So here’s a little three question hypothetical for you to ponder today:
How do you feel about getting a fund raising letter from your co-worker’s kid who is doing a summer trip to build orphanages in Africa?
[Hey, that is awesome and I am proud of you for giving up part of your break to go serve. Happy to donate.]
What if the ask is because his baseball team needs to cover the expenses for them to go down to Florida for a week to play in a tournament?
[Huh, probably not so much. I did not sign up to fund your extracurricular activities, boy. Go mow some yards.]
How about you contribute to my GoFundMe campaign that will help me pay for my college tuition?
[Are you out of your mind? I have my own kids to get through college. You really have the audacity to even ask?]
Well, to the third version of the question, apparently a lot of people have high levels of either desperation or chutzpah because GoFundMe has had over 130,000 campaigns that have raised over $60 million to pay for college tuition.
For sure, many of those cases are folks in real need and getting support this way from friends and even strangers is their only path forward. But some are in the ‘audacious chutzpah’ category…they are able-bodied folks from working families who just had the nerve to ask.
I picked up this example because on one end, asking a community of people to share in the cost of a good cause or true need is something most of us can, and do, support. But somewhere along the continuum it crosses a line and we are offended by an inappropriate ask. Depending on our world view, we all draw the line at a different place.
This is part of the underlying complexity of our healthcare debate. The bottom half of the population, in terms of healthcare spending, accounts for only 3-4% of all spending. That portion has been relatively stable going back to 1970. This group incurs only $75 per person per year in out-of-pocket spending on healthcare. They spend more on Girl Scout cookies and wiper fluid. And they don’t have trouble getting access to care when they need it. This whole thing works for them – it is relatively cheap, pretty accessible, and technology innovations are making their consumer experience better every day.
So no matter the mechanism – from the conservative tax credits to the liberal single payer system, they are effectively being asked to donate to someone else’s GoFundMe campaign. The only question is whether they feel like they are giving to a missions project for the needy or subsidizing some dude who doesn’t want to get a job to pay his own bills. One is OK, the other does not go down so well.
The math is hard anyway, but answers are even harder because this dilemma is lurking just under the surface, regardless of the financing vehicle.BACK TO LIST
Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.