Hedda Martin’s GoFundMe, Spectrum Health, and Putting a Band-Aid on the Cancer of American’s Health Care System

By Lambert Strether of Corrente.

And now abideth faith, hope, charity, these three; but the greatest of these is charity. –Corinthians 13:13

I posted this letter in Links, but I found I could expand on it. Spectrum Health Care’s letter to Hedda Martin speaks for itself, and for what our health care system has become under neoliberalism:

(The provenance: I started with AOC, who hat-tipped @DanRiffle, who linked to the original poster, @DanRadzikowski, quoted above. From Radzikowski’s thread, Hedda Martin: “This is me”; Martin’s GoFundMe, which was successful.) In this post, I’ll focus on two things: the intriguing backstory of Spectrum Health, the institution that denied Martin care until she could raise $10,000; and the weaknesses of GoFundMe as a solution. Before I get to the main part of the post, however, I’ll point out that Hedda Martin’s example is not exception, and it shows what a debacle the laughingly-named “Affordable Care Act” has been. Mother Jones:

The total amount in donations generated by crowdfunding sites has increased eleven­fold since the appearance of Obamacare. In 2011, sites like GoFundMe and YouCaring were generating a total of $837 million. Three years later, that number had climbed to $9.5 billion.

Wowsers. It’s almost like there are people who don’t have “access” to care, isn’t it?

Spectrum Health Care and Squillionaire Richard DeVos

Spectrum Health System, located in Grand Rapids, MI, is a “a not-for-profit, integrated, managed care health care organization.” It’s a $6.5 billion firm with a $100 million venture capital fund. You will have noted the following line at the bottom of the Spectrum Health stationery, which explains why Martin sought them out:

SPECTRUM HEALTH RICHARD DEVOS HEART AND LUNG TRANSPLANT CLINIC

DeVos, eh? It’s not crystal clear which “RICHARD” is meant: Richard “Dick” DeVos, Jr., Spectrum chair, or his father, Richard DeVos of Amway (“American Way”) fame. (Junior is married to Betsy, charter weasel and purveyor of dubious medical remedies, sister of mercenary and war criminal Erik Prince, currently Secretary of Education.) But since DeVos Senior (d. 2017) was a major Spectrum donor, we’ll assume that’s his name on the stationery. From MLive:

Rich DeVos has left a large imprint on health care in Grand Rapids, particularly with the life-saving programs at Spectrum Health.

Spectrum has a rising transplant program: significant private donations and the availability of donor organs.

DeVos and his wife, Helen, provided the money to launch Spectrum’s Richard DeVos Heart & Lung Transplant Program, including an endowment to pay the salary of Dr. Asghar Khaghaniover, the renowned surgeon on the U.K. transplant team that gave Rich DeVos a new heart in 1997.

(The transplant program seems well-regarded.) Oddly, or not, MLive doesn’t mention anything about the health care system in which Dr. Khaghaniover practiced in the U.K. Digging a little deeper, we find this from the Daily Mail in 1999[1]:

Billionaire thanks God for his NHS heart.

An American billionaire thanked God last night for giving him a new heart – in a British hospital ahead of Health Service patients.

‘I believe in miracles and I praise the Lord for giving me this,’ said Richard DeVos, 73. ‘It had nothing to do with money.’….

How he was able to jump the queue in Britain for a £60,000 operation performed by Sir Magdi Yacoub at Harefield Hospital, West London, in June 1997, remained unclear yesterday.

I’ll bet. From the Scottish Daily Record & Sunday Mail, also in 1999:

I can’t buy a way out of my death sentence; Mum’s anger as billionaire pays pounds 60,000 for new heart

But John Evans, chairman of the British Organ Donor Society, said: “I look at this with a degree of unrest.

“It appears as though an American billionaire has been able to receive a transplant via the back door.

“What troubles me is that we just do not know what is going on behind the scenes.

He added: “We are deeply opposed to people buying organs for transplant. It would mean the impoverished would have no chance of receiving treatment against someone with money.

“In America, they are very, very worried about people buying their way into the system. And that is in a country where cash is usually the bottom line.”

[DeVos] is a devout Christian who bankrolls a TV evangelism group and has immense influence in US business and political circles.

The irony is so thick you can cut it with scalpel, isn’t it? DeVos BUD FROM LEGAL gives every appearance of having used his billions to jump the queue at the UK’s National Health Service — socialized medicine, ZOMG!!!!! — to get a new heart stitched into his chest. Then, to be fair, DeVos “gives back” by endowing Spectrum and hijacking the NHS’ doctor. But when it comes time for Spectrum to treat somebody who doesn’t have the money to join the queue at all, what does Spectrum do? They turn her down. Still being fair, I suppose we should thank the Spectrum Health for their relative restraint and positive attitude. After all, they helpfully gave Martin a link to GoFundMe, instead of simply telling her to pray harder, as no doubt DeVos would have done.

