Skip to comments.Two Gall Bladders, a Paradigm, and a Sharing Ministry
Posted on 12/26/2013 11:30:16 AM PST by RKBA Democrat
Most of us are convinced that if not for insurance we would all be dead tomorrow.
Politicians have been telling us that for the past few years, but it was likely the insurance companies themselves that perfected the creation of not just marketing talk, but of a paradigm. They did a great job of it.
But when you step out of the world of insurance and into the world of health care sharing, you discover not just a different way to have medical bills paid, rather you discover an entirely new paradigm.
Paradigms dont change easily, but once they are seen for what they are, it is far easier to get people to step out of the old way, and into a new way, one more liberating than frightening.
The Tale of Two Gall Bladders
On New Years Eve 2007, while on vacation, my wife had to take her sister Lisa and Lisas husband Mark to the emergency room in Ruidoso, NM. Mark was in excruciating pain in his abdomen, which wouldnt abate, so they headed to the ER.
While there, they discovered several things. One is that the ER on New Years Eve isnt a fun place to be for anyone. But 2 hours later, before mid-night and the New Year, they were discharged, having had some fine pain medicine provided to Mark, with the diagnosis of a gall stone attack, and a strong recommendation of seeing a physician back in Austin as soon as we returned home.
That visit to the ER in Ruidoso was several thousand dollars, but due to the wonders of high deductible insurance, Mark and Lisa, since they hadnt met their deductible in 2007, were stuck with that entire bill as theirs to pay. You see, with high deductible insurance you get the privilege of paying premiums each month for the joy of then having to fork over even larger amounts out of your pocket. (Even the health care exchange has a deductible of higher than $5,000 per individual in the Bronze plan.)
Its like pushing a giant rock up a hill for 365 days, only to see that rock slide frustratingly back to the bottom on the first day of the New Year.
Thats what Mark and Lisa faced on January 1, 2008. They had their 2007 deductible to pay, but they faced the coming doctor bills related to the same attack for 2008 too.
When they returned to Austin Mark saw a physician, who set him up with a surgeon, and later in January Mark gave birth to a large bouncing gall stone. Abdominal pain ended, but pain in the family wallet was just beginning.
Once the surgery was completed, the bills from the hospital began to come in, and once again, because it was a new year, and a new deductible was in play, Mark and Lisa started moving that rock up that hill.
Many more thousands of dollars later, Mark was finally healthy, but they were more than $20, 000 poorer. Oh, and they still had that premium to pay monthly.
2013 Time for a New Paradigm
In January of 2013, after much encouragement, Mark and Lisa became members of The Health Co-Op, and by virtue of that, members in Samaritan Ministries. There were monthly payments, with the smaller amount paying for premium benefits from The Health Co-Op, and the larger amount going to a Samaritan member monthly.
Lisa found that writing the monthly share check and note of encouragement to a Samaritan member who had had a medical need shared to be amazingly satisfying, and far more meaningful than writing a check to an insurance company.
But in November 2013, Lisa and Mark had a chance to discover how very different this new health care sharing paradigm can be when their 21 year old college student woke up one Saturday morning with extreme abdominal pain (does this sound familiar?).
Lisa drove her daughter to a hospital of her own choosing, which she was able to do since The Health Co-Op (and Samaritan Ministries) have no network restrictions. They spent a couple of hours in the emergency room, before being admitted to the hospital for an emergency surgery to remove Katlyns gall bladder. It seems the gall bladder doesnt fall far from the tree.
But this time, rather than giving the admitting clerk her insurance card, Lisa explained that she was a self-pay patient, and that she was part of a health care sharing ministry called Samaritan Ministries.
Later that evening, the surgery went smoothly, and the next day Lisa and Katlyn were be discharged from the hospital.
This time, rather than facing tens of thousands of dollars in personal, out-of-pocket expense, Lisa and Mark were facing only $300 that would not be shared by Samaritan Ministries. Total. For the entire medical event. (And had this occurred on New Years Eve 2013 instead of mid-November, it still would only have cost them $300.00. Samaritan Ministries, because it is not insurance, does not have deductibles, only $300 would be unshared, even if the medical situation carries in to a new calendar year.)
Lisa told me: I have never felt more at ease at having to go to a hospital. Rather than facing thousands of dollars of bills, I knew my the only amount not shared by Samaritan Ministries would be $300. And I knew I had two great organizations backing me (The Health Co-Op and Samaritan Ministries).
**Two Gall Bladders, a Paradigm, and a Sharing Ministry**
If I had two gall bladders I would certainly share one of them.
I would too, otherwise people would say about me, "the gall of that guy."
Or is it Gaul?
So what’s to come on the 3rd Day of Obamacare ??
Since the article gives no details about what the insurance premiums were, it is very hard to tell whether they are any better or worse off now. By nature, the “catastrophic” policies would have much lower premiums, and were designed to keep people from having to sell off assets or go bankrupt to pay medical bills. In theory, people should have set aside some savings each month (since the insurance premiums were relatively lower) to use toward actual medical bills.
CANCER WARRIORS PING
This is a ping list for cancer survivors and caregivers to share information. If you would like your name added to or removed from this ping list, please tell us in the comments section at this link (click here). (For the most updated list of names, click on the same link and scroll to the end of the comments.)
June 2011 I doubled over at 10 pm and was rushed to the local hospital; gall stones were the problem and I was admitted. 36 hours later I was discharged after my gall bladder was removed.
The bill came a week later:for my day and a half in the hospital the bill came out to be $35,000. My insurance covered all but $500 of it, but I was outraged. I made an appointment with the head of hospital administration for a line by line accounting of the charges.
He told me, “this will be a meeting short on time and to the point on specifics. It’s very simple: 35-40% of the people who come through these doors have no insurance at all, but under federal law, we must serve them. Payment for goods and services are a separate issue. Of course your pain pills don’t actually cost $75.00; your invoice reflects making up for a portion of the 40% uninsured. We take your bill and jam as much as we can on top of it to pay for those who have no coverage. They are free-riding on your ability to pay and the fact that you are a responsible citizen.
Not saying it's not a viable idea in some ways, but has that ever happened? 20 members end up needing emergency surgery for gall-bladder removal or whatever, in one year?
I would love to not acknowledge insurance coverage and just pay cash, with reimbursement later from insurance (lower rates!) but that would probably be illegal?
My sister went to see a new doc and did nothing but talk for a bit and she found out that Medicare was billed for a few thousand bucks for stuff that did not happen.
On the local Christian radio station in central Texas they advertise “MediShare.” Sounds like it works much like the share program in this article. They rely on more well off Christians to contribute. Sounds like what the early Christians did helping each others needs. Thanks for the ping.
Thanks for the information. I know of people who participate in a Christian cost-sharing program, but I’ve always been hesitant to try it.
This kind of thing was common in the old days. People would pay into a co-op for various expensive aspects of life, including death and funereal expenses.
It’s yet another old idea that people think is new.
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