Editors’ Note: The following is excerpted, with minor adaptations, from Crowded Out: The True Costs of Crowdfunding Healthcare by Nora Kenworthy. Reprinted with permission from The MIT Press. Copyright © 2024.

When users consider starting a GoFundMe campaign, they are bombarded by messages of opportunity. The company has good reason to present crowdfunding as a marketplace of equal opportunity, welcome to everyone. But most users quickly ascertain that not everyone is treated equally.

As I show in my new book, Crowded Out: The True Costs of Crowdfunding Healthcare (MIT, 2024), the moral terrain of crowdfunding is fueled by two persistent social ideologies that powerfully shape our social, health, and cultural systems: these are the dual, and intertwined, myths of meritocracy and the “deserving poor.” Michael Young originally coined the term meritocracy in a 1958 book, using it to describe Britain’s transformation from a society where life chances were determined by one’s status at birth to one where status was allocated based on personal achievement. However, he used the term satirically, trying to describe how institutions that seemed merit-based in fact rewarded and elevated those who already had the economic and social means to succeed.

Meritocracy, as Daniel Markovitz has written, is a trap: societies, especially neoliberal economies such as the United States, have enshrined a system where people are told that if they just work hard enough they can succeed, but radically hierarchical and racist institutions reproduce and reinforce elitism. When people fail to succeed in this system, it becomes particularly easy to blame their own efforts or characteristics rather than the falsely meritocratic systems themselves. “It is hard indeed in a society that makes so much of merit,” wrote Young in 2001 as he reflected on this misuse of the term meritocracy, “to be judged as having none.” The ubiquity of our belief in meritocratic systems is evident in the widespread use of phrases like “equal opportunity” and “pull yourself up by your bootstraps.” In particular, given the economic, educational, and social impacts of structural racism in US society, meritocracy upholds and justifies racial inequities. As Tressie McMillan Cottom observes in Thick, “We do not share much in the U.S. culture of individualism except our delusions about meritocracy. . . . I can talk to hundreds of black folks who have been systematically separated from their money, citizenship, and personhood and hear at least eighty stories about how no one is to blame but themselves. That is not about black people being black but about people being American. That is what we do.”

If meritocracy is a relatively recent myth, the myth of the deserving poor is a much older one. Political philosophers have long debated to whom society owes forms of social support. As early as the seventeenth century, poor parishioners in England were given badges to wear in exchange for social support under the Elizabethan poor laws. These were intended to elicit shame and deter a sense of entitlement among the “able-bodied” poor. By the 1800s, as the philosopher Elizabeth Anderson has written, poor laws allowed citizens to “lay claim to aid from the state only on condition that they accept inferior status . . . [creating a] distinction between the deserving and the undeserving disadvantaged, between those who are not responsible for their misfortune and those who are.” In the United States, nineteenth-century charities upheld similar values: the social policies and programs which grew out of these practices, including health-care safety nets, powerfully upheld this ideology.

As conservative leaders in both the United States and the United Kingdom retrenched postwar social programs in the 1980s and 1990s under the banner of neoliberalism, the “political imaginary of social welfare” shifted, creating dominant discourses that severely blamed the poor for their circumstances. Narratives of a “culture of poverty” and racist, denigrating portraits of “welfare queens” laid the moral groundwork for exclusion from the body politic based on “presumed moral laxity.” Ironically, as Gay Becker observes, “deservingness [in US social policies] is related to productivity, and hence, to wealth—in short, to the ability to find the financial resources to pay for medical care.” Thus, those who most need financial assistance for care—due to structural racism and histories of economic exclusion—are often deemed the least deserving of it.

These dual myths of deservingness and meritocracy have been particularly powerful tools for upholding gender, class, and, particularly, racial hierarchies. Charity given under such ideologies, Elizabeth Anderson writes, “reflects the mean-spirited, contemptuous, parochial vision of a society that represents human diversity hierarchically, moralistically contrasting the responsible and the irresponsible, the innately superior and the innately inferior, the independent and the dependent. It offers no aid to those it labels irresponsible, and humiliating aid to those it labels innately inferior.” As Ampson Hagan shows, within the context of neo-liberalism and post-Jim Crow racial resentments, deservingness increasingly became a means by which Black people could be scapegoated—with White Americans blaming Black Americans for getting too much support from scarce social programs while also blaming them, rather than structural inequities, for their circumstances. Deservingness served to uphold racial hierarchies and signal that marginalized groups did not belong to the body politic.

Finally, deservingness offers one more advantage to the powerful: it focuses social attention on constructing elaborate criteria by which the poor and powerless can be deprived of resources. These petty public dramas of deservingness distract us from turning our attention toward the rich and the powerful and asking how they came to deserve what they have or whether they have any obligations to redistribute their wealth. Selective deservingness enshrines the already powerful as arbiters of who will get handouts while insulating them from questions about why the powerless are left to fight for unfairly distributed handouts at all.

