On GoFundMe, You Decide Who Deserves to Live
Crowdfunding platforms are fueled by America’s broken safety net and our desire for control
Most people hate asking for money, even when it’s for a good cause. I spent several years writing about nonprofit fundraising — digging through research, case studies, and trends to advise people on how to solicit donations for causes ranging from cancer research to arts programs to hunger. Not only do nonprofit fundraisers have to fight against their own fear of begging or inconveniencing others, they must also overcome donors’ apathy and suspicions of inefficiency or fraud.
It’s daunting enough to ask for money for others. The discomfort runs even deeper when we ask for ourselves. We fear looking weak, irresponsible, and selfish. Yet more and more Americans are asking not just close loved ones but the world at large for financial support in the form of online crowdfunding campaigns. You see them popping up in your Facebook feed, your email inbox, and even in the news. And the most common reason for these appeals is an illness or medical emergency.
When the campaigns succeed, they’re touted as feel-good stories, a welcome reprieve from a terrifying news cycle. But like reports of coworkers donating vacation hours to pregnant or cancer-stricken colleagues, these campaigns are symptoms of our failure as a society, not our success. If it were not for America’s lack of a comprehensive social safety net, our neighbors would not need to rely on what amounts to a marketing and popularity contest in order to weather life-threatening illness and injury.
The Cost of Getting Sick
A severe illness or injury can be financially catastrophic. According to the American Cancer Society, cancer patients paid $3.9 billion out-of-pocket in 2014.
And even though insurance plans have a mandated out-of-pocket cap…
“Their plan may not cover a treatment they received, they may have used a provider who was not in-network, or the plan did not reimburse the provider for the full billed amount and the patient has to pay the difference (this is sometimes called “balance billing”). The amount of these surprise bills often do not count toward the patients’ out-of-pocket maximum.”
And that is the fate of people with health insurance.
According to Gallup, the percent of uninsured Americans has grown nearly 3% since 2016 (to a four-year high of 13.7%). If you’re one of the millions of Americans who are not insured, even a relatively minor injury could put you in debt for years. A broken leg can cost $7,500. A three-day stay in the hospital could rack up a $30,000 bill. 50% of wage earners in the United States make less than $30,000 in a year.
Almost no one has the savings to cover a catastrophic injury or illness without help. That’s one reason we feel good about giving to medical fundraisers — because we understand that a simple stroke of bad luck can ruin you financially.
But if we all understand this, why not demand a healthcare system (and larger safety net) that releases individuals from that burden? How can so many Americans object to socialized medicine and then turn around and make donations to acquaintances and even strangers?
Why We Love Crowdfunding
Many of the reasons people are motivated to give to crowdfunding campaigns are the same principles I educated nonprofit fundraisers about to better appeal to donors. One of the most important and effective concepts is the Identifiable Victim Effect.
Often summed up by a quote attributed to Mother Teresa, “If I see the mass I will not act, if I see the one I will,” the gist of the Identifiable Victim Effect is that people prefer to give to an individual than a large group. That’s why those late night infomercials would ask you to “sponsor a child” instead of “give to the children.” That’s why you’d rather donate to an acquaintance’s GoFundMe page than have some of your taxes go toward covering everybody. And we’ve known about this preference for decades.
“There is a distinction between an individual life and a statistical life. Let a 6-year-old girl with brown hair need thousands of dollars for an operation that will prolong her life until Christmas, and the post office will be swamped with nickels and dimes to save her. But let it be reported that without a sales tax the hospital facilities of Massachusetts will deteriorate and cause a barely perceptible increase in preventable deaths — not many will drop a tear or reach for their checkbooks.”
It’s more personally satisfying to think that your $25 made a difference in one person’s life than to think that your small contribution (among millions of others) supported a system that cared for many. We want our contribution to matter and when there’s one victim, we feel like it does.
Major crowdfunding platforms like GoFundMe, Fundly, and Plumfund advise users to tap into the Identifiable Victim Effect, encouraging fundraisers to include pictures of themselves and tell their stories. These platforms know that fundraising pages that make viewers feel a connection to the victim generate more donations.
Another way crowdfunding platforms tap into the psychology of giving is by the skillful use of goals and progress measures. Along with the greater satisfaction of feeling your donation has helped an individual person, giving to a crowdfunding campaign also has an element of gamification. Fundraisers must set a goal when setting up their page and the platforms advise users to set incremental goals and use these to communicate urgency and progress to the audience.
This strategy is meant to take advantage of the Goal Proximity Effect. This principle states that the closer you are to a goal or victory, the more responsible people feel for that success. It’s the same idea as attributing a win in a 3–2 soccer match to the last goal scorer, even though the win could not have happened without the earlier goals. Essentially, the closer you are to your fundraising goal, the more a donor feels like their gift makes a difference. With a federally or state-run healthcare option, we would all pay in, just as we do with Social Security, but there’s no progress bar, no fundraising goal to hit, no finish line. When you’re just crowdfunding for one person’s care, you can create a sense of finality (at least for the donors, recipients will often face a long road to recovery and reclaiming their everyday life). But universal healthcare just doesn’t have the same psychological pizazz.
