Home › Forums › Random Thoughts › Alternative health plan (christian services only?)
Tagged: ACA, healthcare sharing ministry, Medical insurance
- This topic has 31 replies, 9 voices, and was last updated 8 years, 6 months ago by
Jay.
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11/23/2016 at 9:57 am #6412
I know of one seller here who uses an alternative medical insurance plan.
Here’s an example: http://samaritanministriesreview.com/samaritan-ministries-vs-liberty-healthshare/It’s not really insurance, but a group of people who pay into a fund. That fund then pays any bills you send in. I believe that the fund negotiates good rates because they pay cash.
Catch is that it seems aimed for Christians who must sign a “statement of faith”.
Anyone have experience with these?
Are there similar co-ops that are secular who who accept non-christians? -
11/23/2016 at 10:47 am #6418
I have several friends who have one of these faith based health plans and they are VERY happy with their plan. Our mid-wife has it and she was finally able to get a knee replacement she has needed for many years but never had insurance to pay for it. Another family we know has it and it works great for them.
It’s funny you mention this, because I was wondering the same thing just yesterday. Why isn’t there any decent secular group insurance funds? There really is no reason why there is not. Religious plans have two fundamental benefits that contribute to their success: The fundamental similar belief structure and a the existing and well organized network of churches. I think alot of the work is done by volunteer ministry as well, so overhead costs are low. Any successful secular plan would need to build off the backbone of an existing organized structure. A volunteer workforce is nice too, which is the hard part.
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11/23/2016 at 12:48 pm #6424
Agreed. The sharing of a similar faith probably keeps people “honest”. At least these people would know who exactly they were screwing over by not paying up.
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11/23/2016 at 12:11 pm #6422
My family has been members of Samaritan Ministries since 2001. The faith aspect of the ministry is central to its mission and is what leads to the exemption from the ACA. Here is the short paragraph from the IRS which specifies their exemption:
Members of a health care sharing ministry – You are a member of a health care sharing ministry, which is an organization described in section 501(c)(3) whose members share a common set of ethical or religious beliefs and have shared medical expenses in accordance with those beliefs continuously since at least December 31, 1999.
Because of the last requirement, no new groups being formed are allowed to be exempt from ACA. Also, as I stated before, the faith aspect is at the core of the group’s mission.
I have heard of one group that does not require a statement of faith. I have not researched the group very much but you may want to look into Liberty HealthShare
As far as our participation goes, we opted into Samaritan Ministries when our insurance went up 90% to $1000 a month in 2001. That was unsustainable for our family and we looked for alternatives. We’ve loved it and have conservatively saved over $25,000 since we began.
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11/23/2016 at 12:58 pm #6426
It’s a really interesting model. I wonder how they navigate the issue of too many old/sick people in their group vs younger, healthier people to balance the costs.
This is the current problem.
People who need healthcare seek it out.
People who don’t need healthcare don’t buy it.
This doesn’t work because you have more need for healthcare than money to pay for it.The ACA was supposed solve this issue by requiring everyone to pay in since everyone eventually needs healthcare. It’s not a fair system if you only seek healthcare if you need it..and expect the community to bear the expense.
I guess the best solution is for healthcare to be cheap enough that you can pay out of pocket. Just not sure everyone would then be getting state of the art treatment. Those machines, medicines, and fancy degrees don’t pay for themselves.
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11/23/2016 at 1:50 pm #6431
Samaritan has a cap on amount per incident per year. That way there is some restriction to the amount being paid out for catastrophic illness. There is a secondary set-aside amount that is used for catastrophic needs that you have to sign up for. As I understand it, there is no limit to that plan and would pay as long as monies are available from the participants.
Since we have been members of Samaritan, there have been probably 10 rate increases. The rates are increased by a majority vote of the members and only after there have been pro-rated needs for a couple of months before. There seems to be a good mix of old vs young and they offer incentives for younger people with lower rates.
The biggest advantage to this system is that people negotiate cash rates with providers. A local hospital offers 80% off for cash payment. That is atypical. Most of the time we see a 30-50% reduction in price for cash payment.
