NYT on Scamaritan

[gustava]

Very good article.

 

http://www.nytimes.com/2014/12/26/us/fo ... odayspaper

[Peas n carrots]

$250k lifetime cap? The young couple featured in the article better pray hard to their God there isn't a major medical crisis in their life. That $250k cap can be met pretty fast in many emergencies.

[Buzzard]

The Beilers, who joined Samaritan on the recommendation of a children’s minister at their nondenominational church, are all in good health. They get supplemental vision and dental insurance from Ms. Beiler’s job at a mental hospital.

Members know they are expected to pay for services like yearly checkups, Mr. Hopp said. “You’re dealing with like-minded people who are committed to this concept of helping each other out,†he said. “They don’t have to be supporting something that is in conflict with their values. That’s big.â€

Mr. Beiler, 27, said he was “not particularly a fan†of the Affordable Care Act because he was uncomfortable paying into an insurance plan that covered services, like some forms of contraception, that he objects to on religious grounds. The couple said the insurance mandate opened their eyes to a Christian alternative. Mr. Beiler’s concerns echo a national discussion about the government’s role in regulating health coverage for people with diverse religious beliefs. In June, the United States Supreme Court ruled that federal health law could not force family-owned corporations with religious objections to pay for insurance coverage of contraception.

“This is an important option, a faith-based proposition for a fairly targeted group of people,†said Anne Dunkelberg of the Center for Public Policy Priorities, a liberal research group in Austin. “If your faith is strong that one of the ministries is right for you and is not going to disappear when you need them most, then that’s a choice for you.â€

So they have the option to have actual health insurance through an employer but they are foregoing it for Samaritan Ministries? What kind of mental gymnastics do you have to go through to reach that as a logical alternative?

I get the self insured who are paying the entire premium justifying some high and mighty belief that insurance is evil, it supports gayz, it encourages abortion/bc, it encourages sex, or some other deluded idea. I cant wrap my brain around someone who is only paying a portion of the premium, with the rest going to an employer who is paying it anyway, turning down a legitimate policy because it MIGHT use $0.32 of your premium for birth control pills. Its the perfect example of cutting off your nose to spite your face.

These people have a baby. Sure, they covered the uneventful birth at 10k and she got nice notes telling her what a great person she is. Babies are expensive. They need to see a doctor, get shots, they get sick a lot... they havent even added her to the policy! All of those tests cost money, money that they are paying out of pocket for no reason (possibly to a dr that supports the things they despise in charitable contributions using their money) and NOT using to better their child or themselves. :angry-banghead:

[DGayle]

And if a ministry member contracts a sexually transmitted disease, he or she has to foot the bill.

Better hope you don't get herpes from being raped.

“This is an important option, a faith-based proposition for a fairly targeted group of people,†said Anne Dunkelberg of the Center for Public Policy Priorities, a liberal research group in Austin.

Well. The name of the day is Anne. So many dumb Annes this week. Also? FUCK YOU for thinking Christians are the ones who have it sooooo tough when your religion is the one that controls the goddamned country!! Get back to me when this country moves forward enough to have a menorah next to the tree in the White House!!

[DGayle]

These people have a baby. Sure, they covered the uneventful birth at 10k and she got nice notes telling her what a great person she is. Babies are expensive. They need to see a doctor, get shots, they get sick a lot... they havent even added her to the policy! All of those tests cost money, money that they are paying out of pocket for no reason (possibly to a dr that supports the things they despise in charitable contributions using their money) and NOT using to better their child or themselves. :angry-banghead:

My insurance covered the kids from birth. Those idiots don't have any coverage yet for their daughter. Why the delay? The Dummy says tests are for peace of mind. Isn't that what real insurance is for? It sounds like those tests aren't covered at all by the way the article was written.

I wonder if you get disqualified if you get really sick and just didn't pray hard enough. I can see that going really bad for anyone who does get sick. And then we evil tax-payers will be stuck with the bills.

[Emme]

$250k lifetime cap? The young couple featured in the article better pray hard to their God there isn't a major medical crisis in their life. That $250k cap can be met pretty fast in many emergencies.

Extremely fast. That seems like such an irresponsible way to live, using Scamaritan. What happens at the cap? They're on their own to pay? Love how the article ends with routine blood work on an infant not being covered...

