ABSTRACT

Crowdfunding is becoming a popular way of financing healthcare. Some commentators suggest that crowdfunding could serve as a new institution that fills gaps in conventional safety nets. Others suggest that crowdfunding is simply another way of obtaining help from family, friends, and local associations, and has little transformative potential. We provide one of the first quantitative analyses of medical crowdfunding, and the first to model the broader societal context in which campaigns are situated. We scraped data on US medical campaigns from the leading platform and combined them with county-level socioeconomic data, to model predictors of campaign frequency and success. Our findings suggest that many seek help from crowdfunding when both formal and informal conventional safety nets fail them. Significantly more campaigns are initiated in US counties with poorer private insurance coverage, lower social security provision, fewer social associations, and weaker cultures of giving. However, few campaigns reach their goals where most needed. More successful campaigns are found in counties that are wealthier and healthier and have more social associations. Crowdfunding is not merely ‘friendfunding’: fundraisers can increase their chances of success by having their appeals widely shared on social media. However, the returns to sharing are greater for campaigns initiated in wealthier areas. Overall, our findings suggest that medical crowdfunding is an entrepreneurial safety net: one where protection is not afforded universally or on the basis of need, but on the basis of one’s ability to appeal to the audience and out-compete rivalling needfuls.

摘要

众筹正在成为一种流行的医疗保健融资方式。一些评论员认为，众筹可以作为一种新的机构来填补传统安全网的空白。其他人则认为，众筹只是从家人、朋友和当地协会获得帮助的另一种方式，几乎没有变革潜力。我们提供了第一个医学众筹的定量分析，并且第一个模拟了活动所在的更广泛的社会背景。我们从领先的平台上抓取美国医疗活动的数据，并将它们与县级社会经济数据相结合，以模拟活动频率和成功的预测因子。我们的研究结果表明，当正式和非正式的传统安全网都失败时，许多人会从众筹中寻求帮助。在美国私人保险覆盖面较差、社会保障提供程度较低、社会协会较少且捐赠文化较弱的县发起了更多的运动。然而，很少有活动在最需要的地方达到他们的目标。更成功的运动出现在更富裕、更健康、有更多社会联系的县。众筹不仅仅是“朋友筹款”：筹款人可以通过在社交媒体上广泛分享他们的呼吁来增加成功的机会。然而，对于在较富裕地区发起的活动，分享的回报更大。总的来说，我们的研究结果表明，医疗众筹是一种 很少有活动在最需要的地方实现目标。更成功的运动出现在更富裕、更健康、有更多社会联系的县。众筹不仅仅是“朋友筹款”：筹款人可以通过在社交媒体上广泛分享他们的呼吁来增加成功的机会。然而，对于在较富裕地区发起的活动，分享的回报更大。总的来说，我们的研究结果表明，医疗众筹是一种 很少有活动在最需要的地方实现目标。更成功的运动出现在更富裕、更健康、有更多社会联系的县。众筹不仅仅是“朋友筹款”：筹款人可以通过在社交媒体上广泛分享他们的呼吁来增加成功的机会。然而，对于在较富裕地区发起的活动，分享的回报更大。总的来说，我们的研究结果表明，医疗众筹是一种企业安全网：一种保护不是普遍提供的，也不是基于需要，而是基于一个人吸引观众和在竞争中胜过竞争对手的能力。