Health Care Sharing:

You'll be hearing a lot about that from now on. The first time I'd heard about it was on Friday's Limbaugh show when a caller extolled the virtues of a sharing plan - which had some sort of connection to a church or faith organization. Limbaugh didn't know what it was about and said that you have to be careful with some of these kinds of operations - it might be a scam.

Over at The American Prospect, there is an article on this subject, The Lord Is My Insurer. There's a lot of conformity demanded to participate (religious & social), but here's the basics of the operation:

[Members] must agree to pay their membership fee and monthly share ...

Members pay for their medical costs out of pocket, and submit their receipts to the ministry, which then "publishes" members? "needs" in a monthly newsletter. There is a $100,000 cap on reimbursements, and certain medical conditions, including some pre-existing conditions, pregnancies of single mothers, abortions, drug and alcohol rehabilitation, and sexually transmitted diseases, are excluded. Each member then sends their monthly "share" to a member who has a published "need."

There is this critique:

[T]he National Association of Insurance Commissioners has consumer-protection concerns about [Health Care Sharing Ministries], noting, "Such arrangements are not insurance and the participants do not have the protections available to purchasers of licensed insurance plans." Michael McRaith, director of the Illinois Department of Insurance, says, "This is not an issue of whether faith-based communities are appropriate vehicles to share health-care costs. The issue is: Are consumers in fact receiving what they?ve been told they?re paying for?" Unlike conventional insurance companies, McRaith says, sharing arrangements are not required to maintain reserves to pay out claims; the contracts are not subject to the same conventions and interpretations as insurance contracts; and consumers do not have recourse to state regulators or private litigation if their claims are denied.

Looks like a shaky system for health care. Limbaugh might have been right to surmise that, at the very least, it's a risky venture.


posted by Quiddity at 4/15/2010 12:52:00 PM