GoFundMe CEO: The U.S. health care system 'is really broken'

Despite progress that’s been made over the last decade through the Affordable Care Act, many Americans are still in need of alternative ways to pay surprise medical bills.

While some people find a miracle —a Texas teacher who had a heart attack saw his hospital bill go from $108,951 to $332.29 after NPR told his story last year — the more common method is crowdfunding.

“The health care system in the United States is really broken,” GoFundMe CEO Rob Solomon said in a recent interview with Kaiser Health News. “Way too many people fall through the cracks.”

GoFundMe, the world’s largest online crowdsourced fundraising platform, has raised more than $5 billion from 50 million donations in over eight years of existence. Many people use the website to raise money for a variety of causes, including medical bills, travel, covering lost wages for a patient or caregiver, research, accommodations for families, and other costs associated with receiving care or recovering from treatment.

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

‘We are facing a huge potential tragedy’

In 2017, 91.2% of individuals had health insurance for all or part of the year. Conversely, 28.5 million people did not have health insurance at any point during 2017, according to the U.S. Census Bureau. It is unknown how many of these people turned to crowdfunding to offset the lack of insurance.

“[The system] needs to be rethought and retooled,” Solomon said. “Politicians are failing us. Health care companies are failing us. Those are realities. … We are facing a huge potential tragedy.”

Lovisa Gustafsson, assistant vice president for The Commonwealth Fund, a private foundation that funds health care, said that crowdfunding “seems like a last resort” for those experiencing high-cost situations or medical emergencies.

“I wish our health system was designed in a way where that wasn’t necessary, where we have the proper insurance and products in place, and where people would get the care they need at an affordable cost,” she told Yahoo Finance. “I think there are ways to get there if we make that a priority.”

Gustafsson noted a trend she’s seen over the last decade in which more medical costs are being shifted onto patients. “We see this through high deductibles, in which you have to pay a lot of money out of pocket before your insurance kicks in and helps cover some of your services,” she said.

Another major issue in managing health care costs, Gustafsson said, is that patients often don’t realize how much a service will cost them ahead of time.

“It leads to another key issue … transparency and access to information about what health care services actually cost and knowing before you actually get the service,” she said.

‘Addressing the prices will go a really long way’

Gustafsson wouldn’t describe the health care system as “broken” but did note that there are always ways it can be improved by making it “more affordable and more acceptable to people.”

One way is by increasing coverage, particularly through the expansion of Medicaid.

“That would cover a lot of lives,” she said. “Medicaid is a very efficient program and it does a good job of providing affordable care to people. A key thing is thinking about affordability for patients, for workers, for the public. Making sure it’s affordable for them is a really important thing.”

She also said there “needs to be a hard look” at health care prices.

An average person spent $185 on out-of-pocket physician services and $104 on hospital expenses in 2017.

“We’ve seen more and more how those prices are going up and how a lot of drugs are unaffordable to patients who really need them,” Gustafsson said. “But think about the broader issue, that for health care services … prices are extremely higher in the U.S. than in other developed countries.”

The U.S. spends nearly twice the amount that other high-income nations do on health care, according to a study published last year in the Journal of the American Medical Association. In 2016, the U.S. spent $1,443 per capita on pharmaceuticals compared to a range of $466-$939 outside the U.S., the study found.

“Studying that, trying to understand, trying to curb health care prices in the U.S., that would go a long way to help patients be able to afford the care they need,” Gustafsson said. “Addressing the prices will really go a long way.”

Solomon echoed that sentiment. “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.”

Adriana is an associate editor for Yahoo Finance. Follow her on Twitter @adrianambells.

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