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I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of s

I worked in insurance for over five years. This is a very good read. 1. They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor. They have established sources of information and support for this practice. 2. When it comes to medical care, they are not Luddites and are willing to use cutting edge technologies to care for medical issues. 3. I was struck by the repeated mention of genetic disorders. It makes me wonder if this is a big issue in the Amish community. If so, one solution would be to encourage young people to marry outsiders, which is probably not encouraged as it tends to be a threat to the culture of groups like this. By I see it as extremely irresponsible to knowingly pursue practices that increase the odds of children being born with genetic disorders. Neither Amish Hospital Aid nor congregational alms funding cover health care needs that result from prohibited activities within the Amish community. One interviewee mentioned an incident that occurred with a teenage boy in her congregation who was injured in a snowmobiling accident. The use of motor vehicles (e.g., cars, tractors, snow mobiles) is strictly forbidden in Old Order Amish culture. This may sound harsh to some people, but all insurance policies have exemptions which (at least for accident policies) more or less boil down to "if you are behaving irresponsibly and get yourself hurt through taking undue risks, we are not paying for the consequences of your foolish behavior" -- only, you know, in legalese that is defensible in court if necessary. I will note that as someone who processed accident claims, minors who lost limbs driving recreational vehicles like snow mobiles always broke my heart. If you have children and you own anything like a snow mobile, please make sure it is secured and they cannot go for a joy ride on Saturday morning while you sleep in.

andrewl 4y ago
I had an anthropology professor in college who did some work on genetic diseases in the Amish. It is a problem. This Wikipedia has a short overview and a lot of references: https://en.wikipedia.org/wiki/Health_among_the_Amish https://en.wikipedia.org/wiki/Health_among_the_Amish
- wyclif 4y ago
  Anecdotal, but I once had a friend and roommate that came from an ex-Mennonite family of 12 siblings with two sets of twins. He and one of his brothers both developed late-onset Tay-Sachs disease. Although relatively high-functioning and able to do most tasks such as hold down a job and drive a vehicle, there were some unfortunate consequences. For instance, the brothers had lack of coordination, ataxia, and minor speech problems. They were constantly getting pulled over by the local cops for minor violations (like driving too slowly) and nearly every time the cops would insist that they were drunk even though they didn't have a drop of alcohol. To the untrained eye, their affect looked very similar to an intoxicated person: slurred speech, bobbing while standing in place, stumbling when walking or getting out of the car, &c. So yes this is a big problem in these communities.
praptak 4y ago
The Amish are aware of their small population problem. I believe their population bottleneck was a few hundred people. They do sometimes adopt children from outside their population. I don't know how common that is and whether it makes a difference.
mikeyouse 4y ago
> This may sound harsh to some people, but all insurance policies have exemptions which (at least for accident policies) more or less boil down to "if you are behaving irresponsibly and get yourself hurt through taking undue risks, we are not paying for the consequences of your foolish behavior" -- only, you know, in legalese that is defensible in court if necessary. Some accident policies may have those features, but zero health insurance ones do.
- DoreenMichele 4y ago
  All insurance policies have limits on what they will pay. Those limits come in various forms, such as: 1. What you pay out of pocket before insurance coverage kicks in. 2. No coverage for out-of-network providers. 3. Caps on how much they will cover. Insurance is a numbers game. Rest assured, all insurance policies and all insurance providers find ways to limit how much they pay out. You may find some means to limit payments more distasteful than others, but they all do this. It's the only way they can possibly stay in business.
  - watwut 4y ago
    Which are all an entirely different thing.
giantg2 4y ago
"They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor." Two other factors for low cost would be their healthy lifestyle and end of life care choices. The Amish get about 20k steps in per day - double the recommended 10k steps that most English fail to meet. Rates of many chronic diseases are lower. When they do get old, they don't drag things out and they generally don't go into longterm care facilities. Most English tend to want the doctor to "do everything you can".
- watwut 4y ago
  Not really > Amish mortality patterns were not systematically higher or lower than those of the non-Amish, but differed by age, sex, and cause. Amish males had slightly higher all-cause MRs as children and significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69). Amish females MRs for all causes of death were lower from age 10-39, not different from 40-69, and higher over age 69. https://pubmed.ncbi.nlm.nih.gov/7315833/ https://pubmed.ncbi.nlm.nih.gov/7315833/ Basically, Amish boys are more likely to die young. There are no long term lifestyle benefits for Amish women. And "English" by which I assume you mean Americans don't have infinite funds.
  - giantg2 4y ago
    What do you mean "not really"? It seem you just posted what I was saying for lower rates of many chronic diseases. "significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69)" As they said, cause differs. When looking at costs, causes are very important. Things like cancer and cardiovascular diseases tend to cost a lot of money to treat as they drag on. If you die young in an accident, it's likely to cost less.
    - watwut 4y ago
      Women had literally zero benefits. And young boys die more. There is only one segment of population that is getting some benefit and that benefit is small. In order for lifestyle to be healthier, I would want to see more benefits then just some middle aged men mortality shifted onto young ones.

