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Health Care Where Your Community Is Your Insurance


Controlling costs while delivering better health outcomes is the holy grail of health care reform. But what if that holy grail isn’t as hard to find as we thought? Reason profiles Samaritan Ministries, a private group of Christians who cover each other’s medical care directly, without using insurance as a third-party payer. When anyone in the group (or in a member’s family) gets sick, the other members across the country send checks to make up the difference between the bill and what the family can pay out of pocket.

One surprising result of this system is that its members work hard to keep their medical bills as low as they can, so as to not burden other members of the ministry:

Take Roger Stuber, a Samaritan member and residential contractor in Tremont, Illinois. He experienced a series of seizures last year that revealed a leaky vein in his brain that required surgery. Even in the midst of this terrifying episode, Stuber went to lengths to insure that he wasn’t overcharged. The hospital initially was going to bill him more than $63,000 for his surgery, which he negotiated down to just over $36,000. When he was billed $5,000 for a follow-up MRI, at first the hospital refused to offer him much of a discount. So he marched down to the finance office and demanded to see the manager in charge. She eventually agreed to accept just under $1,500 dollars if Stuber paid cash on the spot.

If he hadn’t gone to all of this effort, the bills would have been covered almost entirely by other members. “But I’m part of a body there at Samaritan,” says Stuber, “and if I can keep costs down, I’m helping the group.”

The kind of social solidarity represented by Samaritan ministries can do more than just control costs. Study after study has shown that strong relational and communal ties are vital for recovery from illness or injury. Those who lack these ties have a much harder time getting and staying healthy.

Of course, Samaritan Ministries is spread out nationally, so not everyone who sends checks to sick members is in a close relationship with them. Nevertheless, there’s more communal solidarity to be found here than there is in a third party payer, insurance-dominated system.

Ultimately, sustainable health care reform will depend as much on thickening social ties among individuals as it does on cost-control measures via technocratic tinkering at the federal level. The basic principle guiding the Samaritan Ministries concept looks like a good place to start.

[Photo of stethoscope and money courtesy of Shutterstock.]

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  • Anthony

    Selling of health care: original charge $63,000; accepted payment $36,000 a 43% differential. Follow-up MRI $5,000 initial charge; accepted payment $1,500 a differential of 70%. As a community concern, the selling of health care needs to become equally important a public policy matter as furor surrounding ACA.

    • Andrew Allison

      The example given is just another one of the utter perversity of a healthcare system in which providers are forced to extort money from the uninsured in order to make up for the losses incurred in providing care for the insured and the indigent. The fact that hospitals are willing to offer enormous discounts for cash on the barrel head shows just how unecessary costly the curent system is.

  • Andrew Allison

    Heartening news, but of course it only works for a group to which all members feel responsibility to the group. Unhappily, there’s not a whole lot of that left in our entitlement society.

    It seems to me that the only practicable alternative for society at large is, as VM has argued, to make the cost of heath care very visible to the individual recipient, i.e., high deductible and co-pay insurance.

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