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Believers Put Faith In Christian Health Plan

nygaard-family.jpg

By STEVEN G. VEGH, The Virginian-Pilot
© April 30, 2002

The David and Jan Nygaard family of Va. Beach has had more than $100,000 in medical bills covered by Christian Care Medi-Share. Twins were born prematurely, and the youngest son has undergone heart surgeries. David and Jan Nygaard were stunned. Their 8-day-old son — pink, healthy-looking Nathaniel — had just been diagnosed with a heart defect that could kill him. He needed immediate surgery. It was no ordinary operation; the bill would surely be extraordinary, too. And the Nygaards had no health insurance.

"I'm the dad thinking, 'Let's get our son taken care of — how are we going to pay for it?' " said David, who owns a jewelry store in Virginia Beach.

nygaard-family.jpgThe self-employed have to provide their own health care coverage and four years earlier, the Nygaards had looked at buying medical insurance. But many insurers rejected them because Jan was pregnant at the time. Other companies were willing to sell them a policy but charged premiums the Nygaards couldn't afford.

Instead, the couple joined a nationwide Christian group whose members pay a monthly fee and pledge to defray each other's medical bills.

Now, Nathaniel's catastrophic needs would test that pledge as the Nygaards' previous, routine bills never had. Crying and distraught, David called Christian Care Medi-Share.

A grandmotherly voice on the other end of the line, he recalled, immediately reassured him:

"We care for you — we're going to immediately put you on this prayer chain — let me pray for you right now, on the phone, and don't worry."

Soon, get-well cards and e-mails began pouring in from Medi-Share members across the country. When the hospital bill came, the Nygaards paid the first $200. Medi-Share paid the rest.

"To my recollection," Nygaard said, "that bill was $38,000."

After Nathaniel's condition recurred a few months later, Medi-Share paid more bills totaling $60,000. The Nygaards again paid $200.

For some families, mutual aid or "direct-share" groups such as Medi-Share have become the "uninsurance" solution to the high premiums, limited choice of doctors and red tape that they've encountered with traditional health coverage.

Local Medi-Share participants like the Nygaards say their monthly payments are as low as half what they'd pay for insurance. And they can choose any doctor, any specialist. But there is a catch.

Medi-Share requires applicants to have "a verifiable Christian testimony indicating a personal relationship with the Lord Jesus Christ." Applicants have to attend worship services regularly and be involved in church ministries.

And they must walk the talk.

"Our concern is that they are living a biblical lifestyle, in the accepted evangelical Christian sense of the definition," said the group's chief executive officer, E. John Reinhold.

That means no smoking, no illegal drugs, no alcohol abuse, no extramarital sex.

Medi-Share won't cover someone who gets the AIDS virus from a homosexual partner or catches hepatitis through drug abuse. It doesn't grant membership to people who are dangerously obese.

Direct-share organizations can exclude whomever they want, because they are not providing insurance.

Medi-Share emphasizes — and insurance regulators concur — that it is a voluntary association of members who share a moral commitment to pay each other's bills.

Insurance involves a legal contract that guarantees indemnification of policy holders. Since Medi-Share makes no guarantees and is an association of churches, it can set some unusual limits — ones that, for a conventional insurer, could constitute illegal discrimination in some states.

That's fine with the Rev. Joseph Gwynn, who joined Medi-Share in 1994 because the Virginia Beach church he pastors was too small to pay for his health insurance.

"They tell you up front there's a lot of things they won't cover, like AIDS, psychiatric counseling, abortions," Gwynn said, "and all that was music to my ears anyway. That's just not compatible to a Christian lifestyle."

Medi-Share, which has about 45,000 members — including 42 households in the Norfolk area — was started in 1994 by the American Evangelistic Association, a nonprofit group of conservative Christian churches. Similar direct-share organizations include Samaritan Ministries International, Christian Brotherhood and Beracah Ministries Inc.

In Medi-Share's case, the monthly "share" paid by members reflects household size. A family of three or more, for example, pays $281 a month, while a single person pays $114. All subscribers are subject to paying a once-a-year deductible of $250.

Each member receives a monthly invoice and writes a check to Medi-Share. Enclosed with the invoice is the name of a person whose bill will be paid using that share and usually shares from many other participants. Subscribers send payments and medical bills to Medi-Share, based in Melbourne, Fla. Office staff negotiate with hospitals and doctors for discounts on bills, just as insurance companies do, and then pay the agreed amount.

Members share the first $50,000 in bills that any individual incurs for a single medical incident. Costs above that amount, up to $5 million per person, are paid not by members, but by a "stop-loss" or backup policy from an insurance company. The policy is owned by a trust that acts on behalf of Medi-Share members.

Medi-Share keeps members' monthly shares low because it is nonprofit and because its lifestyle requirements sift out people whose habits make them more likely to get sick or hurt.

Many medical problems also don't qualify for coverage, but not at the whim of an actuary or bureaucrat. Once a year, members vote on whether the cost of treating certain diseases or injuries should be shared.

For example, members rejected a proposal to cover medical bills incurred by 17- and 18-year-olds who were injured while driving drunk. Reinhold said the prevailing sentiment was that such teen-agers were old enough to be accountable for their actions.

"Our members, they went very, very hard-line on that issue," Reinhold said. "I thought the vote would come back a little more liberal."

Medi-Share can be stern about lifestyle violations, too. A New England member was booted out after Medi-Share learned from another member, who belonged to the same church, that the man was committing adultery.

Individuals have been dropped for abandoning their spouse and running off with a lover.

"Anybody who practices fornication, adultery or a homosexual lifestyle is not in line with the scriptural lifestyle as we know it," Reinhold said.

But trust, not enforcement, ultimately sustains direct-share arrangements.

"You have to have a constituency with a basic degree of integrity," Reinhold said. "If that's not there, the thing can't possibly succeed."

Integrity exists outside Christianity and so can direct-share arrangements, Reinhold said. His organization has shared its software and advice with Jewish, Mormon and "New Age" groups.

Still, Medi-Share considers itself a Christian ministry that is inspired by the apostle Paul's instruction, "Bear ye one another's burdens and so fulfill the law of Christ."

The Christian traditions dovetail with the mutual aid and cost-saving themes of direct-share. Because Medi-Share is Christian, Reinhold said, compassion rivals medical cost savings as a top concern.

Members are asked to send prayers, cards and e-mails directly to the sick or recuperating member named in their monthly share invoice.

David Nygaard is convinced the prayers are why Nathaniel survived and why twins born subsequently also survived medical problems. Medi-Share paid $30,000 in medical costs related to the premature birth.

"Prayer works," Nygaard said. "I've seen it work in the lives of my last three children."

Some Christian observers find fault with the idea of excluding non-Christians, Christians who aren't "evangelical" and Christians who violate "biblical" lifestyle standards.

"Can there be a theological justification for that approach to health care? My answer is no," said the Rev. Abigail Rian Evans, a theology professor at Princeton Theological Seminary and a clinical professor of medicine at the Robert Wood Johnson Medical School.

Evans calls Medi-Share's restrictions incompatible with the basic Gospel requirement that Christians help all people, regardless of their religious practice or lifestyle.

"Christ defined that for us with the parable of the good Samaritan: Your brother or sister is the person in need," she said. "There was no theological discussion before the good Samaritan helped the man who fell among the thieves. If you see your brother or sister falling by the wayside, you should help them." But Nygaard said the Medi-Share approach is fair because people have the freedom to choose how they live and how they relate to God.

"We look at life with a specific world view and commonality of morals and values," he said. "If you don't prescribe to these standards, that's fine, you don't have to be in our group."

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