The difference is that there are many actions that help other people but don't give an appropriate altruistic high (because your brain doesn't see or relate to those people much) and there are actions that produce a net zero or net negative effect but do produce an altruistic high.

The built-in care-o-meter of your body has known faults and biases, and it measures something often related (at least in classic hunter-gatherer society model) but generally different from actually caring about other people.

I came to the conclusion that I needed more quantitative data about the ecosystem. Sure birds covered in oil look sad, but would a massive loss of biodiversity on THIS beach effect the entire ecosystem? The real question I had in this thought experiment was "how should I prevent this from happening in the future?" Perhaps nationalizing oil drilling platforms would allow governments to better regulate the potentially hazardous practice. There is a game going on whereby some players are motivated by the profit incentive and others are motivated by genuine altruism, but it doesn't take place on the beach. I certainly never owned an oil rig, and couldn't really competently discuss the problems associated with actual large high pressure systems. Does anyone here know if oil spills are an unavoidable consequence of the best long term strategy for human development? That might be important to an informed decision on how much value to place on the cost of the accident, which would inform my decision about how much of my resources I should devote to cleaning the birds.

From another perspective, its a lot easier to quantify the cost for some outcomes ... This makes it genuinely difficult to define genuinely altruistic strategies for entities experiencing scope insensitivity. And along that line giving away money because of scope insensitivity IS amoral. It differs judgement to a poorly defined entity which might manage our funds well or deplorably. Founding a cooperative for the purpose of beach restoration seems like a more ethically sound goal, unless of course you have more information about the bird cleaners. The sad truth is that making the right choice often depends on information not readily available, and the lesson I take from this entire discussion is simply how important it is that humankind evolve more sophisticated ways of sharing large amounts of information efficiently particularly where economic decisions are concerned.

Because I wouldn't actually care if my actions actually help, as long as my brain thinks they do.

What is the difference between an altruistic high and caring about other people? Isn't the former what the latter feels like?

If there's no difference we arrive at the general problem of wireheading. I suspect very few people who identify themselves as altruists would choose being wireheaded for altruistic high. What are the parameters that would keep them from doing so?