One that I’ve been working on over the last year is one where the concept of “crowdfunded healthcare” evolves into a dystopian game show where people go on TV and share their sob story on why they need money. Then the viewers at home get to choose who gets the show’s prize money each season through a bracket style voting system that crowns a champion at the end.
I had to stop working on it as it got really, really dark the more I wrote.
On that note, I find it supremely fucked up that people have to turn to crowdfunding to get their unexpected healthcare costs covered by benevolent internet citizens.
The show Undercover Boss is kind of like that. Every episode some CEO realizes that all of their employees are underpaid, picks one with an especially sad story, and gives them some money to pay for their kid's surgery or college tuition.
The fact that it disturbs you so much is indicative of its value, I think. A lot of people were disturbed by the first Black Mirror episode, but I think it had less to do with the inherently disgusting conceit and more to do with how undeniably realistically events unfolded. It disturbed us because it shone a light on an aspect of our being that should disturb us, and we'd otherwise be content to ignore.
Jesus, this blew my mind. Not because the concept is outlandish, but because it wouldn't surprise me at all if it actually existed, and I think it would be immensely popular.
I had seen The Running Man (https://en.wikipedia.org/wiki/The_Running_Man_(1987_film)) but didn't realize it was set in 2019! That silly trivia aside, it sounds like your would be a great short story in the rich tradition of dystopian art and literature.
Your idea of people competing for who has the biggest sob story is pretty much exactly the 1950’s TV show “Queen For A Day” (except that the studio audience did the voting).
Oddly, the only hard to believe thing I see about that scenario as an actual, real thing in the US’s very near future is the use of bracket style voting rather than whole-field voting where some number are eliminated each episode.
That would violate a strong trend in the reality competition genre.
Not exactly this, but in Brazil there's actually a TV show called "In the red", where the requirement for being a contestant is that they must have debt that they can't pay off. The winner gets to pay off their debt, losers go home empty handed.
I will be down-voted to hell, but I have worked in health insurance company.
Large insurance companies have doctors and layers that basically sit down and make decisions about how much they will pay (if ever) for treatment.
Your scenario has real life basis.
I saw a couple people link to the student debt stuff, which is way more relevant, but it reminded me of the Latin American community having Gana La Verde[0] since 2004.
A cheap fear factor knock off, where the contestants compete for a green card, in the form representation from an immigration attorney. This usually has the contestants eating a platter of worms in the form of tacos or a taco shell bowl and their final challenge is proving that they can be functioning member in the United States by selling sodas or something of the likes in a public space. There might have been physical challenges, but it was mostly the worms and selling stuff that I recall.
One thing I’ve been studying a lot on my free time is the deep history of the concept of socialism. Not a particular implementation but the idea that it would be a good idea for us to intentionally build a world where everyone has certain basic needs met by society at large. In particular there is a rich history of “libertarian socialism” which advocates for direct social support of one another without a state. Typically it is advocated that this be done via organizational structures that do not require any individual to reach in to their pocket when another is in need, but by arranging society such that things like medical care are simply abundant, and only ever putting effort in to unnecessary developments (luxuries) once the basic needs of all people have been met. Obviously doing this is nontrivial and could only be achieved through a long process of repeated democratic decision making.
The idea that we could care for one another without a state is both obvious and perplexing. People have always cared for themselves somewhere in the world even if some societies have been highly centralized.
All this said, I have been fostering a deep appreciation for socialism as a utopian ideal to be discussed rather than either a bogey man or as something that requires the expansion of state power to realize. Many well meaning leftists have empowered authoritarians in their effort to force their desired outcomes. At the same time, the state as it stands today could be used to materially improve the lives of many impoverished people.
I think the answer is to use the state as needed in the short term to help those in need, while recognizing the “technical debt” it creates by ultimately undermining freedom. Any work done with the state should be done cautiously and with the understanding that the state power will need in the long term to be eclipsed by power organized by the people. And we cannot simply advocate for state power - long term we must build these structures inside our society, not rely on state power to enforce our idea of a just society.
But we must fight for socialism. I’ve enjoyed these two videos by Murray Bookchin recently.
