How do Amish decide where to get medical treatment?  There are multiple factors that go into that decision, but since Amish pay cash for medical care, a big factor is cost.

If you’ve ever traveled through Millersburg, the seat of Holmes County, you may have passed by Pomerene Hospital.  Amish are perhaps 40% of Holmes County’s population, one reason they make up a large part–20%–of the hospital’s annual business.  Last year Pomerene had over 1,100 “self-pay package customers” which for the most part are the Amish patients.

Pomerene has been trying to attract more Amish customers by responding to their needs.  The hospital has a “full-time Amish advocate” who speaks Pennsylvania German, has developed a hospital transport system, and even opened the “Amish House” for Amish relatives to stay overnight (more on the Amish House here).

Pomerene Hospital AmishThis recent story about Pomerene has a very free-market feel to it.  Since they don’t carry traditional insurance, Amish are motivated to shop for better deals and negotiate.  Pomerene CEO Tony Snyder comments: ‘“When we as individual citizens are responsible for a significant portion of our health care bill, we’re going to shop prices and quality,”… “Americans spend more time researching the purchase of a new car than they do health care providers.”’

I think Snyder has a point–that we are more apt to consider choice in purchasing consumer goods than we are in medical services.  Perhaps it has to do with the idea that health care involves a (sometimes quite intimate) personal relationship and thus a need to feel comfortable with the provider–probably one reason why family doctors treat generations of a single family for years and years.




Open-minded medicine

Amish do approach their health care with an openness to different solutions.  Besides conventional hospitals, they choose local clinics, birthing centers, alternative medicine, folk remedies, sympathy healing, and care in distant medical centers, sometimes even outside of the country.  As you’d imagine, not all Amish opt for all of these solutions, or even consider them as a serious option.

But across Amish society, there is a general willingness to reach into both alternative and conventional health arenas.  In a study* on the subject Anna Frances Wenger sees the Amish as having an “active involvement in health care and openness to choose from a broader array of types of health care than most persons in the dominant American culture.” Wenger found Amish in an Indiana community choosing from a full slate of options, from folk to professional providers.

If you’re interested you can also explore health care among Holmes County Amish in chapter 7 of An Amish Paradox (“Health along the Life Cycle”) which covers topics including birthing, diet, immunization, and alternative medicine. I quite enjoy the quote that opens that chapter, from a local physician: “They don’t come in every time they sneeze.”

(*See “Health and Health Care Decision-making: The Old Order Amish” in Internal and External Perspectives on Amish and Mennonite Life 4, 1994)

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