GoFundMe for Health Care as a Dystopian Hellscape

I’ll look at GoFundMe — generically, crowdsourcing[2] — from two angles: market dysfunction, and class warfare. But first, I’m sure you’ve all seen health care GoFundMes — maybe some of you have run them yourselves — but for the record I’ll post two:

(This and the next should not be interpreted as solicitations to donate; I’ll get to information asymmetry issues below. But one example from the New York Post: “Homeless vet, couple allegedly made up story for GoFundMe scam.”) And the second:

(Just looking at the images, I’m not seeing NPR tote bags, let alone Rolex watches; Martin was 60 — not yet old enough for Medicare — and a dog-walker/pet-sitter.)

And now let’s turn to market dysfunction. Matthew J.Renwick and EliasMossialos, in “Crowdfunding our health: Economic risks and benefits” (Social Science & Medicine, October 2017) have a useful wrap-up. They write:

However, the market for crowdfunding is susceptible to market inefficiencies that may impede economically valuable transactions or even cause market failure. The primary dilemma appears to be asymmetrical information. This discrepancy in information availability is amplified in the crowdfunding setting. Project initiators are often geographically isolated from their funders whom are often inexperienced in the project field.

As we saw above in the example from the New York Post. More:

Thus, the relationship between funders and the project initiator is described as that of a principal and agent….The project initiator (i.e. the agent) is essentially paid to carry out the project’s stated goals on behalf of the funders (i.e. the principal).

Two chief negative outcomes can arise from a principal-agent relationship: moral hazard and adverse selection. Moral hazard would describe a situation where a project initiator acts in self-interest and fails to deliver on project goals.

It’s hard to see how “moral hazard” would kick in for Martin’s new heart — why would she not deliver on “project goals”? — but for fundraisers that are not matters of life and death, you can easily see that the money raised, being fungible, could be used for any purpose.

Given the nature of crowdfunding, funders cannot easily hold the initiator accountable or may not be privy to information regarding the project’s progress and success. Adverse selection might occur when high-quality project initiators consistently choose to access funding through more traditional avenues like banks, leaving only low-quality ventures in the crowdfunding market pool.

That would be the case here, since the “traditional avenues” of health insurance, or Medcaid/Medicare, are not available or inadequate.

Herding behaviour is another consequence of information asymmetry that has been observed in the crowdfunding market (Agrawal et al., 2014, Belleflamme et al., 2015; E. Lee and Lee, 2012). Herding occurs when funders collectively make inferences about project quality based on decisions of other funders. There is a tendency for funders to swarm projects that are receiving strong support because the crowd perceives these projects to be higher quality.

Martin’s “project” was surely swarmed, by virture of having gone viral, and then being boosted by AOC.

Next, class warfare. First, understand that most crowdsourcing projects fail. The Outline:

But crowdfunding’s fatal flaw is that not every campaign ends up getting the money it needs. A recent study published in the journal Social Science & Medicine found that more than 90 percent of GoFundMe campaigns never meet their goal. For every crowdfunding success story, there are hundreds of failures.

Why? Because the skills to run a successful fundraiser aren’t evenly distributed! More:

Crowdfunding is as much about marketing as it is about charity, and those who can’t package their struggles in a compelling way — because they lack the social capital, the social network, or whatever magic ingredient causes some campaigns to go viral — often fade into obscurity.

Buzzfeed writes:

And while crowdfunding platforms themselves may not be discriminatory (although they do prohibit “controversial” campaigns like abortions and euthanasia) the crowdfunding paradigm is not itself fair. It discriminates without intending; much like society at large, it benefits those who are skilled and young and attractive and connected.

The Financial Times confirms:

Crowdfunding may also perpetuate existing inequalities. Well-off people can tap into networks of well-off friends who have money to donate in a crisis. Poorer people tend to have ties to poorer people with less to give. [Nora Kenworthy of the University of Washington] and co-researcher Lauren Berliner warn that results can also be distorted by prejudicial notions of ‘deservingness’ based on race, class and immigration status. ‘Crowdfunding seems to be best for people who are of a dominant social group who have fallen on hard times,’ Kenworthy says. 

And nobody seems to mention that crowdsourcing requires the Internet, which is in itself a form of class warfare. I mean, it’s hard to imagine running a GoFundMe campaign from a public library connection.

* * *

It is odd that the United States regards charity as an invidual act, or at best the province of churches or non-profits. Why can’t the state been seen as performing charity? Isn’t passing Medicare for All about as good an example of “faith, hope, and charity” as you could find?

