The Amish manage their healthcare without modern medical insurance through a unique community-based system that reflects their values of self-sufficiency and mutual aid. Here’s how they approach healthcare:
Community-Based Aid
The Amish rely on a church-based system where members contribute to a shared fund[1][2]. This fund, often referred to as “alms,” is distributed by church leaders to those in need, effectively replacing the social safety net and health insurance[2]. Members pay monthly contributions, typically between $90 and $110, to participate in this self-pay program[1].
Amish Hospital Aid
About a third of Amish participate in a more formal institution called Amish Hospital Aid (AHA)[2]. This not-for-profit organization, run by unpaid elders, collects fixed fees from members and pays for hospital care when needed. It’s particularly useful for wealthier Amish who might feel guilty using church alms meant for the poor[2].
Negotiated Discounts
Amish communities often negotiate discounts with local hospitals and healthcare providers[1][3]. They leverage their ability to pay bills quickly, sometimes within 10 days, to secure lower prices for medical care[1]. Some Amish carry benefit cards to help hospitals track these negotiated discounts[3].
Alternative and Preventive Care
The Amish tend to rely heavily on folk medicine, chiropractors, and other forms of complementary and alternative medicine (CAM)[2][5]. They also maintain an active lifestyle through manual labor, which may contribute to lower rates of chronic conditions like diabetes and heart disease[3].
Limited Use of Modern Medicine
While the Amish do use modern medicine when necessary, especially for obstetrical needs and traumatic injuries, they generally avoid it when possible[5]. They tend to distrust the American medical and pharmaceutical industry, viewing it as profit-oriented[5].
Benefit Auctions
For exceptionally high medical bills, Amish communities often organize benefit auctions, also known as “mud sales”[3]. These events raise funds to help cover significant healthcare expenses.
Government Exemptions
The Amish are exempt from many healthcare-related laws and taxes, including Medicare, Social Security, and the Affordable Care Act mandate[2][3]. This allows them to manage their healthcare costs according to their cultural and religious beliefs.
This system allows the Amish to maintain their healthcare needs while adhering to their cultural values of community support and separation from mainstream society.
Citations:
[1] https://www.sideeffectspublicmedia.org/community-health/2019-09-11/how-the-amish-live-uninsured-but-stay-healthy
[2] https://www.slatestarcodexabridged.com/The-Amish-Health-Care-System
[3] https://www.nbcnews.com/healthmain/u-s-struggles-health-reform-amish-go-their-own-way-8c11345954
[4] https://pubmed.ncbi.nlm.nih.gov/3446212/
[5] https://pmc.ncbi.nlm.nih.gov/articles/PMC8431948/
[6] https://listverse.com/2012/10/29/10-things-you-probably-dont-know-about-the-amish/
[7] https://www.usatoday.com/story/news/nation/2014/08/15/amish-ten-things-you-need-to-know/14111249/
[8] https://www.youtube.com/watch?v=cstNYON7wRI