Yesterday Micah underwent surgery for his finger he split open with the table saw on Tuesday. (See Surviving the Emergency Room.) We’re exiting emergency mode and entering healing mode. His hand will take 6-12 months to heal, and we’re so thankful for the treatment he received. Overall, the diagnosis looks good.
Now we get to focus on another pain: the medical bills.
Times like this require insurance. We all know the economic, bureaucratic, and political mess insurance has become in recent decades. It’s a hassle, and when an emergency hits, it’s a hassle that frustrates you. This article isn’t an attempt to unravel this mess, but to show a solution that has removed much of the hassle when dealing with the mess: Samaritan Ministries.
Samaritan is the cooperative insurance that we subscribe to. To some it appears too “out of the box” or radical, but when you think about its root function, it makes total sense. When you figure out how it works, you begin to understand its brilliance. You also wonder why more people don’t subscribe to it.
How Samaritan fits into the system
Ask yourself, What is the purpose of medical insurance? Fundamentally, medical insurance is a group of real people pooling their funds for the sake of medical emergencies. Those who pay in understand (or should understand) that they will likely pay in more than they retrieve. Insurance “assures” those who participate that their bills will be covered if they end up one of the medical emergencies.
If you thought of insurance differently, you’re not alone. Many people see insurance as a slush fund to pay for prescriptions and doctor visits. Or they see it as a savings account to draw from, making sure they get their piece of the fund, at least as much as they paid into. Others see insurance as something the government should manage, thinking of medical expenses as trivial, something that need not be paid personally, but a responsibility of society (that is, tax payers).
Samaritan isn’t a pool of funds, it is a pool of people, as we believe insurance was meant to be. Subscribers aren’t sent a monthly bill. Instead, subscribers are sent directions to pay a certain amount of money to other members. Essentially, Samaritan serves as an accountant to divvy up claims among its members. It is the responsibility of members to follow through with their payments.
There are administrative costs associated with this, but it comes directly from the yearly subscription for the newsletter. Unlike insurance companies that receive bazillions of dollars in revenue and distribute bazillions of dollars (minus their profits) in claims, Samaritan is able to clear most of this from its P&L. Technically, very little revenue comes in, and very few expenditures go out. It is a well managed accounting machine, and millions of dollars in medical bills go paid through the system every year.
How Samaritan returns humanity to the medical industry
One of the criticisms of the medical industry is how impersonal it is. And no wonder! Insurance companies view patients as numbers, little emotion is exhausted from a paper pusher who decides what illness is covered and what isn’t. Government insurance isn’t any better. Someone eventually pays for the medial service, and an hourly worker in some skyscraper is no different than a bureaucrat in Washington. Arguably worse.
Not so at Samaritan. Sure, they have their restrictions, but what insurance company doesn’t? With Samaritan, you are taken care of by real people who are in the same boat as you. They’re brothers and sisters in Christ who have your best interests at heart.
The monthly instructions come with a newsletter of prayer needs of other members. It’s a great pool of people, and we love to read through the concerns and blessings from month to month. When we have had to file claims, we receive handwritten get-well cards or congratulations to the birth of a new child along with the checks.
Of course, there is the risk that someone may take advantage of the Samaritan system. Two thoughts on that. First, folks who try to cheat Samaritan (bouncing checks, not sending them, or making false claims) are quickly weeded out. Remember, you’re dealing people-to-people, not bureaucracy-to-people, so efficiencies are much tighter. Second, we can count the number of checks that didn’t come through on one hand, that after thousands of dollars in claims over the years. Besides, claims are covered with several small checks, not one big one, so even if we were to get cheated, it wouldn’t be by much.
How Samaritan brings medical costs down
Doctors and hospitals face a brunt of criticism, too. If they weren’t so expensive, insurance companies wouldn’t charge such high premiums, and patients wouldn’t find themselves in such dire straights. While there is plenty of blame to go around, we find it difficult to hang much blame on doctors or hospitals. Their medical expenses are so high because of the insurance mess, not the other way around.
Samaritan members see this every time they end up in an emergency situation. With Micah’s saw accident, we were required to pay certain amounts. The ER required $150 down payment, and the rest of the bill will come later. The specialist’s clinic visits are free, but the operation will run an estimated $4,400. The hospital, too, will cost money for the operation. So, in the end, Micah’s wood-making project will cost somewhere around $10,000.
