GoFundMe CEO: ‘Gigantic Gaps’ In Health System Showing Up In Crowdfunding

By Rachel Bluth, Reporter for Kaiser Health News and Peggy Girshman Fellow. She was previously the lead political correspondent for the Annapolis Bureau of Capital News Service and has also written for the Maryland Reporter and the Prince George’s Sentinel. Originally published at Kaiser Health News

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.”

This year, Time Magazine named Solomon one of the 50 most influential people in health care.

“We didn’t build the platform to focus on medical expenses,” Solomon said. But it turned out, he said, to be one of those “categories of need” with which many people struggle.

Solomon talked to Kaiser Health News’ Rachel Bluth about his company’s role in financing health care and what it says about the system when so many people rely on the kindness of strangers to get treatment. The conversation has been edited for length and clarity.

Q: KHN and other news outlets have reported that hospitals often advise patients to crowdfund their transplants. It’s become almost institutionalized to use GoFundMe. How do you feel about that?

It saddens me that this is a reality. Every single day on GoFundMe we see the huge challenges people face. Their stories are heartbreaking.

Some progress has been made here and there with the Affordable Care Act, and it’s under fire, but there’s ever-widening gaps in coverage for treatment, for prescriptions, for everything related to health care costs. Even patients who have insurance and supposedly decent insurance [come up short]. We’ve become an indispensable institution, indispensable technology and indispensable platform for anyone who finds themselves needing help because there just isn’t adequate coverage or assistance.

I would love nothing more than for “medical” to not be a category on GoFundMe. The reality is, though, that access to health care is connected to the ability to pay for it. If you can’t do that, people die. People suffer. We feel good that our platform is there when people need it.

Q: Did anyone expect medical funding would become such a big part of GoFundMe?

I don’t think anyone anticipated it. What we realized early on is that medical need is a gigantic category.

A lot of insurance doesn’t cover clinical trials and research and things like that, where people need access to leading-edge potential treatments. We strive to fill these gaps until the institutions that are supposed to handle this handle it properly. There has to be a renaissance, a dramatic change in public policy, in how the government focuses on this and how the health care companies solve this.

This is very interesting. In the places like the United Kingdom, Canada and other European countries that have some form of universal or government-sponsored health coverage, medical [costs] are still the largest category. So it’s not just medical bills for treatment. There’s travel and accommodations for families who have to support people when they fall ill.

Q: What have you learned that you didn’t know before?

I guess what I realized [when I came] to this job is that I had no notion of how severe the problem is. You read about the debate about single-payer health care and all the issues, the partisan politics. What I really learned is the health care system in the United States is really broken. Way too many people fall through the cracks.

The government is supposed to be there and sometimes they are. The health care companies are supposed to be there and sometimes they are. But for literally millions of people they’re not. The only thing you can really do is rely on the kindness of friends and family and community. That’s where GoFundMe comes in.

I was not ready for that at all when I started at the company. When you live and breathe it every day and you see the need that exists, when you realize there are many people with rare diseases but they aren’t diseases a drug company can make money from, they’re just left with nothing.

Q: But what does this say about the system?

The system is terrible. It needs to be rethought and retooled. Politicians are failing us. Health care companies are failing us. Those are realities. I don’t want to mince words here. We are facing a huge potential tragedy. We provide relief for a lot of people. But there are people who are not getting relief from us or from the institutions that are supposed to be there. We shouldn’t be the solution to a complex set of systemic problems. They should be solved by the government working properly, and by health care companies working with their constituents. We firmly believe that access to comprehensive health care is a right and things have to be fixed at the local, state and federal levels of government to make this a reality.

Q: Do you ever worry that medical fundraising on your site is taking away from other causes or other things that need to be funded?

We have billions being raised on our platform on an annual basis. Everything from medical, memorial and emergency, to people funding Little League teams and community projects.

Another thing that’s happened in the last few years is we’ve really become the “take action button.” Whenever there’s a news cycle on something where people want to help, they create GoFundMe campaigns. This government shutdown, for example: We have over a thousand campaigns right now for people who have been affected by it — they’re raising money for people to pay rent, mortgages, car payments while the government isn’t.

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  1. Dave

    Oh one other thing…..surgeons performing joint replacement surgery and back surgery on morbidly obese patients. No profit in telling them to lose 100lbs, eat healthier and do PT then come see me if you still have a problem.

    1. Dr Mike

      I’d encourage you not to be casual about advising someone to lose 100 lbs. Not an easy thing to do, particularly with severe joint pain limiting exercise (as would be the case in your example of someone getting a joint replacement). I’ve had patient after patient come back from surgeons and other specialists being told “just lose weight and you’ll be fine” and feeling utterly crushed and demoralized. In most cases they have spent years trying to lose weight without success.

      1. Jeff

        Sounds like a go fund me idea. Broad based support and exercise science support for obese who are committed to losing weight but have not been able to do so.
        One of the Health share ministry organizations charges a higher monthly share amount if you are overweight and provides dietary counseling to help you lose weight. Good carrot/stick approach.

