Time: D H M S

SNARK: 'Reason' crows about success of socialized* healthcare system, fails to grasp irony.

Over at Reason.com (a right-wing publication)*, there's an interesting article about the growth of 'Sharing Ministries' as a completely legal alternative to ACA-compliant policies:

Samaritan Ministries is an organization of devout Christians who eschew traditional health insurance to pool their money and cover each other’s catastrophic medical bills. It’s one of the very last mutual aid societies in the U.S., in which a community of individuals with shared beliefs band together to form a voluntary social-safety net. A century ago, an estimated one-third of American men belonged to mutual aid societies, but most faded away with the expansion of the welfare state.

Three years ago, I travelled to Samaritan’s headquarters in Peoria, Illinois to learn more about this remarkable organization.

In the story that came out of that trip, I predicted that Obamacare would lead to the demise of Samaritan and two similar organizations in the U.S. This model, I thought, wouldn’t be able to compete with the heavily subsidized plans soon to become available on the new health-care exchanges.

Wow, did I get that wrong. As The New York Times reported recently,

[M]embership in sharing ministries has more than doubled over the last six years, to 535,000 from about 200,000…The growth seems to have come largely through word of mouth, at churches, schools and workplaces.

The Times story also notes that Samaritan added about 50,000 members just last year, swelling its total to about 200,000. When I covered the group in October 2013, it had 86,000 members. I didn’t foresee Obamacare’s disastrous rollout and the extent to which new mandates would drive up premiums and leave customers seeking out cheaper options.

*Update: As pointed out in the comments, it was unfair of me to describe Reason as "right-wing"; technically they're a LIbertarian publication.

Well, bully for them! First, let's take a look at exactly what a "sharing ministry" is:

A health care sharing ministry is an organization that facilitates sharing of health care costs between individual members who have common ethical or religious beliefs in the United States. A health care sharing ministry does not use actuaries, does not accept risk or make guarantees, and does not purchase reinsurance polices on behalf of its members. Members of health care sharing ministries are exempt from the individual responsibility requirements of the Patient Protection and Affordable Care Act, often referred to as Obamacare. This means members of health care sharing ministries are not required to have insurance as outlined in the individual mandate.

In other words, sharing ministries are essentially one of the last remnants of non-ACA compliant coverage. Unlike official ACA-approved policies, coverage through these organizations appears to amount to pretty much whatever the ministry says it is. The Reason article specifies "catastrophic" medical bills, while the Wikipedia definition above specifies that they can still kick y ou to the curb for whatever reason they want to (which doesn't sound very Christian to me, but hey, I'm Jewish, so what do I know?).

From a free-market capitalistic POV, I suppose this sounds fantastic, since there's zero regulation...oh, wait, what's that?

Most ministries are oriented toward practicing Christians, with restrictions like abstaining from sex outside of marriage, excessive drinking, tobacco, and illegal drugs. They usually require members to make a statement of belief as well. For instance Samaritan Ministries requires an statement of Christian faith including belief in the triune God and divinity of Jesus; Liberty HealthShare is more inclusive, accepting members with a wide variety of religious and ethical beliefs. All such ministries require that members subscribe to the ethical principles of individually responsibility for health, and helping others in need.

Well, whaddya know? Turns out that sharing ministries are heavily regulated after all...it's just that instead of being required to actually provide comprehensive healthcare coverage, they specifically control pretty much every other aspect of their members' lives. FREEEDOMMMMMMMM!!!

OK, I kid, but I'm still not sure how this story in any way "proves" that the ACA itself is "failing". My takeaway is that, thanks to the Affordable Care Act, about 335,000 more people are covered via these organizations. The article suggests that a large portion of these folks moved to ministries from private coverage, and perhaps that's true...but even if, say, 2/3 of them did so, that's still an extra 100,000 people who now have some type of coverage who didn't otherwise have it before. In my book, that's a positive for the ACA, not a negative.

Having said that, it still seems to me that the article is missing out on the ultimate irony here, right in the opening paragraph:

a community of individuals with shared beliefs band together to form a voluntary social-safety net.

Hmmm...'shared beliefs' such as, I don't know, the shared beliefs of a democratically-elected, representative form of government, with the rights to life, liberty, the pursuit of happiness, freedom of speech, freedom of religion and so forth...'pooling their money' to...

cover each other’s catastrophic medical bills.

It seems to me that "Sharing Ministries" are essentially nothing more than a religious-specific version of...dare I say it...socialism*?

Again, according to Wikipedia:

Health care sharing ministries are founded on the biblical principle of believers sharing each other’s needs. Ministries often cite the mandate of Galatians 6:2 to “Bear one another’s burdens, and thus fulfill the law of Christ” as applicable to medical costs. Some see origins in the Book of Acts where early Christians "were together and had everything in common" and "gave to anyone as he had need", (Acts 2:44-45).[5][6]

Hmmmmm....that sounds awfully familiar...

From each according to his ability, to each according to his need (or needs) is a slogan that Karl Marx made popular in his writing Critique of the Gotha program, published in 1875.The German original is Jeder nach seinen Fähigkeiten, jedem nach seinen Bedürfnissen. Once society has changed to Communism, it will produce enough goods and services so that everyone's needs can be satisfied.[1][2]

Nah, it can't be that, because that would be Evil.

Update: *OK, I assumed that the snark in this post was fairly obvious, but I suppose it isn't (as noted in the comments). So, to clarify: Obviously there are tremendous differences between actual "socialism" and the "sharing ministries", as well as between both of those and the private insurance market. My larger point is simply to highlight the absurdity of anyone enrolled in "full price" heatlh insurance trying to claim that they "pay their own way" for all medical expenses since the whole point of insurance itself is to pool resources to cover expenses that few can pay for by themselves.