Even though they don’t work, high-risk pools are back as a purported way conservatives will cover those with pre-existing conditions. But because they don’t work, it’s worth asking what conservatives actually want for the sick and the poor. It’s not government coverage in the form of Medicaid expansion, and it’s not the jury-rigged insurance subsidies that Obamacare provided. The real conservative solution for sick people without adequate insurance already exists, and it’s called GoFundMe.
If you burrow far enough into a health-care debate with most conservatives or libertarians, they’ll eventually get to their real solution: private charity.
Historically, we had charity. We had places that say, if you are down on your luck, if you failed to be responsible, we will take care of you, but that doesn’t mean that you’re necessarily going to get a private room, that you’re necessarily going to get everything somebody would get who’s been prudent and who has taken care of themselves.
We interact in our lives through our charities, through our civic organizations…. when government gets too big, when government gets too distant from us, it ends up crowding out those very institutions of civil society that advance the common good.
One of the things I hold against the welfare system most seriously is that it has destroyed private charitable arrangements that are far more effective, far more compassionate, far more person-to-person in helping people…
If people are in enough trouble, charity will eventually step in: This is the conventional right-wing view, though most politicians won’t be pinned down into admitting it. And Milton Friedman was wrong: Our social safety net is weak enough that those arrangements haven’t been destroyed. One of those arrangements, GoFundMe, is in fact a good preview of the society conservatives would create if given the opportunity.
GoFundMe allows people to create campaigns to raise money for any number of things—businesses, natural disasters, teachers—but a major section is devoted to medical bills. People start campaigns because their mother had a heart attack, or their friend is bankrupt. Visiting GoFundMe’s medical section triggers a pretty predictable series of emotions: first, sympathy for the tragedy of individuals’ circumstances, followed by horror at people having to solicit money under those circumstances.
Conservatives who romanticize private charity rely on soft, gauzy phrases like “civic organizations” and “charitable arrangements” because the reality is web buzzwords plastered over the sick and wounded.
Basic Internet functions like tags become stomach-churning when their actual function is “Show me everyone who can’t afford their leukemia treatment.”
But let’s humor conservatives: Could this private charity work? Well, no. There are indeed many cases of funding being provided, but many campaigns are about someone who’s already been bankrupted, or is just looking for a few thousand dollars to help get by as their lives are continually upended. And the worst does happen. Sarah Jones at the New Republic highlighted this case: “Shane Boyle, a type-1 diabetic, started a GoFundMe campaign to cover a month’s worth of insulin due to a gap in his insurance coverage. His mother died on March 11. Boyle died of diabetic complications one week later, without meeting his fundraising goal. His family has started a new GoFundMe to pay for his funeral.” So no, it doesn’t work.
But really, even if it did work, it’s beside the point. That parents have to post pleas for money to treat their sick daughter’s leukemia is grotesque; that friends have to pray for Internet virality to cover the costs of a liver transplant is a national embarrassment.
And though conservatives would make this much worse, Democrats and liberals are the furthest thing from blameless. GoFundMe is stuffed with people who had (bad) insurance through ACA exchanges and still went bankrupt. There is only one answer: single-payer.
And just in case any shred of you still thinks there’s some romantic, nostalgic value in receiving a check from “the community” instead of the government, here’s Andrea Louise Campbell, an MIT professor and welfare scholar whose sister-in-law became quadriplegic after a car accident:
[T]heir financial future is shattered. Family and friends are raising money to buy a wheelchair van and to renovate their home for accessibility. The generosity of the local community is stunning. One incident in particular struck me to the core. A woman from a small community nearby had something for us. A cancer survivor, she had decided to “give back” by placing donation cans in stores around town. She had finished her drive and consolidated the money. The small coffee can she handed over to me and my sister-in-law had a slit in the lid and was decorated with pink felt and ribbons, now a little smudged from handling. Inside were several hundred dollars in small bills. We burst into tears. This is social policy in the richest nation in the history of the world.
It must really be something to be able read that last line with pride, and not with shame.