what about Christian healthcare sharing ministries?

I get asked fairly frequently for my opinion about Christian healthcare sharing ministries. I’ve not had very many patients who use them, so I don’t have a lot of experience from the provider side. However, my wife and I used them while we were married and still in school, so I have some experience there. Laura Turner wrote a lengthy article about all of the ins and outs of these ministries which I would highly recommend for anyone trying to get a grasp on how they work. She explains:

Every month, members pay a certain amount (their “share”) into the ministry. When a need arises — say you break your leg, or get diagnosed with lung cancer, or have a baby — you submit your bills to the ministry’s office and you receive payments for the total amount you owe, usually in the form of checks or direct deposits from various members. Some ministries hold the funds in an online escrow account; others have members mail their checks directly to the other members. Shares out are published by the ministries each month, so you can see that your $405 is going to, say, Irene in Idaho who recently had a hip replacement.

However, there are big categories that aren’t covered: preventive care, dental or vision expenses, pre-existing conditions, mental health, or anything that might be remotely related to something you did that went against Christian teaching (e.g. STD treatment or pregnancy out of wedlock).

Since these programs require that you be rather healthy to join, don’t pay out for a lot of expenses, and ask all members to negotiate down the price they pay before chipping in, they end up with a member base that all of the other insurers in the country want — except that these folks are paying anywhere between 1/10th and 1/2 of what they might otherwise pay for insurance coverage. That’s a great deal if you’re healthy, would keep to the strict moral code anyway, and want to help out people who can’t get insurance through their employer.

However, the number of people who meet these criteria are a minority of the population. So my first observation is that these ministries aren’t going to be the answer for our national healthcare crisis; they’re a stopgap for a system that is broken and needs to be fixed. It’s sad that these folks are the only ones in our current system who can manage to negotiate a price with a hospital.

My other observation is that the code of conduct you’re expected to follow can be more stringent than you realize. I will not share all of the details, but while I was on one of these plans I had a medical emergency that ended up costing tens of thousands of dollars. While we were in the midst of negotiating a price with the hospital, a zealous doctor billed for something which implied that I was in ongoing violation of the code of conduct, which led to the sharing ministry threatening to not pay a single cent of my hospital bill. I managed to clear up the misunderstanding, but it was still a scary time. There are a lot of things that aren’t covered, so someone who’s considering one of these plans needs to read the fine print.

What about the “common good” aspect? While Christians absolutely have a moral obligation to help the sick and work towards a better healthcare system, I don’t think they have any moral obligation to fork over thousands of dollars to insurance companies that are in the business of making doctors bang their heads against the wall. The atomistic attitude that wants to avoid helping anyone who might in some way be responsible for their own problem is gross and un-Christian, but opposing it does not require that we all pay into a malignant system.

For the people who qualify (and that is not a lot of people), these ministries are a great way to save money and help other people that qualify. So if you’re willing to take the risk of not having certain things covered, go for it. Otherwise, you’re stuck with the lousy system we’ve got.