NOTES

[1] Because the Internet is making us stupider with link rot and destroyed data, the original stories for both the Daily Mail and the Scottish Daily Record are not available. I found references to them, however.

[2] The academic expert on crowdsourcing appears to be Daren C. Brabham. From his 2008 article:

Coined by Jeff Howe and Mark Robinson in the June 2006 issue of Wired magazine (Howe, 2006f), the term crowdsourcing describes a new web-based business model that harnesses the creative solutions of a distributed network of individuals through what amounts to an open call for proposals.

As we can see, although the platforms may have remained the same, desperate people seeking health care doesn’t really fall under the heading of “an open call for proposals.”

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About Lambert Strether

Readers, I have had a correspondent characterize my views as realistic cynical. Let me briefly explain them. I believe in universal programs that provide concrete material benefits, especially to the working class. Medicare for All is the prime example, but tuition-free college and a Post Office Bank also fall under this heading. So do a Jobs Guarantee and a Debt Jubilee. Clearly, neither liberal Democrats nor conservative Republicans can deliver on such programs, because the two are different flavors of neoliberalism (“Because markets”). I don’t much care about the “ism” that delivers the benefits, although whichever one does have to put common humanity first, as opposed to markets. Could be a second FDR saving capitalism, democratic socialism leashing and collaring it, or communism razing it. I don’t much care, as long as the benefits are delivered. To me, the key issue — and this is why Medicare for All is always first with me — is the tens of thousands of excess “deaths from despair,” as described by the Case-Deaton study, and other recent studies. That enormous body count makes Medicare for All, at the very least, a moral and strategic imperative. And that level of suffering and organic damage makes the concerns of identity politics — even the worthy fight to help the refugees Bush, Obama, and Clinton’s wars created — bright shiny objects by comparison. Hence my frustration with the news flow — currently in my view the swirling intersection of two, separate Shock Doctrine campaigns, one by the Administration, and the other by out-of-power liberals and their allies in the State and in the press — a news flow that constantly forces me to focus on matters that I regard as of secondary importance to the excess deaths. What kind of political economy is it that halts or even reverses the increases in life expectancy that civilized societies have achieved? I am also very hopeful that the continuing destruction of both party establishments will open the space for voices supporting programs similar to those I have listed; let’s call such voices “the left.” Volatility creates opportunity, especially if the Democrat establishment, which puts markets first and opposes all such programs, isn’t allowed to get back into the saddle. Eyes on the prize! I love the tactical level, and secretly love even the horse race, since I’ve been blogging about it daily for fourteen years, but everything I write has this perspective at the back of it.

55 comments

  1. jo6pac

    I wonder if the darker side is eric (the dark) prince of war business has body parts for sale side? That way they can keep it in the family.

    Thanks Lambert

    Reply
  2. Joe Well (JW)

    Is Bud from Legal a new member of the team?

    Thank you again for being an island not only of sanity but also human decency on the internet.

    One observation from my own life as an American who travels a lot: I’ve gotten a LOT of my healthcare outside the US, and in fact it’s been life-changing since at least two significant medical issues would not have been diagnosed otherwise (US doctors kept sending me home with pills and some subtle admonishment to stop whining).

    I have sometimes wondered at the morality of that, since I’m usually paying full freight and skipping over the locals, as well as escaping the disaster of the US your-money-or-your-life mafia. And yet if I hadn’t, I’d still have some issues that would severely impact my quality of life without being life-threatening.

    I think if the US medical/”health” mafia faced international competition the way GM, Ford and Chrysler did, we’d all be a lot better off, but how to do that without harming the other countries?

    Reply
    1. orange cats

      I worry about the same thing although I don’t trust competition as a benign force in any sphere.

      I had dental work done in Costa Rica for one third the price of California (ten years later it’s still good). I was also an expat in Thailand and China and watched fellow americans get first rate procedures for half the cost…but locals were priced out and suffered accordingly. The system is two-tiered in Asia and latin America as far as I can tell. Another anecdote: my friend fell and broke her wrist in Paris. The surgery was quite delicate, with an overnight hospital stay. Money was never discussed. When she got back to Marin county her Kaiser insurance got a bill for a couple hundred dollars.

      Reply
      1. John Zelnicker

        @orange cats
        November 25, 2018 at 4:31 pm
        ——-

        Traveling with my girlfriend in Norway in 1971, she broke a tooth. We found an English-speaking dentist who performed a root canal and temporary cap for $9.75 (not a typo) and apologized for having to charge twice the rate a Norwegian would pay, since we were tourists.

        Later, we had dinner with a couple just in from the US. He had recently had the same procedure in the US for $225.00 (also, not a typo).

        My girlfriend’s temporary cap was still good 4 years later when I last saw her.

