The Devil Is In The Details: The Legal Grift Of Religious Insurance “Alternatives”

The most troubling detail in this NPR article is not the grift in religious clothing that is a "medical cost-sharing plan."

The most troubling detail in that story is not the $160,000 that a pastor unexpectedly owes for a (fairly routine) medical procedure.

The most troubling detail is not even the deeply unjust and broken healthcare system in the United States.

The most troubling detail is that the victims are not blaming the grifters.

These plans are best kind of grift — at least, from the point of view of the grifter — because they’re entirely legal. As broken as the current medical insurance model is in the United States, you probably have a rough idea of what is meant when someone says they have "health insurance."

These cost-sharing plans are careful to quietly note that they are not insurance while loudly trumpeting themselves as an alternative to insurance.

Again, this is technically true… in the same way that a plate full of gravel is an "alternative" to chocolate cake for dessert.

Several of these organizations are, or have been, under investigation for false advertising and similar concerns. They may have morality clauses, such as requiring you to "attend church regularly. You must agree to abstain from certain behaviors, such as ‘sexual immorality’ and drug abuse. Preventive care, routine prescriptions and mental health care may not be reimbursed. Forget about abortion. Coverage for your preexisting conditions will likely be limited — at least initially." (I am quoting KHN News here.)

The devil is in the details…and the fine print.

All that said, there’s a pretty flow of how this is supposed to go. The hospital or doctor bills your insurance, and whatever your insurance doesn’t pay is passed on to you. Or, alternatively, the hospital or doctor bills you directly, you pay the bill, and then your insurance reimburses you.

Except in the case of the King family — the pastor featured in the NPR story mentioned earlier — that chain of events broke down when their "medical cost sharing plan" would not cover the heart ablation that Jeff King needed, saying that it was a pre-existing condition and he had not been with the plan long enough for the procedure to be covered.

But that is not where the Kings seem to think the breakdown occurred:

Kareen King calls it "the ultimate paradox": The hospital that saved her husband Jeff’s heart also broke it.

"It’s just so tragic the way our system is," Jeff said. "It puts so many people into impossible financial straits.

And that is the most troubling detail.

Yes, the system is broken. The ways that medical procedures are priced is crazy [1].

But in this case, the hospital did exactly what they were expected to do.

It was the religious "cost sharing plan" — the "refreshing non-insurance approach to managing large and unexpected health care costs" — that took advantage of this pastor and his family’s faith.

But rather than point directly at the cost-sharing-plan, the Kings point at the hospital, or at "the system."

For some reason — presumably because they’re also Christian — the Kings don’t appear to recognize that the staggering hospital bill is the result of the cost sharing plan’s business model working exactly the way it is supposed to.

Again, yes, the US healthcare industry is deeply, deeply flawed. Insurance companies have perverse incentives to look out for investors instead of those they’re insuring.

But as some people keep having to find out the hard way, claims to be religious are very, very different from being "moral" or doing the "right thing."

And until we hold religious entities to the same standards as the secular ones — both personally and as a society, this kind of grift will continue to prey on those they claim to represent.

Featured Image by Sasin Tipchai from Pixabay

[1] WFAA in Dallas, for example, used a browsable set of data to determine that prices around Dallas were far more expensive than neighboring cities, for example.

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