• Jim Cross

    Your conclusion that health sharing ministries are “not a viable alternative for most Americans” may be partly correct, but for altogether different reasons.

    “Guarantees” of coverage are dubious, and dependent on viable risk pools and sound actuarial assessments. For example, the failure of health co-ops in the face of irresponsible funding projections coupled with the federal government’s failure to fulfill promises to subsidize them left many co-op members stranded with unpaid bills.

    The macro pressures of an aging population are affecting all health plans. Insurance companies manage this by rationing care. There’s no silver bullet for this problem. We all need to moderate our expectations regarding end of life care. Doctors for example, often do not follow their own advice for cancer treatment, preferring a shorter, more fulfilling and meaningful end of life, as opposed to buying a few more months with radiation, chemo, and the illness and financial ruin that it brings.

    New, innovative treatments need not be costly. The best new treatments reduce the length of hospital stays, are less invasive and as a result, less costly.

    Costs in health care have risen dramatically for several reasons. One, it’s a third party payer system, where no one is responsible for watching the bottom line, and nobody knows what the true cost is. Second, a code driven fee-for-service model rewards activity based on volume. Third, the insurance industry with all of its’ administration and red tape adds a huge burden of overhead to health care, and adds no actual direct patient care. Note that the ACA legislation was all about insurance, not about actual health care.

    Health care sharing ministries are actually at the cutting edge of consumer driven health care, which puts responsibility back in the hands of the patient and their providers, with no intermediary. Many practitioners are beginning to appreciate the freedom and simplicity of not dealing with insurance companies.

    Networks and insurance companies often require additional testing before access to a procedure is granted. In a bid to ration access to expensive procedures, insurance actually adds volume and cost. Networks will tout savings of 30-40%, but the hospitals chargemasters are already inflated beyond reason. This cozy arrangement between hospitals and insurance companies helps the hospitals pay for their facilities and keep everyone well fed.

    By taking the insurance companies and networks out of the middle, patients can become their own best advocates, shopping for their care based on price, pressuring providers to be transparent in their pricing, and making decisions with their providers without regard to the protocols of network gatekeepers.

    So, health care sharing ministries are not for everyone. Too many Americans are conditioned to passively consume health care, blindly accepting the pronouncements of the gods in the white coats, and focusing on their co-pay and deductible, not realizing the true costs. Yet, as ACA plans increase deductibles and pass more cost to the patients, everyone will start asking questions and requiring more transparency from their providers. There are only two groups that I can think of who might not be benefit from health care sharing ministries – public employees and union members. Those are the two groups of people who are often insulated from economic reality.