andrewl 4y ago

I had an anthropology professor in college who did some work on genetic diseases in the Amish. It is a problem. This Wikipedia has a short overview and a lot of references: https://en.wikipedia.org/wiki/Health_among_the_Amish https://en.wikipedia.org/wiki/Health_among_the_Amish

wyclif 4y ago
Anecdotal, but I once had a friend and roommate that came from an ex-Mennonite family of 12 siblings with two sets of twins. He and one of his brothers both developed late-onset Tay-Sachs disease. Although relatively high-functioning and able to do most tasks such as hold down a job and drive a vehicle, there were some unfortunate consequences. For instance, the brothers had lack of coordination, ataxia, and minor speech problems. They were constantly getting pulled over by the local cops for minor violations (like driving too slowly) and nearly every time the cops would insist that they were drunk even though they didn't have a drop of alcohol. To the untrained eye, their affect looked very similar to an intoxicated person: slurred speech, bobbing while standing in place, stumbling when walking or getting out of the car, &c. So yes this is a big problem in these communities.

praptak 4y ago

The Amish are aware of their small population problem. I believe their population bottleneck was a few hundred people. They do sometimes adopt children from outside their population. I don't know how common that is and whether it makes a difference.

mikeyouse 4y ago

> This may sound harsh to some people, but all insurance policies have exemptions which (at least for accident policies) more or less boil down to "if you are behaving irresponsibly and get yourself hurt through taking undue risks, we are not paying for the consequences of your foolish behavior" -- only, you know, in legalese that is defensible in court if necessary. Some accident policies may have those features, but zero health insurance ones do.

DoreenMichele 4y ago
All insurance policies have limits on what they will pay. Those limits come in various forms, such as: 1. What you pay out of pocket before insurance coverage kicks in. 2. No coverage for out-of-network providers. 3. Caps on how much they will cover. Insurance is a numbers game. Rest assured, all insurance policies and all insurance providers find ways to limit how much they pay out. You may find some means to limit payments more distasteful than others, but they all do this. It's the only way they can possibly stay in business.
- watwut 4y ago
  Which are all an entirely different thing.

giantg2 4y ago

"They keep costs down in part by pursuing home remedies for a lot of things instead of seeing a doctor." Two other factors for low cost would be their healthy lifestyle and end of life care choices. The Amish get about 20k steps in per day - double the recommended 10k steps that most English fail to meet. Rates of many chronic diseases are lower. When they do get old, they don't drag things out and they generally don't go into longterm care facilities. Most English tend to want the doctor to "do everything you can".

watwut 4y ago
Not really > Amish mortality patterns were not systematically higher or lower than those of the non-Amish, but differed by age, sex, and cause. Amish males had slightly higher all-cause MRs as children and significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69). Amish females MRs for all causes of death were lower from age 10-39, not different from 40-69, and higher over age 69. https://pubmed.ncbi.nlm.nih.gov/7315833/ https://pubmed.ncbi.nlm.nih.gov/7315833/ Basically, Amish boys are more likely to die young. There are no long term lifestyle benefits for Amish women. And "English" by which I assume you mean Americans don't have infinite funds.
- giantg2 4y ago
  What do you mean "not really"? It seem you just posted what I was saying for lower rates of many chronic diseases. "significantly lower MRs over the age of 40, due primarily to lower rates of cancer (MR = 0.44, age 40-69), and cardiovascular diseases (MR = 0.65, age 40-69)" As they said, cause differs. When looking at costs, causes are very important. Things like cancer and cardiovascular diseases tend to cost a lot of money to treat as they drag on. If you die young in an accident, it's likely to cost less.
  - watwut 4y ago
    Women had literally zero benefits. And young boys die more. There is only one segment of population that is getting some benefit and that benefit is small. In order for lifestyle to be healthier, I would want to see more benefits then just some middle aged men mortality shifted onto young ones.