This critique of the left from 1986 is hugely applicable to today (he even mentions Bernie Sanders briefly):
https://youtu.be/kBP_BMOblzc
This video gets at the way our fantasies about technology can ignore our own desires as human beings, and presents an interesting contrast between then notion of futurism and utopianism:
https://youtu.be/wS3-PffLKqM
Are you sure there aren't any TV shows that fit that dystopian game show description already? It seems like a no brainer winner for TV stations -- it's a glorified lottery mixed with lots of emotions, and bonus revenue if users vote by SMS. Surely some producer did that somewhere.
> On that note, I find it supremely fucked up that people have to turn to crowdfunding to get their unexpected healthcare costs covered by benevolent internet citizens.
Keep in mind the percentage of folks who abuse this method of fundraising, instead of being truly needy.
> On that note, I find it supremely fucked up that people have to turn to crowdfunding to get their unexpected healthcare costs covered by benevolent internet citizens.
So who should pay for it? All taxpayers instead? All countries that have tried that are now in the red. The only good solution, I think, it to work to make healthcare a lot cheaper in the long run.
>Or the Tennessee couple who want to get pregnant, but whose insurance doesn’t cover the $20,000 worth of “medications, surgeries, scans, lab monitoring, and appointments [that] will need to be paid for upfront and out-of-pocket” for in vitro fertilization.
Would an ideal healthcare system cover in vitro for anyone, full stop? Took a buzz through the NHS requirements[0] and there are definitely restrictions. And in vitro is certainly not an uncontroversial procedure.
I just thought that was a strange example to use. There are always going to be gaps in what a health system will cover, right?
There's always gonna be a market for crowdfunding health stuff, and that's not inherently a bad thing. (Which is my only point, not trying to comment on the broader issue.)
Agreed. Were the US to adopt a system similar to the NHS, I would hope that electives like IVF would continue to not be covered. Presumably it was chosen because the number is more shocking than the typical $500-2,000 request to cover a deductible or the less kindly viewed request to cover living expenses during a medical situation.
NHS coverage is a mixed bag. Other countries that offer full coverage of at least one cycle would be Sweden, France, and Belgium. A good like, half of Europe has some kind of at least partial public coverage of IVF.
Compare to the US where only a dozen(ish) states have requirements that group insurers offer infertility coverage, and those dozen are all over the place. California doesn't require IVF coverage while Illinois does. If you buy a Marketplace plan, I guess... sucks to be you, zero coverage.
Anyway, I will say that literally all of my reproductive health issues that were causing issues elsewhere in life were uncovered in the process of being diagnosed with infertility after literally 15 years of a dozen doctors that had no fucking clue, and that it's a big shame that not even that is covered for a lot of people in large parts of the US - which is a far cry from covering a $20k+ IVF cycle.
It just happened that I had a paper discussing IVF vs IVM last week. There are some researches, inconclusive, that suggest that state-paid IVF/IVM is beneficial for the country, as a newly minted citizen on average will produce significantly more in the tax revenue than an original bill for the procedure, even if you consider 1/5 chance of success for such procedure.
Obviously, it is not clear cut. At the very least likely there is an upper limit how many citizens country can support, but certainly, it is not a 100% undesirable for the state to fund such procedures.
We need to get rid of health insurance companies. They are the reason all of our costs are massively inflated.
The same thing is happening in education: universities know that a large percentage of students are getting financial aid, so the true costs are buried in a layer of bureaucracy.
Fees and administrative fees continue to go up and the universities will always get their money.
The students are then on the hook to pay the loan back. If the Universities actually had to worry about students defaulting, they would be forced to reduce costs or they would go under.
Most people involved in health care, like insurance companies, health care providers, drug companies, doctors and gofundme want more money to be spent on healthcare. That's because it goes eventually into their pockets. The U.S spends double, as a percentage of GDP, on healthcare (16%) as any other country which is good evidence that the solution to healthcare problems being to spend more money is very popular.
