Sometimes there’s a topic that makes me so mad at times I can’t see straight — health insurance is one of them. There are few things that work more against your health than your health insurance! I want to explain some of the problems produced by health insurance and discuss various options for optimizing your health with or without health insurance.
WHO DECIDES YOUR HEALTH?
This is the fundamental question: Do you decide your health or does your insurance company? If you find yourself saying things like, “I can’t do that because my insurance won’t pay for it,” you are allowing your insurance company to decide your health . . . and that is absolutely ridiculous! Why would you let a bunch of faceless bureaucrats decide what’s good for your health? They don’t care anything about your health — they don’t even know you! If you are going to be healthy, you must make health decisions independent of insurance considerations. Radical idea, isn’t it?
Most of my adult life I have not had health insurance by choice. I pick out the doctors I want to see, select the tests I want to have run, and pay for them. And overall, I’ve spent a lot less money that way than I would have by paying for insurance premiums. The main point is that I stay in the driver’s seat and direct my own health strategy.
“BUT MY EMPLOYER PAYS FOR IT”
Many people are stuck with health insurance automatically from the company they work for. Therefore, you may not have a choice relative to the alternatives I’m going to discuss. But even here there are still positive decisions you must make in spite of your insurance coverage. It just means that when you are convinced of your need for a health service or product that is not covered by your insurance, you pay for it yourself. That may involve some budgeting or saving, but it’s ultimately a matter of priority. This is what probably 95% of the clients at Pacific Health Center have done, and rightly so.
It’s unjust that you’re paying for insurance and paying for other health services that your insurance doesn’t cover, but nobody said life was fair. It’s analogous to parents who private or home school out of deeply felt conviction, yet still have to pay thousands of dollars in property taxes to support the government schools they neither use or nor believe in.
One point of clarification: A lot of people labor under the mistaken idea that their employer pays for their health insurance. That is untrue. You, as the employee, are still the one paying for it. Your insurance is just part of your compensation—you are being paid less in salary to cover the cost of your insurance benefit. There’s no free lunch. Your employer can just pay you in dollars or pay you in a combination of dollars and benefits—their choice.
THIRD PARTY PROBLEMS
You and your health practitioner are the only parties that should be involved in your health care decisions. Your insurance company shouldn’t be telling either you or your doctor what to do. Nor should your doctor have to go to the insurance company for anything, including payment. If it’s between you and your doctor, who wants a meddling, uncaring third party involved?
For this reason at our clinic we only deal with our clients, not with insurance companies. We have been “hired” by our clients and have no relationship with their insurance company. If our clients have an insurance agreement and want to deal with their insurance company on that — fine, but that’s between them and the insurance company they have “hired.” Remember, if you have insurance, your insurance company works for you, not the other way around. Unfortunately, most people act like they work for their insurance company!
IMPORTANCE OF HEALTH INSURANCE
Lest I give the wrong impression, let me hasten to add that I think the concept of health insurance is great. If fact, the concept of insurance period is great. Insurance of any kind is predicated on the idea of a group of people sharing the risk of an unlikely catastrophic expense. And there can be catastrophic expenses when it comes to your health. Hospitalization can amount to $2000-$3000 per day, surgeries can be in the tens of thousands of dollars, and some drugs can cost $100 a pill.
Just as I think someone’s life, home and car should be insured against catastrophic loss or expense, so I believe the same is true when it comes to your health. The question is, “How is the best way of going about it? and “Does the current insurance method I’m using deliver what I need?”
ROUTINE vs. CATASTROPHIC EXPENSE
Health insurance for most people is not about catastrophic expenses but simply routine services from health practitioners. People have been lured into the concept of their health insurance taking care of everything for them . . . only to be alarmed to find out their insurance company then tells them what they can and cannot do by way of health services.
This would be analogous to my car insurance paying for my tune-ups, car washes and gas, instead of just paying for accidents — i.e. catastrophic events. Can you imagine what car insurance would cost if it did that? And then can you imagine your insurance company telling you which repair shops you could go to for that tune-up, or which gas stations you could buy fuel at? Ridiculous? You bet, but that’s just the way most people’s health insurance works.