[doggie]

Better hope you don't get herpes from being raped.

You forget rape is a choice a woman makes by inviting it. shame on you for forgetting. why should someone else pay for her poor choices? :pink-shock: :head-desk:

[doggie]

this whole thing just ends up ripping on it's users they get less end up paying more all because of faith.typical religious scamming. if you have strong faith you will pay out the butthole for it.

[Seven Severn]

$250k lifetime cap? The young couple featured in the article better pray hard to their God there isn't a major medical crisis in their life. That $250k cap can be met pretty fast in many emergencies.

I wonder how close Melanie Maxwell is to meeting that cap; five problem pregnancies ain't cheap and then there's NICU on top. She better hope she doesn't become even remotely ill.

[DGayle]

Are you expected to keep paying even when you hit the cap?

[sparkles]

I wonder how close Melanie Maxwell is to meeting that cap; five problem pregnancies ain't cheap and then there's NICU on top. She better hope she doesn't become even remotely ill.

According to the article, it's a cap PER MEDICAL CONDITION, not a lifetime cap for everything. So each of Melanie's pregnancies would be considered a separate condition. It's still inadequate plan as far as I'm concerned and you could still run through that amount in the blink of an eye, but at least the cap is a bit more reasonable.

Most members also face a lifetime cap of $250,000 per medical condition — an amount that can be easily spent if a person is seriously injured or faces a long-term illness.

[Seven Severn]

According to the article, it's a cap PER MEDICAL CONDITION, not a lifetime cap for everything. So each of Melanie's pregnancies would be considered a separate condition. It's still inadequate plan as far as I'm concerned and you could still run through that amount in the blink of an eye, but at least the cap is a bit more reasonable.

Gotcha. Thanks for the clarification. Still, cancer treatment can run close to a cool million, I think, and prayer isn't going to do jack shit. These people are screwed if something major happens.

[CelticGoddess]

Extremely fast. That seems like such an irresponsible way to live, using Scamaritan. What happens at the cap? They're on their own to pay? Love how the article ends with routine blood work on an infant not being covered...

Yep. in 2004, I developed pancreatitis due to a blocked duct from gall stones. I had an 8 day admission to the hospital that would have run me $125,000 had I not had insurance. (We had awesome insurance, so it cost us $500 for the co-pay, and $100 for the surgeon).

My cousin, who is a brittle diabetic (since age 6) has racked up over $100,000 in med bills. That was WITH insurance. I don't even want to know how far in debt she would have been had she not had insurance.

People just don't seem to understand that sometimes, bad shit happens to good people. They are going to have to learn this the hard way,

[Dandruff]

These people have a baby. Sure, they covered the uneventful birth at 10k and she got nice notes telling her what a great person she is. Babies are expensive. They need to see a doctor, get shots, they get sick a lot... they havent even added her to the policy! All of those tests cost money, money that they are paying out of pocket for no reason (possibly to a dr that supports the things they despise in charitable contributions using their money) and NOT using to better their child or themselves. :angry-banghead:

What happens if the baby has an expensive medical emergency this year, before they've added her to the policy? Are a baby's medical expenses covered for a certain period of time following birth, or does coverage end once the baby leaves the hospital? What if there's a home birth but a complication arises soon after? What if the mom has fertility treatments, ends up with a high-multiple pregnancy, then a NICU full of preemies?

[doggie]

the thing is you also have to negotiate a better price. What if the hospital wants payment after treatment? A preemie needs care right now and they are not going to let you negotiate payment when you get around to it.

[Cartmann99]

Better hope you don't get herpes from being raped.

Well. The name of the day is Anne. So many dumb Annes this week. Also? FUCK YOU for thinking Christians are the ones who have it sooooo tough when your religion is the one that controls the goddamned country!! Get back to me when this country moves forward enough to have a menorah next to the tree in the White House!!

I interpreted Ms.Dunkelberg' s statement in a different way. I read her use of the word 'targeted' to mean that she felt that Samaritan would only appeal to a smaller group of people, not that she felt Christians were under attack.

[PennySycamore]

Yep. in 2004, I developed pancreatitis due to a blocked duct from gall stones. I had an 8 day admission to the hospital that would have run me $125,000 had I not had insurance. (We had awesome insurance, so it cost us $500 for the co-pay, and $100 for the surgeon).