    2. orange cats

      Neither is there profit in telling people to come back after quitting smoking, eating salty processed artery-clogging food, not exercising–losing weight is MUCH harder than those lifestyle changes. People single out the obese because they can see it and it offends them. Not cool.

      1. notabanker

        I’ve had to do all those things plus refrain from alcohol. Do I want to slam down a pizza smothered with sausage and cheese or two pounds of nachos? You betcha. Do I hate having to ration what I eat when I’m at a social gathering? Yup. Is it really hard to find something in my diet when I’m not at home to cook? U h huh. Do I do those things anyway? No, because I have to then enter the wretched healthcare system in this country, which I wouldn’t wish on anyone.

        It takes effort and research. It is extremely inconvenient. It’s actually less expensive. And I lost 20% of my body weight in the process.

        What’s “not cool” is having the ability to mitigate your healthcare problems and instead choosing uber expensive treatments for the symptoms of not choosing to. Call me judgemental, I don’t care. I don’t have the luxury of consuming anything I want anytime I want to. I would literally be dead by now.

        1. orange cats

          My point was that MOST of us could prevent a lot of problems by making better choices, why single out a group that is constantly judged and ridiculed at every opportunity. Skinny people are a burden on our healthcare system too ya know. I lost count of the number of unnecessary procedures my slim trim constantly dieting pals have had.

    3. JerryDenim

      My brother-in-law is an orthopedic surgeon. He routinely infuriates his extremely overweight patients by telling them exactly that. He refuses to do joint replacements on the morbidly obese. He sees it as total waste that side steps the real issue, obesity and lifestyle choices. Being “skinny” or extremely fit-looking may not be feasible for everyone, but human bodies do not want to be 100 pounds or more overweight. When you are that overweight the smallest lifestyle changes can pay giant dividends, like eliminating soft-drinks or junk food or walking for twenty minutes a day. People who claim otherwise are lying to hide their unwillingness to experience the slightest amount of discomfort. True morbid obesity is not natural and has only been made possible by modern junk diets and lifestyles. There are no accounts of half-ton humans prior to the twentieth century, but now there are TV shows dedicated to them.

      1. Avalon Sparks

        Interesting, the only people I know that have needed back surgery or knee replacement were all average weight. I guess they would pass your BIL’s sniff test. Hopefully your BIL’s infuriated patients went to a better surgeon that would actually help relieve them of pain.

        1. JerryDenim

          Or milk them for dollars while putting them under the knife and exposing them to serious surgery related complications for a procedure (knee) which is probably 60% effective at best.

          Me personally, I prefer an honest doctor that only wants to expose me to the risk of surgery if it’s necessary and likely to be effective. To each their own I suppose. There’s certainly no shortage of charge-happy aggressive doctors out there if you have the money and inclination.

      2. JBird4049

        The condescension oozing from some of the comments on fat people is rightfully called ignorant and insulting. Does anyone here wonder why being overweight is now a class marker of poverty instead of wealth as it use to be?

        Live in a food wasteland with no decent grocery stores. Beither too poor for a gym or too often worked to the bone in some crap job(s), with little to no access to healthcare, surrounded by high calorie food that is not only designed to be addictive but is often either the cheapest or only food available. Often exhausted, overworked, poor, depressed and ill while living in often lousy areas with the only other people around are trapped just like you.

        So when comments on those people not taking care of themselves because somehow they aren’t really trying I want to grab by the collar and shake some sense into their self-congratulatory wonderfulness. And maybe drag their asses into the not so nice places in America.

  2. Kurtismayfield

    o fix our problems is not just a provider/insurance problem. HC workers (especially doctors) would have to accept lower pay scales, we would have to ration care and people would have to take ownership of their lifestyle decisions. I do not see that happening anytime soon.

    We already ration health care by dollars and time, so don’t worry most of us are already used to having things rationed. As far as “personal responsibility”, the entire country is designed around unhealthy living. Unhealthy food is subsidized, living areas are designed around the car lifestyle, your morning news does nothing but sell anxiety, and your electronic device is designed to get you addicted to it. You are blaming the victims here, and the entire culture would need to be changed in many small ways to be supportive of a healthy lifestyle.

    1. Carla

      Thank you. Obama failed us on many fronts; ditching Main Street to save Wall Street was first, and healthcare was second — or were they really one and the same?

      1. tegnost

        anything involving indebting the masses for the wall st lucre,…health care, insurance,, real estate, finance. A very effective evil. And the second democrat pres who tried to pull off the “grand bargain”. When some of my loyalist friends refer to him as the best pres ever then I know they’re among those who got a big payoff. Usually as simple as didn’t lose their job during crash, had their health insurance get cheaper because o care sticks those unable to cover their deductible with basically unending payments for nothing, had grandma and grandpa pony up dough for the youngun’s college because everyone knows what a ripoff student loans are, which is why they cash out refi’d and payed off their own student loans (cause they aren’t deadbeats donchaknow) with their already owned home, or one that had a mortgage they could keep paying, which of course led to the cash out refi. And I haven’t even mentioned foerign policy or the TPP. Worst president ever including the nutcase currently holding court.

