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If we’re going to be true to little5bee’s intent of this thread as she claims it’s been hijacked why not really analyze this alternative? From the sound of it, Medishare is good if you want to save money and are healthy, but if you’re sick it is pretty bad. But as far as I’m concerned, that defeats the whole purpose of having insurance.
Thank you for the constructive comments!
I think the problem is not so much that it doesn't cover sicknesses (once you're in they won't kick you out and will cover your situation), but with the limitations on what it will cover.
The article you cited erred in saying that Medi-Share won't cover STDs. Like pre-ACA insurance, it will disclaim responsibility if it finds any fact that violates the terms of the agreement. So if you got an STD from sex outside of marriage, well, that voids the agreement. But it will cover STDs you got from your spouse. (Not saying if it will cover your spouse.)
[Medi-Share won't cover] Sexually transmitted diseases (STDs) including HIV – Exceptions include innocent transmission via transfusion, rape, in the practice of a healthcare profession or sex within marriage.
Again disregarding ethics (to the extent possible here), the problem I have with this coverage limitation is that its purported rationale is to minimize risk. But any purely monogamous relationship, inside or outside of marriage, gay or straight, would have the same level of risk. There is no economic benefit to the more stringent restriction, unlike, say, restrictions on drug use.
There are other similarly irrational policies. Hypertension when controlled by medication, is not considered a preexisting condition (for the purposes of future incidents such as a heart attack). But another condition, likewise controlled by medication, would not be handled the same way. Any incident that could be linked to this other condition would be excluded from coverage for a period of years after joining. Medi-share's explanation is that how they handle these things depends on members' votes, i.e. not on any rational basis.
Regarding the BBB complaints - we need to provide a frame of reference, e.g. by comparing the reports here with reports on insurers or health care providers. Many people only post negative reviews (a point emphasized to me yesterday at a glutten free expo, where a speaker urged the posting of helpful positive reviews as well as negative ones). The BBB is pretty much by design a site where people come to complain, not praise. Are the complaints here out of line with those that insurers receive? Real question, I don't know.
It occurred to me that, as with "Medicare for All", we may not be speaking the same language when it comes to "single payer". @Crash seems to be using it to mean where the money comes from (taxes, the government). I apologize if I'm misreading or misrepresenting. Please correct as needed.
The way I use it, and from what I can tell, the way it is used when one is being precise, is that it refers to who pays the providers. Thinking this way, even Medicare isn't pure single payer, because it includes Medicare Advantage, where private insurers pay providers, albeit largely with dollars that they get from the government.
There are at least two ways for the government to control costs. One is as a market participant - it pays for services and negotiates the rates, like any other large insurer. If it's the only payer (single payer), then it has even more bargaining power. It's not the biggest elephant in the room, it's the only elephant.
The other way is through regulation. The government could set rates (or ranges) that all providers must follow, regardless of what insurer or individual pays the bill. There are more constitutional issues here (how far do Congress' powers extend). I haven't looked at this at all, but I doubt there's a problem here.
Nah, no need; they're mistaken as a result of timidity, which is all too common in business editorial work. They can discover the cancer.gov "style". Or not.
Laetrile was widely lowercase-generic before this nonsense
depending on the savvy of the newspaper. It's sort of surprising this registration development occurred in the first place. The bogus medicine had been all in the news because of the court case and death of Massachusetts 3yo Chad Green, whose parents effectively killed him by denying him proper, court-ordered, leukemia treatment (fully curable then and now) and spirited him to Mexico for laetrile "treatment". Jerry Brown subsequently gave the family asylum in California. I wrote a column about it in the later 1970s which at the time got the most mail for anything ever published in the Boston Phoenix, where I worked, so upset were Mass. residents about this they-got-away-with-it child murder. Brown's state sanctioning of fatal abuse by parents remains outrageous.
Tip on USPTO - you can't link directly, because there's a session ID embedded in the URL and your session expires. I'll assume you looked the same place I did - trademark database search, wordmarks, live&dead entries for Laetrile.
Common usage without mark is (generally) not an indicator that a trademark doesn't exist. However, if the appearance of an unadorned trademark is pervasive and no effort is made to defend the trademark, then it can move into generic usage. (This is just to get stuff down "on paper"; I'm sure you know all of this.)
However, a failure to enforce a trademark by monitoring the mark for misuses will result in a weakening of the mark and loss of distinctiveness, which can lead to a loss of the trademark.
I'll stipulate as to the toxicity of laetrile (however you want to spell/mark it); that's the point. Who has the right/power to take notice of that fact and prohibit doctors from prescribing it? If the government has no business limiting what a doctor can prescribe, and the patient wants it and the quack doctor prescribes it, who's to block that?
