factors, etc.
- johnwatson11218 9y agoLike I mentioned in the top comment, I'm still reading the book, so I'm interested to see how things like moral hazard and preventative care are addressed. In the first chapter he advocates splitting our system into two parts. The first would be government supplied cradle to grave health insurance that only covers unexpected, catastrophic events. The idea being that 90% of the population would never even file a claim. For everything else the author recommends the free market with doctors and providers competing for our business. He gives the example of LASIK eye surgery. Apparently it isn't covered by insurance and has to be paid for with cash. After 20 years you can find it as low as $299 in some cities while some doctors charge more and claim to offer a higher quality service. I'm still not clear on how a bad lifestyle that leads to diabetes which leads to foot amputation would be dealt with under this system but I'm enjoying the book anyway.
- skywhopper 9y agoOverheard on Twitter: What if... we had this one giant GoFundMe for all medical bills that everyone paid into?
- hippich 9y agoit would be treated exactly like people want universal healthcare - everyone just accepted they deserve one, without being grateful for it. Unlike such funds GoFundMe recipients know exactly who gave them life. This is very powerful distinction.
- skywhopper 9y agoWhat about the people who don't have a network of friends and acquaintances with enough extra money to help pay their bills? What about chronic problems that require thousands or more dollars each year to address and never end? Should those people just keep begging? Eventually that will destroy their relationships if they kept trying it year after year. But I'm confused why you think gratefulness and knowing how "gave them life" is key. If my work-provided insurance plan pays for medicine I need to survive, who should I be supplicating myself to to satisfy your moral demands for appropriate gratefulness? Do I have less value as a human being in your eyes because I accepted payment from a faceless remote corporation instead of by begging my social network to give me the money?
- hippich 9y agoNot sure why you switched it to personal attack here. I personally have no demands about you using your insurance plan you paid for. I just explain how people who get something for free from something very abstract they could care less about, do not value what they get. Health care is not naturally given. Someone have to do it. And just like I do not owe you to write code on a whim, the same way doctor is not obliged to slave himself to provide health care for you. (Or are we back to slave times, except this time based on professional occupation?) When specific doctor provides, or someone donates/volunteers their time/money/etc - you naturally grateful for that, or at least should be, otherwise good luck with that. If you do not believe me, try to set up giveaway of some product. You immediately find out what I am talking about.
- clamprecht 9y agoWhat about medical tourism? Seems like a possible solution for non-emergency care. Paul Buchheit tweeted a few years ago that he wanted to fund the "Uber of medical tourism". The tweet seems to be gone (not sure why?), but here's my previous comment about it: https://news.ycombinator.com/item?id=10731415 https://news.ycombinator.com/item?id=10731415
- hkmurakami 9y agoIt's considered politically insensitive these days.
- davidcbc 9y agoSeems like a really bad solution for people who are poor
- michaelchisari 9y agoOr those who need emergency care.
- cpr 9y agoHealth sharing co-ops have been at this for some time, based on Christian principles. Samaritan Ministries, e.g., is $500/month for family and generally pays 100% of medical expenses, though no guarantees. Our monthly check goes directly to someone else in the group. Minimal overhead for admin. Also grandfathered in the ACA.
- awalton 9y agoGo with me here, what if instead of paying into a crowdfunding campaign, these people paid into a central pool of money, and then when they had exceptional health care costs, they could dip into this pool and pay off their bill? Imagine what kind of revolution that'd make.
- jklein11 9y agoI understand you are being sarcastic, but this is how both single payer systems and private insurance market places work. The only difference is, in one system people are elected to determine how the central pool of money is collected and distributed and in the other decisions are driven by shareholders.
- davidf18 9y agoCities are states are free to work the the Federal Government to set up healthcare for their citizens. For example, where I live in NYC (at least prior to Obamacare) 450,000 New Yorkers without health insurance could go to one of many Community Health Centers funded by Feds, State and other sources as well as go to one of 11 public hospitals. Interestingly, ObamaCare cut the DSH funding to these and similar public hospitals throughout the country. [1] Part of the funding in NY State / NY City comes from $4.35 state and an additional $1.50 city tax per pack on cigarettes. The tax revenues are then put into Medicaid funding which in the case of NY State is matched 1:1 by the Federal Govt. Trumpcare should restore the DSH funding that ObamaCare unwisely cut and increase the funding for Community Health Centers. States should increase tobacco taxes and use those funds to help pay for healthcare for their residents. [1] https://en.wikipedia.org/wiki/Disproportionate_share_hospital https://en.wikipedia.org/wiki/Disproportionate_share_hospita...
- cmurf 9y agoThis is both market failure and government failure. And the reason why we're arguing is the politics demands fighting for government or for the free market. Health care industry in the U.S. includes hospitals, doctors, R&D, pharmaceuticals, insurance. All of those things are for-profit, but are also anti-competitive because they don't voluntarily, or by law, publish prices; they have conglomerated (mergers) more than banks; we confuse insurance with payment plans, a fair chunk of insurance cost is a payment plan for predictable procedures colds, annual checkups, pregnancy, aging. Aging is probably the biggest part of the payment plan because almost everyone is going to have problems related to it eventually. My main criticism with ACA and proposed AHCA is that it effectively subsidizes a busted system. The U.S. spends 3x per capita for healthcare that does not cover everyone, compared to OECD countries who do cover everyone. U.S. pays more money to cover fewer people. It's an inherently classist system. To really solve this we have to be willing to merge private insurance, Medicare, Medicaid, FEHB, military and veterans medicine, into one system. All of the conglomeration says is this is a natural monopoly but we keep trying to force something that's inherently anti-competitive to be competitive. It'd still be unfair but metric tons better than what we have, to just hand over the whole mess to a team made up of epistomologists and economists and then adopt their recommendation.
- naaaaak 9y agoAmerica's Health-Care Crisis??? You mean Obamacare didn't end skyrocketing costs and fix what it purported to? You mean the sole accomplishment of a corrupt President didn't accomplish anything? Say it isn't so! Now explain why Marxist idiots "need" to "save" it.
- sctb 9y agoYou're not welcome to start flamewars like this, and you've been using this account primarily to post ideological comments, which counts as an abuse of the site. Please post civilly and substantively or not at all. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html