The solution has hit negative marginal returns though and the only way out is a more fundamental change to health care, possibly in the form of price controls on drugs or the 150% of Medicare reimbursment maximum price on all procedures. This sort of predictability of costs will obsolete a whole layer of insurance price game players at the hospital and insurance companies that add to health care costs.
I'm on insurance, and to be very real I have gotten bills in the past from providers that I never ended up paying. The reality is that this is more common than not...providers only collect some small % of the part of the bill the patient (and not insurance company) is responsible for. They usually end up selling this debt for pennies on the dollar to collections agencies.
Do I feel guilty? Not really. But the lesson is that the number you see on some bill from a hospital or provider is not non-negotiable, and in general unlike the IRS they don't exactly have any power to garner your wages to collect.
If you find yourself in a position where you're getting some ridiculous bill, you should definitely hire a trusted lawyer to negotiate down a bill on your behalf.
In America health care is supposed to be as expensive as possible. People demand the system spare no expense on their care.
I have some notes to write about "the predicaments of old people". Both my grandfathers lived an extra few years thanks to the pacemakers Medicare paid for. But they just suffered for those final years.
A lot of old people's problems are related to excess alcohol consumption. IMHO, there would be much more funds available to spend on the gaps experienced by younger people, if doctors assumed their elderly patients are drinking heavily and treated them for that instead of blowing the programs' budgets on treating the down-stream effects of heavy alcohol consumption [edit2].
I have some friends who lived in Canada for a while. They said the Canadian system doesn't go all-out to keep people alive who are going to die anyways...
A few years ago I stopped by to see one of the passengers whom I'd given a free ride to a few years before. She told me she was pregnant. "But I thought you were becoming a man?" She wasn't a he yet, and she'd gotten with a cis-male... They'd called it off before too long, but that's how she'd gotten knocked up. She also said it had a heart defect (she was maybe 4 months along?). This was caused by the hormones she'd been taking to transition.
I was pretty sure the baby wouldn't survive long, but didn't say anything... I followed them on teh Facebook. ... Scheduled c-section, a half dozen heart surgeries, after maybe four or six months the infant died anyways.
I think other countries' health systems are more careful about how they allocate their health resources [0].
> I think other countries' health systems are more careful about how they allocate their health resources [0].
Yeah, when you can go for free to a doctor your entire life and your prescriptions are free or subsidized because the government can negotiate prices in bulk, the end result is that you get better results spending less.
It's not perfect, but it leads to a better outcome than when people only see a doctor when it's an emergency because they are too afraid to go bankrupt or because they are poor enough that they can't even pay for a simple visit to do an yearly check up.
When you say "People demand the system spare no expense on their care." is that really all americans?
So there's no market for cheaper but somewhat less effective health care?
Given that medical bills are the number one cause of personal bankruptcy in the USA[1], it seems really odd that all those people who's lives are getting seriously messed up by this wouldn't want some form of cheaper health care, even if it wasn't the no.1 most effective option.
Every gas station and convenience store I go into has a glass jar with somebody's family picture and a handwritten note pleading for money to help them afford a life saving operation. Most times it's that f*cker, cancer.
GoFundMe is comical, every day there is a new idiot asking for money for not buying (or invalidating) their travel insurance . Little Fred is sitting in hospital now with bills over $xx,xxx due to a motorbike accident whilst backpacking in XYZ, please give generously so Little Fred can keep his iPhoneX and his large family don't have to put their hands in their pocket.
This is what bothers me... I once donated to a GoFundMe run by someone I know (not really friends) - their house got heavy water damage in Houston a couple of years ago.
Only a couple weeks later to see pictures of them buying a new car from a dealership to their son.
I do not know... Perhaps it is because me, who unlikely to ever buy a new car (despite having several Xs of income than that family) or perhaps the fact they were not committed 100% to solve their immediate problem themselves first and instead looked for someone to donate some extras - it pissed me off. Unlikely to ever donate to anyone ever again, unless I know for sure people are in genuine trouble.
The example you have given seems to be targeted to close friends and acquaintances he may have or individuals that connect to his cause like others that had similar issues before. A place like GoFundMe allows this community to come together to help the individual without having to figure out how to wire money to him.
