Medical crowdfunding – evidence of a failing system

As we’ve seen over the past few weeks, Americans are nothing if not resourceful in the face of adversity.

For many, that problem-solving instinct is nothing new when it comes to healthcare. Amid rising premiums, deductibles, copays and coinsurance, more and more people nationwide need to find creative ways to afford lifesaving treatments.  

Some turn to organizations like the PAN Foundation or other charitable patient assistance programs that provide financial help for underinsured patients facing high out-of-pocket costs.

Many more appeal to relatives, friends, co-workers, and in some cases, total strangers.

Over the past few years, there’s been a significant rise in crowdfunding, the practice of funding a project or venture by raising many small amounts of money from a group of people, often through the internet.

In a recent study, leading research institution NORC at the University of Chicago found that around 20 percent of American adults have donated to a crowdfunding campaign to help raise money for a medical bill or treatment.

That means about 50 million Americans have helped people raise funds for medical costs using sites such as GoFundMe.

The study found that eight million Americans had started a campaign for themselves or someone in their household and more than 12 million had started a campaign for someone else. It stands to reason that countless more crowdfunding campaigns will appear in the coming weeks and months to help patients diagnosed with COVID-19.

Reversing a Troubling Trend

While it’s admirable that so many people have helped loved ones and strangers afford care, the difficult truth is that crowdfunding platforms have become a de facto safety net for a substantial portion of Americans. This trend, which is starting to feel alarmingly normalized, reflects decades of healthcare policy that has placed an insurmountable financial burden on some of the country’s most vulnerable citizens.

Only thoughtful, bipartisan healthcare reform will eliminate the need for the unfortunate last resort of crowdfunding. Congress must enact policy changes to lower out-of-pocket medical costs so that individuals can afford the care they need to stay healthy.

Here are a few of the most important measures—popular on both sides of the aisle—that we support:

1. Institute an annual cap on out-of-pocket drug costs for Medicare beneficiaries.

Medicare Part D beneficiaries are the only insured group in the U.S. that isn’t protected by a cap on annual out-of-pocket costs. An annual cap would go a long way to help patients better anticipate and plan for their medication expenses so that they don’t have to turn to alternative sources for financial support.

2. End the harmful practice of frontloading out-of-pocket medical costs.

Policymakers, insurers and other stakeholders should modify the structure of public and private insurance plans so that out-of-pocket costs for prescription medications can be spread more evenly over the course of the year, and patients can access and remain on the treatments they need.

3. Modernize the Medicare Part D Low-Income Subsidy (LIS) program.

Established in 2003, the LIS program was designed to help low-income seniors and people with disabilities afford medicine they need. Unfortunately, the program is weighed down by complex application processes and outdated eligibility thresholds. Reforms such as increasing the eligibility thresholds, removing the asset test and decreasing the program’s complexity will ensure that more beneficiaries would be eligible and enroll in the program.

Congress must act to reform Medicare Part D, so that Americans don’t have to rely on the charity of organizations like the PAN Foundation, the generosity of family and friends or the kindness of strangers just to afford the medical treatment they need.