I also stopped paying for health insurance; the cost of healthcare was already high and Obamacare only exacerbated the problem. This article is misleading, suggesting that the problem is the Trump administration rolling back Obamacare. The reality is that health insurance was high (over $1000/mo for me) before Obamacare, and Obamacare only made it higher still, nearly doubling the monthly cost.
I'm a self-employed contractor paid by the hour, and for my healthy family of 4, Blue Cross Blue Shield insurance here in Minnesota was going up to $1800/month. (It was $1600/mo in 2017, and $1400/mo in 2016.)
I switched to a Christian health bill sharing ministry[0]. You pay $450/mo for the entire family. And if you go to the hospital, you're on the hook for the first $500. Anything over $500 they cover 100%.
So, I lowered my health bill from $1800/mo to $450/mo.
The amount I save each month I put away in a separate bank account to use as emergency funds, medical or otherwise.
> I’m assuming you mean the Affordable Healthcare Act?
I’m assuming you mean the Patient Protection and Affordable Care Act, probably in combination with the related parts of the Health Care and Education Reconciliation Act of 2010.
Even Obama thinks the word Obamacare is fine[1] and it is much better name than the official one. "Obamacare" is short, unique and not made up of words that put some kind of spin on the bill. Names like "PATRIOT" act should be ridiculed and not used by the press or the public.
And this follows the "Romneycare" pattern or naming these sorts of things after their major proponents like "Reaganomics". I guess this "anthropomorphism" of concepts allows them personality and transfers some of their namesakes' charisma making the things "more relatable" to the "average Jane and Joe".
My Health insurance has also been in limbo since Obamacare.
I was working in retail at the time and my employer used it as justification to immediately cut our health insurance and start paying us a once yearly health insurance subsidy. Obamacare seemed ok for the first year, but it has slowly crept up and is now insanely pricey.
Will the government ever learn that pouring tons of taxpayer money into a broken system doesn't fix it? If milk was $50 a gallon a good fix would not be to give everyone a $200/month milk stipend (unless you wanted those sweet dairy kickbacks).
My health insurance was something like $800/mo with ObamaCare for 2 adults. When Trump said he wouldn’t reimburse insurance companies my insurance almost doubled to $1500 for the same plan(ish) with a higher deductible. We also opted for some sort of health sharing plan.
So yes, Trump rolling back Obamacare did massively increase health insurance.
Yes, you're correct, parts of Obamacare are still in effect. Trump "blew it up" by increasing the costs for insurance companies which passed the costs onto the insured.
Sorry for my question, but I am not familiar: What is the difference of the "Christian health bill sharing ministry" to health insurance. It seems to me to follow the main idea of health care, just you know in a social humane way closer to EU approach and not that of a we are going to gouge your eyes out like health insurance companies in the U.S. do. What am I missing?
Its the same thing, but its exempt from insurer regulations.
That means they are not obligated to cover your medical expense and you are not allowed to sue them. Repayment is always up to their discretion, and they can spend the money however they want.
They generally reimburse you after you've paid out of pocket, and normally have a lower cap on how much they'll reimbourse, something like up to 250k max.
Its Christian based, they normally only allow Christians to join, and won't pay for injuries caused by activities they don't believe follow their values. Such as STDs from sexual relations outside of marriage, drugs, alchool, fighting, etc.
So what is regulation replaced by? Trust in other Christians. If you trust Christians to be less corrupt and more fair in distributing the pool of money contributed in a fair way to members who most need it. And if you trust other members to be willing to suddenly give extra in case the pool runs out and people still need money for their medical expenses.
In contrast, with normal insurance you have to trust government audit to make sure insurers follow regulations, and trust that they won't wait for you to take them to court to pay up.
Generally, because real insurers have those regulation, they'll want to be very sure they can cover people even in the worst case, which means boosting premiums and deductibles, etc. Also, most normal insurers are for profit and might also want to charge more simply to boost their profit, while health sharing ministries are non for profit, though some of them have been criticised for their founders and employees to pay themselves too big a salary and give themselves too many bonuses.
> So what is regulation replaced by? Trust in other Christians.
Man it would be great if other areas of Human Life worked this way. You could get rid of the SEC and just let the bankers run with Christian trust instead of regulation.
I personally think the regulation is there for a reason but I'm really glad you found something that works for you and hope that your trust isn't taken advantage of.
