Tag Archives: Good Samaritan

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 www.pnhp.org— all are welcome.

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Work in Progress

I wanted to let my readers know I’m taking some time off, probably one more week, to finish working on a project I hope you will be pleased with.  I’m actually taking 6 vacation days to do this, although I have a few meetings and such that I’ll be going to during this time. As I mentioned a few months ago, I had an idea to put together a book of essays on healthcare reform from a faith perspective.  I had hoped to collect several essays from a variety of authors– I had a couple of volunteers, but not enough to make a book.

But I think I have enough material to go ahead and finish writing it myself!  It is based on the Good Samaritan parable and includes some of my personal experience with patients and advocacy.  I’ve got the full outline and a good bit of the writing done– I’m hoping in the next several days to be able to get the whole thing finished.  I’ll let you know how it goes and later how to get a copy.  I’m planning to have any profits be divided between our local North Alabama Healthcare for All and the national organization Physicans for a National Health Program.  So wish me luck– I’ll be back to reading PPACA soon.

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Revisiting Access

This weekend, as I was reviewing my talk about healthcare in the framework of the Good Samaritan parable, I realized that “access” to care could have another aspect, one we  haven’t really explored.  Most of us have talked about how we could change our system so that everyone who needs care can get access to it– but in the parable, there is no talk of giving access to the wounded man so that he can crawl to the inn and get help.  Access in the parable would include the ability of the passerby to get to the one who needs help, and it would require removing all barriers, mental and physical, that stand in the way.

Have you ever thought about access this way?  There are studies to support what we intuitively know, that altruistic behaviors make us healthier.  It appears we have a natural human need to provide care to one another and that neglecting this need can actually hurt us.  I am not talking here about racking up karmic or health brownie points for ourselves by being generous– I think it is really more fundamental than that.  Our essential humanity depends to some degree on our willingness to honor our desire to be kind.

I wonder how much of the bitterness and frustration I’ve heard from physicians over the last year is not due to what they think it is– not due solely or even primarily to their perception of unfairness in the system or loss of control.  Maybe it has as much to do with having been thwarted so often in their desire to be healers.  Most of the medical students I’ve worked with come into training with the intention of helping their fellow humans and have at least some sense of vocation.  If physicians are continually limited in their access to helping patients, perhaps eventually they become jaded and begin to deny this part of themselves without even knowing it.

It is true that those who are suffering from lack of access to care are in need of our help– but in our current healthcare environment, the helpers are also suffering.  What would change if we began to recognize our deep need to care for each other?  Would we become determined to remove every barrier in our paths?  What would it be like?


Filed under Healthcare reform