My cousin, who is a brittle diabetic (since age 6) has racked up over $100,000 in med bills. That was WITH insurance. I don't even want to know how far in debt she would have been had she not had insurance.

People just don't seem to understand that sometimes, bad shit happens to good people. They are going to have to learn this the hard way,

Back in 1987, my premie daughter's NICU bill for 4 months was about 300K. We had really good insurance, though, or we would have been screwed.

[chaotic life]

One of my kids has Hemophilia. He costs an insane amount of money to keep alive every year and we rejoiced when lifetime caps were lifted. A good year with no bleeds and no complications costs us $500K to keep him alive at his current weight. His medicine is weight based, it will keep going up as he grows.

I'm certain these good, moral Christian families are simply counting on the state CHIP programs or Medicaid to cover children born with inconvenient things like Hemophilia, Spina Bifida, Cystic Fibrosis, congenital heart conditions or those that have the audacity to develop childhood cancers.

[August]

Whenthey say your bills are paid by others sending their premiums to you, does that mean you incur the dreaded debt until they're paid off? Are there no financial reserves? Half a dozen cancer diagnoses in the same month would really stretch a system like that.

And,if the check comes straight to you, how is that counted for tax, a gift? And are the payers told what it's for? What if they decide your diabetes is your own fault for being fat and refuse to pay?

[doggie]

There are only so many paying so if there is more out then in then there is less than all around. And yes you are judged that's the whole thing to control others

[LaLele]

Gotcha. Thanks for the clarification. Still, cancer treatment can run close to a cool million, I think, and prayer isn't going to do jack shit. These people are screwed if something major happens.

Having worked on both the medical side and insurance side of health care, I can say the most common way for a pt to hit a million is by either being born before 28 weeks, having chronic renal failure, or needing a transplant of some sort. Any of those can very easily hit a mil in a year. 250k is a drop in the bucket compared to the cost of a lot of illnesses.

[Coco]

One of my kids has Hemophilia. He costs an insane amount of money to keep alive every year and we rejoiced when lifetime caps were lifted. A good year with no bleeds and no complications costs us $500K to keep him alive at his current weight. His medicine is weight based, it will keep going up as he grows.

I'm certain these good, moral Christian families are simply counting on the state CHIP programs or Medicaid to cover children born with inconvenient things like Hemophilia, Spina Bifida, Cystic Fibrosis, congenital heart conditions or those that have the audacity to develop childhood cancers.

If only they would be honest and say that unbiased, guaranteed coverage is the best way to help people who are in dire need. A well managed single payer system would be wonderful, esp. drawing from success in other countries that have made it work. Some close friends of mine, who are Mennonite, have a severely disabled son who has been receiving treatments, wheelchairs, therapy, and all the usual benefits others receive, his entire life. I'm so thankful that their church does not judge others in that situation, but most of the time government aid is seen as an evil thing by fundies and a way the government will try to take control of personal details. (like having birth control coverage available in insurance)

The book Escape by Carolyn Jessop says that some FLDS groups purposely take advantage of "single" mother benefits. They call it bleeding the beast. (the government) I don't know if that's true, but it does seem likely. Such a sad situation for those trapped kids and women.

[DGayle]

I interpreted Ms.Dunkelberg' s statement in a different way. I read her use of the word 'targeted' to mean that she felt that Samaritan would only appeal to a smaller group of people, not that she felt Christians were under attack.

I read her comment as aiming this at people who are targeted, as in persecution, because OMG birth control is covered, the way Hobby Lobby's owners see themselves as targeted.

[cindyluvs24]

And if little uninsured Arabella needs costly medical care, you can bet they'll have no problem using whatever socialist, ungodly, government program is out there.

And another thing: They're in their 20's! Of course they don't need much insurance other than praying and eating right. Wait until they hit their 40's and 50's. Dummies.

[uber frau]

I should bloody well hope they use whatever state health care they can get for Arabella. It's not her fault she has morons for parents.

There are some fundies who won't accept state aid-even for enormously expensive things like the care of micro premmies. They'd rather cry poor to the hospital and get the hospital to absorb most of the cost and then emotionally manipulate the godly into covering the remainder. Do a search for the Zimmerman family. According to them, it's wrong for the taxpayer to support them through taxes but okay for pass on their bill to taxpayers through increased insurance premiums. They're just such special snowflakes.