        Reply
      2. JerryDenim

        Had a little spill on a motorbike in Thailand once (2011) I ripped a pretty good sized gash in my arm that needed 20 stitches. Three trips to the doctor- stitches, follow-up exam, removal, plus lidocane shot and antibiotics set me back about $18.

        We are being robbed here in the US.

        Reply
          1. ChristopherJ

            Only two options JT, complain, shut up, or move. Mass complainin’ might work, but you need to be prepared for a fight. Truth and right aren’t enough; they never were

            edit, ha, three options!!

            Reply
      3. yan

        As far as Latin America goes, it depends on the country a lot. I had a pretty horrible celullitis infection and got diagnosed, treated (wide-spectrum antibiotics), analysis, etc…for 2 dollars (as a foreigner). In Brazil, however, my father fell and had a small craneal hemorrage and the -private- hospital where we went would not let him go from ER to the ICU (where he needed to go) until he could show his insurance would be able to cover…30.000 USD. Final bill was 5.000 USD for a a 5 day stay in the hospital, of which one was ICU.

        Reply
        1. Joe Well (JW)

          Private hospitals/clinics in Latin America are absolutely businesses. There generally is no effective requirement that they provide life-saving care, which is pretty scary when you think about it.

          I was once asked to show my credit card and also asked the limit in a private ambulance in Mexico.

          Reply
    2. Carl

      I sprained my ankle on the last night of a trip to Peru a couple of weeks ago, and after icing and elevating it all night, when it was still swollen and tender the next morning my first thought was, “I should get this looked at,” and my next thought was, “I’m glad it happened here, because it’s going to be a lot cheaper..” And sure enough, it was. I deliberately chose the most expensive private clinic in Lima just to see how expensive it would be. All in, with an exam by an English-speaking doctor, an xray, a bandage (put on by the doctor herself!) and a filled prescription, was $200 US.

      When I got back home, there was a letter from my health insurance company informing me that my premiums are going up around 15% next year.
      I’m opting out.

      Reply
    3. Wukchumni

      The 1997-98 el nino was something else, that produced the most long lasting snow into summer i’ve ever seen in the Sierra until a couple years ago, and i’m out solo crossing an ice bridge 15 miles deep into the backcountry that collapses on me when I made a test run sans pack, throwing me down a gully with my back left shoulder being the first point of contact and I break my scapula in the process, leaving my arm immobilized in entirety pretty much.

      I slowly climbed out of the dozen feet deep dirt crevice to the lifeline-my backpack, and once I get to it, everything will be better, even though i’m hurting bad. You don’t realize how much you need your limbs in the simple act of getting up once you’re in a prone position, but i’m in a sleeping bag on a thermarest pad not far from the trail, eating well, wishing I had something stronger than aspirin.

      The next day, I take a series of short hikes to see how I feel, and decide to go for help with a sling made out of capalene longjohns and enough clothes on and food to walk 4 miles (not that you have any choice in the matter-but always opt for an upper body injury in lieu of lower extremity maladies) to a ranger station, and I get a couple miles before running into the ranger, who’s a friend i’ve known a long time, and she gives me the once over and i’ve got softball to dinner plates bruises in a few places, but no worse for wear, and she walks with me back to the ranger station and I get a loaner sleeping bag and pad and have an ok sleep and when I wake up in the a.m., she asks if I want a helicopter?, and I tell her yeah, and an hour later the NPS chopper shows up and whisks me down to the helipad near park hq toot suite in say 20 minutes.

      Cost to me: 0

      For whatever reason, I had to take an ambulance from there to Visalia (any old car could’ve got me there easy-peasy) and we had to fight the insurance company to pay the $506 charge, and they finally relented.

      Sequoia NP still doesn’t charge a cent for being rescued by helicopter here, or if you end up missing, they’ll mount SAR teams sometimes composing dozens of people looking for you, and again, you’ll not be presented with a bill.

      Reply
  3. Joe Well (JW)

    An issue I have with crowdfunding that did not appear above: much, and I would bet probably most, of it is money that the person would have gotten anyway from friends, family, and community. We’ve always had medical fundraising in the US, after all (think of all those church suppers and car washes for little Baby Smith’s bone marrow transplant).

    Reply
    1. Afrikaan

      Exactly. I ran a small GoFundMe campaign on behalf of a friend’s child. The people who donated were either my friends, or friends of the family. This is exactly what GoFundMe said would happen. GoFundMe makes it possible to donate by credit card, instead of sending a check.

      Although it made a significant difference, we did not reach our goal.

      Reply
  4. Clive

    I wish I had more time to expand on this now, but having had to do my own pay-to-queue-jump for transplant tissue, it is a very murky world indeed.

