Admittedly I didn't dive much into this to get the full context, but it's saddening to me that a legendary game designer had a GoFundMe. I was hoping achieving that level of status in a traditionally well-paid industry would leave one well off, financially.
It's such an erractic industry in terms of compensation. You can found a studio, make some acclaimed darlings, and still end up shuttering and being no better off than your average joe. Then there's being a "software engineer in games" where you're a cog in a wheel fixing bugs in the yearly Sportball game that gets compensated 200k and you live very well despite never truly "impacting" the industry the same way. 200k isn't mindblowing for a software engineer, but it's well beyond "average joe" range at that point.
I'm that cog. Or at least, was. Situations like this make me thing a lot about the state of the industry and where I lie in life.
Yep, unfortunately that's a big part of the reason I left for a more traditional tech role. The same skills are extremely valuable at any company writing performance critical software.
I'm wondering if she actually got the fundraiser money, considering how quickly this moved - the last update implied it would have to go to her funeral, and I hope it pays for the bills or helps her family.
The United States is the wealthiest nation on the planet according to Forbes, richer than the subsequent three nations combined.
It’s a tragedy that our own citizens are not the direct be beneficiaries of that wealth.
I think a lot about the scene in Star Trek IV when McCoy is in a hospital and says “what is this the dark ages?”
Gofundme is like a kafkaesque tragic absurdity that - hopefully - will be looked at as an indictment of the inequitable K shaped economy we’ve built, and hopefully fixed in the future.
> The United States is the wealthiest nation on the planet according to Forbes, richer than the subsequent three nations combined.
This framing by Forbes (any many others really) is insidious because it doesn't take into account the population number and how unevenly wealth is spread.
For instance, Switzerland is not a huge economy - around the 20th in the world, but its citizens enjoy an extremely high quality of life because both income inequality and incomes overall are significantly better that in the US.
Population size is usually included in those calculations. It’s typically GDP per capita.
But I couldn’t agree more that the inequality and social safety net (or lack thereof) make the numbers deeply disconnected from QoL. Which I believe is the whole point.
> As for whether this represents a "kafkaesque tragic absurdity" we would need intimate knowledge of a lifetime of financial decisions. Maybe she was really bad with money, and frittered it away in casinos. Maybe she was amazing with money, and donated to others more than will ever be donated to her.
As someone in a nation with socialised healthcare, no you don't. It's a Kafkaesque tragic absurdity, and this sentiment of "maybe she was bad with money" sounds a bit like "maybe she was holding the live hand grenade wrong".
The US is maybe the only developed nation where this happens, insurance exists because massively unlikely, massively expensive events are very hard to budget for. It's not the person's fault if they didn't manage that.
The UK has socialized healthcare, and that's not going so well. Societies excel at stuff they prioritize. Pretty much all societies don't prioritize other people's tragedies.
It's definitely going better than the US, where you basically need to beg people for treatment money. I'm not sure what "not going so well" means, in that regard, since virtually every other developed country is doing better than the US on this.
I’ve lived in both Canada and the US. My grandma in Canada had to wait 9 months for a hip replacement. Even though the government provided help with paid aids, it was not a great situation.
My mom here in the states needs a hip replacement and she can’t afford it because she’s maxed Medicare.
You mentioned ambulance. My wife called an ambulance for our kid who tripped on something at a park and a rather hysterical person told her she needed to call an ambulance right away. Pressured, she did so; our kid was fine. But we then owed $3,500 for the ambulance. Though we were paying on a payment plan and never missed a payment, the bill got turned over to collections for some unknown reason. We got it sorted it out but it took about 15 hours of work to resolve and fix our credit.
I’ve found that my Canadian relatives complain often about the system but very few seem to truly understand what is good about that system.
Pick your poison. Like many things here in the US, healthcare in the US is great if you have money, bad if you don’t.
It's not that great even if you have money. Unless you're talking about the type of money needed to pay for all of your treatments out of pocket, and give you access to special private care most people don't even know exists.
My experience has been: if you have an immediate health issue with an obvious solution, you can get pretty good care. Say if you have a broken arm, gun shot wound, heart attack, stroke, etc. Anything uncommon, or that requires ongoing care, is a life sucking nightmare.