The crock of the healthcare system is that none of the insurance companies pay the inflated rates that the healthcare providers say they charge. If you’ll examine your bill you’ll see that the insurers only pay a portion of the inflated imaginary cost. The only people that pay those rates are people that have insurance and are meeting their deductibles. You can’t negotiate a cash rate if you have insurance and are using it. I’ve known people to go outside of their insurance to pay directly for tests because the cost was so ridiculously cheaper.
There’s a reason that the biggest corporate buildings are insurance companies. It takes a lot of jack to keep those businesses going.
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11/23/2016 at 2:31 pm #6436
Oh there absolutely needs to be billing reform in the healthcare industry. That alone is killing people financially since most businesses are switching to high deductible healthcare with HSA’s. The days of co-pays are long gone for me. The insurance companies have to be loving this swing to high deductible HSA plans that pretty much absolve them from paying anything.
It is a HUGE problem that medical providers are still billing their absurdly bloated rates even though a large portion of their patients are on high deductible insurances. At this point I’d prefer to simply have a catastrophic insurance plan with something like a 20k deductible and negotiate everything else as straight cash – it would be cheaper in the long run. I pay $170 out of pocket to go to my general practitioner for the sniffles. In what world is that considered affordable?
I have a 6k deductible with my work insurance plan. I do get a match to my HSA contribution, but one hospital stay for anyone in my house and I am wiped out.
In summary I am paying a huge fee called a premium every month for the privilege to pay for ALLof my healthcare costs 100% out of pocket at prices that are significantly higher than what I would pay without insurance. That is the definition of insanity.
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11/23/2016 at 2:45 pm #6439
Wow! $170 for a doctor visit is ridiculous.
That brings me to the other part of our health care. About a year ago we started going to a doctor who is part of the Direct Primary Care movement. She does not accept insurance of any kind. Instead, she charges a monthly fee. In our case, we pay $120 a month for unlimited use (for a couple). It’s kind of a blue-collar concierge service.
DPC doctors limit their practice to a manageable amount. In our doctor’s case, she limits herself to 500-750 patients. She typically sees 1% of her patients in a day – in other words, a typical day she will see 5 to 7 people. She is no longer limited to 15 minute office visits but gets to spend however long the patient’s condition dictates.
We have had 2 hour long visits with our doctor and there is never a feeling that we are being rushed. She also runs a pharmacy out of her office and we pay her wholesale costs on drugs. One drug alone that my wife takes saves us enough to pay for our monthly fee for the doctor.
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11/23/2016 at 4:15 pm #6448
interesting, i think you emailed us about this service (it sounds familiar). what state are you in and how did you find this woman?
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11/23/2016 at 4:58 pm #6455
In summary I am paying a huge fee called a premium every month for the privilege to pay for ALLof my healthcare costs 100% out of pocket at prices that are significantly higher than what I would pay without insurance. That is the definition of insanity.
You nailed it! That’s exactly why we opted out of traditional insurance years ago.
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11/23/2016 at 4:55 pm #6454
We’re in Kentucky. Our doctor was my primary care physician in a traditional practice. She notified all her patients that she was moving to her own practice and had information meetings about the model. A lot of her patients didn’t move with her, but many did and she added many more that are looking for an alternative to traditional health systems.
Obviously, this is not a replacement for insurance. You still need a catastrophic plan for when you are referred to a specialist or need hospitalization. But for the garden variety stuff it is perfect. Our doctor does pretty much full-service work. Full testing, skin growths removed, Pap smears, EKGs, stitches for a cut, etc.
Our doctor loves it and says she would never go back. She says that now she is getting to do what she was trained to do – practice medicine. She’s not spending countless hours filling out paperwork and abiding by the ridiculous restraints that insurance and the ACA put on physicians.
It doesn’t look like there are any DPC doctors in your immediate area. You can look at this map for possible doctors. Also, there are other sources for finding doctors. Just look up Direct Primary Care.
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This reply was modified 8 years, 6 months ago by
okieopie.
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11/24/2016 at 8:23 am #6476
I’ve heard of the fancy concierge doctor service, but that seemed like rich luxury living.
