基于社交网络的大病众筹信任问题研究——从“指尖公益”到“眼前质疑”的过程—机制分析

The Trust Problem of Crowdfunding Model for Serious Illness Based on Social Network—An explanation from“Fingertip Public Welfare”to“Immediate Doubt”

当前,我国基于社交网络的大病众筹模式正在从“指尖公益”走向“眼前质疑”并遭遇严重信任危机。既有相关研究难以对当前大病众筹信任危机及其根源复杂性做出充分解释。基于大病众筹项目实践的过程-机制分析表明:当前基于社交网络的大病众筹模式,本质上是一种基于互联网技术、面向社会公众、远超熟人社会范围、人人皆可参与的现代新型社会互助机制。求助人、众筹平台、捐助人是其中最重要的三个主体:求助人作为大病众筹项目发起人,天然具备隐藏自身家庭财产状况、通过制造悲情叙事来吸引社会公众关注,以获得爱心捐助的内在心理和行为逻辑;众筹平台作为信息发布平台和公益项目商业化运作公司,在既有资本谋利逻辑下,天然具有放松信息筛查、降低信息审查门槛以吸引潜在用户、引导社会公众进行爱心捐助进而收割流量的强烈动机;作为捐助人,社会公众天然属于被悲情叙事宣传、广泛社会动员的潜在宣传动员对象,缺乏对模糊信息以及虚假求助信息的甄别判断的基础性环境。在此过程中,作为重要基础性信息掌握者的熟人社会、权威信息掌握者的政府以及专业信息掌握者的医疗机构专业人士又往往是缺席的。在既有大病众筹网络环境下,以上各主体秉持各自利益立场与常见话语,必然导致信任危机的出现。优化思路在于:一是建立面向求助者信息发布的追责机制,确保信息真实有效;二是完善面向平台公司的市场监管机制,维护市场良性秩序;三是探索建立政府职能部门与平台公司的协同治理机制,确保公共机构积极履责不缺位;四是积极引导并建立由医疗机构和专业人士组成的专业参与机制,积极发挥专业信息的建设性作用。治本之策关键在于:一是通过医药体制改革,有效降低居民家庭医疗成本负担;二是在医疗成本短时间内难以有效降低的情况下,可探索成立由国家主导或省级政府主导的福利导向的普惠性补充医疗保险,最大限度地缓解绝大多数家庭的就医困境。

At present,China's social network-based crowdfunding model for serious diseases is changing from“fingertip public welfare”to“immediate doubt”and encounters a serious crisis of trust.Existing research is difficult to fully explain the current crisis of trust in crowdfunding for critical illnesses and the complexity of its root causes.The process-mechanism analysis based on the practice of crowdfunding projects for serious illnesses shows that the current crowdfunding model for serious illnesses based on social networks is essentially a new model of social support mechanism based on Internet technology,oriented to the public,far beyond the social scope of acquaintances,and accessible to everyone.Help seekers,crowdfunding platforms,and donors are the three most important subjects:As the initiator of crowdfunding projects for serious illness,help seekers naturally have the ability to hide their family property status,and create tragic narratives to attract public attention to obtain the internal psychology and behavioral logic of loving donations.As an information release platform and a commercialized operation company for public welfare projects,crowdfunding platforms naturally have the ability to relax information screening and lower down the threshold for information review to attract potential users and guide the public to conduct business under the logic of profit-seeking with existing capital.As donors,the public is naturally a potential target of publicity and mobilization by tragic narrative propaganda and extensive social mobilization,and lacks a basic condition for screening and judging vague information and false help-seeking information.During this process,the acquaintance society as the master of important basic information,the government as the master of authoritative information,and the professionals of medical institutions as the master of professional information are often absent.In the existing crowdfunding network environment for serious diseases,the above-mentioned subjects uphold their own interests and common discourses,which will inevitably lead to the emergence of a crisis of trust.The optimization idea is:first,establishing a accountability mechanism for information release for help seekers to ensure that the information is true and effective;second,improving the market supervision mechanism for platform companies to maintain a benign market order;third,exploring the establishment of coordination between government functional departments and governance mechanism for platform companies to ensure that public institutions actively fulfill their responsibilities;fourth,actively guiding and establishing a professional participation mechanism composed of medical institutions and professionals,and actively playing the constructive role of professional information.The key to solving the problem lies in:firstly,through the reform of the medical system,to effectively reduce the medical cost burden of residents'families;second,in the case that it is difficult to effectively reduce the medical cost in a short time,the establishment of welfare-oriented supplementary medical insurance led by the state or provincial government can be explored to maximize the medical dilemma of the vast majority of families.