Sunday, August 15, 2010

Like the Amish - Medical Expense Sharing

I learned that the new ObamaCare bill has a loophole that should be utilized to the point of collapsing the whole charade of "government" mandated health care insurance.

There is a religious exemption in the bill based on the Amish (and other Christian sects) belief it is the religious duty of communities is to provide for one another when they are sick. There has been a long-standing historical tradition to grant exemptions based on religious beliefs. The bill uses the same religious exemption that was used for Medicare, which exempts certain groups if they have religious objections and they belong to a recognized religion. The existence of the exemption, would release an Amish person or Old Order Mennonite from the individual mandate.

To qualify for the exemption, a person will have to prove he is a member of a qualifying religious group that has been in existence continuously since 1950. The details of the bill, such as how to apply for such an exemption, have yet to be determined.

The interesting thing is that it would be unconstitutional for the government to reject, let's say, a mainline Christian medical sharing organization the same exemption.

Largely unknown to the general public and surely not examined during the "health care" debate is the fact that there exists serious alternatives to standard health insurance that have been around since the 90's when health care costs started rising into the stratosphere. One is a medical sharing plan. In short, the participants in the plans assume responsibility for paying the medical expenses of the program members. This is done by averaging the cost of health care and dividing that into a monthly premium or pledge that each participant is required to make. Instead of pooling the money, the participants send their monthly pledge directly to another participant who has a current medical expense. Participants pledge that they are church-going Christians and that they abstain from alcohol and tobacco. This helps keep the health costs lower than those of the general population.

As many as five Christian-based medical sharing programs have been successfully administered for over a decade. Almost all participants are generally satisfied and find the medical sharing programs equal or superior to standard health insurance policies.

There are some downsides to any of these programs, not the least of which is the problem of dealing with health care providers without standard insurance. Most of these plans have indicated that this is not a serious problem. As it happens many hospitals and doctors already have experience with one or more of the medical sharing plans. Additionally it is not uncommon for hospitals and doctors to give very decent discounts because they are being paid in cash rather than having to deal with insurance companies.

One serious problem has been if expensive health care is needed the hospital and doctors have not wanted to perform costly procedures without a substantial down payment. It seems to me that this could be worked out by creating a reserve in advance. Also, in some of these plans there is little in the way of maternity care. If there are complications for mother or child in childbirth, or within the first six months of the child's life one could be stuck with a bill of tens of thousands, if not hundreds of thousands of dollars, with no way to pay it.

Obviously someone gaming the system and the good will of the "Plan" could sour the whole concept. It is a voluntary system and it is my understanding that no contracts are signed. Looking at the Samaritan Ministries program: (PLEASE NOTE, THIS INFO FOUND ON THE INTERNET...) the cost is $85 per month for single, $170 for married, and $195 for a family with three or more children. There is also a $150 per year fee that goes to the operation of Samaritan Ministries. The subscriber pays for the first three medical incidents per year under $300, and the program shares the cost of treatments over $300 (up to $100,000). Simply put, based on what I pay for health care through my employer this is comparable. My guess is that if this practice of medical sharing became larger these costs would come down simply because no one is trying to make a profit. Since the hospitals an doctors get paid as a fee for service the free market system would be preserved. There would be more cooperation between the patient and the provider to keep the costs down and the need for the government to control every aspect of the delivery of medical care would disappear.

In my mind this sort thing is closer to what we should be doing than a Canadian style government owned health care system. Doctors, nurses and hospital workers all across this country do not want to be federal employees - and nothing good will come if they are.



Anonymous said...

Great article. Well written and very useful. Thanks a lot.

Check this out too:
Medisoft Program