I'm the original poster. FWIW, my friend is on the same Christian healthcare. Last year he had a pulmonary embolism, which required an ambulance and a week in the hospital. The final bill was over $30,000.
Within two weeks, the Christian healthcare wrote him a check covering the whole bill. I saw the check with my own eyes.
30k isn't much for insurance coverage. The point is these arrangements have no legal recourse if they simply deny you coverage, and the fact that they aren't bound by any type of insurance regulation means that nothing is stopping them from doing so except some feelings of charity. When that feeling of charity is overruled by financial sense for the group, people will be screwed over.
I don't deny that some things can go wrong, and I don't claim the system is perfect.
But at the same time, in my 2 decades with Blue Cross Blue Shield, I paid through the nose (more than my mortgage!) and things still went wrong. Hospitals went out of coverage due to failed negotiations with insurance providers. I was charged for things I didn't receive, I was billed more than expected for simple visits.
I'm not saying everyone needs to switch to Christian healthcare. I'm saying, the switch has worked well for me so far and I have saved over $10k in the span of about 10 months.
Yep. People will be screwed by this when the fund decides it doesn't want to pay out. Thoughts and prayers don't cure disease and insurance regulations exist for a reason
Apparently they're based on the bible quote: "Bear one another’s burdens, and thus fulfill the law of Christ.”
Which sounds to me like a good justification for nationwide healthcare like we have in Canada. Except its done in a Christianwide way instead of nationwide.
I find that interesting, since the argument against nationwide healthcare is often: "Why should I pay for other peoples health issues if I'm healthy." Or to put it differently, the every man for themselves mentality.
What are your thoughts on nationwide healthcare then, as an extended version of CHM, but where the values (aka, rules of elegibility, and what is covered/not covered) are those of the nation instead of those of specific Christian organizations?
Is it really important for you for it to be an opt in system? Is it really important that it be based on a specific interpretation of Christian values instead of the larger US values? Or is it just whatever is cheapest?
I ask out of interest in understanding varied perspectives, feel free to ignore my questions if you find them too personal.
I think most Americans who look deep into it view Health Sharing as a national Healthcare initiative. It's certainly extremely similar to me, minus the contributions coming in post-paycheck.
People (Americans) probably couldn't visualize savings with a national system before these really starting to become populate as of late. Maybe because it was mostly just an idea in our situation? (the burden of one spread across all)
Let's be honest, the Church is probably better at budgeting for this than the Government.
I wouldn't be surprised at all if these become more and more common for the common man that a suggestion to move to a national system is brought up (and taken a bit more seriously).
> What are your thoughts on nationwide healthcare then, as an extended version of CHM, but where the values (aka, rules of elegibility, and what is covered/not covered) are those of the nation instead of those of specific Christian organizations?
I don't like it for a few reasons. First, government is famous for inefficiency and bloat. I am certain the government would do a poor job of good, affordable healthcare. (Rational people must concede this given the evidence today.)
Secondly, cost will be a problem for any system that covers existing conditions; it's the equivalent to buying house insurance when your house has already burned down. That's not insurance.
Third, and most importantly, nationwide insurance is not a self-maintaining community. In small groups that share values, when someone no longer lives according to the community's standards, they're removed from the community. This is not possible in nationwide healthcare.
So, someone abusing the medical system or living a lifestyle contrary to standards of our community cannot continue abusing the system.
This self-maintaining socialistic system works well in smaller communities with shared values, where abusers can be removed from the community. In a nationwide system, this isn't possible, driving up costs further.
> Is it really important for you for it to be an opt in system?
Yes. I do not wished to be coerced into government programs of any kind. That this is both private and optional makes this attractive to me from a libertarian standpoint.
> Is it really important that it be based on a specific interpretation of Christian values instead of the larger US values?
Not a specific interpretation, no. Just the basic interpretation of caring for the sick; a plain interpretation of Jesus' words[0].
How does/did your prescription costs compare (if you had any)? I assume a generic co-pay for tiered drugs for your traditional plan; not sure what Health Sharing's different prescription discount plans provide.
I don't have much of anything against Christianity, but I think there's a market for Agnostic Health Sharing programs; for those who may be affected by these first two requirements, of which may be non-qualifying for some organizations/individuals.