I’m surprised I haven’t heard more about direct primary care:
https://en.wikipedia.org/wiki/Direct_primary_care
It reminds me of the old time doctors that worked out of their homes and did house calls.You can search for providers in your state.
http://mydpc.org/dpc/directoryOur closest direct care provider is about an hour away. Not too bad.
He charges between $45-$85/month depending on what level of service we want.
(Although he does charge a $25/visit fee as well. Maybe this is to cut down on members abusing the service?)I can see how having a super high deductible (and hopefully cheap) insurance plan + a DPC doctor could be a cool combination.
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11/24/2016 at 10:45 am #6484
The main difference between concierge service and DPC is the acceptance of insurance. DPC providers do no insurance. It ultimately saves them on costs because of the paperwork involved with billing insurance and the inevitable repeated denial and re-filing that occurs. Our doctor has minimum staff – basically a full-time nurse and a part-time nurse. They do most of the paperwork themselves. She shares her office with another DPC doctor and they cover for each other during absences or vacation.
Every DPC doctor provides their own brand of service. Our doctor does house calls with no charge for cases she deems necessary. Also, she does Skype sessions – especially for college students away from home. The best bargain is for families. I think the monthly charge is $150 no matter what size family you have.
Her business model is actually fairly simple. Gain enough subscribers to cover expenses and salaries and provide services with no worries about how much to bill. Every time I see her, I ask her if she’s still as positive about it as she thought she would be – and she always says she would never go back to the old system.
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This reply was modified 8 years, 6 months ago by
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11/23/2016 at 5:10 pm #6457
I will add one other possibility. If the ACA is repealed or reformed it is very possible that secular groups could form as an alternative to traditional insurance. There would no longer be that restraint from them forming. However, state insurance agencies have all looked at the health costs sharing ministries with a critical eye. They are legal in every state, but I’m not sure if the faith component is what allows them to function, or if there are other factors in play. I do know that all these ministries must warn people that what they are agreeing to is NOT insurance. Therefore they are free to operate outside of the regulations of the state health insurance boards.
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11/23/2016 at 7:15 pm #6459
And just for future reference, these are the official term for this: https://en.wikipedia.org/wiki/Health_care_sharing_ministry
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11/25/2016 at 8:11 am #6527
Funny side story… my sister interviewed for one of these “faith-based” alternative healthcare groups. It was going really well until the guy told a graphic story of running over his own kid with a lawnmower. She went through the rest of the interview, even got a call back. The organization had some other issues(super legalistic) as well but I think the main thing was she felt uncomfortable with the person who would have been her boss.
My thoughts were, “that story isn’t a good story to share on a first interview”.
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11/25/2016 at 8:53 am #6534
Before HMO’s came into existence people had basically catastrophic coverage, and that’s all. You didn’t go to the doctor for a cold or the flu because you had to pay out of pocket. You used home remedies and developed a basic understanding of preventive healthcare. I remember many episodes of treating my children with a high fever with cool-down baths and Home remedies. You didn’t go get annual checkups with dozens of tests just because it was “free”. You only went to the doctor if you were actually SICK. You didn’t have to get expensive tests done to cover your doctor’s rear end from ridiculous multimillion dollar liability coverage or reams of government regulations or from having to have a huge staff of office workers to take care of all the HIPA and insurance and gov’t forms and making phone calls to various insurance companies to get authorization for every little thing. These are the things that have made insurance so expensive. The doctors and hospitals often have to completely stop accepting patients from a certain type of insurance because each visit/treatment/admission actually COSTS them money. The only people getting rich on medicine are the insurance companies, the lawyers, the politicians and the lobbyists. THAT is where the changes HAVE to be made. The first one is to open state lines so there is MORE competition (NOT less) between insurors. The second is to stop lobbyists from making it profitable for politicians to complicate health care. Life was so much cheaper and easier before government began meddling in healthcare. If you want something totally screwed up, give the job to the governemnt so self-serving politicians can find a way to be middle men.
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11/25/2016 at 9:00 am #6535
I respect your view of healthcare since you are a nurse and your husband is a doctor. I hope you will be as tough with the Conservative leaders that will soon be completely in control and who, as of yet, have not put forth a comprehensive fix other than abandoning the ACA.
Let’s remember that before the ACA, lack of healthcare and expensive insurance was already huge problem. The ACA didn’t cause the problem but was a good faith effort to fix it.