    The key question we can’t answer is whether DeVos used a donor organ supplied by the NHS Blood and Transplant Service. This is a highly dysfunctional organisation since the Conservative party’s “reforms” (see for example their new CEO https://www.nhsbt.nhs.uk/media/nhs-blood-and-transplant-appoints-new-chief-executive/ — freshly recruited from a previous stint at failing upwards at the U.K. Defra organisation which handles payments to farmers for farm subsidies, or would do if it hadn’t been the victim of, shock, horror, a botched IT project https://www.computing.co.uk/ctg/news/2437392/defra-and-gds-slammed-for-ineffective-collaboration-for-gbp154m-cap-programme). Yes indeedey, everything is like CalPERS now.

    If not, where did the donor organ come from? And how was it obtained? Even if it was supplied by the U.K. NHS Blood and Transplant Service, there is a significant shortage of organs for those needing transplant surgery. Are we really to believe it just fell into DeVos’ lap (or chest) — right at the opportune moment?

    I will see what I can dig up on that one, it might be in the contemporaneous reporting.

    Reply
    1. Kokuanani

      Here in the suburbs outside DC there’s an ad that’s been running on tv for a month or so. It shows a long, long line of people with an ominous, “if you’re waiting for a liver transplant, waiting could cost you your life. It’s time to get out of line.” Then someone comes along and pulls one of the folks out of line and presumably they go on to a transplant & a happy life. https://www.ispot.tv/ad/dlH3/upmc-living-donor-liver-transplants

      This is the University of Pittsburgh transplant center.

      So those with money can jump the line here. And as folks without money [but with healthy organs] get more & more desperate, the “supply” should increase.

      Reply
      1. ambrit

        Someone correct me if I’m wrong, but isn’t the liver a special case? I understand that one can lose half of it and it will still function. The other part than functions as the transplant donor organ.
        Now hearts…..

        Reply
        1. JBird4049

          People sometimes do donate a part of their liver especially as a healthy one can grow back, but it is major surgery done on an essential organ and there is a small, but real chance of death for the donor.

          Reply
      2. ChristopherJ

        Thank you, Kokuanani, paying money to use the short queue… it’s been business for like forever. I hate it too when standing in the queue for a themepark ride, only to see those who’ve paid three or so times my ticket price get to go on the next ride. It’s the society we have created, eh?

        Reply
  5. Susan the other

    My god Lambert. The Devoses are more unmoored than their yachts. What a sleasy history. Richard Senior was a door to door salesman of Amway products turned billionaire entrepreneur by many minor expoitations. Yuck. Betsy is definitely a moron and she’s only an in-law. She is so goddamn dumb I honestly can’t believe it. And Eric is disgusting – how did the DeVoses come to this from just door to door bull-shitting? Well that’s a cautionary tale in and of itself. Everything (always more than 50%) is genetic. So now it’s crowd fund or die. What a disgusting sewer. At the netherworld of crowdfunding and Health Care. (2words). “Wowsers, it’s almost like there are people who don’t have access health care.” Bury my heart at Wounded Knee. What a bunch of first class shitheads. Spectrum Health Care. Go Fund your first $10K and then we’ll have a closer look at you. Excuse me while I puke.

    Reply
  6. The Rev Kev

    To be crude about it, having a health company suggest GoFundMe as a solution seems to be more of a GoF***You on the part of that health company. As for Richard DeVos. At 73 you would think that it was a waste of a good heart unless he did not have one in the first place. It would be interesting to learn what the donor’s family thought of the whole thing but probably DeVos would say that this was a case of ‘markets’ working as they were intended to. Billionaires pole-vaulting their way over people that actually have a more valid case for a body part. The market must have been low on hearts if he had to fly to the UK for one. Is there some sort of service that tracks body part availability across international countries?

    Reply
    1. wilroncanada

      The Rev Kev
      I was thinking the same thing: DeVos didn’t have a heart replacement, he had to have one installed.

      Reply
  7. Amfortas the hippie

    this is the reality of it.
    i was only peripherally aware of crowdfunding until 2 people set them up for my wife.
    (friends and family, respectively, who have immigrated to far flung places like dallas or denver.)
    so i went to the links they sent…and then wandered around all over that site. it’s like the never ending St Jude’s commercials on holidays; depression inducing.(https://www.youtube.com/watch?v=uOojAUFJgj8 )

    “richest country in the history of the world…”

    Since I moved to this far place, I’ve always tried to empty my pockets on the way out of the grocery store when there’s a bake sale…and there’s always a health related bakesale…
    Now, it’s our turn, it seems.
    we are fortunate to live in such a small place, that’s so tightly connected.
    I can only imagine dealing with all this in an anonymous city.

