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Crowded Out: The Dark Side Of Crowdfunding Healthcare And Its Historical Precedents

The moral terrain of crowdfunding is fueled by two persistent social ideologies: the dual, and intertwined, myths of meritocracy and the “deserving poor.”

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.