I'll give some examples from my own life. I live outside a major metropolitan area. A relative was visiting me and had a stroke in my living room. I called 911, and an ambulance appeared 5 minutes later, in 25 minutes they were in a hospital with a telemedicine link to a stroke expert. The expert said they needed to be brought to a downtown hospital so they were sent there by helicopter. One of the two best neurosurgeons in the city performed an endoscopic removal of the clot and saved their life.
Contrast this with a different relation who struggles with chronic pain and spine problems and has spent the last 20 years bouncing around various doctors, battling insurance companies, pharmacies, waiting to be seen, waiting endlessly for specialists, tests, and having to keep track of all of their information themselves because the system is fragmented and every office wants a complete restatement to their medical history.
Yeah, exactly, I don't know much about the NHS but I wouldn't be surprised if the recent issues are because it's getting defunded so it can be sold off to private owners.
> this sentiment of "maybe she was bad with money" sounds a bit like "maybe she was holding the live hand grenade wrong".
Yes, it does sound like that when taken as an isolated sentence fragment. I'm not sure what your point is though, since no reasonable system of economics could possibly solve for people holding the metaphorical live hand grenade wrong.
I think the sentiment is not that generosity to those in need is bad, but that something bad must be causing so many to be in such desperate need.
It may be relevant that the US has higher health-care costs than every other country in the world except for Switzerland, but not because it's providing better care. Many countries have better outcomes.
The fact that you need intimate knowledge is evidence of the Kafkaesque nature. It describes a world where virtue doesn't exist except for the case of financial planning (which often equates quite well to luck).
Based on my understanding of Kafka, to fit the definition, funerals would be essential goods whose costs should be socially guaranteed. In reality, a funeral is a discretionary event about the deceased and for the living. Crowdfunding for the benefit of the crowd is not an inversion of responsibility, it's simply voluntary collective spending.
You could say it's an inversion of societal norms, but that's not Kafkaesque.
My apologies, I misread the original article and I was left with the impression that the GoFundMe was only for end-of-life and funeral costs. I must have missed the standfirst, which is where it was described as a "cancer fundraiser".
The Churchill line is about democracy, but the adapted version is a common variation. It works as a standalone maxim without need of attribution to some famous person.
I don't know if you've noticed, but internet discussions collectively can't seem to avoid "no true Scotsman"-ing what counts as capitalism, likewise its alternatives.
I've seen some people on HN criticise the "socialist" healthcare of the nordic countries on the basis of what Stalin was like, and others saying that China as is today is each of communist and capitalist depending on the point the poster wants to make.
I also clicked through ten pages of Google search results for "capitalism is the worst economic system, except for all the others", each of which showed the literal quotes in the preview excerpts, at which point I became too bored to continue.
I mean, how is "healthcare" from 500 years ago the bar here?
And isn't single-payer state-funded healthcare the scaled version of a small town passing the plate around anyway?
As I think about it, gofundme is even more kafkaesque in that it gatekeeps fundraising to those who have online social networks strong enough to fundraise. We don't hear about those who aren't able to because in the Jia Tolentino definition of "silence," they are not able to express that need online.
> Maybe she was really bad with money
I guess I fundamentally disagree that a kind of Dave Ramsey level of financial saving is a prequisite for healthcare. Indeed, I'd argue that casinos are a symptom, not a problem, of a system in which the only "viable" way out is gambling - again another tentpole in a complicated kafkaesque system.
I agree that single-payer baseline healthcare is the obviously correct answer. The experiment has been run countless times globally, and there's enough evidence to put this beyond debate. Rebecca's circumstance isn't Kafkaesque, it's merely adding to that mountain of evidence.
> how is "healthcare" from 500 years ago the bar
I agree completely, but it's not Kafkaesque for a person to ask one's own community for voluntarily contributions in their time of need, just because that community happens to be online.
> gofundme is even more kafkaesque in that it gatekeeps fundraising to those who have [strong] online social networks
There's nothing Kafkaesque about a popular person having more opportunities than an unpopular person. And there's nothing inherently capitalist about it either. This is human nature, nothing more. I would be far more concerned about an economic system that sought to "guarantee equality" in a way that reduces the individual's incentive to be kind to others.