We don't know if a large portion of the fund comes from the family or not, neither do we know whether he has the latest generation foldable cellphone or not. You have to make your decision whether a GoFundMe like this falls under your profile or not, it does not mean others have the same profile as you.
I hate to be such a negative nancy here but... how many of these are downright scams, that is people lying about being sick, or being sick but lying about the extent of their medical bills, or even people simply being greedy because they have a sob story.
I'm guessing a large percentage, or at least significant.
Call me cold hearted but I just really don't like GoFundMe as a concept. Seems to encourage all life challenges to become chances to collect money. I'm not uncharitable, I just think it breed greed.
This is ridiculous and infuriating. I did not realize it was that easy to raise money to pay health bills. Here I was at 18 scraping 3 grand for an emergency room visit, while people are getting an easy pass just by talking about their shitty situation and taking some photos. I understand there are some legit cases where you are kinda screwed insurance or not, but this motorcycle accident abroad crap is a big Nope.
This is wonderful, it really warms my heart to see people contribute voluntarily.
That being said, it appears a large portion are people that were uninsured and then came upon a major medical emergency. Why do people take their health for granted? Even those that are insured, look at the obesity and smoking rates, two significant factors in unexpected early death.
[+] [-] sharkweek|7 years ago|reply
One that I’ve been working on over the last year is one where the concept of “crowdfunded healthcare” evolves into a dystopian game show where people go on TV and share their sob story on why they need money. Then the viewers at home get to choose who gets the show’s prize money each season through a bracket style voting system that crowns a champion at the end.
I had to stop working on it as it got really, really dark the more I wrote.
On that note, I find it supremely fucked up that people have to turn to crowdfunding to get their unexpected healthcare costs covered by benevolent internet citizens.
[+] [-] badfrog|7 years ago|reply
[+] [-] AnIdiotOnTheNet|7 years ago|reply
[+] [-] pault|7 years ago|reply
[+] [-] throwaway5752|7 years ago|reply
[+] [-] ihm|7 years ago|reply
[+] [-] drfuchs|7 years ago|reply
[+] [-] dragonwriter|7 years ago|reply
That would violate a strong trend in the reality competition genre.
[+] [-] temp1928384|7 years ago|reply
https://www.trutv.com/shows/paid-off-with-michael-torpey/ind...
[+] [-] lhorie|7 years ago|reply
[+] [-] newprint|7 years ago|reply
[+] [-] rollthehard6|7 years ago|reply
[+] [-] leovander|7 years ago|reply
A cheap fear factor knock off, where the contestants compete for a green card, in the form representation from an immigration attorney. This usually has the contestants eating a platter of worms in the form of tacos or a taco shell bowl and their final challenge is proving that they can be functioning member in the United States by selling sodas or something of the likes in a public space. There might have been physical challenges, but it was mostly the worms and selling stuff that I recall.
[0] https://www.imdb.com/title/tt0421032/
[+] [-] anonytrary|7 years ago|reply
[+] [-] SequoiaHope|7 years ago|reply
The idea that we could care for one another without a state is both obvious and perplexing. People have always cared for themselves somewhere in the world even if some societies have been highly centralized.
All this said, I have been fostering a deep appreciation for socialism as a utopian ideal to be discussed rather than either a bogey man or as something that requires the expansion of state power to realize. Many well meaning leftists have empowered authoritarians in their effort to force their desired outcomes. At the same time, the state as it stands today could be used to materially improve the lives of many impoverished people.
I think the answer is to use the state as needed in the short term to help those in need, while recognizing the “technical debt” it creates by ultimately undermining freedom. Any work done with the state should be done cautiously and with the understanding that the state power will need in the long term to be eclipsed by power organized by the people. And we cannot simply advocate for state power - long term we must build these structures inside our society, not rely on state power to enforce our idea of a just society.
But we must fight for socialism. I’ve enjoyed these two videos by Murray Bookchin recently.