Do you know what happens to health insurance premiums when they only cover major expenses, like amounts over $5000 or $10,000? The premiums are but a fraction of regular “covers everything” type of insurance.
WHO YOU’RE PAYING FOR
One issue should significantly bother most Christians — who and what is causing their insurance premiums to be so high. It is estimated that 80% of all health insurance claims are related to lifestyle choices — tobacco, drugs, alcohol, AIDS, gluttony, sexual immorality, etc. If you have regular health insurance, that’s mostly what you’re paying for! What if instead of pooling health expenses with the population at large, you instead pooled them with practicing Christians who are non-smoking, non-drinking, non-homosexual, not overweight etc.? You guessed it: a dramatic reduction in cost, and that’s just what one organization has done.
MEDI-SHARE — AN ALTERNATIVE
If you work for a company where you are forced into their insurance plan, this company will not be of help. But if you have a choice about your insurance, you would be a fool not to do this. The Christian Care Medi-Share Program is a group of Christians that share medical needs including sickness, accidents, hospitalization, and maternity (including home birth and midwifery). It is not an insurance company, but simply a private association of Christians agreeing to share expenses within the organization’s criteria.
They don’t take everybody. You have to be a Bible-believing Christian who regularly attends church, you can’t do drugs, you can’t abuse alcohol, you can’t be HIV positive, and you can’t be extremely overweight — “walking coronaries” are not a very good risk. You also can’t have many pre-existing conditions that make you likely to incur major health expenses.
So, it leaves out a lot of people, but that’s what produces the savings. The members share bills to $5 million. They offer two plans: Covering 100% of expenses over $250 for $85/month for a single, $155/month for a two person family, or $210/month for a family of three or more. A second plan covers 80% of expenses over $911 for $65/month for a single, $95/month for a two person family, and $119/month for a family of three or more.
If you’re self-employed or otherwise able to choose your insurance, and if you are accepted, this is unbeatable. (Information packets on Medi-Share are available at the Clinic.)
STUCK WITH YOUR INSURANCE?
Medi-Share is great for those who qualify, but what do the other 80%+ that are locked in to their health insurance do?
- Make your health decisions based upon what kind of services you want and need, not what your insurance company wants for you.
- Budget and save for those expenses. That may be nutritional supplements, chiropractic, dental amalgam removal, massage, or coming into Pacific Health Center for testing (Note: a few insurance companies do cover at least part of our services.)
- Encourage your employer to offer more alternatives, including funds set aside for your own discretionary health spending.
- Encourage your state and national legislators to make Medical Savings Accounts (MSA’s) widely available. This would do more to lower health care costs and expand choice than any other single item.
In this system part of your current premium goes to a “catastrophic policy” covering, say, expenses over $5000, while the rest goes into your Medical Savings Account for you to spend as you please for your health. Liberal politicians, who want the government running health care (the only thing worse than insurance companies running it) hate MSA’s. MSA’s do not provide the paternalistic dependence necessary for their political survival! That’s what the health care debate is all about — who’s in control.
Declare your freedom from health insurance — don’t be in bondage to its dictates. With careful planning, saving and God’s ever-present provisions, you can have the health services you really need, whether your insurance company reimburses or not. It’s a matter of priority. Just as I paid for home schooling in addition to paying taxes for government schools I did not use, so I believe we must with our health. The alternative is self-destruction.
Better Health Update is published by Pacific Health Center, PO Box 1066, Sisters, Oregon 97759, Phone (800) 255–4246 with branch clinics in Boise, Idaho, Post Falls, Idaho and Portland, Oregon. E-Mail: drkline@pacifichealthcenter.com. Monte Kline, Clinical Nutritionist, Author. Reproduction Prohibited.
DISCLAIMER: The information contained in this publication is for educational purposes only. It is not intended to diagnose illness nor prescribe treatment. Rather, this material is designed to be used in cooperation with your nutritionally-oriented health professional to deal with your personal health problems. Should you use this information on your own, you are prescribing for yourself, which is your constitutional right, but neither the author nor publisher assume responsibility.