Modern Health Care Costs Challenge Ind. Amish’s Tradition of Self-reliance

Mounting health care costs are testing the Indiana-based Amish traditions of self-reliance and community support.

Amish families generally don’t carry health insurance and pay their medical bills out of pocket and promptly.

“They pay immediately,” said Janice Welch, vice president of patient financial services for Parkview LaGrange Hospital. LaGrange County in the state’s northeastern corner has a large Amish population.

That reliability and market presence has helped the Amish negotiate discounts with Parkview LaGrange _ where more than a third of the patients are Amish. Those who pay within 45 days receive a rate comparable to the best rates managed care plans are charged, Welch said.

But when medical bills climb into the tens of thousands of dollars, family and community resources can be stretched thin.

Rose Miller’s family faced more than $100,000 in medical costs for surgery and hospital care after she was injured in a car crash in November 2004. A community pizza drive raised about $40,000, and the balance of $60,000 depleted the family’s savings.

Amish also can tap an informal financial plan managed by deacons and bishops that draws from church offerings. Many Amish say banding together to cover unexpected expenses is an extension of their religious beliefs.

But some wonder how much further frugality and faith can be stretched.

Amish Bishop Bontrager has a phone in his rural LaGrange County home because of his role as a liaison to area hospitals for the Amish community.

Some believe the Amish may have to make other concessions to modern life out of medical necessity.

Lynn Gerig, a nurse who helps coordinate cancer care for Parkview LaGrange’s patients, said many of her Amish patients choose to forgo radiation and chemotherapy, in part to spare their loved ones the expense.

She said that while outsiders could learn from the Amish example of supporting each other, it is difficult to obtain optimal health care without insurance. In this day and age, and with the cost of health care, it is not a good idea for people not to have insurance,Gerig said.