9. Unwed mothers
There are times even in the Christian community that unwed
women become pregnant. Christian Healthcare Ministries members
have agreed not to share medical bills for pregnancies of unwed
mothers. Instead, CHM recognizes that in such circumstances
the assistance needed goes far beyond financial aid...
To be part of our community, you must abide by the community's rules. Our values include an ideal of male-female marriage, no sex outside of marriage, no drug use or alcohol abuse, etc. You know, the things we adherents of the Bible have believed for 3500 years. :-)
Interestingly enough, many of our values -- monogamy, heterosexual marriage, no drugs or alcohol abuse -- tend to produce people with fewer health issues.
You don't have to agree with us. If you don't like our values, by all means form your own medical health sharing groups.
Sure, I get it. I was genuinely intrigued. It seems that every health sharing program has a Christian background. Was wondering if there were other associations available.
But how is heterosexual marriage healthier than homosexual marriage?
I'd like generally know more about your prescription prices, if you don't mind elaborating (if you have any).
Homosexuality in general is associated with higher risk of disease[0].
But from a values standpoint, we believe (as we have for 3500 years) that God's ideal for humanity is monogamous male/female marriage. Homosexuality can't produce children and families, which are important for the stability of a civilization.
And, frankly speaking from experience, as a child and teen I benefited from having both a masculine father and a feminine mother. I needed both growing up. They both taught me things the other couldn't. All other things being equal, it is good and scientifically natural for a child to have both a mother and a father.
Prescriptions: Prescription prices can be bad. You get discounts as a self-payer. Places like Costco and Walgreen's typically have a membership where you get a pharmacy card and thus lower costs on prescriptions. But ultimately you're on the hook for the cost; health sharing ministries (at least, the one I'm using) don't help with it. If you have high cost prescriptions, health sharing ministries might not be a good option for you.
Not to pour cold water on you or anyone this is working for, but since this can read as a recommendation, it's worth pointing out a few things.
This is another form of insurance. It's arguably a distinct model for it than a conventional insurance company, but it's a way of addressing the same fundamental set of problems, so it's subject to the same realities and dynamics any insurance solution is.
So... why would it be so much cheaper?
Possible answers include no profit overhead, freedom from regulation might allow administrators to find efficiencies. And for some programs, particularly long-running ones tied to tightly-knit communities invested in taking care of everyone inside, perhaps it more or less works that way.
Possible answers also include basically everything you worried about conventional private insurers doing pre-ACA: avoiding expensive obligations through various exclusions, bureaucratic obstruction, or selectivity in adding people to the shared-cost pool. There's also the risk that for the given fees it's actually not going to work out for some HCSMs once they hit the wrong group roll of the health-event dice.
This is not to say it won't work out for you. It's worked out for some communities for a long time and may go well. Just be aware that it's also possible that the reason you're paying less is that you're not getting the same kind of backstop.
It's not insurance. They disclose this on their own site[0].
When you go to the hospital, you disclose that. "I don't have health insurance, I am self-paid with a health sharing ministry."
I think another major reason is that health sharing ministries don't typically cover pre-existing conditions. That is huge; acquiring health insurance for a pre-existing condition is like buying house insurance after your home has already burned down.
Another reason the cost is lower is that, unlike nationwide healthcare, we're a self-maintaining community. You abide by the communities standards -- which tend to decrease disease -- and you remain in the community. But if you break the community standards, and engage in medically-risky behavior, you're removed from the community.
This works great for smaller groups with shared values. It cannot work in nationwide healthcare. And it's a big reason the cost is so much lower.
Yeah it's basically weighing the cost of something expensive that probably won't happen (a claim) against the cost of something expensive that definitely will happen (premiums). If you can possibly save enough to "self-insure" against major expenses, you'll always be better off than paying for it.
Considering the origins of social healthcare, the benefits of it are usually highest for those who earn the least (when Bismarck introduced it in germany, workers who got injured were usually dead either by the wound or by starving because they lost money due to not showing up to work, not even beginning to be able to afford a doctor other than "susy from across the street knows how to amputate a leg")
Not even! The baseline of reasoning is to avoid sickness. Sickness is an uncomfortable thought, so some prefer to ignore it.
Which leads me to the paranoid thought that severe costs of some procedures are a tax on illness. Well, illness is taxing itself, so, by syllogism, that wouldn't even be absurd.
>Given the numbers these people are facing, I’d be a “gambler” too.