    …………
    and related…it occurred to me the other day, after retrieving the mail:
    we’re getting collection notices already…from all the surgeon collectives, labs, xray people, and apparently everyone who happened to walk past the hospital over that 3 week period.
    But medicaid is glacial…even “expedited” like in wife’s case.
    One must apply and be denied “disability”, then wait around for SSI to catch you.
    Surely all these bean counters in the medical orbit are aware of this,and hold off accordingly on sending it to collections.
    we decided that it would be prudent…given limited resources…to wait and see what medicaid would do/pay for…if anything at all….before distributing the money.
    Soon, the collection people will start calling my wife, incessantly.
    It just feels off…like the collection people must be given a chance to wet their beaks.
    It shouldn’t be this way.

    Reply
    1. John Zelnicker

      @Amfortas the hippie
      November 25, 2018 at 5:51 pm
      ——-

      My sympathies for the difficult situation in which you find yourselves.

      A bit of advice for collection calls: If the caller is with the original debtor, such as the hospital or doctor’s office, you can’t stop the calls.

      However, if the debt goes to a third-party collector tell them on the first call that you are disputing the debt (even if you aren’t) and demand documentation that you actually owe it. This will at least slow them down while they get the original billing from the hospital, etc. There are also legal limits on how often they can call.

      (I used to do this kind of work, except it was for credit cards, not medical bills.)

      Reply
      1. Amfortas the hippie

        thanks.
        my philosophy with such things is “blood from a turnip”, where I’m the turnip.

        I’ve mentioned it before in relating these experiences and observations…but the thing that bothers me the most about all that I’ve seen(intellectually, at least) is how widespread lack of money and/or insurance is among our fellow patients and their families. almost every person I talked to or overheard was in essentially the same boat.
        a thousand acres of turnips.
        add in the size of the bills…few thousand here, few thousand there, plus the quarter mil for the hospital itself(“forgiven”, thankfully).
        How does the System make any money, at all, when “Inability to Pay” seems to be baked in?
        I wander around the billions of dollars worth of new wings, watch the tens of thousands of dollars worth of helicopter rides come and go,marvel at the tech that is omnipresent,admire all those thousands of nurses and doctors and cleaning staff…all getting paid…and the suits, skimming the cream, presumably…
        and yet the people all this is meant to serve more often than not have no money or insurance…unless they luck into medicaid(which my family doctor of 20 years says pays fer shit and is a PITA to deal with).
        just seems counterintuitive, to me.
        I’ve long thought that it was stupid and cruel to call this a Market…it doesn’t work on a moral level.
        I wonder if…like Big Ag…it only appears to work on an economic level….but only if you ignore numerous “externalities”.

        Reply
        1. ambrit

          As long as the ‘suits’ get to ‘skim the cream,’ this travesty of justice will continue. Remove the inducement to corruption, or establish a sufficient deterrent, and watch much of the problem fade.
          How is your wife coming along with her recovery? Your tone above suggests she is doing tolerably well.
          Not only do I have fingers and toes crossed, but I’m spinning the prayer wheel too. Strength and fortitude to you both.

          Reply
          1. Amfortas the hippie

            Thanks. she is tolerably well. worst sinus infection ever, but still.
            forced to skip a round of chemo while we wait for medicaid to creak into gear, so we can do outpatient, with a pump…instead of spending 3-4 days in hospital.start again first week of december.
            she’s gone through the stages of grief a lot quicker than I have…my studied stoicism be damned.
            now it’s all about what’s important…the pretension of the mundanes shucked off like a spent exoskeleton.
            I grit my teeth…bruxist tenacity…mind aswirl with music and poetry…and on the seventh day(friday) I am allowed to rest in dissolution. Shiner Vacation…to re-charge…re-set…decompress.
            we marvel at how utterly our lives have changed since september…I coax and cajole and bundle her up to go out and watch the moon set behind our hill that we call “Mountain”.

            ” Love is patient, love is kind. It does not envy, it does not boast, it is not proud. It does not dishonor others, it is not self-seeking, it is not easily angered, it keeps no record of wrongs. Love does not delight in evil but rejoices with the truth. It always protects, always trusts, always hopes, always perseveres.”

            More poetry…it’s meaning for her is different than it’s meaning for me.
            Amor Fati is the hardest thing in the world.

            Reply
      2. Brian (another one they call)

        USE the FDCPA, Fair Debt Collection Practices Act, deny the debt. Send a letter citing the statute and third party creditors go away.
        When the people of this country realize that nothing is going to MAGA, perhaps they will get as pissed off as those of us that have suffered improper care. My idiot doctors (and I) saw I had a large growth and f(*&WQRQing ignored it for 4 months until I had to yell at them and demand a referral to a real doctor. 4th stage cancer. I only survived because I became old enough to qualify for Medicare. I was within a week or two of dying due to the spread of a virulent attacker. One of my best friends got cancer before he could qualify for Medicare. He was sent by the local hospital to a clinic that took money but did nothing.
        How many millions of people aren’t so lucky? Do you feel like your government has tried to kill you? You are correct, they are.
        Vote for your own interests and forget the murderers in “your” party. Both parties are there to profit on your loss and dance on your grave. What do people like this deserve? Keep it polite when you talk about torture, this is a family blog.

