Amish Health Care

Scott Alexander (who just recently un-cancelled his blog) offers his thoughts on the Amish health care system.

My takeaways, in no particular order:

• Small, tight-knit, high-trust communities of faith can be extremely powerful and life-giving—not just relationally but economically.
• The standard American lifestyle (especially the standard American diet) isn’t healthy at all: “[M]aybe [the Amish’s] system relies on a very low rate of mental illness and chronic disease. … [T]heir autoimmune disease rates are amazing, and when you take out the stresses of modern life maybe a lot of the ailments the American system was set up to deal with just stop being problems.”
• At a certain point, expensive end-of-life care isn’t worth it.
• Honesty and non-litigiousness go a long way. (Maybe Jesus was onto something after all!)
• We need to think in terms of improving health outcomes rather than expanding access to health care, which may or may not be an effective way of actually improving health.
• “[T]here’s something to be said for a faceless but impartial bureaucracy, compared to having all your neighbors judging your lifestyle all the time.” Good thing we non-Amish slaves to bureaucracies don’t have to worry about being judged by each other!
• “I asked my literal grandmother, a 95 year old former nurse, how health care worked in her day. She said it just wasn’t a problem. Hospitals were supported by wealthy philanthropists and religious organizations. Poor people got treated for free. Middle class people paid as much as they could afford, which was often the whole bill, because bills were cheap. Rich people paid extra for fancy hospital suites and helped subsidize everyone else.”
• Government-provided health insurance is suboptimal, to say the least.

I’d love to see more churches and other similar groups experiment with models like that of the Amish. Of course, they’d only be able to do so if they had similarly tight-knit communities. And that’s an uphill battle since Americans (including American Christians) have been so thoroughly atomized.