When Insurance Isn't Enough: Crowdfunding For Health Care Costs

With David Folkenflik

Americans who have health insurance are increasingly being forced to turn to charity for help paying medical bills, despite having coverage, so reports the Los Angeles Times. We unpack what’s happening.

Guest

Noam Levey, writes about national health care policy out of Washington, D.C., for the Los Angeles Times. (@NoamLevey)

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Inside the high-deductible insurance revolution that is transforming U.S. healthcare

From The Reading List

Los Angeles Times: “Charity becomes a lifeline even for Americans with health insurance as deductibles soar ” — “‘I’m scared, Mommy,’ Bo Macan protested.

“Bo, who is 9, was trying to be brave as a nurse probed his bare chest with a needle, seeking a surgically implanted port below his skin where she could attach an IV line for his weekly antibiotic.

“‘It hurts. It hurts! Please make it stop,’ Bo pleaded, clutching his mother’s hand more frantically with each push from the needle.

“Taking care of Bo — who was born with a unique combination of complex illnesses that have required 53 surgeries and more than 800 days in the hospital — is a full-time job for Carolyn Macan.

“Macan also spends a lot of time looking for money.

“‘It just breaks you down,’ she said.

“Medical charities and crowdfunding have long helped fill the gaps for Americans who lack health coverage.

“Now, Americans who have insurance are increasingly turning to charity as a lifeline, as a revolution in health insurance has driven up deductibles more than threefold over the last decade, forcing tens of millions of Americans to delay care and make difficult sacrifices to pay medical bills.”

The New Yorker: “The Hidden Cost of GoFundMe Health Care” — “For those who want their hearts broken, the story of Zohar and Gabi Ilinetsky, the parents of one-year-old twins, is a world to live inside. Zohar: twenty-seven, confident, and voluble, a construction project manager proud of his work. Gabi: fastidious, attentive, academic, an early-education specialist who used to work at a preschool. They met in Israel, where he grew up, and settled in the San Francisco Bay Area, her childhood home. While dating, they would speak often about the parenting styles that they hoped to have. ‘We’re old-school people,’ Zohar told me recently. ‘My friends now are waiting until thirty-five to start thinking about kids, but always we knew we were going to get married. We knew we were going to have children.’

“To their delight, Gabi gave birth to twins: a boy, a girl. They called the children Yoel and Yael. Zohar, who does not believe in baby talk, had long, one-sided conversations with his newborn children, in Hebrew; he thought that they could understand him, or soon would. Before long, his son did the most precocious thing an infant can and rolled over. It was while watching Yoel roll on the floor one day, chatting to him as if to a middle-aged man, that Zohar noticed a fleeting peculiarity in his son’s eyes, which seemed to flicker back and forth, like the pupils of somebody trying to read a subway-station sign through the window of a moving train.

“Until then, doctors had assured the Ilinetskys that the babies were healthy. Gabi took Yoel to the pediatrician, who told her not to worry, that Yoel seemed fine. But Gabi worried. She went to a second pediatrician, and a third. The Ilinetskys buy family insurance through the Kaiser Permanente network, and it costs them about fifteen hundred dollars a month. Against the pediatricians’ counsel, Gabi demanded a referral to a specialist, and Yoel underwent an MRI and other tests. At four months, he was given a diagnosis of Canavan disease, which causes rapid degeneration of the brain and, almost always, death in childhood. For a while, his parents were in shock. ‘After shock,’ Zohar said, ‘comes depression.’ ”

Los Angeles Times: “News Analysis: Democrats ask if Americans are ready to give up job-based health coverage” — “Sharp disagreements among the presidential hopefuls at this week’s debates have crystallized a critical and explosive political question: Are Democrats willing to upend health coverage for tens of millions of their fellow Americans?

“The party is closer than it’s been in decades to embracing a healthcare platform that would move all Americans out of their current insurance and into a single government-run plan.

“Plans pushed by three of the four leading candidates — Sens. Bernie Sanders of Vermont, Elizabeth Warren of Massachusetts and Kamala Harris of California — differ in their particulars but would all end the job-based system that provides coverage to more than 150 million people.

“That’s a hugely risky strategy, as more-centrist rivals reminded the three senators during the two nights of heated, sometimes confusing, debates.”

Kaiser Health News: “GoFundMe CEO: ‘Gigantic Gaps’ In Health System Showing Up In Crowdfunding” — “Scrolling through the GoFundMe website reveals seemingly an endless number of people who need help or community support. A common theme: the cost of health care.

“It didn’t start out this way. Back in 2010, when the crowdfunding website began, it suggested fundraisers for ‘ideas and dreams,’ ‘wedding donations and honeymoon registry’ or ‘special occasions.’ A spokeswoman said the bulk of collection efforts from the first year were ‘related to charities and foundations.’ A category for medical needs existed, but it was farther down the list.

“In the nine years since, campaigns to pay for health care have reaped the most cash. Of the $5 billion the company says it has raised, about a third has been for medical expenses from more than 250,000 medical campaigns conducted annually.

“Take, for instance, the 25-year-old California woman who had a stroke and ‘needs financial support for rehabilitation, home nursing, medical equipment and uncovered medical expenses.’ 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.

“The prominence of the medical category is the symptom of a broken system, according to CEO Rob Solomon, 51, who has a long tech résumé as an executive at places like Groupon and Yahoo. He said he never realized how hard it was for some people to pay their bills: ‘I needed to understand the gigantic gaps in the system.’ ”

HuffPost: “Life And Debt: Stories From Inside America’s GoFundMe Health Care System” — “The human body is a frail thing, and illness is a pitiless adversary. Every day, an untold number of Americans are diagnosed with a devastating illness or suffer a sudden injury that threatens to upend their lives and tear apart their families.

“This misfortune often comes at a staggeringly high financial cost that can be just as cruel.

“While health insurance or government programs like Medicaid and Medicare can shield against huge medical bills, massive debt and even bankruptcy, only the truly wealthy can feel secure that sickness won’t lead to financial ruin.

“This is why thousands of Americans have turned to crowdfunding website GoFundMe in the last decade to help cover medical bills and related costs. HuffPost is profiling some of those people, and what their stories reveal about the shortcomings of the American health care system.

“These are not feel-good stories.”

Grace Tatter and Stefano Kotsonis produced this hour for broadcast.

This article was originally published on WBUR.org. [Copyright 2019 NPR]