The United States has some of the world's top hospitals and is a powerhouse of medical innovation, but every year tens of thousands of Americans must turn to the kindness of strangers to help pay medical bills, often in the form of online crowdfunding appeals.
Despite spending more than $4 trillion annually on health care – a per capita rate about twice as much as other industrialised nations – the US does not guarantee cradle-to-grave coverage for all of its citizens and most Americans must instead navigate the notoriously complicated private health insurance market that often fails to cover the true price of treatment.
Sites like GoFundMe have become a lifeline for Americans looking to raise money to pay for medicine or hospital costs. In a country where 62 per cent of bankruptcies are due to unpaid medical expenses, asking for help from strangers is often the only hope people have to pay their debts.
British Griffis, an urban farmer from Chicago, has set up an appeal on GoFundMe as she looks to offset recent medical and other expenses. Last year, she became a victim of the city's rampant gun violence and was left with large bills and no way to pay them.
Ms Griffis, 29, had just attended a concert and dropped a family member off at home when, with no warning, someone opened fire at her car.
Police didn't follow up or even attempt to fully investigate the attack, she said.
“I have family members and friends who have been directly and indirectly impacted by gun violence. So unfortunately, it's something that's common,” she said.
The vehicle was struck by seven bullets and Ms Griffis sustained a serious eye injury from pieces of shattered windscreen. An ambulance took her to a nearby hospital but she was forced to wait overnight until a specialist could examine her and remove the glass from her eye.
The bill for her ambulance journey and time in the hospital? $15,000.
Ms Griffis had health insurance through her employer, but the high excess meant she was left $8,000 in debt. She was initially reluctant to ask strangers for help but said such requests have become “normalised” in the US.
“Everybody should have equal access to health care and nobody should have to pay into a system and reach a certain threshold in order to be fully covered,” Ms Griffis told The National.
“Nobody plans to get shot at and to be burdened emotionally and financially with taking on these costs. It's just disheartening.”
Ms Griffis hopes by sharing her story she will help raise awareness of America's pervasive gun violence and the lack of support for survivors trying to pay their medical bills. The pages of GoFundMe are packed with stories of gunshot victims, many of them still in intensive care, struggling to cover their medical expenses.
Insured but still vulnerable
A decent health insurance premium can cost upwards of $1,000 a month for an individual, much more for a family. Employers usually subsidise these amounts, but even then people can pay hundreds of dollars a month for a policy and a Byzantine set of rules means patients still pay some part of bills out of their pocket thanks to “co-pays”, “co-insurance” and “deductibles”.
For many, the system is a bureaucratic nightmare that must be navigated just when a patient should be focused on getting better. Insurance companies must abide by complicated government guidelines and insurance rules mean patient claims are often rejected or only partially paid.
According to its website, GoFundMe hosts more than 250,000 medical fund-raisers each year, raising more than $650 million in contributions.
A representative for the platform said appeals for help with healthcare costs were one of its largest categories but the phenomenon is not limited to America. GoFundMe operates in 19 countries, including the UK, Germany, France and other countries that provide citizens with universal access to government-funded or capped-cost health care.
The representative noted GoFundMe quickly reflects societal changes. A lot of fund-raisers now are for people who've had late-stage cancer diagnoses after not seeing a doctor during the Covid-19 pandemic.
“There's been so many stories about how people deferred treatment because of the pandemic,” they said. “So we've seen that, actually, there's been a 20 per cent increase in cancer-related fund-raising.”
People often need help not only with medical bills, but the ancillary expenses that go with being sick, including needing to take time off work or help with childcare.
Alyssa Snow, from Boise, Idaho, set up a fund-raiser in May to help pay for her husband's sinus surgery. She said the couple now have health insurance through her employer, with premiums costing about $400 a month, but before they were able to get a policy they racked up thousands of dollars in diagnostic medical bills.
So far, the appeal has raised only $265 of the $3,000 goal. Ms Snow said her experience of asking strangers for help has been “quite negative”, with a lot of people judging them.
“They weren't very kind about us reaching out for this additional support from our community,” she said.
“There was always this feeling that people were trying to tell me that my husband's medical issues and conditions didn't warrant us asking for help.
“There were a lot of feelings of shame and I've heard that from other folks as well. And to then be faced with the backlash of the lack of support made it almost doubly so,” Ms Snow told The National.
America spends on average about $13,000 per person on health care each year, roughly double what other industrialised countries pay. Bureaucratic bloat is encoded into the American system, where hospitals and providers spend one third of all healthcare costs chasing bills and dealing with insurance companies.
Many Democrat politicians have spent decades pushing for a single-payer system in which costs are footed by the government. They say this would help more people have healthcare coverage that doesn't leave them at risk.
Grace-Marie Turner, founder and president of the Galen Institute, a non-profit research centre that promotes market-based solutions to health care, said such a system would not work in the US given its enormous population of more than 330 million people.
“It is much more diverse, much more segmented, much more geographically diverse than other countries like Switzerland or even Germany,” she told The National.
Americans “want what they want, when they want it”,
Ms Turner said health care costs too much in the US and blamed rising prices on government involvement in how care is administered, including through Medicare and Medicaid, types of taxpayer-funded health care for older people or America’s most vulnerable.
“It is way too expensive,” she said. “That has a lot to do with the fact that so much of it is government-controlled, rather than having market forces and competition being able to get prices down.”
