Wall Street Journal Examines Negotiations By Amish, Mennonite Communities To Reduce Their Cost Of Health Services

Main Category: Public Health
Also Included In: Medicare / Medicaid / SCHIP
Article Date: 23 Feb 2006 - 11:00 PDT

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The Wall Street Journal on Tuesday examined how the Amish and Mennonites -- members of the Anabaptist religious denomination -- have been able to "organize and drive down the price of [their] medical care" in Pennsylvania. The two groups, who "choose to go without insurance or Medicare as part of their rejection of the secular world," became effective negotiators in part because of their experience in seeking health services in Mexico, where private hospitals and other providers charge lower rates than those at Pennsylvania hospitals, according to the Journal. The experience provided Anabaptists the "medical price benchmarks with which to compare rates at local hospitals," such as at Heart of Lancaster Regional Medical Center in Pennsylvania Dutch Country, the Journal reports. A delegation of Amish and Mennonite elders went to the hospital after it opened in 2004 to negotiate discounts on behalf of their community, which spends about $5 million annually on health services in Lancaster County. The hospital agreed to discounts of 40% off its top rates, ending up with prices that are slightly higher than Medicare reimbursements. Although the Amish and Mennonites asked for further discounts, the hospital could not offer them, saying that if it reduced prices to below Medicare rates, it could be charged with fraud. The Amish and Mennonites receive "flat rates such as $16,577.60 for a hip replacement, $3,200 for knee arthroscopy, and $7,542 for a mastectomy," which includes fees for hospital stays, surgery, anesthesia, medication, testing, medical supplies and specialists. The rates are "more than what a Medicare patient might expect to be billed, but as little as half the full retail rate other uninsured patients are likely to be charged," the Journal reports. The Amish and Mennonites must pay 50% of fees upon admission to the hospital to qualify for the discounts and agree not to sue for malpractice. In addition, because hospitals are not allowed to treat uninsured Anabaptists different than other uninsured patients, the Amish and Mennonites only can receive treatment at the hospital after being referred there by a local doctor with a largely Anabaptist practice, according to the Journal (Millman, Wall Street Journal, 2/21).

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