Crowded Out: The True Costs of Crowdfunding Healthcare
GoFundMe now has over 100 million users worldwide, but who actually benefits from healthcare crowdfunding? And what does its rise tell us about the relationship between charity, technology, and social justice? Nora Kenworthy’s forensic investigation is essential reading for anyone thinking seriously about the ethics and future of giving.
Over the past decade, charitable crowdfunding has exploded in popularity across the globe. Sites such as GoFundMe have transformed the ways we seek and offer help. When faced with crises — especially medical ones — people are turning to online platforms that promise to connect them to the charity of the crowd. But what does this phenomenon actually reveal about the changing ways we seek and provide care?
In Crowded Out, Nora Kenworthy examines how charitable crowdfunding so quickly overtook public life, where it is taking us, and who gets left behind by this new platformed economy. Although crowdfunding has become ubiquitous in our lives, it is often misunderstood: rather than a friendly free market “powered by the kindness of strangers,” crowdfunding is powerfully reinforcing inequalities and changing the way people think about and access healthcare.
Drawing on extensive research and rich storytelling, Crowded Out demonstrates how crowdfunding for health is fuelled by, and further reinforces, financial and moral “toxicities” in market-based healthcare systems. It offers a unique and distressing look beneath the surface of some of the most popular charitable platforms, and helps foster thoughtful discussions of how we can better respond to healthcare crises both small and large.
Although the book focuses primarily on the United States, the dynamics it exposes are highly relevant to fundraisers and charity professionals in the UK and beyond. For example, the role of platforms like GoFundMe in shifting responsibility from the state to the individual; the racialised inequities of who succeeds in crowdfunding campaigns, and the moral questions about who is deemed “deserving” of public generosity.
An excerpt from the book, exploring the historical precedents for crowdfunding’s culture of selective deservingness, is available at HistPhil.
About Nora Kenworthy
Nora Kenworthy is Associate Professor of Health Studies at the University of Washington Bothell, with adjunct appointments in the Departments of Anthropology and Global Health at the University of Washington Seattle. A writer, professor, and public health expert, her work examines how politics, technology, and inequality affect health.
Her writing has appeared in the American Journal of Public Health, Social Science and Medicine, PLOS One, Scientific American, the Washington Post, and the Los Angeles Times. Crowded Out is her second book; her first, Mistreated: The Political Consequences of the Fight Against AIDS in Lesotho (Vanderbilt University Press, 2017), won the African Studies Association’s Bethwell A. Ogot Book Prize.
Reviews
“A powerful exposition on the morality of an economic and charitable system that forces the most vulnerable to become, at their moment of greatest need, digital campaigners on behalf of Big Healthcare. Crowded Out also illustrates how the rise of crowdfunding is yet another chapter in the financialisation of charity, amassing private profits under the guise of doing public good.”
The Chronicle of Philanthropy
“With moral urgency and compelling clarity, Kenworthy offers a searing indictment of the symbiosis between Big Healthcare and Big Tech that allows them to grind out their billions off the backs of millions of Americans.”
Abdul El-Sayed, Towsley Policymaker in Residence, Ford School of Public Policy, University of Michigan; author of Medicare for All: A Citizen’s Guide
“A critically important book for anyone interested in what our healthcare system is really doing to patients and their families. Kenworthy skillfully weaves together patient stories and penetrating analyses to explore the dark side of a crowdfunding phenomenon that is deepening inequalities and perpetuating disturbing ideas about who deserves help in our society.”
Noam N. Levey, Senior Correspondent, KFF Health News
Buy on Bookshop.org Buy on Amazon“Nora Kenworthy’s excellent book exposes the failings of digital crowdfunding in America’s dysfunctional health system, showing it to be ineffective, inefficient, inequitable, and totally incompatible with the goal of achieving universal health coverage.”
Robert Yates, Executive Director, Centre for Universal Health, Chatham House