So voters have voted. Let’s judge the results.
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11/25/2016 at 4:19 pm #6548
Jay, you are right about that. But one of the problems with the ACA is that it was done by being forced through by ONE party, with ZERO votes from the other half, and by the “nuclear option”, and by politicians who had “to vote for it to find out what’s in it.” If I can speak for Conservatives, We are ready to put everyone’s feet to the fire, especially all of the Republicans we have sent to fix these problems in the past. We are beyond furious; we are ready to abandon the Rep Party and really go rogue if they don’t step up. The problem is that politicians on both sides of the aisle sell out after getting to Washington. Gov’t bureaucrats, lobbyists, lawyers, and the media are all in bed together–seriously corrupt and on the take. That’s why we went all out for Trump. I have been praying for years for a strong outsider to blow up Washington, and I haven’t been alone. I have had extensive experience in the insurance business as a case manager for both Cigna and Fireman’s Fund Worker’s Comp. so I have a perspective from both sides. I don’t hate the insurance or the medical industry. I do realize that outrgeous demands from gov’t and consumers have made for outrageous prices. NO ONE wants to see citizens/patients without affordable healthcare. That is an absolute necessity for everyone. But the we all need to scale back our expectations unless we want to pay for it. My point was that we now expect insurance to cover so many small things that not everyone needs, from Viagra to birth control pills. It costs much more to go through middle men. They all get a piece of the action. That’s why we want smaller gov’t involvement, plus everyone else involved as a result of that. My husband and I pay for our own dental care out of pocket. That motivates us to take better care of our own teeth. The one time we tried dental insurance we felt like we were treated like cattle and got extremely poor treatment. So not worth it. You don’t need annual tooth xrays, and can say no thanks at check ups to that. There are many ways to economize. But for those who want it there needs to be coverage for dental/medical, and at the level you are willing to pay for. Just like car/homeowners insurance you should be able to choose your specific coverage and deductible. I really sympathize with you all who are fearful of losing your insurance. That will NOT happen. No gaps. It will only get better and better. Just give it a chance and be a little patient. This is a new beginning for a lot of things all at once. One encouraging thing I’ve seen already is that Trump’s cabinet/staff/appointees have to sign a commitment to not be lobbyists for 5 years after leaving office; and forever regarding lobbying for foreign governments. Maybe they can make THAT a law. Plus term limits, finally.
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11/25/2016 at 5:47 pm #6550
I hope your optimism is justified. The last time we had a President let his Vice president do all the deal making, things didn’t go well. We’ll wait and see. As we said, we’re ready for anything!
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11/26/2016 at 1:54 pm #6623
The ACA requires that all insurance companies, not only those who sell through exchanges, cover basic preventative care like mammograms, colonoscopies, etc. so even if you are buying catastrophic with a high premium those basic services are covered, the ACA requires that there is no prejudice against pre-existing conditions (for many insurers that could mean something like pregnancy for heaven’s sake!), no caps on care, so if you do get cancer like me you still have insurance after the fact. Linda the ACA only had Democratic votes because the Republicans refused to work with the President from day one, it is no more nefarious than that, he tried to work with the Republicans and 3 did work with him initially and were pressured to vote NO. 40,000 people died each year before the law was passed due to lack of insurance, and unpaid medical expenses were the number one cause of bankruptcy, Hospitals were being put out of business because they must give emergency care even if unpaid for. People also forget that health insurance costs were rising at an exponential rate before the law-the ACA slowed that down, and the problem with expensive premiums could be fixed, but the Party of No refuses and Americans, even those in Red State America like yourself Linda, are getting hurt, and are in for a world full of pain in the next 4 IMO. I will wait to see what the new President opposes to “replace” the ACA but I am not optimistic.
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11/28/2016 at 9:31 am #6692
Omfug, thanks so much for that response. My blood pressure was reaching unsustainable levels and I’m pretty sure my eyeballs were about to explode. 🙂
Retro, we have a similar plan to yours, through Obamacare. It’s vastly cheaper per month than it was pre-ACA, but we still really, really, REALLY weigh the merits of each trip to the doctor, and more often than not end up staying home. I suppose some would argue that’s the superior outcome.
