Centre for Health Policy, University of Strathclyde, Lord Hope Building, 141 St James Road, Glasgow, G4 0LT, UK.
Edinburgh Medical School, University of Edinburgh, UK.
Soc Sci Med. 2022 Sep;308:115214. doi: 10.1016/j.socscimed.2022.115214. Epub 2022 Jul 11.
The expanding phenomenon of crowdfunding for healthcare creates novel potential roles for members of the public as fundraisers and donors of particular forms of provision. While sometimes interpreted as an empowering phenomenon (Gonzales et al., 2018), or a potentially useful communication of unmet needs (Saleh et al., 2021), scholars have predominantly been critical of the way in which crowdfunding for healthcare normalises unmet needs and exacerbates entrenched inequalities (Berliner and Kenworthy, 2017; Igra et al., 2021; Paulus and Roberts, 2018). We report a thematic analysis of the text of 945 fundraising appeals created on JustGiving and GoFundMe in the first months of the COVID-19 pandemic, where the recipient was NHS Charities Together's dramatically successful COVID-19 Urgent Appeal. Unlike in existing accounts of individual healthcare crowdfunding, we identify the relative absence of both coherent problem definition and of a fundable solution within the pages. Instead, appeals are dominated by themes of solidarity and duty during the UK's 'hard' lockdown of 2020. A national appeal reduces the risks of crowdfunding exacerbating existing health inequalities, but we argue that two kinds of non-financial consequences of collective crowdfunding require further exploration. Specifically, we need to better understand how expanded practices of fundraising co-exist with commitment to dutiful, means-based funding of healthcare via taxation. We must also attend to how celebration of the NHS as a national achievement, might squeeze spaces for critique and challenge. Analyses of crowdfunding need to explore both financial and non-financial aspects of practices within different health system and historical contexts.
众筹在医疗保健领域的不断扩展为公众成员创造了新的潜在角色,他们可以成为特定形式医疗服务的筹款人和捐赠者。虽然众筹在医疗保健领域有时被解释为一种赋权现象(Gonzales 等人,2018),或者是一种潜在有用的未满足需求沟通方式(Saleh 等人,2021),但学者们主要对众筹在医疗保健领域将未满足的需求正常化并加剧根深蒂固的不平等现象持批评态度(Berliner 和 Kenworthy,2017;Igra 等人,2021;Paulus 和 Roberts,2018)。我们对 COVID-19 大流行初期在 JustGiving 和 GoFundMe 上创建的 945 份筹款呼吁文本进行了主题分析,这些呼吁的对象是 NHS Charities Together 大获成功的 COVID-19 紧急呼吁。与现有的个人医疗众筹账户不同,我们在这些页面中发现,几乎没有连贯的问题定义和可融资的解决方案。相反,呼吁主要集中在 2020 年英国“严格”封锁期间的团结和责任主题上。全国性的呼吁降低了众筹加剧现有健康不平等的风险,但我们认为,集体众筹的两种非财务后果需要进一步探索。具体来说,我们需要更好地理解筹款活动的扩展实践如何与通过税收来履行、以手段为基础的医疗保健资金投入相共存。我们还必须关注 NHS 作为国家成就而受到赞誉,可能会挤压批评和挑战的空间。众筹分析需要在不同的卫生系统和历史背景下探索实践的财务和非财务方面。