Not me. Premiums, as brutal as they are, absolutely pale in comparison to what health care can cost you in the US under the rubric of for-profit health insurance.
At several thousand per month, risking bankruptcy is actually the most prudent thing to do for many people. They can't take your house, and generally you can start getting loans a year afterward.
Recent bankruptcy actually makes it easier to get credit cards than the typical pre-bankruptcy credit history. You're barred from filing bankruptcy again, so credit card companies are surprisingly willing to lend you money (since if you don't pay them back, they can sue you and garnish your wages and you have little recourse).
Something like 62% of bankruptcies are due to medical bills.
>At several thousand per month, risking bankruptcy is actually the most prudent thing to do for many people. They can’t take your house
“They can’t take your house” is not only totally false, it betrays a property owner’s perspective that tens of millions of patients at risk of medical destitution do not share. This kind of hand-waving is self-absorbed, clueless and destructive.
Sure, renters are in a tougher spot. However the scale of the problem has expanded to include property owners - people we'd previously consider to be pretty financially secure.
Many do so because they don't have a choice - they cannot afford it. Even if they can scrape together enough money to pay $10,000+ annually in premiums, that doesn't account for the $5,000+ deductible they have to pay out of pocket before insurance starts paying (some!) of the costs. Most Working people cannot afford to shell out $15,000 a year - it isn't a matter of choice. This is yet another stain on our country when, per capita, we already spend far more than ever other nation in the world - many of whom have universal healthcare and all of whom have far better national health and longer lifespans than we do here in the USA. We are below Costa Rica, Chile, and Slovenia in lifespan - 31st globally! One of just many reasons people are sick on tired of the neo-liberal garbage rhetoric spewed by the criminals in Washington DC (and why they are willing to vote for against them no matter how corrupt or despicable the "outsider" is).
US$150 a month for family of three, to cover if I want to go private and be served immediately.
Otherwise I can go to our public healthcare system which is good and pretty much free but may have a waiting period for not so urgent care.
I don’t know why some Americans hate this. It’s not either/or. We have both public and private healthcare, use both, and our taxes are not insane to pay for it (33% income tax at top tier).
Example: Paid all of US$50 for all the medical scans and pre-checks over 9 months, birth and 3 day hospital care for my recently born son. Parking at the hospital over those 3 days was more.
However: Dental care after 18 is not free, and is closest to the American system. And it is also insanely expensive here. Looking at a few grand for basic procedures.
But we don't have a military industrial complex to feed.
Also, New Zealand is laughably straightforward in terms of governing structure. Hard to have too much duplication (and easy to hit economies of scale) when there's only one Police Force for example. In the US there's the Federal, and the State, and the Municipal level. All with monster bureaucracies.
I'm not advocating zero cost sharing. I'm in favor of percentage based cost sharing (vs. copay), along with prenegotiated fixed rate for costly procedures.
If you're conscientious about health care utilization it's worse than that, though. If you have a zero deductible policy, you're priced based on the typical health care utilization of somebody on a zero deductible plan. Since people on zero deductible plans probably utilize more health care than people who are not, you're paying for high utilization whether you use it or not. IMO, it's probably better for most people to be on a high deductible plan and then just be judicious about going to the doctor.
Co pays can address the utilization problem, at least to some extent. That way you have a reason not to go in for every little thing but don't get slammed by a big bill from a specialist.
Nonsense. I'm happy to pay my actual health care costs (nevermind doctors don't know how much they'll charge me). I want health insurance for the crazy once in a lifetime bankrupting event. I want insurance, where if I end up in a random ER through no fault of my own I don't have to pay a $100k+ bill. Meanwhile, let me have a large deductible so I can 'self insure' as much as possible, and save money on monthly premiums.
I thought that this was a reasonable way to think about health insurance until the time I ended up in a random ER "through no fault of my own", and after spending several months watching bills roll in and learning just how skillful an insurance company can be at accomplishing their primary job, which is to avoid paying for health care, found that the impact of an enormous unexpected expense you cannot possibly afford is not substantially lessened by the knowledge that it could have been worse.
There is a corollary to the law of diminishing marginal utility here. If having health insurance actually meant I didn't have to worry about the impact of future unexpected disasters, then the incredible monthly cost might seem worthwhile; but all it's going to do is push the threshold of disaster upward, so I'd rather manage risk by maximizing flexibility and keep the cash in my pocket instead.