I’m glad, though, that we decided to pay up when my husband’s doctor (during one of those apparently unnecessary routine physicals) found a mole he didn’t like, which turned out (upon inspection/biopsy at a specialist) to be a melanoma. No amount of cold water baths, smug self-sufficiency, diligent self-care, or healthy living would have allowed us to to prevent or detect that cancer on our own, and if we’d waited until he was actually SICK, he’d be dead.
Instead, he’s merely uninsurable (once we throw off the chains of government oppression by repealing ACA, that is.)
But that’s okay, if the cancer returns, I can scrape it off with an exacto knife and wipe his skin down with a cold compress, I guess. At least we’ll have our dignity.
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12/11/2016 at 6:50 am #7790
An interesting question about joining healthcare sharing ministries: http://www.nytimes.com/2016/12/10/opinion/sunday/should-i-lie-about-my-beliefs-to-get-health-insurance.html
Though I don’t condone lying, it’s an obvious weird situation when you want good healthcare and a Christian healthcare coop may be your only choice…but you dont necessarily believe in the moral requirements you must live by. And these moral ideals really have nothing to do with the healthcare service either. What does it matter if you choose to have sex before marriage? Does someone check if you believe in Jesus Christ as the Lord and Savior? How does this affect whether or not I have the flu and need a doctor?
I respect these Christian healthcare sharing ministries for organizing so well. But our crazy healthcare system forces people to ask these questions as they seek affordable healthcare. The system may become crazier as the ACA is probably soon dissolved.
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12/11/2016 at 7:38 pm #7824
I agree. It is a messed up system where one would have to consider lying about their beliefs in order to avoid being penalized by the government. But as the ACA continues its death spiral, be assured that this quandary is going to be more commonplace.
The good news is this: If the ACA is repealed, there may be no reason that a group could not be formed as a secular healthcare cost sharing organization. Such organizations are not regulated by state insurance regulatory agencies. Some state agencies have tried in the past to outlaw such groups but they have lost in court or have been protected by the state legislatures which have passed laws to protect such groups. The problem that a secular group would have would be keeping health care costs under control.
Christian groups require adherence to strict guidelines for membership for several reasons. People share a common belief system and support one another in more than monetary ways. Members agree to not only send money to people who have a need, but also to pray for the person’s healing and well-being. We believe there is power in prayer. We believe that Christians are called to support one another in their needs. Healthcare costs are kept under control by members’ adherence to moral and ethical guidelines which lower risk factors.
You ask why it matters whether someone would choose to have sex before marriage. While one could choose to have a monogamous sexual relationship, the simple fact is that statistics show that having sexual relations outside of marriage increases the risk exponentially to STDs and higher healthcare costs. The same thing could be said of recreational drug use or smoking or excessive alcohol use – all of which are shown to raise healthcare costs substantially and all of which are prohibited by healthcare sharing networks.
That being said, I do not presume that Christians do not participate in these activities. While it may seem that the healthcare sharing organizations are looking over your shoulder to make sure members are not stepping out of their puritanical line, I really don’t think that is the desire or intent. In fact, the opposite is true.
There are often needs that are shared in the newsletter that goes out to the membership that are not eligible for the normal sharing. People are asked to pray for and to voluntarily donate to help these needs that do not meet the criteria for sharing – eg. pre-existing condition.
It is important to remember that these groups are NOT insurance. We tend to compare them to insurance because they function in similar ways – but there is no guarantee that you will receive the benefits. As such, they avoid the litigious environment that insurance businesses find so much a part of their world.
This is an interesting site that lays out the considerations for healthcare sharing ministries: Obamacare Facts
They incorrectly list a prohibition on contraception (unless they actually mean abortion).The author of the article you referenced in the New York Times states, “For those on the religious right, their beliefs grant them exemption from federal law, and access to decent affordable health care. Unfortunately, there’s no such loophole for clean-living, charitable nonbelievers.”
The health care system that we access is the exact same one that she accesses. The difference is in how we choose to pay for it. The loophole was not created as an escape from the requirements of Obamacare but because there were already many people who had chosen this way of payment long before Obamacare was even thought of. To force those groups to cease operation because the government dictated it was abhorrent to many legislators who made sure the exemption was provided.
