Wherever the Road Leads

Health Care

The American Dilemma

I have an opinion about everything, but I’m mellowing in my old age. After the last American election, I realized that the power and control of the country was in the hands of those much younger, less experienced and more idealistic than I am.

My hare-brained scheme declared my acceptance that the country did not think my way and though I wish it well, it will have to forge ahead without my input, opinion and most of all, my being aware. The hare-brained scheme was designed, in part, to allow me to play ‘ostrich’, with my head buried in the sand, then to carry forth with my own life, surviving as best I could as I traveled about exploring this great nation.

This President, and ObamaCare, has divided America in a manner going back to the fifties. Generalizing and not weighing in on either argument, one side asks itself how any civilized nation can allow its citizens to be deprived of basic health care. They view it as a ‘right’.

The other side argues that the Health Care bill is aimed at benefiting Blacks and Hispanics – many of whom illegal – at the expense of the those (whites) who work and already have insurance. This side contests that those ethnic groups already have the ‘right’ to a permanent lifestyle of welfare, food stamps, subsidized housing and MedicAid. They drop of out of school, pregnant or to sell drugs and are supported for life already. Either that or they’re in jail, living off the taxpayer anyway.

Chief Justice John Roberts did not make the decision easy for conservatives to close the door on Obamacare but instead of one man declaring ObamaCare legal or illegal, he more democratically put the decision into the hands of the American people through the voting process.

America voted and I retired.

The $165 threshold

Having decided that life was now all about me, I investigated my Health Care options. For eighteen months, I could continue to stay on the Office Depot plan, but pay the entire premium myself. For a while, that’s what I did. The premium was nearly $400 per month. At 62, I was not eligible for premium-free MediCare. It was available to me but the monthly premium was higher than the Office Depot amount.

Then I learned about Samaritan’s Health Cost Sharing and have been a member for nine months, now. Samaritan’s is NOT health insurance. It is a cost-sharing pool amongst a somewhat specific group: Christians who agree to live a Christian lifestyle. You have to get your Preacher to sign the application to join Samaritan’s.

What is Samaritan’s definition of a Christan Lifestyle?

“Members must be professing Christians who attend church regularly. They must agree to abstain from sinful practices such as drug abuse and sexual immorality. Alcohol in moderation is allowed, tobacco use is not. They must be accountable to a pastor or other church leader for the needs they submit.”

From the Samaritan’s website:

“Simply put, health care sharing is a Biblical approach to paying for health care. Galatians 6:2 says, “Bear one another’s burdens and so fulfill the law of Christ.” That law is the royal law of loving one another.

Although it’s actually pretty straight forward, health care sharing can be difficult for us to understand because we are so used to thinking in terms of insurance.

Here’s how the need sharing process works in a nutshell:

Each member commits to sending a set “Share” amount each month. These “Shares” are sent directly through the mail from one household to another, to the members with “Needs”. Samaritan Ministries uses a database that randomly matches Shares to Needs, so that the Sharing is coordinated and Shares go to the appropriate members with Needs.

“With more than 30,000 member households participating in the ministry, there is about $7 million available each month to meet health care needs.”

 

My ‘share’, as a single person, is $165 per month. A couple’s ‘share’ is $315 per month.

How does it work?

Let’s say Johnny breaks his leg. Johnny is treated by his doctor or the hospital as “Uninsured, cash patient”, though letting them know that he is a Samaritan’s Member. The total cost, let’s say, is $3,500. Johnny is responsible for the total bill.

Johnny gathers all the bills, completes the Samaritan forms and gets his Preacher to sign off, then submits the package to Samaritan’s. They confirm the legitimacy of the claim, then divide the $3,500 amongst the members.

For that month, I would be directed to mail a check for my $165 ‘share’ directly to Johnny, 123 Main St., Bugtussle, Missouri. Sufficient other members would be directed to mail their ‘shares’ to Johnny as well, enough to cover the $3,500.

Johnny cashes the checks then pays the doctor and hospital.

Naturally, nothing in life is that simple. Samaritan’s has a $300 minimum. When you go to your doctor for a routine visit to have your blood pressure checked and a prescription renewed, you’re on your own for the cost. If Lab work is required, Samaritan’s asks that the doctor use one of their preferred Labs, not necessarily the one he typically uses.

The maximum for a claim is $250,000, though there are provisions to handle larger-cost claims. Re-occurrences – pre-existing conditions – can affect a claim. However, if you have had throat cancer in the past, then need to be treated for prostate cancer, the prostate cancer is covered; it is a ‘new’ condition.

Both Johnny and Samaritan’s keep track of whose ‘shares’ have been received. If a member forgets, he is gently reminded. If the member needs temporary financial assistance to pay his share, he can get it. If he continually does not pay without legitimate reason, his membership is revoked.

If the ‘needs’ exceed the ‘shares’ in a given month, everyone’s need is prorated. If your expenses were $10,000 you may receive only $8,000. It is infrequent and generally can be made up the next month.

Samaritan Ministries has been in operation sharing needs since 1994. Health Cost Sharing is specifically mentioned in the ObamaCare bill and if one is a member of Samaritan’s, one will not be subject to a fine as a non-participant in ObamaCare.

Further details are available at the Samaritan Ministries website – click here.

 

Naively, I have returned to Canada to get something for nothing – “free” Canadian Health Care. My eyes have been opened during these past few months. Canada has many things to offer and many benefits but is a considerably more expensive place to live than the US. My vehicle insurance alone is an additional $100 per month, payable year round. Gas and food is so much more expensive and RV site rental is near double for the five months that I would be up here. Plus 13% sales tax.

If I was still paying $400 per month for Health Care Insurance, it might be worth it to reclaim Canadian residency for the “free” health Care. But I’m not paying that amount. Thanks to Samaritan’s, I can get coverage for $165 per month.

I guess that makes it ‘My Canadian Dilemma’.

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