Two Gall Bladders, a Paradigm, and a Sharing Ministry

Guest post: Thad Puckett, The Health Co-Op*

What A Difference A Share Makes – How Insurance Fails

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 don’t 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 Year’s Eve 2007, while on vacation, my wife had to take her sister Lisa and Lisa’s husband Mark to the emergency room in Ruidoso, NM. Mark was in excruciating pain in his abdomen, which wouldn’t abate, so they headed to the ER. 

While there, they discovered several things.  One is that the ER on New Year’s Eve isn’t 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 hadn’t 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.)

It’s 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.

That’s 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 Katlyn’s gall bladder.  It seems the gall bladder doesn’t 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 Year’s 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).”

For more information about how you can have a totally new health care experience, please visit The Health Co-Op

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6 Responses to Two Gall Bladders, a Paradigm, and a Sharing Ministry

  1. Pingback: Blog Post at Self-Pay Patient — Thad Thoughts

  2. DR. Mike Vasovski says:

    When I have a patient without insurance who needs a head CT scan, we call the three competing radiology groups in the next large town and shop the procedure. Amazingly, the cost to the patient is sometimes BELOW $400. That is 1/3 of the amount charged to the insurance company and probably less than the patient would have to pay out of pocket. Yes, the patient has to pay cash at the time of service, but they would have to anyway if their deductible has not been met, and probably more than the up front cash price.

    • Thad says:

      Mike, that is exactly what I have found as well. The idea that insurance gives you a preferred rate for a procedure is really a myth.

    • Adam G. says:

      When we were temporarily without insurance, we shopped around and ended up going to the low cost bidder: the same outfit that did our scans when we were insured. Their total charge to us for cash was less than our copay with the insurance.

      Obamacare is a mess in itself, but the system it uses as its foundation is also a mess.

      • Thad says:

        That has been my experience too. Self-pay patients, if they will ask, will be amazed how much lower health care costs can be.

  3. Pingback: Guest Post: The Benefits of Joining The Health Co-Op & Samaritan Ministries |

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