My editorial point was that laetrile was widely identified before these applications (see google's ngram for it, starting early 1960s, peaking well after Chad Green's death, which is when registration / protection efforts commenced, looks like) and it is not common for such recognition / protection to be granted when that's the case (wide prior usage). It's not unheard of, though. All sorts of case law about this sort of thing, which if you're smart you learn about OtJ if you didn't go to editor school (as I didn't), and if you have common sense besides, you learn to ignore and scoff when ridiculous. Boston Acoustics once got in touch with the Boston Audio Society about BA's tm-ing of 'Boston' for all things having to do with audio (this was extra wack because the BA founders were local audio friends and Society members). A reply letter from an attorney BAS member pointing out the comedy of their position and inviting them to try their luck defending their registration got the whole thing dropped instantly. So there's often serious lack of common sense going around about these things. When I worked at Bell Labs I sometimes talked w ATT attorneys in the office next door and they were pretty funny (off the record) about the company's lame and wack efforts to try and enforce / preserve the term Unix. Eventually at one point it was decided that all they could really do to protect it as their own, or something, was to go w/ the cap version UNIX. That died, as eventually wide journalistic practice won out. uspto history would not really capture all the usage ins and outs of that.
As for substance effects, I'm a huge believer in regulatory limits on what providers can do and am always surprised to hear arguments otherwise.
Not unlike abuse, somewhat. The Green parents actually should be getting out of jail about now.
Trademarking "Boston" does seem absurd, but then there's the Kentucky trademark. A finger linkin' good story. And why we're seeing Colonel Sanders again.
@MSF Have you read the comments on Medi-Share on the Better Business Bureau web site I linked?
Here are a few excerpts:
1. My wife went into the emergency room because her doctor recommended she go. It ended up they recommended an MRI. I've had MRI's before and they were around $1200.00 or less (Not ER). These crooks at the hospital charged $6500.00 for the MRI, which resulted in a $10,000.00 ER bill. Our insurance (or whatever you call it!) (Medi-Share) covered around 25% of it and we're stuck with the rest. This was for sitting in the ER for over 4 hours, Exam, and a single Abdominal MRI with contrast. So, all this sounds like it's just the hospital right? Not completely. Medi-Share does not negotiate for you like real insurance does. When I called them, they say that our house hold portion was met (like a deductible) and that were were free to negotiate with the hospital. Yeah right, the problem is the hospital does not negotiate and says that's the job of your insurance. See where I'm going with this? Any savings we had with Medi-Share is going to be erased because Medi-Share does not negotiate hard enough. These hospitals are free to charge whatever they want and Medi-Share just allows it even if the services were severely overcharged. Buyer beware!!
2. I was looking for inexpensive medical health coverage, and a friend lead me to CCM. I enrolled almost a year ago, and have had some minor medical needs that required financial assistance. To this date, CCM has yet to help in any way, and I've learned my medical bills (the few that CCM actually covers) would've been cheaper if I just paid cash directly to the hospital. That's my story, and good bye CCM, what a waste of my money!
3. I have had the worst experience with everyone I have spoken to at Medi-Share from Member Services, to Development, to Payment Processing, etc. Every. Single. Person says they will follow up with me and NOT ONE actually has. And I am not just referring to long exhausting phone calls where I need to explain our situation yet again, but even emails go unanswered. The people I have spoken with have all had very professional tones and demeanors but none have actually been helpful, often placing me on hold to talk get a supervisor, whom also offers no help or I end of being transferred multiple times. When I've requested manager's contact information, I am told that they cannot share that information but that they will relay my message and have said person contact me. And of course, nobody ever does. I pray every time for the Holy Spirit to fill me with His fruits so that I can extend grace but boy, does this company test me. I'm praying for discernment here and hoping it is just poor management, communication, and execution and not just another "non-profit" just in it for the money.
4. DO NOT USE MEDI-SHARE! I have spent the last 3 months fighting with these people, after taking my money all year when I finally go to a doctor and need something they won't cover it. Prior to this year I went to the doctor 3 times a year at most and all of those visits were for something that I couldn't get rid of, an infection or something else. In all of those doctor visits I had never been told I had high blood pressure or that my blood pressure was an issue, even my life insurance physical didn't show me as a high blood pressure risk. While my wife is pregnant with our son, she was placed on bed rest and was checked into the hospital. It was during one of her times being checked into teh hosptial that I started having chest pain and trouble breathing. I go to the emergency room that night and get checked in for a blood pressure spike. Talking with my doctors there, the extremley stressful job, coupled with the stress at home and poor eating in the last month had led to my blood pressure getting as high as it was. I was admitted and put on some medicine and a low salt diet and leave the hospital. Now I have been paying medi-share this whole time and I hadn't been to the doctor yet. My bill from the hospital and follow doctor visits are submitted to medi-share and after sitting on them for 2.5 months they deny the claims. I begin calling to find out why and I cannot get a straight answer, someone says my chart was checked as high blood pressure as a preexisting condition and that is why, call the hosptial get the records and it isn't. I then get told that it was in a doctors notes and I needed those ammended, it wasn't and there is nothing to amend. I finally got told today that my childhood asthma is a pre-existing condition and that becuase of that it cuased my bloodpressure issues and is not being covered. If I had it to do all over again i would have paid the outrageous obama care prices and been better off than trying this sham. Do not waste your money, they will look for any reason not to pay your bills and offer no help as to how to get these things resolved. Thet are unresponsive and no matter how many times you ask for a supervisor or there extension because this is the thrid time you have gotten a different answer they will not transfr you and they will not give you an extension. I have spent more time trying to get them to honor there part of the deal than I have ever dealt with any other insurance/coverage/service in my life. It is a nightmare and please save yourself the headache and find another way. I would not wish this experience on anyone, they are not in the business of being Christian or helping people.