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12/12/2016 at 6:07 am #7833
Fair enough. I don’t think these Christian ministries should be abolished. I give them credit for creating what is basically an old time co-op where like-minded people come together to negotiate better prices with their purchasing power. I guess legally it’s not insurance, but it certainly acts the same way.
As the system that has been built is taken apart, millions of people will be pressured to find a way to pay their medical bills (us included). What’s interesting in this debate is that there’s no admitting that the healthcare system was already broken before the ACA. The ACA was a good faith attempt to fix healthcare for anyone not associated with an employer that offered an insurance plan. I hear way too much “I got mine, so shut up about this” from too many people.
It wasn’t long ago when healthcare corporations were denying people coverage even when they wanted to pay because the people weren’t going to be profitable. Or these companies would retroactively find reasons to not pay claims for their paying customers (“you didn’t check a box”). And it’s a well known fact that bankruptcy in America is full of people who get sick and then cant pay all the bills because their insurance coverage had a limit.
As OMFUG said, hospitals already legally have to help anyone who comes in the door. So people without insurance just use the emergency room for healthcare, and then don’t pay the bill. Our taxes have been paying for public healthcare for decades this way. This is the most inefficient, ineffective, and expensive way to run a healthcare system.
A real Free Market healthcare system is to demand a credit/insurance card before entry into a hospital. If not, you can die in the street. It sounds harsh, but at least this would be honest. As it now, the only people who really suffer are working people who want to get insurance but cant afford it. It’ll be interesting to see what alternatives are created in the coming four years.
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12/12/2016 at 2:28 am #7831
sigh…the ACA is not on a “death spiral” in my state–it is working very well actually. It is not working in states that didn’t extend medicaid (the uninsured poor cost more taxpayer money when they use the emergency rooms for “healthcare” than providing them basic preventative services) and those who didn’t create their own exchanges. all moot I suppose since the new administration is determined to rip health insurance away from 22 million people and let them flounder–back to the pre ACA days when Americans died for lack of coverage and health care costs were skyrocketing, you think that premiums in some states have gone up? just wait until after the ACA is abolished,, especially if you are older, those of us with pre-existing conditions are SOL. I refuse to lie about my religious belief to get in on some Christian based plan. The self employed always seem to get screwed–we pay all our own FICA taxes and now won’t even have basic health insurance as most of us can’t afford it. To top it off, some Republicans are trying to cut social security and medicare benefits…
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12/12/2016 at 1:38 pm #7873
This is such a huge topic that it becomes difficult to address all the points that are brought up. There are layers and layers of issues but I’m going to try to address a couple of the statements Jay & omfug made…
Jay said,
“I give them credit for creating what is basically an old time co-op where like-minded people come together to negotiate better prices with their purchasing power.”
There is no group negotiation in our system. We simply individually negotiate directly with the providers. Amazingly, most providers already have some sort of cash discount set up. For example, my wife is having surgery this coming week for an ailing gall bladder. Her surgeon is doing the surgery for $550 (published rate $2400). The hospital is giving us a 77% cash discount for a cost of $2200 (published rate is just under $10,000). The anesthesiologist is doing it for $321 (published rate $1500 to $4000). That is a real life example of what real costs are for the medical system – not some made up imaginary numbers.
The costs for this surgery will be turned into Samaritan Ministries as a need and we will be reimbursed 100% for these costs.
Now, if we had insurance with a $5000 deductible, we would be paying the published rates to fulfill the deductible and the insurance company would be paying the remainder on their discounted pre-negotiated rates. Which likely means the insurance company would be paying $0 because the deductible cost has already covered the “real” cost.
omfug states,
…the ACA is not on a “death spiral” in my state–it is working very well actually. It is not working in states that didn’t extend medicaid (the uninsured poor cost more taxpayer money when they use the emergency rooms for “healthcare” than providing them basic preventative services) and those who didn’t create their own exchanges.