This critique of the left from 1986 is hugely applicable to today (he even mentions Bernie Sanders briefly): https://youtu.be/kBP_BMOblzc
This video gets at the way our fantasies about technology can ignore our own desires as human beings, and presents an interesting contrast between then notion of futurism and utopianism: https://youtu.be/wS3-PffLKqM
[+] [-] jlebar|7 years ago|reply
[+] [-] ddebernardy|7 years ago|reply
[+] [-] bitcoinmoney|7 years ago|reply
[+] [-] Antoninus|7 years ago|reply
[+] [-] dgzl|7 years ago|reply
Keep in mind the percentage of folks who abuse this method of fundraising, instead of being truly needy.
[+] [-] conanbatt|7 years ago|reply
What is your answer to heavy health expenditures/
[+] [-] ekianjo|7 years ago|reply
So who should pay for it? All taxpayers instead? All countries that have tried that are now in the red. The only good solution, I think, it to work to make healthcare a lot cheaper in the long run.
[+] [-] Brendinooo|7 years ago|reply
Would an ideal healthcare system cover in vitro for anyone, full stop? Took a buzz through the NHS requirements[0] and there are definitely restrictions. And in vitro is certainly not an uncontroversial procedure.
I just thought that was a strange example to use. There are always going to be gaps in what a health system will cover, right?
There's always gonna be a market for crowdfunding health stuff, and that's not inherently a bad thing. (Which is my only point, not trying to comment on the broader issue.)
[0]: https://www.nhs.uk/conditions/ivf/availability/
[+] [-] 1123581321|7 years ago|reply
[+] [-] silencio|7 years ago|reply
Compare to the US where only a dozen(ish) states have requirements that group insurers offer infertility coverage, and those dozen are all over the place. California doesn't require IVF coverage while Illinois does. If you buy a Marketplace plan, I guess... sucks to be you, zero coverage.
Anyway, I will say that literally all of my reproductive health issues that were causing issues elsewhere in life were uncovered in the process of being diagnosed with infertility after literally 15 years of a dozen doctors that had no fucking clue, and that it's a big shame that not even that is covered for a lot of people in large parts of the US - which is a far cry from covering a $20k+ IVF cycle.
[+] [-] Aloha|7 years ago|reply
[+] [-] solatic|7 years ago|reply
https://www.health.gov.il/English/Topics/fertility/Pages/ivf...
[+] [-] hippich|7 years ago|reply
Obviously, it is not clear cut. At the very least likely there is an upper limit how many citizens country can support, but certainly, it is not a 100% undesirable for the state to fund such procedures.
[+] [-] Waterluvian|7 years ago|reply
[+] [-] jimrhods23|7 years ago|reply
The same thing is happening in education: universities know that a large percentage of students are getting financial aid, so the true costs are buried in a layer of bureaucracy.
Fees and administrative fees continue to go up and the universities will always get their money.
The students are then on the hook to pay the loan back. If the Universities actually had to worry about students defaulting, they would be forced to reduce costs or they would go under.
[+] [-] narrator|7 years ago|reply
The solution has hit negative marginal returns though and the only way out is a more fundamental change to health care, possibly in the form of price controls on drugs or the 150% of Medicare reimbursment maximum price on all procedures. This sort of predictability of costs will obsolete a whole layer of insurance price game players at the hospital and insurance companies that add to health care costs.
[+] [-] temp1928384|7 years ago|reply
Do I feel guilty? Not really. But the lesson is that the number you see on some bill from a hospital or provider is not non-negotiable, and in general unlike the IRS they don't exactly have any power to garner your wages to collect.
If you find yourself in a position where you're getting some ridiculous bill, you should definitely hire a trusted lawyer to negotiate down a bill on your behalf.
[+] [-] taxicabjesus|7 years ago|reply
I have some notes to write about "the predicaments of old people". Both my grandfathers lived an extra few years thanks to the pacemakers Medicare paid for. But they just suffered for those final years.
A lot of old people's problems are related to excess alcohol consumption. IMHO, there would be much more funds available to spend on the gaps experienced by younger people, if doctors assumed their elderly patients are drinking heavily and treated them for that instead of blowing the programs' budgets on treating the down-stream effects of heavy alcohol consumption [edit2].