      2. jefemt

        Please don’t leave out Max Baucus (retired) US senator from Montana (D). He had nurses who were advocating single payor, protesting ACA- escorted out of ACA hearings by cops. Montana seems to be suffering through the yand pahse of post-Mike Mansfield / Jeanette Rankin glory days. Baucus, Zinke, Gianforte, Daines… the hits hopefully will soon stop coming!!!

        And why Obama tethered his name to the ACA, for posterity, was perhaps one of the largest hubris moves I recall in recent memory.

    2. Procopius

      I wouldn’t object to blaming Obama except for the way in which the Republicans completely changed the political system to make him a one-term president. The way Grassley and that woman senator from Maine played the Democrats for ten months — I can’t even remember now the name of the idiot Democrat who persuaded Obama to give him “just a few more days” to get the holy grail, a single Republican vote in favor of ACA. Filibusters used to be rare. Now every single action in the Senate is filibustered, no business can even be introduced without “unanimous consent.” I blame the Republicans for the current health insurance mess, but I admit there are plenty of Democrats to blame as well.
      ETA: Max Baucus — that’s the name I couldn’t remember.

  3. oaf

    Any and every amount of money channeled to Health Care (illness maintenance) will be absorbed; directed to bloat in infrastructure and CEO/Admin compensations. Gotta stay on the leading edge; you know…to compete…latest and greatest everything…and gobs of money to *attract and retain* top personnel…

  4. economicus

    Why would a casual internet user give money to a stranger for a ‘honeymoon’ a ‘wedding’ or a ‘special occasion’? If I need funds for that then i can get that from close friends and family. But I, personally, am not going to surf the gofundme site looking for opportunities to give my money to strangers for consumption habits that I disagree with. I think most sane people are the same. Medical expenses, however, elicit sympathy and, true to form, the more pathetic the story, the better the donations. Lets say I have $1000 and I need a wedding and a knee operation, each costing that amount. It makes sense to spend on the wedding and solicit donations for the knee operation. This CEO is really naive on how the human mind works when it comes to getting something for nothing. The article even mentions that the Europeans, with their ‘superior’ health system still ask for medical donations. While I agree that the US medical system has severe issues, this particular symptom has little to do with it.

  5. Jeff N

    I once donated towards funeral expenses after a suicide. (a coworker in another state that I wasn’t close to)

  6. rc

    Why aren’t there lawsuits challenging the healthcare industry for anti-trust violations? The laws are on the books. Restraint of trade is illegal. Agreements between a handful of statewide and local oligopolies collude on price and provision of healthcare damage the country to the tune of 10% of GDP–over $2 trillion per year or capitalized at over $20 trillion in wealth stolen through allegedly illegal activity. Either a private litigation firm or state AG’s could go after the executives and the companies that collude against citizens and taxpayers in this country.


    The Sherman Act broadly prohibits (1) anticompetitive agreements and (2) unilateral conduct that monopolizes or attempts to monopolize the relevant market. The Act authorizes the Department of Justice to bring suits to enjoin (i.e. prohibit) conduct violating the Act, and additionally authorizes private parties injured by conduct violating the Act to bring suits for treble damages (i.e. three times as much money in damages as the violation cost them). Over time, the federal courts have developed a body of law under the Sherman Act making certain types of anticompetitive conduct per se illegal, and subjecting other types of conduct to case-by-case analysis regarding whether the conduct unreasonably restrains trade.

    The law attempts to prevent the artificial raising of prices by restriction of trade or supply.[2] “Innocent monopoly”, or monopoly achieved solely by merit, is perfectly legal, but acts by a monopolist to artificially preserve that status, or nefarious dealings to create a monopoly, are not. The purpose of the Sherman Act is not to protect competitors from harm from legitimately successful businesses, nor to prevent businesses from gaining honest profits from consumers, but rather to preserve a competitive marketplace to protect consumers from abuses.[3]

  7. Moshe Braner

    What rubs me wrong is tech companies like GoFundMe keeping a *percentage* of the funds that they handle. With no connection at all to the actual cost of running the web site etc. Of course the same can be said about eBay, Paypal, and on to the more traditional banksters.

  8. Code Name D

    Of all the issues out there, healthcare is the one where the disconnect from reality is the largest from Clintionland. They actualy think that the ACA is popular. As a result, they frequently BRAG about being the arckatect of the very instituion that is the hated ire of so many Americans.

    Dispite the disaster, the ACA has pushed the very subject of healthcare outside the overton window. It could be another 20 years before the issue can even be discused in Clintonland.

  9. Catsick

    I wonder if the us gov launched a go fund me drive to try raise money for the 5 trillion + spent on wars in the middle east how far would they get ?

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