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Sharing the Load: Amish Healthcare Financing (2016)

ncbi.nlm.nih.gov

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Re: Sharing the Load: Amish Healthcare Financing (2016)

#11
post #2

For an example of how most of these cost-sharing plans go, see this article on the implosion of a commercial plan that preyed on the Mennonites of southern Ohio: https://www.propublica.org/article/liberty-healthshare-healt... Amish economics are weird, because the deep aversion to debt tends to create winner-take-all scenarios: an Amish farmer might become wealthy from mineral and gas rights on his property, for exam…

Your own article indicates it really has nothing to do with the research piece posted:

Health care sharing ministries have existed since the early 1900s, primarily among Mennonites and the Amish. The idea was simple: Members chip in what they can to help cover a neighbor’s costs when someone breaks a leg, say, or falls ill. It was the financial equivalent of a potluck dinner, with everyone contributing something to the table and sharing the spread.

Few outside those communities knew or cared that health care sharing ministries existed. They were tiny, didn’t advertise for new members and posed no threat to corporate insurance. Most importantly, no one envisioned making money from a ministry.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#12
post #8

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

Is that not what I do when comparing plans on healthcare.gov?

That’s exactly what it is except they have base “minimum essential coverage” laws that these ministries don’t abide by.

“HCSMs are not regulated by the ACA. The coverage you get will vary from one HCSM to another, but they are not required to cover pre-existing conditions, cap out-of-pocket costs, or cover essential health benefits. And they can still have annual and lifetime benefit caps.”

Since they’re not regulated entities, there’s no enforcement mechanism if you get sick and they decide not to pay out or delay your reimbursement.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#14

I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor. They have established sources of information and support for this practice. 2. When it comes to medical care, they are not Luddites and are willing to use cutting edge technologies to care for medical issues. 3. I was struck by the repeated ment…

> This may sound harsh to some people, but all insurance policies have exemptions which (at least for accident policies) more or less boil down to "if you are behaving irresponsibly and get yourself hurt through taking undue risks, we are not paying for the consequences of your foolish behavior" -- only, you know, in legalese that is defensible in court if necessary.

Some accident policies may have those features, but zero health insurance ones do.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#15

I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor. They have established sources of information and support for this practice. 2. When it comes to medical care, they are not Luddites and are willing to use cutting edge technologies to care for medical issues. 3. I was struck by the repeated ment…

> This may sound harsh to some people, but all insurance policies have exemptions which (at least for accident policies) more or less boil down to "if you are behaving irresponsibly and get yourself hurt through taking undue risks, we are not paying for the consequences of your foolish behavior" -- only, you know, in legalese that is defensible in court if necessary. Some accident policies may have those features, bu…

All insurance policies have limits on what they will pay. Those limits come in various forms, such as:

1. What you pay out of pocket before insurance coverage kicks in.

2. No coverage for out-of-network providers.

3. Caps on how much they will cover.

Insurance is a numbers game. Rest assured, all insurance policies and all insurance providers find ways to limit how much they pay out.

You may find some means to limit payments more distasteful than others, but they all do this. It's the only way they can possibly stay in business.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#16

Earlier quoted context omitted.

> This may sound harsh to some people, but all insurance policies have exemptions which (at least for accident policies) more or less boil down to "if you are behaving irresponsibly and get yourself hurt through taking undue risks, we are not paying for the consequences of your foolish behavior" -- only, you know, in legalese that is defensible in court if necessary. Some accident policies may have those features, bu…

All insurance policies have limits on what they will pay. Those limits come in various forms, such as: 1. What you pay out of pocket before insurance coverage kicks in. 2. No coverage for out-of-network providers. 3. Caps on how much they will cover. Insurance is a numbers game. Rest assured, all insurance policies and all insurance providers find ways to limit how much they pay out. You may find some means to limit…

Which are all an entirely different thing.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#17
post #8

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

Is that not what I do when comparing plans on healthcare.gov?

I mean kind of. There’s a ton of restrictions on who can have what plan where though, it’s not a very “free” free market.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#18
post #8

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

Is that not what I do when comparing plans on healthcare.gov?

Sort of. ACA set ground rules for one segment of the market and did a good job doing so. There is a real competitive process in most states.

Taking about free markets in the context of US health insurance in general is a waste of time.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#19

Its crazy that there are laws against offering health insurance in the open market. There is no reason you couldn't shop around for a plan just like you do for car or home owners insurance.

Trust me, it's worth it. Most people have no idea the kind of unethical shit that HIPAA and then the ACA regulated out of existence—stuff that would make you say "How in the name of all that is holy was that legal until 1996???"

One of the necessary casualties of that is restrictions on who is able to offer what and when. It's a good trade.

Re: Sharing the Load: Amish Healthcare Financing (2016)

#20

I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor. They have established sources of information and support for this practice. 2. When it comes to medical care, they are not Luddites and are willing to use cutting edge technologies to care for medical issues. 3. I was struck by the repeated ment…

"They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor."

Two other factors for low cost would be their healthy lifestyle and end of life care choices. The Amish get about 20k steps in per day - double the recommended 10k steps that most English fail to meet. Rates of many chronic diseases are lower. When they do get old, they don't drag things out and they generally don't go into longterm care facilities. Most English tend to want the doctor to "do everything you can".

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