Via Ahram:
The debate over US healthcare reform that has gripped the nation and led to a government shutdown is of small concern in rural Pennsylvania’s Amish country for a very simple reason.
Along with eschewing cars and many other modern technologies, the descendants of 18th-Century German immigrants who practice the Amish and Old Order Mennonite religions, have effectively opted out of Obamacare, along with most federal safety net programs.A little-known provision of the law with its roots in a 1950s battle over Social Security exempts these communities from the individual mandate, an element of the Affordable Care Act that requires most Americans to purchase health insurance in some form.
But it is not the idea of health insurance the Amish reject – the close-knit communities essentially insure themselves.
“We have our own health care,” said a retired Amish carpenter, who like other Amish interviewed for this story, asked that his name not be used because of a traditional aversion to publicity and bringing attention to oneself.
“They (hospitals) give you a bill,” he said. “If you can’t pay it, your church will.”
The Amish system is a little more complicated than that. Some 280,000 people live in Amish communities scattered through the United States, with the largest populations in Pennsylvania, Ohio and Indiana, according to research by Elizabethtown College in Pennsylvania.
While practices vary by community, most Amish fund their health care through a system that merges church aid, benefit auctions and negotiated discounts with local hospitals – promising quick cash payment in exchange for lower rates.
“The way they come together to pay for health care is amazing,” said Jan Bergen, chief operating officer at Lancaster General Health. “It’s a tithing. Their sense of responsibility extends beyond themselves and to the community.”
SHARED RESPONSIBILITY
The Amish exemption to Obamacare dates back nearly 60 years to when Congress extended the Social Security tax to the self-employed and to farmers. Many Amish refused to pay. The Internal Revenue Service moved to enforce the law, sometimes with disastrous public relations consequences.
“There was an Amish guy who refused to pay Social Security. IRS agents confiscated his horses while he was out in the field plowing,” said Donald Kraybill, author of “The Amish” and professor at Elizabethtown College.
In 1965, Congress passed a law giving certain Amish and Mennonite religious orders the right to opt out of Social Security, Medicaid and a host of other government benefits.