Frame of reference is important. I've already given examples of poor handling of paperwork by insurers. I could give several others. So I tend to discount complaints like #3.
Edit: the rest is a complete rewrite. @LewisBraham didn't post the company response to complaint #1. That response (reproduced below) illustrates how, even when subscribers try to convey actual problems, their complaints often fail to communicate a clear, accurate picture:
- Medi-Share did not pay roughly 25% of the total bill as stated in the complaint. Its rented network PHCS (which is used by many insurance companies such as Kaiser Permanante) negotiated the rate down 25%. No payment here, the 25% was taken off the top.
- He was not stuck with the rest as stated in the complaint. Medi-Share paid 100% of the negotiated rate above his annual deductible.
- As he acknowledged in complaint, he was comparing rates outside of ERs with this ER rate. We don't know how much of a difference this made, but it's often substantial.
For example, here's an admittedly extreme case from NPR (April 9, 2018) of a single patient having the same CT scan performed at a free standing clinic and in an ER within months. $268 for the first, $5,516.14 (after insurer negotiated a reduction of 40%) for the ER scan, of which insurer Cigna paid about half.
It's not that the excerpted items aren't problems. Rather, little here suggests a higher frequency or severity of problems than one might encounter with real insurers.
Matt, we are sorry that your wife's medical procedure was so expensive. The reality is that the cost of care is set by providers, not by Medi-Share. Medi-Share's network provider, PHCS, did in fact negotiate a 25% discount reducing the cost of the bill from $9990 to a little less than $7500. Once your Annual Household Portion (AHP)⃰⃰⃰ was met, Medi-Share members shared the remainder of the bill. Because your AHP has now been met, any future eligible medical bills will be shared by your fellow members. ⃰ Medi-Share members choose the AHP, the financial commitment their family is willing to make before bills will be submitted for sharing. Members are responsible to pay any medical expenses until they have satisfied this amount.
However, as I've said already, when problems do occur, state regulators in most states aren't going to be able to help, since they don't regulate the ministries as insurers.
Comments
I think the problem is not so much that it doesn't cover sicknesses (once you're in they won't kick you out and will cover your situation), but with the limitations on what it will cover.
The article you cited erred in saying that Medi-Share won't cover STDs. Like pre-ACA insurance, it will disclaim responsibility if it finds any fact that violates the terms of the agreement. So if you got an STD from sex outside of marriage, well, that voids the agreement. But it will cover STDs you got from your spouse. (Not saying if it will cover your spouse.) https://mychristiancare.org/globalassets/media/medi-share/ms_sa_gl_1015-1.pdf
Again disregarding ethics (to the extent possible here), the problem I have with this coverage limitation is that its purported rationale is to minimize risk. But any purely monogamous relationship, inside or outside of marriage, gay or straight, would have the same level of risk. There is no economic benefit to the more stringent restriction, unlike, say, restrictions on drug use.
There are other similarly irrational policies. Hypertension when controlled by medication, is not considered a preexisting condition (for the purposes of future incidents such as a heart attack). But another condition, likewise controlled by medication, would not be handled the same way. Any incident that could be linked to this other condition would be excluded from coverage for a period of years after joining. Medi-share's explanation is that how they handle these things depends on members' votes, i.e. not on any rational basis.
Regarding the BBB complaints - we need to provide a frame of reference, e.g. by comparing the reports here with reports on insurers or health care providers. Many people only post negative reviews (a point emphasized to me yesterday at a glutten free expo, where a speaker urged the posting of helpful positive reviews as well as negative ones). The BBB is pretty much by design a site where people come to complain, not praise. Are the complaints here out of line with those that insurers receive? Real question, I don't know.
