Another Perspective

Collateral Health Care Damage

Yet another overlooked cost of universal health care reform.

By 2.6.09

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Perhaps no group is happier to see Obama's health care reform stumble and face delay than health care sharing ministries (HCSMs), whose health care system faced ruin under reform.

HCSMs are nonprofit organizations that allow members of similar religious beliefs to share health care costs. James Lansberry, the president of the Alliance of Health Care Sharing Ministries (AHCSM), which represents HCSMs in public policy, told the Spectator that under the kinds of reform Obama has advocated, HCSMs would face shutting down forever.

The problem is that any plan like the one Tom Daschle, before he stepped down, wanted to implement would crowd out HCSMs by offering subsidized public plans. HCSMs were very lucky to survive a similar plan adopted in Massachusetts in 2006. The plan, authored by then-Governor Mitt Romney, mandated that everyone have insurance. Such measures force members of HCSMs either to pick up coverage, rendering sharing redundant, or skirt the law.

The Massachusetts plan became a policy nightmare for everyone in the state. The AHCSM, however, was able to obtain a regulatory waiver for its 100 or so member families in the state. According to Lansberry, the regulators granted the waivers because they didn't want more people picking up the state-offered insurance plan, which was already spiraling into debt.

HCSMs may not be so lucky under a federal reform. Washington regulators might not bother to protect 100,000-plus HCSM members scattered throughout all 50 states. Furthermore, in Massachusetts crowd-out was limited by the fact that even the subsidized plan was still more expensive than sharing costs. Unlike states, which must balance their budgets, the federal government can accrue as much debt as necessary to supply a cheap government-subsidized option. In that case, HCSMs would become merely an unnecessary added expense for their members.

THE THREAT OF A single payer system, however, is more dire than that of a Massachusetts-style plan. "As of the date of the implementation of the single payer plan, we would cease to be necessary," Lansberry warned. When health care is universal and free, there is no way to share costs.

Single payer is the goal for liberals. Obama endorsed Daschle's plan because a government-subsidized option would eventually crowd out the private market, making the transition to single payer much easier. Of course, single payer or socialized medicine would be disastrous: the government would either have to raise taxes or ration care to afford it. In either case the government, instead of families and doctors, would make life-and-death decisions regarding what care patients receive.

Single payer would cause HCSM members to lose more than the autonomy from bureaucratic insurance companies they currently enjoy. They would also lose the ability to ensure that their health care money goes toward treatments that are consistent with their values. Most importantly, they would lose the assurance that none of their funds help procure abortions. "In a lot of states, there are no health insurance options where some of the funds don't go toward abortions," Lansberry noted.

Lansberry also offered an anecdote that reflects what else HCSM members stand to lose.

A few years ago, he had an appendectomy that cost $23,000. Afterwards, the checks began to arrive to pay for his treatment. Along with the checks came notes and cards from people spread all across the country, offering words of encouragement and offers of prayer.

"We were able to see the care and the love of the religious community for us...we were able to share that as part of the experience. With my children around the supper table we would open the mail...and see how God takes care of us," Lansberry remembered. "That faith-based community aspect of what we do is something that I wouldn't trade for anything."

The Obama plan would replace all that with the government.

HCSMs work well. All members contribute the same amount. To take care of people with pre-existing conditions they simply collect what members are willing to contribute. Often the HCSMs are able to negotiate lower fees from doctors because they pay cash quickly, without having to go through red tape. They allow members to keep clear consciences, and offer a sense of community that cannot be duplicated.

HCSMs would flourish if they didn't compete with overregulation and tax breaks for employer-provided health insurance. Those problems could easily be alleviated, but they won't be. Instead, over the next few years the government will enact a reform that's bad for all Americans, but especially for those who simply want to share each other's health care costs.

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About the Author

Joseph Lawler, former managing editor of The American Spectator, is editor of Real Clear Policy. Follow him on twitter: @josephlawler.