How Are the Amish Lowering Health-Care Costs?

Feb. 23, 2006 — -- The Amish of Lancaster County, Pa., don't have insurance, but they won't have to pay full price for medical expenses or travel to Tijuana, Mexico, for affordable health care anymore, either.

"They came to us and asked us to create an agreement with them for payment of their services," said Brad Nurkin, chief executive officer of Lancaster Regional Medical Center. "We negotiated a price."

The Amish, who shun television and electricity, will save up to 40 percent on complicated procedures -- mastectomies, hip replacements, arthroscopic knee surgery, and many more -- not with a heavily lawyered contract, but in the traditional Amish way. That is, with a handshake and a promise.

"An Amish patient is good to deal with," said Donald Kraybill, an Amish studies professor at Elizabethtown College in Elizabethtown, Pa., "because you don't have to worry about insurance. They're going to pay you with cash. They're going to pay you up front, and they're not going to sue you."

Plus, the Amish spend about $5 million a year in Lancaster County for health services -- all in cash -- providing a true incentive for any hospital to make a deal.

"Some may actually bring a box with money that will total the amount that the bill was for, and it's actually full of dollar bills in various denominations to pay the bill off," said John Porter, CEO of Ephrata Community Hospital, where there's a barn to park horses and buggies.

Health advocates caution that for uninsured people who are not part of a group like the Amish, negotiating for health care would be very difficult.

"By, in effect, having a deal with the Amish, the hospital is getting a deal," said Ron Pollack, executive director of Families USA. "It's not easy to do that for anybody who's uninsured, who's not part of a group, and where there isn't a guarantee they'll all go to the same hospital."