Meritocracy and deservingness are everywhere on crowdfunding sites like GoFundMe. Many popular campaigns implicitly or explicitly appeal to these values, using phrases like “hardworking,” “breadwinner,” “hero,” and “super-mom.” The rhetoric of superheroes is particularly prominent, especially among campaigns for children, reflecting the near super-human characteristics of strength and goodness that crowdfunders must claim to succeed. GoFundMe itself reflects this rhetoric by highlighting the work of “GoFundMe Heroes” and “kid heroes” through a podcast, social media accounts, and “heroes celebration” events. Reflecting the mythology of meritocracy, GoFundMe brands its heroes as “everyday people doing extraordinary things.” Most of these so-called heroes are people who have launched projects to help communities or neighbors. Yet this rhetoric excludes a primary way that crowdfunding is used: by people seeking help for themselves in desperate circumstances. While GoFundMe highlights the ways it is “powered by kindness,” its marketplace often quietly rewards campaigns that successfully appeal to the unkind and discriminatory myths of meritocracy and deservingness. While it is certainly not the first charitable system to do so, its wide-reaching platform is deepening and extending these myths in powerful ways.

For centuries, assessments of deservingness have been central to charitable giving. The individual virtues or character flaws of those in need are held up to public scrutiny, while compelling stories of misfortune are circulated to potential donors who seek to “save” the deserving poor. It would be impossible to cover the history of these practices in depth here, but their persistence over time provides an important antecedent to contemporary crowdfunding. Below, I present two examples from my book of historical charity practices that have particular resonance with today’s cultures of crowdfunding.

The Orphan Election This first example begins with a painting by George Elgar Hicks from 1865, depicting an “infant orphan election at the London Tavern, ‘polling.’” In the painting, election posters and pamphlets don the walls of the tavern as colorfully dressed women and men engage in earnest conversation. In the foreground an anxious-looking widow, dressed all in black, clutches a small girl to her legs. In the right-hand corner several men in dark suits seem to be recording election results. Were it not for this painting, the practice of “orphan elections” might have been forgotten entirely. But so-called charity electioneering was a common practice in London society in the 1800s, whereby donors (“subscribers”) voted for those who would receive charity from institutions like orphanages, asylums, and hospitals. Subscribers were allocated a certain number of votes and often campaigned for months on behalf of preferred candidates, using cards and circulars describing their unfortunate circumstances. Hicks’s painting depicts an election to decide which infants would receive scarce spots in an orphanage after the death of one or both parents.

While an orphan election may seem particularly distasteful to us today, its practice reflects dominant social mores of charitable giving. The first of these was the perceived scarcity of aid itself—that charitable aid was a rare gift to be bestowed only on the most deserving. Deservingness here reflected the already socially entrenched stigmatization of the poor: elections were limited to the orphaned children of “upstanding members” of society. Those who were illegitimate, had deformities or disabilities, or whose families had previously received any “poor relief” would not be granted spots at many institutions. The severe limitations placed on orphan ‘candidates’ stand in stark contrast with the voting liberties granted to subscribers. The private selection of an extraordinarily slim deserving few served not only as status symbol and entertainment for the donor class but also as a symbolic and political alternative to state-run relief projects.

Child Sponsorship My second example begins when the American Christian evangelist Bob Pierce was working in China as a missionary, and developed the idea of “child sponsorship,” similar, though different, from the orphan elections described above. Child sponsorship became the cornerstone project of World Vision and other Christian development aid organizations, spreading to nearly every low- and lower-middle- income country around the world. The premise of child sponsorship was simple: Christians in higher-income countries were invited to “sponsor” an orphan or needy child abroad and committed to providing monthly or yearly support for their well-being. Sponsors were sent pictures and information about “their” child and wrote frequent letters in return, encouraging faith, educational commitment, and hard work. While World Vision has shifted its focus over time from support for individual orphans to families, and eventually to communities, the collection of names of needy children continues to be a primary way that both donor interest is cultivated and recipient communities participate in World Vision’s projects.

Marketing children’s personal stories of struggle and orphanhood remains central to World Vision’s fundraising and public outreach. As Erica Bornstein shows, the relationships fostered by such sponsorship are intimate but shaped by steep hierarchies between sponsor and child. Many critics cite the program as an example of “poverty porn” and exploitative White savior practices. Its resonance with the London orphan elections is striking, though World Vision’s success relies more heavily on the power of interpersonal charity. The opportunities for identity formation, relationship building, and meaning-making practices for donors is an engine that drives this model of development. World Vision has also, however, faced persistent critiques from donors who feel the organization has misrepresented the allocation of funds that go to sponsored children and the impacts donations have on children’s lives. These disappointments reflect the norms of a donor-recipient relationship premised on ideals of personal investment and even, perhaps, ownership, rather than Christian biblical ideals of selfless charity.