I have some friends who lived in Canada for a while. They said the Canadian system doesn't go all-out to keep people alive who are going to die anyways...
A few years ago I stopped by to see one of the passengers whom I'd given a free ride to a few years before. She told me she was pregnant. "But I thought you were becoming a man?" She wasn't a he yet, and she'd gotten with a cis-male... They'd called it off before too long, but that's how she'd gotten knocked up. She also said it had a heart defect (she was maybe 4 months along?). This was caused by the hormones she'd been taking to transition.
I was pretty sure the baby wouldn't survive long, but didn't say anything... I followed them on teh Facebook. ... Scheduled c-section, a half dozen heart surgeries, after maybe four or six months the infant died anyways.
I think other countries' health systems are more careful about how they allocate their health resources [0].
[0] How Cubans Live as Long as Americans at a Tenth of the Cost - https://www.theatlantic.com/health/archive/2016/11/cuba-heal...
[edit1: minor edits] [edit2: changed this from quip about keeping people alive for an extra month or two]
[+] [-] thomasfortes|7 years ago|reply
Yeah, when you can go for free to a doctor your entire life and your prescriptions are free or subsidized because the government can negotiate prices in bulk, the end result is that you get better results spending less.
It's not perfect, but it leads to a better outcome than when people only see a doctor when it's an emergency because they are too afraid to go bankrupt or because they are poor enough that they can't even pay for a simple visit to do an yearly check up.
[+] [-] raesene9|7 years ago|reply
So there's no market for cheaper but somewhat less effective health care?
Given that medical bills are the number one cause of personal bankruptcy in the USA[1], it seems really odd that all those people who's lives are getting seriously messed up by this wouldn't want some form of cheaper health care, even if it wasn't the no.1 most effective option.
https://www.thebalance.com/medical-bankruptcy-statistics-415...
[+] [-] ourmandave|7 years ago|reply
[+] [-] ferros|7 years ago|reply
I’d be keen to know what percent of listings are health related vs what percent of total money raised is health related.
[+] [-] adsadadsad|7 years ago|reply
e.g. https://www.gofundme.com/injured-by-scooter-accident
[+] [-] hippich|7 years ago|reply
Only a couple weeks later to see pictures of them buying a new car from a dealership to their son.
I do not know... Perhaps it is because me, who unlikely to ever buy a new car (despite having several Xs of income than that family) or perhaps the fact they were not committed 100% to solve their immediate problem themselves first and instead looked for someone to donate some extras - it pissed me off. Unlikely to ever donate to anyone ever again, unless I know for sure people are in genuine trouble.
[+] [-] Gpetrium|7 years ago|reply
We don't know if a large portion of the fund comes from the family or not, neither do we know whether he has the latest generation foldable cellphone or not. You have to make your decision whether a GoFundMe like this falls under your profile or not, it does not mean others have the same profile as you.
[+] [-] astura|7 years ago|reply
I hate to be such a negative nancy here but... how many of these are downright scams, that is people lying about being sick, or being sick but lying about the extent of their medical bills, or even people simply being greedy because they have a sob story.
I'm guessing a large percentage, or at least significant.
Call me cold hearted but I just really don't like GoFundMe as a concept. Seems to encourage all life challenges to become chances to collect money. I'm not uncharitable, I just think it breed greed.
[+] [-] sawhit|7 years ago|reply
[+] [-] mrhappyunhappy|7 years ago|reply
[+] [-] unknown|7 years ago|reply
[deleted]
[+] [-] refurb|7 years ago|reply
https://www.gofundme.com/canadahealthfail
[+] [-] kevmo|7 years ago|reply
[+] [-] unknown|7 years ago|reply
[deleted]
[+] [-] Proven|7 years ago|reply
[deleted]
[+] [-] RickJWagner|7 years ago|reply
[+] [-] exabrial|7 years ago|reply
That being said, it appears a large portion are people that were uninsured and then came upon a major medical emergency. Why do people take their health for granted? Even those that are insured, look at the obesity and smoking rates, two significant factors in unexpected early death.