Faith-based health cost sharing

I saw a very interesting program by Dan Rather last week, with one feature on faith-based healthcare cost sharing plans.  Under PPACA, people can opt for these plans and be exempt from the private insurer mandate.  Members pay a small fee monthly, but instead of paying to the plan itself, they are instructed to send their checks directly to another member who has incurred costs.  A central computerized system keeps track of where money is supposed to go.

Dan pointed out several concerning points about these plans.  They are not actually insurance plans backed by any sort of contract guarantee– if the total pot runs dry, members have no recourse to get payment.  Payment rates to hospitals and providers aren’t negotiated, so members would have to pay the full price for services.  If you’ve ever had a procedure done in a hospital, you know the huge discrepancy between the initial hospital charge and the final payment after insurance write-offs.  Important services like mental illness treatment, addiction treatment,   preventive care, chronic condition medication and contraception are not covered at all.  And there are lengthy waiting periods for pre-existing condition coverage (for example, 7 years after treatment for cancer).  Members have to promise not to smoke, use addictive substances or break religious rules about sex.

The natural result would be that membership would  be skewed towards healthy people– another example of cherry picking.  People who need care will have to get private insurance and will shift our overall risk pool towards higher cost enrollees.  If these entities really take off,  the rest of us will have to pay higher premiums.  Even though I dislike PPACA and the mandate to pay private corporations for shoddy products, if we are going to have the mandate there should not be loopholes like this.

I was interested that during all the smug talk from members about how they were more responsible with their healthy lifestyles, the camera zoned in on the handfuls of cookies they were holding during meetings!  And every one of the members shown was overweight if not obese.  I mention this NOT to blame obesity on moral choices, since I think the evidence is powerful that fat gain doesn’t result from poor self-discipline, but just to show the hypocrisy involved.  Although Dan didn’t comment verbally, the videographer was not very subtle.

As a Christian, the whole thing was depressing to me on a deeper level.  One of these groups calls itself  “Samaritan Ministries.”  If you haven’t read the Good Samaritan parable in a while, go check it out.  What a gross misuse of the story!  Yes, members are sharing resources as early Christian groups are said to have done, described in another part of the Bible.  But their behavior is exactly the opposite of what Jesus was teaching in the Good Samaritan parable.  The parable was about our duty to treat strangers, even those far outside our social circles, as neighbors deserving of care.  It is not in any way a virtue for members of the health plan to share with people they approve of, especially knowing they may benefit themselves.  By excluding non-Christians, they are behaving  just like those who saw the injured man in the parable and passed him by.   I know all of us fall short of perfect neighborliness, but generally we ought to have the sense to be embarrassed about it.  At least we shouldn’t boast about our selfishness on national television.

Maybe the rest of us can form a new religion with a simple statement of faith — “Everybody in, Nobody out.”  This faith organization would allow members to be part of any other faith simultaneously or be atheist.  Instead of forming a faith-based health plan, however, members would naturally want to support legislation enacting  “Improved Medicare for All”, an actual insurance, with no body part excluded.   We would send our contributions through taxes and ask the government to manage distribution of payments to private doctors and hospitals.   Under our plan, insurance would cover believers and non-believers alike.  Anybody want to sign up?  Go to— all are welcome.


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