Health Policy

No Names, Please


Feeling good about your holiday spending?  You’ve made it through most of this mostly horrible 2020, maybe lost a job or even a loved one, but still probably found a way to buy presents for your loved ones and maybe even to give some money to charity.  Indeed, charitable giving was up 7.5% for the first half of 2020, despite the economic headwinds.

Then there’s MacKenzie Scott.

Ms. Scott, as you may recall, is the former wife of Amazon founder/CEO Jeff Bezos.  She got Amazon stock worth some $38b in their 2019 divorce, which is now estimated to be worth around $62b.  She just gave away $4.2b – and that’s on top of $1.7b she gave away in July

In case your math skills are impaired, that’s $6b in six months, which Melissa Berman, chief executive officer of Rockefeller Philanthropy Advisors told Bloomberg: “has to be one of the biggest annual distributions by a living individual.”   Ms. Scott has vowed: “I will keep at it until the safe is empty.”

Kenzie Bryant, writing in Vanity Fair, marveled: “It gives a whole new meaning to “fuck-you money.” 

Private foundations are required to distribute at least 5% of their endowments each year; Ms. Scott not only has given away 10% of her net worth this year alone, but she hasn’t even used a foundation to do so.  As The New York Times reported: “Ms. Scott’s operation has no known address — or even website. She refers to a “team of advisers” rather than a large dedicated staff.”

She doesn’t make recipients plead for money through grant applications.  She doesn’t specify how the money is to be used, or require reports on how it is spent.  She doesn’t expect her name on anything.  She doesn’t even make public how much she is giving each recipient (although some choose to do so).

NYT says:

Ms. Scott has turned traditional philanthropy on its head…By disbursing her money quickly and without much hoopla, Ms. Scott has pushed the focus away from the giver and onto the nonprofits she is trying to help.

Ms. Scott’s Medium post outlined her goals for the giving: “special attention to those operating in communities facing high projected food insecurity, high measures of racial inequity, high local  poverty rates, and low access to philanthropic capital.”  Easterseals, food banks, Goodwill, Meals-on-Wheels, United Way, and YMCAs accounted for a large number of recipients.  She’s guided by “a conviction that people who have experience with inequities are the ones best equipped to design solutions.”

In all, Ms. Scott and her team analyzed nearly 6,500 organizations and made grants to 384, in all 50 states, Washington D.C., and Puerto Rico. 

The Washington Post did its own calculation and estimate that at least $800 million of her donations went to higher education institutions, especially those serving people of color: “$147 million went to Hispanic-serving institutions, $5 million to tribal colleges and $560 million to historically Black colleges and universities. In addition, a total of $130 million went to five other public colleges in Florida, Washington state, Nebraska and Kentucky.” 

Rob Reich, co-director of the Center on Philanthropy and Civil Society at Stanford, told NYT: “She’s moved extraordinary sums out the door, quickly, in an anti-paternalistic way.”  Debra Mesch, a professor at the Women’s Philanthropy Institute at Indiana University added:

If you look at the motivations for the way women engage in philanthropy versus the ways that men engage in philanthropy, there’s much more ego involved in the man, it’s much more transactional, it’s much more status driven.  Women don’t like to splash their names on buildings, in general.

Take that, Mark Zuckerberg (or, rather, take this).   

The New York Post put the difference with typical bluntness:

While all the tech bros fight over colonizing space and California tax codes, banding together for the only thing they really care about — fending off anti-trust legislators — Scott makes them all look like stingy, greedy incels without a shred of compassion for those ruined by COVID-19. 

Healthcare likes to splash donors’ names on buildings.  Healthcare organization, especially hospitals, like to get big donors on their boards as a reward for, or incentive to get, donations.  Look at the nearest big hospital.  Chances are there are wings, departments, even buildings with big donors’ names on them.  Maybe there’s a brick or a plaque with your name on it to commemorate a smaller donation too.  Medical schools have followed suit

Lately, hospitals have made targeted efforts to solicit patients for donations.  In 2019, NYT reported:

Many hospitals conduct nightly wealth screenings — using software that culls public data such as property records, contributions to political campaigns and other charities — to gauge which patients are most likely to be the source of large donations.

“Nightly wealthy screenings.”  That should make us all shudder.  Hospitals do this despite the fact that patients generally look down upon the practice, with most fearing it might interfere with the patient-physician relationship.  They’re probably right.

It’s easy to do those kinds of donations: we sympathize with the hard-working hospital staff, we can tell if the buildings look modern or run-down, and chances are we or someone we know has used that hospital.  Making a donation is an easy way to seem like we’re making a difference; the bigger the donation, the bigger the difference.

And maybe we’ll get our name on something.

That’s not a way to run a healthcare system – or a society.  Ideally, our taxes would help assure that we all have access to enough food, safe housing, good education, clean air and water, reliable infrastructure, decent paying jobs, and quality healthcare – all at affordable levels.  To the extent that our taxes don’t prove sufficient, those of us with some extra left over can help fund organizations that try to make things better for those who are less well off.

Ms. Scott pleaded:

If you’re craving a way to use your time, voice, or money to help others at the end of this difficult year, I highly recommend a gift to one of the thousands of organizations doing remarkable work all across the country. Every one of them could benefit from more resources to share with the communities they’re serving. And the hope you feed with your gift is likely to feed your own.

There are a lot of unmet needs in our society, especially during this pandemic.  Ms. Scott is showing us that we can do something about them.  We shouldn’t just admire her; we should try to emulate her, especially (but not only) anyone with a few billion dollars.

Kim is a former emarketing exec at a major Blues plan, editor of the late & lamented, and now regular THCB contributor.

Categories: Health Policy

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