62 comments
[ 2.9 ms ] story [ 114 ms ] threadI'm a self-employed contractor paid by the hour, and for my healthy family of 4, Blue Cross Blue Shield insurance here in Minnesota was going up to $1800/month. (It was $1600/mo in 2017, and $1400/mo in 2016.)
I switched to a Christian health bill sharing ministry[0]. You pay $450/mo for the entire family. And if you go to the hospital, you're on the hook for the first $500. Anything over $500 they cover 100%.
So, I lowered my health bill from $1800/mo to $450/mo.
The amount I save each month I put away in a separate bank account to use as emergency funds, medical or otherwise.
It's been working out fantastically.
[0]: There are numerous ones, but I use http://chministries.org
I’m assuming you mean the Patient Protection and Affordable Care Act, probably in combination with the related parts of the Health Care and Education Reconciliation Act of 2010.
[1]https://www.politico.com/story/2014/02/barack-obama-obamacar...
I was working in retail at the time and my employer used it as justification to immediately cut our health insurance and start paying us a once yearly health insurance subsidy. Obamacare seemed ok for the first year, but it has slowly crept up and is now insanely pricey.
Will the government ever learn that pouring tons of taxpayer money into a broken system doesn't fix it? If milk was $50 a gallon a good fix would not be to give everyone a $200/month milk stipend (unless you wanted those sweet dairy kickbacks).
So yes, Trump rolling back Obamacare did massively increase health insurance.
That means they are not obligated to cover your medical expense and you are not allowed to sue them. Repayment is always up to their discretion, and they can spend the money however they want.
They generally reimburse you after you've paid out of pocket, and normally have a lower cap on how much they'll reimbourse, something like up to 250k max.
Its Christian based, they normally only allow Christians to join, and won't pay for injuries caused by activities they don't believe follow their values. Such as STDs from sexual relations outside of marriage, drugs, alchool, fighting, etc.
So what is regulation replaced by? Trust in other Christians. If you trust Christians to be less corrupt and more fair in distributing the pool of money contributed in a fair way to members who most need it. And if you trust other members to be willing to suddenly give extra in case the pool runs out and people still need money for their medical expenses.
In contrast, with normal insurance you have to trust government audit to make sure insurers follow regulations, and trust that they won't wait for you to take them to court to pay up.
Generally, because real insurers have those regulation, they'll want to be very sure they can cover people even in the worst case, which means boosting premiums and deductibles, etc. Also, most normal insurers are for profit and might also want to charge more simply to boost their profit, while health sharing ministries are non for profit, though some of them have been criticised for their founders and employees to pay themselves too big a salary and give themselves too many bonuses.
Man it would be great if other areas of Human Life worked this way. You could get rid of the SEC and just let the bankers run with Christian trust instead of regulation.
I personally think the regulation is there for a reason but I'm really glad you found something that works for you and hope that your trust isn't taken advantage of.
Within two weeks, the Christian healthcare wrote him a check covering the whole bill. I saw the check with my own eyes.
But at the same time, in my 2 decades with Blue Cross Blue Shield, I paid through the nose (more than my mortgage!) and things still went wrong. Hospitals went out of coverage due to failed negotiations with insurance providers. I was charged for things I didn't receive, I was billed more than expected for simple visits.
I'm not saying everyone needs to switch to Christian healthcare. I'm saying, the switch has worked well for me so far and I have saved over $10k in the span of about 10 months.
Which sounds to me like a good justification for nationwide healthcare like we have in Canada. Except its done in a Christianwide way instead of nationwide.
I find that interesting, since the argument against nationwide healthcare is often: "Why should I pay for other peoples health issues if I'm healthy." Or to put it differently, the every man for themselves mentality.
What are your thoughts on nationwide healthcare then, as an extended version of CHM, but where the values (aka, rules of elegibility, and what is covered/not covered) are those of the nation instead of those of specific Christian organizations?
Is it really important for you for it to be an opt in system? Is it really important that it be based on a specific interpretation of Christian values instead of the larger US values? Or is it just whatever is cheapest?
I ask out of interest in understanding varied perspectives, feel free to ignore my questions if you find them too personal.
