There's a heart-warming story in the news recently.
Dr Pallavi Patel, pledged $200m to a Florida university - the largest donation ever from an Indian-American to a US institution. Nova Southeastern University (NSU) will use the gift to create two medical colleges - one in Florida, another in India.
So far so good. Let's look at the background:
That's basically the nub of the problem for me. And it is a twofold problem. First of all, you can have an economic system that exploits the vulnerable, as has happened here.
The second part of the problem is that although the system provides some people with the opportunity to give large sums to charity, even this is not without cost. Because the donors can impose their own beliefs and values in terms of who they give the money to and what it can be spent on. Neither of these may always be consistent with the interests of the State as expressed in a democracy.
In this specific instance, a tax based healthcare system makes it obligatory on the rich to pay, the obligations are on them an not the masses. Charity, on the other hand, places obligations on the recipient, the power balance is completely altered.