Another reason some people feel better about giving to a crowdfunding campaign is the notion that your entire donation will go to helping the person in medical crisis. After all, pretty much every platform advertises their lack of fees. But whether it’s by taking a percentage of donations or charging transaction fees, the money has to come from somewhere. Even when the fundraising platform doesn’t take a percentage of donations, the payment processor does. The biggest reason crowdfunding platforms offer educational resources and advice to fundraisers is because they make money when users raise money.
To be clear, I don’t mean to vilify crowdfunding platforms. They provide a service and that naturally comes at a cost. But don’t fool yourself into thinking that giving to a crowdfunding page is the apex of charitable efficiency.
GoFundMe Gives You the Power to Judge
The most obvious difference between crowdfunding and socialized medicine is that the former is voluntary. No one is legally required to donate to Timmy’s leukemia fund. For some people, that’s enough of a difference. There is a contingent of Americans who see paying into and participating into a government safety net as a huge imposition on their rights. Even so, universal access to life-saving care and protection from financial ruin seems like an odd place to draw the line.
But even for those less averse to government involvement, this idea of choice is important. The rhetoric around universal healthcare and other elements of the social safety net often boils down to, “I don’t want to pay for people to get things they don’t deserve.” From Reagan’s myth of the “welfare queen” to the somehow alarming idea of people on government assistance of having a smartphone or eating something other than Spam, Americans are obsessed with determining what their neighbors deserve to have. And crowdfunding gives us that power.
It’s not uncommon for those crowdfunding for relief from illness or injury to emphasize how much they don’t want to ask for help. They want to show that they’re not one of those people. In fact, GoFundMe pages are often created (or at least written in the voice of) friends or family of the person in need. While this is sometimes due to the beneficiaries incapacitation or inability to run the campaign, the discomfort of fundraising for oneself is almost certainly a factor.
Although being able to pick and choose from different crowdfunding pages full of pictures and details makes donors feel like they can make an informed decision and help those most deserving, this is at best a misguided illusion and at worst an exclusionary and elitist competition field. Because it’s not who is most deserving of help, it’s who tells the best story.
I ran into this all the time when I researched and wrote about nonprofit fundraising. Two organizations could have all but identical missions and get vastly different fundraising results. The difference would often come down to marketing, design, and strategic communications. Again, I don’t mean to “expose” any kind of deception or manipulation, merely to illustrate that online fundraising gives us the illusion of being able to judge character when what we are really judging is storytelling.
In a blog from GoFundMe, successful fundraisers advise people to post frequent updates and think hard about who their audience is. “You need to tell a story in your GoFundMe. A really good crowdfunding campaign tells a story and is transparent,” advises Febin, who raised thousands of dollars to celebrate and support college campus workers. Campaign organizers emphasize the importance of photos and videos to “unlock people’s hearts.”
Needless to say, those without consistent internet access are at a huge disadvantage. And although smartphone ownership is higher than ever, there are still 24 million Americans who don’t have high-speed internet.
Several of the interviewed GoFundMe organizers called out the importance of personalized thank you messages. This is almost the exact advice I would give to development professionals at nonprofit organizations. These are effective strategies, but they also put a huge burden on someone who’s just trying to not have their life ruined by an illness. We are essentially asking people to devote hours each day to running a campaign while their spouse or child is fighting for their life.
In her Forbes article, “How Medical Crowdfunding Widens Disparities In Access To Care,” Rita Rubin points out the obvious disadvantage many Americans face when crowdfunding for healthcare.
“But what if you don’t know how to shoot a video or write well? And what if you desperately need assistance with medical bills but prefer not to put your story and photo out there for the world to see?”
Rubin interviewed researchers Nora Kenworthy and Lauren Berliner of University of Washington Bothell, who studied 200 GoFundMe campaigns. “While the top campaign had netted nearly $20,000, seven of the 200 campaigns hadn’t raised any money at all,” writes Rubin.
What about those campaigns that don’t catch our eye? Because as heartwarming as it is to read about how the Waffle House Hero raised nearly a quarter of a million dollars for the shooting’s victims, not all campaigns get the boost of human-interest headlines. For every recipient whose community rallied around them, there are others who couldn’t find the time to devote to their campaign or whose GoFundMe page simply didn’t take off. With universal healthcare, everyone is covered. With crowdfunding, your financial salvation is a function of your popularity.
When someone says they don’t want to pay for a stranger’s healthcare, the implication is that their own family and community should rally around them. For some that will happen, for others it won’t.
Stop Asking Who Deserves Dignity
We contribute to medical crowdfunding campaigns because we all know it could happen to us. But in order to judge each person’s worthiness, we turn illness and injury into an exhausting digital popularity contest that leaves many behind. It’s American Idol, but the prize is relief from financial or physical annihilation.
To be clear, GoFundMe and other crowdfunding platforms are not the villain in this story. We are. When we support candidates who make healthcare more difficult to access and afford. When we place barriers between our neighbors and government aid programs. When we subscribe to the belief that some people are more worthy than others.
By all means, continue to donate to friends, acquaintances, and strangers, but it would be a far greater victory if the United States built a healthcare system and safety net that allowed us all to survive life’s inevitable tragedies.
When people must crowdfund for their healthcare, we ask them to justify their life. We must make a mental shift that sets aside our need for control and recognizes each other’s inherent worthiness.