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Charity, coordination, and medical care

March 1, 2015

A former Arizona deputy sheriff who worked hard against Obamacare and has since refused to sign up for health insurance is now facing financial devastation because he and his spouse have suffered some serious medical problems. He has a GoFundMe campaign to solicit donations. The right wing long has argued that such private charity is how this common problem should be handled.

There are many reasons this kind of charitable effort is a horrible mechanism to handle medical care. 1) Donors cannot know when, in aggregate, they have given enough, too little, or too much. They are moved to give when a specific problem comes to their attention. By which time, it may be too little too late, oversubscribed, or no longer relevant. Sites like GoFundMe are a partial attempt to resolve this coordination problem, and likely work for specific, well-defined projects. Perhaps someone will follow the sheriff’s plight to see how well that works for ongoing medical need. 2) Recipients have to coordinate money coming in with medical needs that are unpredictable, and bills that may seem almost as unpredictable. Recipients who receive more funds than they need for their immediate problem, or whose anticipated expense turns out to be less because a proposed treatment becomes unavailable or isn’t chosen, are left with the issue of dealing with excess funds. 3) Charity campaigns have proven easy venue for con artists, both overt criminals who create a cause from thin air, and the more gray practice of simply spending much more on running the charity than its end purpose. Anyone who thinks Medicare is fraught with waste should look at private charity! I suspect the cause above is honest. But donors generally face a huge problem distinguishing effective charity from conjured, and large overhead to investigate that before making a modest donation. 4) These campaigns favor recipients who have strong social networks, compelling stories, and ability to attract attention. There are many more people with medical needs just as great and just as worthy who never will be able to get their story in front of donors.

There are plenty of areas where private charity makes sense. But for the common problem that any of us might be struck by horribly expensive medical exigency? It is a lousy solution. I hope the couple who are subject of this news story relent and sign up for medical insurance next year. Now that they are able to do so despite their pre-existing conditions.

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