People (Americans) probably couldn't visualize savings with a national system before these really starting to become populate as of late. Maybe because it was mostly just an idea in our situation? (the burden of one spread across all)
Let's be honest, the Church is probably better at budgeting for this than the Government.
I wouldn't be surprised at all if these become more and more common for the common man that a suggestion to move to a national system is brought up (and taken a bit more seriously).
> What are your thoughts on nationwide healthcare then, as an extended version of CHM, but where the values (aka, rules of elegibility, and what is covered/not covered) are those of the nation instead of those of specific Christian organizations?
I don't like it for a few reasons. First, government is famous for inefficiency and bloat. I am certain the government would do a poor job of good, affordable healthcare. (Rational people must concede this given the evidence today.)
Secondly, cost will be a problem for any system that covers existing conditions; it's the equivalent to buying house insurance when your house has already burned down. That's not insurance.
Third, and most importantly, nationwide insurance is not a self-maintaining community. In small groups that share values, when someone no longer lives according to the community's standards, they're removed from the community. This is not possible in nationwide healthcare.
So, someone abusing the medical system or living a lifestyle contrary to standards of our community cannot continue abusing the system.
This self-maintaining socialistic system works well in smaller communities with shared values, where abusers can be removed from the community. In a nationwide system, this isn't possible, driving up costs further.
> Is it really important for you for it to be an opt in system?
Yes. I do not wished to be coerced into government programs of any kind. That this is both private and optional makes this attractive to me from a libertarian standpoint.
> Is it really important that it be based on a specific interpretation of Christian values instead of the larger US values?
Not a specific interpretation, no. Just the basic interpretation of caring for the sick; a plain interpretation of Jesus' words[0].
[0]: https://www.biblegateway.com/passage/?search=matthew+25%3A35...
Do you have to attend a church (and prove it)?
Does it support same-sex marriages?
How does/did your prescription costs compare (if you had any)? I assume a generic co-pay for tiered drugs for your traditional plan; not sure what Health Sharing's different prescription discount plans provide.
I don't have much of anything against Christianity, but I think there's a market for Agnostic Health Sharing programs; for those who may be affected by these first two requirements, of which may be non-qualifying for some organizations/individuals.
===========================================================
From their guidelines:
9. Unwed mothers There are times even in the Christian community that unwed women become pregnant. Christian Healthcare Ministries members have agreed not to share medical bills for pregnancies of unwed mothers. Instead, CHM recognizes that in such circumstances the assistance needed goes far beyond financial aid...
I saw that coming from a mile away...
Helping when help is needed is a core Christian value, I'm told.
To be part of our community, you must abide by the community's rules. Our values include an ideal of male-female marriage, no sex outside of marriage, no drug use or alcohol abuse, etc. You know, the things we adherents of the Bible have believed for 3500 years. :-)
Interestingly enough, many of our values -- monogamy, heterosexual marriage, no drugs or alcohol abuse -- tend to produce people with fewer health issues.
You don't have to agree with us. If you don't like our values, by all means form your own medical health sharing groups.
But how is heterosexual marriage healthier than homosexual marriage?
I'd like generally know more about your prescription prices, if you don't mind elaborating (if you have any).
But from a values standpoint, we believe (as we have for 3500 years) that God's ideal for humanity is monogamous male/female marriage. Homosexuality can't produce children and families, which are important for the stability of a civilization.
And, frankly speaking from experience, as a child and teen I benefited from having both a masculine father and a feminine mother. I needed both growing up. They both taught me things the other couldn't. All other things being equal, it is good and scientifically natural for a child to have both a mother and a father.
Prescriptions: Prescription prices can be bad. You get discounts as a self-payer. Places like Costco and Walgreen's typically have a membership where you get a pharmacy card and thus lower costs on prescriptions. But ultimately you're on the hook for the cost; health sharing ministries (at least, the one I'm using) don't help with it. If you have high cost prescriptions, health sharing ministries might not be a good option for you.
[0]: https://www.cdc.gov/hiv/group/msm/index.html
This is another form of insurance. It's arguably a distinct model for it than a conventional insurance company, but it's a way of addressing the same fundamental set of problems, so it's subject to the same realities and dynamics any insurance solution is.
So... why would it be so much cheaper?
Possible answers include no profit overhead, freedom from regulation might allow administrators to find efficiencies. And for some programs, particularly long-running ones tied to tightly-knit communities invested in taking care of everyone inside, perhaps it more or less works that way.
