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The Complicated Ethics Of Using The Internet To Fund Your Medical Bills

CREDIT: SHUTTERSTOCK
CREDIT: SHUTTERSTOCK

If you’re faced with unexpected medical expenses that threaten to bankrupt your family, should you turn to the internet for help? Two different people facing backlash for running health-related crowdfunding campaigns are renewing some controversy over the practice, which has been on the rise over the past several years.

Ada Guan didn’t realize she was pregnant until she gave birth while she was on an airplane flying over the Atlantic Ocean. Now that the 23-year-old Canadian and her boyfriend have a healthy baby girl, they’ve asked the internet to help chip in for their medical costs, explaining that Guan is currently unemployed.

But they were surprised by the negative reaction provoked by their site, which initially asked for $50,000 — many commenters called them “greedy” and accused them of attempting to profit off their unexpected situation. Some angry people told them they should have been using birth control, while others complained that Guan should get a job. The couple ended up scaling back their ask to $5,000.

South Carolina resident Luis Lang, meanwhile, is sparking a political debate over health care reform with his own crowdfunding site, which is asking people to help cover the costs of a surgery that will help save his eyesight.

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The 49-year-old Republican is self-employed and opted not to purchase health insurance under Obamacare; he says he’s always prided himself in being able to pay for his own medical bills. But now that he’s facing a health emergency stemming from his chronic diabetes, it’s too late to sign up for a plan, and Lang is struggling to come up with the thousands of dollars he needs to treat the bleeding in his eyes. He told the Charlotte Observer that he thought President Obama’s health law would still be able to offer him help in an emergency.

After Lang’s story was covered in the Charlotte Observer, his crowdfunding page was flooded with Obamacare supporters urging him to change his mind about health care policy. “I wish you all the best. I hope you’ll come to see ACA and health care for all as a basic right,” one donor, who gave $5, wrote. Lang has since complained that he didn’t want his crowdfunding effort to be politicized. “But how could it not be political?” Leonard Pitts, an opinion columnist for The Miami Herald, wrote on Monday. “Now, the bill comes due, and whatever he thought of ‘Obamacare’ as a model for financing health care, surely Lang must concede that GoFundMe is even worse.”

Guan and Lang are hardly alone. Faced with rising health costs, thousands of people are turning to online crowdfunding sites — like Kickstarter, GoFundMe, or GiveForward — to ask people on the internet to help them raise money for their medical bills. For health experts, the trend raises some troubling questions about whether it’s appropriate for websites to function as desperate Americans’ safety net.

“There’s a concern that it will become a pop-off valve for a health care system that’s not doing its job,” Margaret Moon, a bioethicist and professor of pediatrics at Johns Hopkins University, told the Atlantic earlier this year for a piece on medical crowdfunding. “If someone’s raising money to cover the cost of cancer treatment, the question that raises on the other side is, why is our health care system not paying for necessary care?”

“It’s certainly no solution, and it’s probably not even a solution for the person raising the money — it just might help with this week’s bill,” Dr. Ida Hellander, the director of health policy for Physicians for a National Health Program, an U.S. organization that advocates for universal health care, told the Canadian Medical Journal for a similar piece published in 2012. “It shows how desperate people are, and it shows the magnitude of the crisis and the fact that the political will is not there to help people.”

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Medical expenses are the leading cause of bankruptcy in the United States, and Americans who require expensive medications for unexpected illnesses like cancer and are especially vulnerable to being forced to completely drain their bank accounts.

Thanks to the expansion of insurance coverage under the Affordable Care Act, there’s some evidence that the health law is slowly starting to tackle this issue. A recent survey conducted by the Commonwealth Fund found that, for the first time in a decade, the number of Americans struggling to pay their medical bills started to decline as the ACA went into effect. “This is a first indication that people are affording care that they weren’t able to get in the past,” one of the Commonwealth researchers told the New York Times at the time.

However, the problem hasn’t been solved across the board. Commonwealth also found that about 66 million adults are still having trouble paying for their care. Perusing sites like GoFundMe, where the largest percentage of all campaigns are health-related, that reality becomes all too evident. Over the past several years, people have set up crowdfunding sites to raise money for everything from lung cancer treatment to in vitro fertilization to gene sequencing.

But for one particular medical procedure, the internet draws the line: GoFundMe won’t allow people to raise money to pay for abortion, saying that the company got complaints after one Illinois woman attempted to crowdfund to terminate a “rough, unplanned and unexpected pregnancy.” The move sparked criticism from reproductive rights supporters. And the controversy over abortion fundraisers provides another example of the potential pitfalls of turning to crowdfunding sites: When the internet becomes the social safety net, who sets the terms?