Article in WSJ: Opting Out

[NonTradMed]

I have not seen a thread on this yet.

There's an interesting article about the struggle that the Amish/Old Order Mennonites are having regarding health care costs (yes, it has hit the Amish).

Since most do not believe in health insurance and opt out of medicare and other gov't services, they typically rely on their community to pay the bill. But since these small communities tend to inter-marry, they also see a larger number of genetic diseases than the general population. So these small communities are plagued with a large number of genetic problems and end up paying out of pocket for expensive surgeries, procedures and drugs.

The article brings up a number of interesting points. Since most Amish/Mennonites are paying essentially out of pocket, they can't negotiate a discount, and end up paying many times over the actual price of service. Some people argue that the Amish/Mennonites should be given the same discount as medicare or private insurance patients.

I'm split on this myself. While on hand, one can't help but admire the Amish/Mennonites devotion to financial responsibility (the Mennonite they interviewed made a modest $50k a year and had paid out $200k already in medical costs), I can't but think they don't realize they *are* already depending on the largess of society in health care. Hospitals who negotiate and give discounts to the Amish, or charge below cost prices *are* letting society subsidize healthcare for the Amish.

And if the the Amish are going to utilize modern health care, it's only fair they also join the modern world in paying our medical bills. It's no longer possible for a small community to donate the the cash needed to pay for expensive surgeries. They are using an outdated 19th century funding system to pay for 21st century medical expenses. If most people could still do that, I think more people would pay in cash for long hospital stays. With the current attitude of Amish 'self-sufficiency' (i.e asking neighbors to pick up the cost of hospital bills), someone is going to go bankrupt, and society may end up having to pick up the pieces.

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[AwesomO]

The article brings up a number of interesting points. Since most Amish/Mennonites are paying essentially out of pocket, they can't negotiate a discount, and end up paying many times over the actual price of service. Some people argue that the Amish/Mennonites should be given the same discount as medicare or private insurance patients.

I know a doc up in PA and she treats many Amish patients. Since they pay cash she gives them discounted rates. She has a whole referral network who do the same.

In fact I think anyone paying with cash can negotiate a better price.

I'm split on this myself. While on hand, one can't help but admire the Amish/Mennonites devotion to financial responsibility (the Mennonite they interviewed made a modest $50k a year and had paid out $200k already in medical costs), I can't but think they don't realize they *are* already depending on the largess of society in health care. Hospitals who negotiate and give discounts to the Amish, or charge below cost prices *are* letting society subsidize healthcare for the Amish.

Depends on the discount. For instance most physicians who give discounts to cash patients do so at a rate higher than the discount they give insurance and medicare.
For instance if a procedure is 100 dollars insurance or medicare may pay 40 dollars. But a cash payer may pay 50. Still a discount but not as cheap as insurance.