Here's Consumer Reports' take on the subject:
https://www.consumerreports.org/health-insurance/buying-insurance-from-a-healthcare-sharing-ministry/
The way I use it, and from what I can tell, the way it is used when one is being precise, is that it refers to who pays the providers. Thinking this way, even Medicare isn't pure single payer, because it includes Medicare Advantage, where private insurers pay providers, albeit largely with dollars that they get from the government.
There are at least two ways for the government to control costs. One is as a market participant - it pays for services and negotiates the rates, like any other large insurer. If it's the only payer (single payer), then it has even more bargaining power. It's not the biggest elephant in the room, it's the only elephant.
The other way is through regulation. The government could set rates (or ranges) that all providers must follow, regardless of what insurer or individual pays the bill. There are more constitutional issues here (how far do Congress' powers extend). I haven't looked at this at all, but I doubt there's a problem here.
Laetrile was widely lowercase-generic before this nonsense
http://tmsearch.uspto.gov/bin/showfield?f=doc&state=4802:wwvzky.2.1
depending on the savvy of the newspaper. It's sort of surprising this registration development occurred in the first place. The bogus medicine had been all in the news because of the court case and death of Massachusetts 3yo Chad Green, whose parents effectively killed him by denying him proper, court-ordered, leukemia treatment (fully curable then and now) and spirited him to Mexico for laetrile "treatment".
Jerry Brown subsequently gave the family asylum in California.
I wrote a column about it in the later 1970s which at the time got the most mail for anything ever published in the Boston Phoenix, where I worked, so upset were Mass. residents about this they-got-away-with-it child murder. Brown's state sanctioning of fatal abuse by parents remains outrageous.
Session starts here: https://www.uspto.gov/trademarks-application-process/search-trademark-database
Common usage without mark is (generally) not an indicator that a trademark doesn't exist. However, if the appearance of an unadorned trademark is pervasive and no effort is made to defend the trademark, then it can move into generic usage. (This is just to get stuff down "on paper"; I'm sure you know all of this.) https://www.justia.com/intellectual-property/trademarks/enforcement/
I'll stipulate as to the toxicity of laetrile (however you want to spell/mark it); that's the point. Who has the right/power to take notice of that fact and prohibit doctors from prescribing it? If the government has no business limiting what a doctor can prescribe, and the patient wants it and the
quackdoctor prescribes it, who's to block that?All sorts of case law about this sort of thing, which if you're smart you learn about OtJ if you didn't go to editor school (as I didn't), and if you have common sense besides, you learn to ignore and scoff when ridiculous.
Boston Acoustics once got in touch with the Boston Audio Society about BA's tm-ing of 'Boston' for all things having to do with audio (this was extra wack because the BA founders were local audio friends and Society members). A reply letter from an attorney BAS member pointing out the comedy of their position and inviting them to try their luck defending their registration got the whole thing dropped instantly.
So there's often serious lack of common sense going around about these things. When I worked at Bell Labs I sometimes talked w ATT attorneys in the office next door and they were pretty funny (off the record) about the company's lame and wack efforts to try and enforce / preserve the term Unix. Eventually at one point it was decided that all they could really do to protect it as their own, or something, was to go w/ the cap version UNIX. That died, as eventually wide journalistic practice won out. uspto history would not really capture all the usage ins and outs of that.
As for substance effects, I'm a huge believer in regulatory limits on what providers can do and am always surprised to hear arguments otherwise.
Not unlike abuse, somewhat. The Green parents actually should be getting out of jail about now.
But we both digress.
https://www.snopes.com/fact-check/kfc-and-fried/
https://statuteofryanne.com/2015/05/29/finger-lickin-good-trademark-kentucky-fried-chicken-colonel-sanders/
Here are a few excerpts:
Edit: the rest is a complete rewrite. @LewisBraham didn't post the company response to complaint #1. That response (reproduced below) illustrates how, even when subscribers try to convey actual problems, their complaints often fail to communicate a clear, accurate picture:
- Medi-Share did not pay roughly 25% of the total bill as stated in the complaint. Its rented network PHCS (which is used by many insurance companies such as Kaiser Permanante) negotiated the rate down 25%. No payment here, the 25% was taken off the top.
- He was not stuck with the rest as stated in the complaint. Medi-Share paid 100% of the negotiated rate above his annual deductible.
- As he acknowledged in complaint, he was comparing rates outside of ERs with this ER rate. We don't know how much of a difference this made, but it's often substantial.
For example, here's an admittedly extreme case from NPR (April 9, 2018) of a single patient having the same CT scan performed at a free standing clinic and in an ER within months. $268 for the first, $5,516.14 (after insurer negotiated a reduction of 40%) for the ER scan, of which insurer Cigna paid about half.
It's not that the excerpted items aren't problems. Rather, little here suggests a higher frequency or severity of problems than one might encounter with real insurers. However, as I've said already, when problems do occur, state regulators in most states aren't going to be able to help, since they don't regulate the ministries as insurers.