These are only glimpses of charitable practices and spectacles across time, but they share common threads. The rights of donors and publics to choose who receives artificially scarce charitable goods stands as a counterpoint to rights-based systems of social support, where citizens have broadly recognized rights to healthcare, shelter, and other basic needs. Those in need must compete—or must have others compete on their behalf—to win favor against sometimes great odds. Conversely, for donors, charitable giving provides an opportunity to elevate their identity, relationships, and social status—either through event and spectacle or through intimate but hierarchical bonds between donor and recipient. Storytelling becomes an important way of assessing and judging people seeking aid. As modern health and social systems are increasingly driven by data, numbers, and metrics, these examples show that what Vincanne Adams calls the “skillful manufacture of stories” is still essential to the affective, relational, and value-laden ways we decide who deserves and who does not.

Charitable crowdfunding is a natural outgrowth of these predecessors, but it makes deservingness and charitable inequity even more challenging for the needy to navigate in several important ways. Technology has increased the specificity, intimacy, and proximity of stories in charitable appeals and has dramatically expanded the size of their potential audience. At the same time, it has increased the marketing and competition among campaigners. Crowdfunding creates an online marketplace that relies on the supposed “wisdom of the crowd” to sort the deserving from the undeserving. But that is not how the market actually works. Instead, visibility, success, and even the ability to craft a compelling story depend to a great degree on who you are, what you need, and who you know. The sheer volume of campaigns and the anonymity of many donors on crowdfunding platforms makes it harder to see these forces at work. What campaigners must offer to compete in this environment and to create connections with potential donors, however, is deeply intimate, and subject to the scrutiny and judgment that people so often encounter on social media.

Crowdfunding creates a powerful social media culture that upholds, and extends, the moral toxicity of selective deservingness, disguising it within a platform that appears to offer equal opportunities for everyone. The power of the crowd is not that it magically manages to select those who are most in need of help; rather, it powerfully selects for a rarefied group of beneficiaries. Crowdfunding takes the narrow, exclusionary, and discriminatory category of the “deserving poor” elevated by orphan elections and poverty programs and twists it into a new category of selective deservingness: the deserving popular. Many of the deserving popular are not even that needy—they have experienced unfortunate crises or setbacks, but instead of providing a safety net, crowdfunding provides them with a trampoline, allowing them to reach greater heights of social status, self-determination, and achievement. Like influencers on other platforms, campaigners leverage hashtags, build connections with audiences, and create a brand out of their campaign. So, too, do campaigns often succeed when their organizers or recipients have already created an online personal brand for themselves with a following that can be naturally tapped into for support.

Troublingly, campaigners, donors, and public audiences have begun to conflate crowdfunding success with goodness and deservingness, adding further weight to the legitimacy of the deserving popular. FundRazr’s CEO Darryl Hatton described crowdfunding to me as “an ATM on your karma bank. If you’ve been depositing a lot of karma into your community over your lifetime, when you have a crisis, crowdfunding lets you make a quick withdrawal when you need the cash.” But as crowdfunding becomes more popular and more competitive, the selective deservingness of its economy becomes even more contorted. No longer is it just that campaigns are successful because they were deserving: instead, people are perceived as deserving because their campaigns are successful and popular.

Crowdfunding is also undermining the idea that everyone should deserve access to healthcare when they need it. When popularity—people “returning the favor of being around a good person”—becomes a form of “insurance,” as one of my informants put it, we quickly lose sight of a more universal kind of deservingness: the idea that everyone has a right to adequate healthcare regardless of how popular or even how “good” they might be. In crowdfunding’s hypercompetitive online marketplace, where the volume of need is overwhelming, donors must use more and more scrutiny to decide who is and is not worthy. Thus, inadequate systems of health coverage fuel the demand and competition that reinforces selective deservingness, which then further undermines public recognition of a more basic, universal right to healthcare. Crowdfunding helps the deserving popular succeed, and even thrive, while causing disproportionate harm to those who need help the most.

When health relies on the charity of a digital crowd, it creates and exacerbates deep inequities and undermines claims to more universal, rights-based systems of healthcare. As Ralph Nader argues, “a society that has more justice . . . needs less charity.” Crowdfunding shows that the inverse of this statement is also true: more charity means less justice. Ultimately, the spillover effects of crowdfunded care impact everyone: the world of the deserving popular is a very unhealthy place to end up. Real-world data reveals just how unequal the crowdfunding marketplace is, particularly for those who need the most help. But more broadly, it shows that the inequities of crowdfunding act like toxins that affect all of us—our health, our sense of what we owe each other, and our visions for the future.

-Nora Kenworthy

Nora Kenworthy is an Associate Professor of Health Studies at the University of Washington (UW) Bothell, and holds adjunct appointments in the Departments of Anthropology and Global Health at UW Seattle. She is the author of Crowded Out: The True Costs of Crowdfunding Healthcare (MIT Press, 2024), and of Mistreated: The Political Consequences of the Fight Against AIDS in Lesotho (Vanderbilt University Press, 2017).