Faith, Hope, and Charity in Health Care - Not Exactly What You Might Think

by Lisa Codispoti, Senior Advisor
and Brigette Courtot, Policy Analyst
National Women’s Law Center

This post is part of a weekly series on Women and Health Reform. 

Since this series began, our health reform blog posts have generally provided graphic examples of the extent of the nation’s health care crisis (with one exception).  As if we needed any more evidence, some recent news stories help make the case for comprehensive health reform:

Faith:  Last week this story described the growing number of faith-based alternatives to health insurance, otherwise known as “faithcares” or “biblical healthcare solutions”. Basically, these are ministry-administered health financing pools that people can join in lieu of purchasing health insurance coverage. For those who don’t have access to affordable real health insurance, faithcares might be the only option for protection against unexpected or catastrophic healthcare costs, since they require lower premiums than that of a typical employer-sponsored or individual health insurance plan. But faithcares sure aren’t for everyone - members must be nonsmokers, moderate- (or non-) drinkers who go to church regularly, don’t have premarital sex, and live by biblical principles. Even for those who fit this description, there is another major problem with faithcares – they are NOT health insurance plans, so they are pretty much unregulated. As the article points out, nothing about these financing models is guaranteed– “If members don’t [send in money] there is nothing to share.” –and this can and has led to problems with members getting their due reimbursement for health costs. Also, because there is little government oversight of faithcares, they are especially vulnerable to fraud or mismanagement. A few years ago a faithcare was required to pay back over $20 million dollars in unpaid claims, because the founder had diverted much of the financing pool to his personal bank accounts.

Charity:  A couple of weeks ago, the TV Newsmagazine 60 Minutes featured this story about a charity called Remote Area Medical, or RAM. The sole mission of this shoestring nonprofit is to airlift medical care to remote areas of the world, and they began by working in the most isolated and undeveloped places on the planet. But now, this group has set up clinics in our very own USA to serve the uninsured and underinsured (those who have some amount of health insurance but still can't afford health care). Unbelievable. One needy patient that 60 Minutes profiles is a woman who had surgery for cervical cancer two years prior but hadn’t received any follow-up care since; with three kids to care for and a husband who had lost his job, she just couldn’t afford the twice-yearly Pap smears that were recommended to keep her healthy.  The fear on this woman’s face as she waited for her test results was palpable (though, thankfully, the Pap smear was clear).  Watching this piece, we were shocked at the sheer number of families the health care crisis is affecting, and—quite frankly—angry and embarrassed that our highly-developed nation hasn’t done better for its citizens.

Hope: After two stories like these, which so clearly demonstrate how far we’ve sunk and how far we have to go to improve heath care in America, we’ll end with a note of hope. Things are desperate, but we’ve got hope that change is in the air for the better- that in the upcoming elections, women—and all people—will demand reforms that will provide affordable, comprehensive and reliable health care, and will then hold their elected officials accountable to deliver this change.

Comments

[Lisa and Brigette]

Kim - Indeed, one objective our health reform work is to make sure that women’s advocates are aware of the progress that states are making to ensure that women have access to meaningful health coverage. But unfortunately, many of the individual health plans that bill themselves as “affordable” are—upon closer examination—anything but that. For example, when low monthly premiums are paired with a deductible of several thousand dollars (which families must pay out-of-pocket before their regular health coverage kicks in), the total cost to the family is much more than it seems on the outset. In the 60 Minutes piece we mention in our blog, the first needy patient profiled is a man who had insurance through his full-time job but couldn't afford to pay the deductible amount – so, he and his family just went without care (and for far too long). In addition, many plans don’t adequately cover women’s needs, which include preventive care and reproductive health services (e.g. maternity care is usually left out of the most “affordable” coverage options), and care for chronic conditions and major medical events. When coverage options are either too expensive or lack the benefits that people need to stay healthy, “under-insurance” results – this is a very real problem in the United States. Finally, you mention affordable coverage for women with pre-existing conditions, which sounds too good to be true, and in most cases probably is. Instead, we imagine one of these three scenarios as most likely for a woman with a previous medical history who tries to purchase a non-group insurance policy: 1) Depending on the state of residence, she may not find any insurer who is willing to offer a policy; 2) If she does find an offer of health insurance, her policy might specifically exclude health benefits related to her medical condition; and 3) If she finds an insurer who will offer a policy, and that policy does include the benefits she needs to treat her condition, the coverage may come at an exorbitant (and unaffordable) cost.

[Kim Morris]

While faith and charity based support will always be important but it makes sense to exhaust traditional options first. Many women are still unaware of the progress toward affordable universal health insurance achieved over the past year and what is expected over the coming 12 months. Insurers are not waiting for a government mandate; they have introduced a wide range of core health insurance and basic health insurance coverage at affordable rates that are available to all without regard to previous medical history. While this does not solve all of our health care problems, it is a positive first step that can be taken now in combination with these community-based health care initiatives.