Possible answers also include basically everything you worried about conventional private insurers doing pre-ACA: avoiding expensive obligations through various exclusions, bureaucratic obstruction, or selectivity in adding people to the shared-cost pool. There's also the risk that for the given fees it's actually not going to work out for some HCSMs once they hit the wrong group roll of the health-event dice.
This is not to say it won't work out for you. It's worked out for some communities for a long time and may go well. Just be aware that it's also possible that the reason you're paying less is that you're not getting the same kind of backstop.
Further reading:
* https://www.buzzfeed.com/lauraturner/christian-health-care
* https://www.theatlantic.com/health/archive/2012/07/a-christi...
* https://www.huffingtonpost.com/entry/christian-health-minist...
* https://www.nytimes.com/2015/02/01/opinion/sunday/onward-chr...
* https://obamacarefacts.com/healthcare-sharing-ministry-exemp...
When you go to the hospital, you disclose that. "I don't have health insurance, I am self-paid with a health sharing ministry."
I think another major reason is that health sharing ministries don't typically cover pre-existing conditions. That is huge; acquiring health insurance for a pre-existing condition is like buying house insurance after your home has already burned down.
Another reason the cost is lower is that, unlike nationwide healthcare, we're a self-maintaining community. You abide by the communities standards -- which tend to decrease disease -- and you remain in the community. But if you break the community standards, and engage in medically-risky behavior, you're removed from the community.
This works great for smaller groups with shared values. It cannot work in nationwide healthcare. And it's a big reason the cost is so much lower.
[0]: www.chministries.org/downloads/newsletters/CHMApril2013.pdf
/thread
Yeah it's basically weighing the cost of something expensive that probably won't happen (a claim) against the cost of something expensive that definitely will happen (premiums). If you can possibly save enough to "self-insure" against major expenses, you'll always be better off than paying for it.
Which leads me to the paranoid thought that severe costs of some procedures are a tax on illness. Well, illness is taxing itself, so, by syllogism, that wouldn't even be absurd.
/thread
Not me. Premiums, as brutal as they are, absolutely pale in comparison to what health care can cost you in the US under the rubric of for-profit health insurance.
Something like 62% of bankruptcies are due to medical bills.
“They can’t take your house” is not only totally false, it betrays a property owner’s perspective that tens of millions of patients at risk of medical destitution do not share. This kind of hand-waving is self-absorbed, clueless and destructive.
Healthcare in America is basically gambling at this point.
- $900 a month, $1000 deductible
- $400 a month, $7000 deductible, doesn’t cover one cent for doctors or hospitals I use
Notice that the deductible gap and the higher fees equal $6000 a year in either plan. Three choices: A, B, or neither
Otherwise I can go to our public healthcare system which is good and pretty much free but may have a waiting period for not so urgent care.
I don’t know why some Americans hate this. It’s not either/or. We have both public and private healthcare, use both, and our taxes are not insane to pay for it (33% income tax at top tier).
Example: Paid all of US$50 for all the medical scans and pre-checks over 9 months, birth and 3 day hospital care for my recently born son. Parking at the hospital over those 3 days was more.
However: Dental care after 18 is not free, and is closest to the American system. And it is also insanely expensive here. Looking at a few grand for basic procedures.
Disclaimer: New Zealand.
Also, New Zealand is laughably straightforward in terms of governing structure. Hard to have too much duplication (and easy to hit economies of scale) when there's only one Police Force for example. In the US there's the Federal, and the State, and the Municipal level. All with monster bureaucracies.
Observations: Also Kiwi, but live in 'Murica.
Even when I had plan with $1000 deductible, I thought twice about going to doctor. $6000? It might as well be called health scam.
Deductible may discourage people from going, but it also encourage over utilization once you go over the threshold.
Vis-a-vis.
The problem is that people are now accepting this type of coverage as new normal and also paying arm and leg for it.
It's a damn shame they made an extremely profitable business out of it.
There is a corollary to the law of diminishing marginal utility here. If having health insurance actually meant I didn't have to worry about the impact of future unexpected disasters, then the incredible monthly cost might seem worthwhile; but all it's going to do is push the threshold of disaster upward, so I'd rather manage risk by maximizing flexibility and keep the cash in my pocket instead.
https://wire.ama-assn.org/ama-news/analysis-health-care-spen...