Medical Care

On Wednesday evening Joe Schmucker presented information at church on Center Aid Plan (CAP), the systematic way our members help each other pay medical expenses.  It was engaging and informative, and gave a reassuring picture of how creating the position that Joe now fills is benefiting us all. 

Several ways of lowering costs were outlined:  1.  Taking advantage of pre-negotiated group price breaks with local providers.  2. Paying promptly for services provided.  3.  Being willing to travel when significantly less expensive services are available elsewhere.  4.  Being at peace with our mortality (especially related to avoiding heroic and expensive measures to prolong life when recovery is not expected).  5.  Being vaccinated against communicable diseases. 

Many of these cost-lowering measures come with "teeth"  designed to encourage compliance.  Mainly, failure to take advantage of them will result in individuals paying out-of-pocket the charges that could have been avoided by choosing one of the less expensive options or by simply asking for the discounts or making payments promptly.  Out-of-pocket payment for complications resulting from failure to immunize is not yet reflected in CAP policy, but it is being discussed.  No end-of-life treatment policy was referenced in the presentation, except to credit the wisdom of those in a recent case who chose not to pursue any life-prolonging measures after a cancer diagnosis. 

People who are no longer members in any of the churches with a CAP policy will not be kept on the plan. 

Overall, I feel much better about what this new Center Aid Plan approach includes than I did the Affordable Care Act (ACA, also known as Obamacare), from which Center Aid Plan exempts us.  Nevertheless, I have a few of the same misgivings--none of which I had the presence of mind to articulate on Wednesday evening, even if there had been time to do so.  Incidents from my own and my family's medical treatment in the past ten years make me wonder how the new policies would have applied in our circumstances--and, of course, if that would have felt good and right or "wrong" in some of the ways that often feel wrong to people with more typical commercial insurance policies. 

Some people like getting their health care needs taken care of locally for the same reasons some people always "buy local" if they can--to contribute to the local economy and to help their neighbors and friends earn a living.  Some people find travel extremely onerous, and do very little of it for any reason.  Poor vision, limited mobility, and slowed mental processes that interfere with perception and decision-making are all possible factors.  Traveling during illness and recovery would look doubly unappealing to such people.  Deciding whether an aged or ill individual should be further treated is not always as easy as one might wish. Vaccinations?  Not as simple as one would wish either. 

When the ACA was being discussed and then finally passed, I remember saying that I believed the good part about that whole endeavor was that out-of-control medical costs were being recognized, along with the inability of people with ordinary means to pay for it.  The bad part of the ACA was that the proposed solutions did very little to address inadequacies in the traditional medical system  (for the moment, I'm not addressing the role of government in health care per se).  Also, some of those who most stand to financially profit from the traditional system were so carefully protected in the ACA that I have very little hope that anything will change for the better in the traditional system.  I'm talking about lobbyists, insurers, malpractice lawyers, and pharmaceutical companies. It's probably true also that a few doctors belong in this category, but I believe it does not apply to most doctors. 

I wish that CAP could take steps to fill in gaps in the traditional medical system rather than focusing primarily on finding ways to pay whatever the traditional system offers or to find ways to avoid paying full price.  I know the shift in thinking would be messy, and I can't for sure see the end from the beginning, but I wish we could be trustful enough of the Lord to show the way that we could prayerfully begin to explore new directions.  I wish we had more collective wisdom about what God provided in the created world that has health benefits without needing high-tech processing first.  Specifically, I wish traditional medical practice could be regarded as a good starting point rather than as a boundary within which all the good options reside. 

Last week when I left the chiropractor's office, I commented to the receptionist that I'm glad Medicare considers chiropractic treatment an allowable expense.  I remember when that changed with typical health insurance plans.  Insurers realized eventually that for some kinds of problems, chiropractic care offered more effective treatment at lower cost than what was offered in traditional medical practice, so they began to cover it.  I'm not sure that CAP is as flexible as the insurance industry on matters like this.

What if CAP could offer financial incentives for wellness initiatives?  I suspect that even without financial incentives, some people would willingly embark on wellness initiatives if some of the logistics could be arranged to fit our lifestyle in various ways. I wish CAP would assume leadership to facilitate such initiatives specifically for the benefit of CAP members.*

Women often like to exercise with other people--but not in mixed-gender groups, and not in ways that can't be done while wearing a skirt.  Could someone organize a women's exercise group?  Indoor walking spaces?  Most of us will not travel from Pleasantview or Partridge to walk at the mall, although I know a few who do.  Could the new activity center be opened for that? Could an outdoor walking path on the AC/school premises be created? 

How about opening a "clinic" once a week for CAP members where people could have help with various kinds of monitoring--blood pressure, blood sugar, pulse rate, weight, etc.  It would not serve as a treatment center, but could provide referrals when problems are observed, and it could perhaps help people with similar needs find each other to help and encourage each other.  If someone with some health care training were on hand, advice could be sought on other matters such as a skin condition, a sore throat, elevated temperature, etc.  All of these things could potentially help reduce medical expenses, both by eliminating charges for unnecessary office visits and by sending people for treatment before a serious condition becomes critical.  Maybe the birth center could set up a satellite location in the Pleasantview-Partridge area once a month or so to do blood draws or take other samples for lab work. Their standard charges could apply, but not having to drive to Yoder would be a benefit to CAP people who mostly live closer to Pleasantview-Partridge than Yoder. 

I wish for one more service, which I will mention in the next section.   

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 I want to say something about vaccination, in hopes of shedding some light and minimizing heat.  I am especially interested in finding a way to deal with what I believe has too often been cast as a choice between only two alternatives:  1.  Get all the shots your doctor recommends--when he or she suggests.  2.  Don't allow any vaccinations.  Neither of these approaches seems wise to me. 

While I would like to see most people getting most vaccinations, I would like to see it happening under the following conditions--which I see as being more ideal than what is the common practice now:

1.  Mercury and aluminum are not present in any vaccines.

2.  Only one (or at least fewer) "toxins"  are injected at once.

3.  More vaccinations are delayed beyond infancy. 

4.  Mothers are believed when they report adverse reactions in a vaccinated child, and no pressure is applied to continue with further vaccinations.

5.  No vaccinations are given when a child does not seem well.

6.  Some parental discretion is allowed.  (In other words, if parents decide that they'd rather deal with chicken pox than one more vaccination, they could do so.  The possibility of contracting shingles later on though should be taken into account.) 

The one additional service that I would like to see offered to CAP  participants is low-cost vaccinations under the above conditions.  I do know that some of the conditions would be difficult or inconvenient or perhaps even impossible to arrange, but I wish we wouldn't give up before we start with trying to offer something better. 

As I understand it, while available vaccines have been individually approved by government regulatory agencies (Food and Drug Administration--FDA), none of them were required to have been tested in combination with other vaccines.  In other words, no tests were done on anyone who received the three vaccines given at once in the MMR (measles,  mumps, rubella) vaccination.  Common sense tells all of us that the combined vaccine increases the pathogen (toxin) load over single-disease vaccine, and that could prove problematic.  If mothers observe a problem in a vaccinated child, they may simply be doing the observations that should have done first during the testing of the products. 

Vaccinating toddlers rather than infants means that immune systems have had more time to mature.  I can't elaborate on exactly how this works, but it makes sense to me to wait till after infancy to undertake a vaccination regimen. 

Injecting mercury and aluminum?  Please just find another way to create vaccines. 

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*I recognize that needs exist outside our CAP participants, and I know it sounds selfish to not offer to serve others who have these needs.  Nevertheless, I believe that starting by limiting it to CAP participants makes sense.  Maybe something else can develop later.