That is a rather simplistic analysis of the reason Obamacare is not working. I’m curious as to what state you are in that it is working well. Illinois is a good example of a state that has created a healthcare exchange where the premiums for insurance are going up significantly. Here is an excellent article in the Chicago Tribune about what the editorial board says is the failure of Obamacare: article
I have a long history with health insurance. In the 80s I was licensed to sell health insurance and have been the plan coordinator for several groups over the years. In my state of Kentucky, we had a disastrous legislative act called the “Health Insurance Reform Act” HB 250 that began in 1994. It attempted to do many of the things that Obamacare has done – require companies to accept pre-existing condition clients with no higher premiums. When it passed, I loved it. There were 43 health insurance providers in the state of KY and companies were forced to offer identical plans so consumers could compare apples to apples. It was great because you could go down the list and choose health insurance for the cheapest price. Long story short…after several years of legislative “fixes” and skyrocketing premiums, every insurer but one had fled the state of Kentucky. By 1998, Anthem was the only private insurer and the state had it’s own high-risk pool insurance plan. Needless to say, premiums were unaffordable which led to my family fleeing the system and going with Samaritan Ministries.
That being said, I do think that it is unethical that insurers can deny coverage because of pre-existing conditions. Samaritan Ministries does not deny membership but does exclude payments for pre-existing conditions. If no recurrence happens with the pre-existing condition, that eventually is covered after a waiting period (not sure of the length of time).
I agree that the healthcare system is broken and has been for a long time. Unfortunately what the ACA did was create more onerous requirements for medical providers which increased costs to them and subsidizes the insurance companies by requiring enrollment. Unfortunately what is happening with many people is that they are gaining worthless insurance which is unaffordable when any significant health condition arises because of high deductibles and skyrocketing premiums. Ideally the health care industry needs to go to a more free-market system that requires consumers to shop around for the best price and not depend on the insurance companies to pay for every hangnail. I feel that what the healthcare sharing ministries have done has made this a reality for many people.
Again, there are many issues involved and I just am scratching the surface on a couple of statements made. We do agree on one thing – the current system is broken.
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12/12/2016 at 4:03 pm #7906
I hear a lot of talk of the free market saving us. As sellers on eBay who deal with a free market every day, it’s an interesting idea. But that all it is right now: an idea, rhetoric, words.
We have one political party actually put their vote on the line to try to fix the system. They’ve paid for it politically.
Now we have the other party, who did nothing for eight years, have the power to enact any changes they want. Will they do anything other than tear it all down? The actors are in place, the story is set. How will it end?
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12/12/2016 at 2:00 pm #7877
here is a good article about the issue–>http://www.salon.com/2016/12/12/obamacare-repeal-is-coming-piece-by-piece-and-in-the-worst-possible-way/ and what a repeal will do to the system
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12/12/2016 at 2:40 pm #7890
My favorite is the radio commercials that says “most premiums are between $50 to $100 per month”. Our family of 3, middle income, cheapest rate $1050. That is with a $12k deductible. Currently we pay around $400 per month with a $6k deductible. That is up from $250 just a couple of years ago. Of course our insurance does not qualify for ACA so we pay another $200 in taxes each month, but we still come out ahead. We try to put $300 into savings per month to pay for doctors visits, since we never hit our deductible. All told our health care costs are almost 20% of our pre-tax income. If we bought through the ACA our expenses would be closer to 30%, and would pass our house note as the largest budget line item. For our situation (and everyone’s is different) it adds a later of complication. We have to re-evaluate every year because it changes every year. We have to try to predict our income, which is more difficult being self employed. We worry about paying penalties if we make too much or overpaying if we underestimate our income.
It feels like the only winners in the ACA are the insurance companies.
Nov 2008 Cigna stock $8, June 2015 Cigna stock $168.
Humana 11/08 – $35, 12/16 $213
ANTM 11/08 – $30, 12/16 $135To me, it is unfortunate that healthcare is now a political football.
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12/12/2016 at 2:44 pm #7891
Interesting article, but it is filled with predictions that may or may not come true. Salon is not exactly known for being the most even-handed publication around. The simple fact is that both sides are guilty of “sky is falling” rhetoric. 🙁
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12/12/2016 at 2:46 pm #7892
LeeinTN – you buy insurance that is outside of the ACA and pay the penalty??? That sucks!
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