We, however, will probably pay about half that. We are constantly amazed at how much doctors and hospitals will slash their price when you tell them you are self-pay. Without hardly a bat of an eye, they drop 35 to 60 percent. We used to think it was because they had pity on us (oh, poor people with no insurance, let me help them!). Not true. By avoiding the insurance debacle, the professionals gain payment upfront and the medical service bypasses collections totally. A collection that oftentimes goes unpaid in the end. It is a wise business move: Ready to pay upfront? You bet we’ll drop the price.
We look at it this way: we actually pay the market price for medical service. If we had insurance, medicare or medicaid, we would pay the bloated price that the corporate and bureaucratic system demands. We feel better about it, too. The good people in the medical field are professionals, and we’re paying them for their good work.
Let’s go back to the humanity of Samaritan for a moment. Once the question of payment is out of the way (we’ll get to that next), both parties (us and the doctors) feel like the elephant is out of the room and we can all return to caring for the patient. The doctor can focus on Micah’s finger, we can focus on the various questions we have and decisions we need to make, and neither party needs to worry about much else. The doctor doesn’t need to worry about whether he’s going to get paid, and we don’t need to worry about whether we will be able to pay. We get to work, and everyone is happy about it. Except Micah, but he’s young and will heal.
How Samaritan truly “insures” us
We’re not wealthy people. Far from it! We live month-to-month like most Americans, trusting God as we work hard to provide for our growing family. Granted, it was tough handing over the credit card for the doctor’s receptionist to run $2,200 on it (half the “normal” cost). These initial bills will be a struggle to work out, but we have no doubt in Samaritan. Before Micah’s finger heals, we’ll have all our bills paid for. Here’s how it works.
The question the front-desk lady asks is, “What insurance do you have?” That’s really not the question. Instead, it is, “How will you be paying for this today?” Our answer, as is it is for every Samaritan member, is, “self-pay.” Doctors and hospitals then send you down an entirely different route than the insurance route. The insurance route is ladened with regulations that a full-time staff (what a heavy cost!) typically handles. Self-pay patients either whip out the checkbook or credit card. Sometimes payment plans can be set up. Whatever the self-pay process, the point is simple: you pay your own medical bill, save the receipts, and submit claims to Samaritan.
This is where most people fear Samaritan. That “self pay” option is difficult, and passing the bill onto an insurance company seems, on it’s surface, worth it. We challenge this thought in two ways. First, is it really worth the 35-60% up charge? That’s how much extra you’ll eventually pay just to kick the can down the road a couple months. Your credit card sure isn’t charging you that much. We cannot economically justify the insurance route.
Second, what if we didn’t have the $2,200? A finger operation is easy sailing compared to cancer or open-heart surgery. A final bill of $10,000 is something we could handle, our credit is that healthy. But what about $100,000? Would that be end-of-story? “Sorry, game over!” It might be with traditional insurance, but not with Samaritan Ministries.
Again: With insurance you’re dealing with corporate or government bureaucracy, with Samaritan you’re dealing with people. And they’re people in the people-caring business. Doctors and hospitals have slashed their prices for us not just for business reasons, but because they genuinely care for us, their patients. In fact, the lady we talked with at the doctor’s office (the one who swiped our credit card) let us know that there is a program at the hospital that waves fees based on income. We’ll be looking into that program later, but my bet is that the program is based on the same Hippocratic values that their hospital is built on: caring for the lives of others.
Horror stories of the insurance system are a dime-a-dozen. It’s a great irony on how inhumane such a human-centered institution can be. In the end, we ask you: which would you trust more? The insurance company, or your doctor? The government agency, or your own decisions? We go with the latter choices, and Samaritan empowers those choices.
How to apply
Samaritan is designed for dedicated Christian laymen, especially the self-employed and ministry leaders, profiles that we fall into perfectly. If that describes you, definitely look into this. But even if not, Samaritan insures thousands of other likeminded Christians nationwide. See their website for complete information (www.samaritanministries.org). And be sure to mention that Chris & Wendy Jeub recommended you!*
*Full disclosure: We receive a discount on our monthly instructions when someone signs up from our referral. However, this article was not solicited in any way by Samaritan and is not an advertisement. We honestly believe in their ministry and want to spread its good will.