        Reply
    2. crittermom

      “But medicaid is glacial”

      Yet I believe it may also be retroactive. You’ve already applied, so it may go back to coverage from that application date, not from the (later) approval date.

      I’m entering year two of stage III breast cancer treatments & surgeries, & had begun to get bills in the thousands despite having both Medicare (just SS, not SSI) & Medicaid. I had even set up a repayment plan of $25 a month.

      After a little more digging on my part, however, I discovered they weren’t billing it to the right Medicaid provider so when we got that straightened out I actually owed NONE of it. (Keep that in mind once you get the approval).

      It seems I’m ‘fortunate’ in that I’m old & poor enough (having lost what I owned to the banksters) that I’m afforded basic coverage thru Medicare & Medicaid that has covered it all. (Yes, I remain shocked but very, very grateful)

      You may want to try to ‘nip it in the bud’ before it goes to a third party collection agency by letting each know that you’re awaiting your medical coverage approval that will pay for it. They should make note of that & move on (to the next ‘victim’ of our health care system).

      I sincerely hope you will be pleasantly surprised once your coverage has been approved, & that much of it (or better yet, all) will be covered.

      I must add that in NO WAY do I feel we have a good health care plan in this country. EVERYONE should have coverage. Health providers denying coverage & suggesting a GoFundMe is completely outrageous!!
      I just happen to be ‘lucky’ in that my cancer treatments have been covered so far & I’m hoping many of those of your wife will be, too.
      My best to both of you.

      Reply
      1. Amfortas the hippie

        Thanks, to you and Brian(I’ll look into that law)…and to all of you.
        it took me a week to get my $hit together enough to figure out how to apply…so the start date is retroactive, but only that far. at issue was that we were in the hospital in San Antonio…but live in the Social Security “service area” of San Angelo. This confused everyone, it seems…and add in the decrepit, baling wire and band aid operation that is the san angelo office(through no fault of the workers there!)…and it was a recipe for incompetence and one hand being unaware of the other.
        almost comical, thanks to my decision to reread Aurelius just then,lol
        If we had been citizens of San Antonio…an SS person would have come to the hospital room.
        We should have a better idea of where we stand come the first of december.

        as far as the bill collector people…I have little regard for them. I’ve forgone raises and positions due to my moral sense…I just don’t think it’s a good excuse for working for Sauron.
        If I still owe after medicaid does it’s thing, I’ll pay the people I actually owe…show up, and see if they take the cash.
        we’re using what may be the last of her income(the only one) to pay down what little debt we had before, and acquire a few more bits of infrastructure to maybe have this place make a little money. I’m not far from having the market garden, the bees and the vineyards up and running…and I’ve been considering a prix fix saturday night, reservation only gourmet dinner(Joe’s Barn and Grill…I’m most well known out here as a chef). This has thrown several wrenches into all that, but I’ll keep plugging along.

        Reply
  8. Mattski

    I think that the original meaning of ‘charity’ was something more like loving caretaking of one’s fellow humans, not this corporatized feature of the system without which capitalism would not survive.

    Reply
  9. John Zelnicker

    Lambert – In your parenthetical between the two GoFundMe tweets, I think your auto-correct got the better of you:

    “This and the next should not be interpreted as solutions to donate;”

    Solicitations?
    ——

    And, a big thank you for getting this out on a Sunday afternoon.

    The entire extended DeVos family is nothing but grifters, Ponzi promoters, war criminals, and just generally morally bankrupt and ethically ugly people.

    Reply
  10. voteforno6

    A coworker of mine had to resort to GoFundMe to be able to afford some specialized treatment for his son. It was extremely expensive, but his son was able to get the treatment. I remember being very angry at that – if we were really a decent country, that would never happen.

    On the other hand, one of the senior executives for the Washington Nationals needed some expensive cancer treatment, so the team used social media to promote that GoFundMe to fans of the team. I think they dropped that quickly – nothing like an organization owned by billionaires hitting up fans to pay for the treatment for someone who surely makes more than most of them.

    As the hat said, America is Already Great.

    Reply
  11. ChiGal in Carolina

    Thanks Lambert, for all the reasons others have cited above. Interesting, I think, that as I write this, there are already three commenters who cop to having “jumped the line” for treatment using cold, hard cash.

    And no, Amfortas, it shouldn’t be this way.