Considering the James Van Der Beek of Dawson's Creek fame is having to hold a fundraising auction of his memorabilia to fund his cancer treatment, cancer is expensive in the US.
actually a difference is also how many players along the supply chain siphon money out of the process. the more greed is allowed and acted on for the treatment, the more expensive it gets. introduce layers of insurances, hedgefonds, pension funds, lobbyism, ... it adds up to riddiculous amounts far beyond the original R&D/infrastructure/treatment costs.
And also downsides, e.g. many treatments just aren't available, and many others would never have had their discovery funded without the market-based system existing.
Governments can (and do) directly fund medical research including drug discovery. This is in part because governments of even just middling competence have an incentive to keep their workforce (which also includes their military) healthy.
This… is a think that people believe, but it’s not as simple as that. Most basic research is universities, all over the place. Many drugs are developed in Europe. A lot of medical machinery is developed and made in Europe (Siemens, Philips and Roche are huge in this space). Like most things, med tech is fairly globalised.
And let's not forget that a substantial amount of medical research performed in the USA is not market-based but rather publicly funded through the NIH.
> This… is a think that people believe, but it’s not as simple as that.
This is a thing people believe because pharmaceutical companies keep repeating it. And to be fair, they're not entirely wrong in that getting a drug/treatment from the lab to the pharmacy is incredibly expensive because most drugs don't work and clinical trials are super expensive.
It does seem to me that a better system would be to split out the research/development and manufacturing of pharmaceuticals into the lab development (scientists), the clinical trials (should be government funded) and the manufacturing (this could easily be done via contract).
Which the US had a situation exactly like that until very recently: development labs, often at Universities, with scientists paid for by grants (some private, but the majority being public, government grants), with clinical trials overseen by government agencies like the National Institute for Health (NIH), and winning research eventually being tech transferred for cheap to Pharmaceutical companies to manufacture, distribute, and market.
The companies have the biggest PR arms, so took the most credit for a system that had been balanced on a lot of government funding in the earlier, riskier stages. Eventually the marketing got so unbalanced people didn't realize how much the system was more complex than the marketing and voted for people that decided it was a "free market" idea to smash the government funding for the hard parts of science.
> Which the US had a situation exactly like that until very recently: development labs, often at Universities, with scientists paid for by grants (some private, but the majority being public, government grants), with clinical trials overseen by government agencies like the National Institute for Health (NIH), and winning research eventually being tech transferred for cheap to Pharmaceutical companies to manufacture, distribute, and market.
Yeah, this isn't a particularly new idea. Like, most of the risk in pharma is on testing, and there's so much waste in spinning up plants for drugs that may not even succeed in Phase III. So I'd like to split that out.
> It does seem to me that a better system would be to split out the research/development and manufacturing of pharmaceuticals into the lab development (scientists), the clinical trials (should be government funded) and the manufacturing (this could easily be done via contract).
The market is there to risk money in the world of imperfect information trying to predict what would be good to pursue. That is one of the hardest parts of the process, but it's not even made your list.
Exactly. This was entirely deliberate as I (personally) believe that market signals are profoundly useless in healthcare. Like, there's no free market in life or death, nobody will quibble over cash when they're in pain so I'm not sure how a market is supposed to work.
Fundamentally, the incentives of society and private companies are misaligned with respect to healthcare. Society wants a cheap, simple treatment that basically works forever (like sterilising vaccines). However, because of how the patent system works, companies want a treatment that is recurring, and can easily be patented multiple times.
Because of this, so much money goes into lifestyle treatments for the rich world, and not enough into re-using things that can't be patented. I think this is a giant waste of resources, hence my suggestions above.
This doesn't make any sense. If you make a thing, the price you set for selling that thing in a country has little to do with where you happen to be living when you made that thing.
It's a lot more expensive in the US. Three years of ribociclib is US$100k here in Argentina, which dwarfs the usual costs of things like chemotherapy, radiation therapy, and surgical resection. (All of which is normally paid for either by a health plan or by the public hospital system.) In the US, if you have to go through all of that, I think the cost is going to be at least an order of magnitude higher.