    Reply
  12. Chris

    This is so terrifically sad.

    And the responses on the thread you posted on links today were terrible also. A mixture of awful stories followed by snide comments on how AOC needs to get the details right. When the details are this is another storefront in the DeVos shop of horrors. I don’t care whether it’s a pseudo hospital with a venture fund tied to it, a legitimate insurance company program, or a non-profit that actually tries to meet the spirit and intent of that US corporate and tax classification, this is wrong. This is a perfect example of a market failure. How many of these do people need to see before thy respond with we need to change the system creating this situation instead of “get the details correct” and “social medicine kills people with long wait times.”

    How long of a wait does someone without crowdfunding prowess have in this situation? Until the end of their life I suppose.

    Reply
    1. Synoia

      This is a perfect example of a market failure.

      It is a perfect example of a lack of Commons, Moral or Civilization failure, a perfect example of Greed at work.

      Market failure? Should there even be a market?

      Reply
  13. zephyrum

    From the 19th century:

    “I can conceive of no greater mistake, more disastrous in the end to religion if not society, than that of trying to make charity do the work of justice.”
    — William Jewett Tucker

    Reply
  14. Conrad

    GoFundMe takes 2.9 per cent as a processing fee plus another 30 cents from each donation. In 2016 they had $100 million in revenue.

    Small beer by insurance company standards but still nothing to sneeze at.

    Reply
  15. Tom Stone

    Thanks to Lambert and the Commenters, especially Amfortas.
    As someone who will be facing some horrific medical bills over the next six months articles like this are very helpful.

    Reply
  16. Olivier

    Gotta love how Ms Cortez became an acronym: a sure marker of fame, in such a short time. And she hasn’t even taken her seat yet! But will she live up to expectations?

    Reply
      1. JEHR

        Depends on what your expectations are, Bill H. Seems to me she has a better set of ideas than any other politician running so far. Give her a break! (I hope your thought is not misogynist.)

        Reply
  17. Bill H

    And yet every time I suggest that “Health Care Reform” was actually not reformative I am excoriated as some sort of right wing Obama hater.

    Reply
  18. Schnormal

    Wow, he got Yacoub to do the surgery! Dr. Yacoub is world famous. Back in the 80s he performed triple bypass surgery on Prime Minister Andreas Papandreou, saving his life.

    Spectacular post, thank you.

    Reply
  19. Big Tap

    So Sarah Palin was right after all. This letter is a perfect example of a ‘death panel’ in action. With the U.S. heathcare system if you don’t have money, Medicare, or good employee insurance you have no right to live. Guess our ‘freedoms’ only take us so far. Aren’t some of these people making life and death decisions of others always claiming they are Pro-Life?

    Reply
  20. run75441

    Lambert:

    Betsy’s hubby, Dick.

    In July of this year the provider Spectrum Health with it’s preferred insurance Priority Health acquired a new president. Lody Zwarensteyn of Health Care Blog penned an open letter to Tina Freese Decker the new Pres. which can be found here:
    An open letter to Spectrum Health’s new CEO

    A partial of the open letter:

    Restore price leadership

    West Michigan, and Spectrum’s components, previously had a solid reputation for being price leaders in the state and nation. That seems to have changed in more recent times, and it’s time to bring back the price advantages that West Michigan had enjoyed.

    At one time, Spectrum’s charges were the lowest in the state. Since then, prices have gone upward — to being in the “bottom quartile,” then to being in the “lower half,” and now Spectrum claims to be “competitive.” Compared to other areas, West Michigan seems to have lost its price advantages, and this is not returning efficiencies to the community. It’s time to restore the price advantages. Current profit margins and the opportunity to more efficiently use assets could provide the opportunity to reduce charges.

    Spectrum operates a network of satellite hospitals, and it should use them to provide cost-effective care in local communities, rather than bringing some patients for routine care to its higher-priced specialized (tertiary) institutions. In fact, most hospital admissions are for routine care, not for specialized care. The tertiary institutions should be saved for tertiary work.

    Work with others

    Spectrum Health provides an insurance carrier — Priority Health — that was specifically intended to keep local price advantages within West Michigan. Somehow, it now services larger parts of the state’s population far outside Spectrum’s service area. This is not keeping things local. Additionally, Spectrum appears to favor Priority Health to the detriment of other insurers. Other insurers purport difficulty in obtaining contracts with Spectrum that come close to the deals it makes with its own insurance company. This is not fair to customers.

    Reply
    1. run75441

      One more comment:

      “The community leaders with names like Butterworth, Blodgett, Meijer and DeVos (the father) never intended their gifts to create a local monopoly to the detriment of others.” Out of the same open letter.

      Correction: The clinic is named after the father.

      Reply

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