By Dr. John Oertle

In today’s healthcare system, patients across the country face a painful reality: even when they do everything right, the system doesn’t always work for them. At Solidarity HealthShare, we strive to help our Members navigate these complex and often confusing waters with dignity, transparency, and justice.

Recently, we had the privilege of helping one of our Members who was scheduled for a medically necessary surgery. A simple procedure quickly turned into a powerful example of how broken our American healthcare system has become—and how Solidarity stands in the gap for our Members.

The Story: A Battle Over Fair Pricing

Our Member was originally quoted a self-pay rate of $17,515 for her surgery, significantly discounted from the hospital’s extraordinary charges of over $112,000, approximately 2,188% higher than Medicare rates. This self-pay rate was calculated based on no insurance involvement.

However, once the hospital saw she was part of Solidarity HealthShare, they attempted to reclassify her as having “coverage” even though healthcare sharing ministries are not insurance. As a result, they raised the price to $84,000.00, about 1,616% above the Medicare rate (that included a 25% discount of Total Billed Charges at $112,000.00). These sudden and conflicting charges left our Member confused, distressed, and unsure if she’d be able to proceed with her urgently needed surgery.

That’s when Solidarity stepped in.

Our team coordinated direct communication with the hospital’s billing department, provided education on healthsharing’s distinction from insurance under the Affordable Care Act, and clearly communicated our Member’s right to fair and consistent pricing. After persistent advocacy, the hospital agreed to honor the self-pay rate of $17,920, with only 50% due upfront.

The result? An 84% savings compared to the full hospital charge, saving our Member over $91,000.

The Systemic Problem: A Two-Tiered Pricing Model

• Unfortunately, cash-pay and uninsured patients often pay more than even insured patients, despite having no network-negotiated “discounts.”

• Employers and insurance premiums absorb inflated hospital charges, driving costs higher across the board.
• Patients are often unaware of what they will be billed until after the procedure.
• 41% of American adults carry medical or dental debt, and medical bills remain the number one cause of personal bankruptcy in the United States (KFF, 2022),
• Healthcare spending per person in the U.S. is nearly double that of other developed countries, yet outcomes do not reflect that cost (Health System Tracker, 2024).
• A 2019 study found hospitals often charge patients with insurance more than the uninsured for the same procedure, further distorting the system (Trinity College Economics Dept.).

Solidarity’s Role: A Shield for Our Members

At Solidarity, we are not insurance. We are a faith-based healthcare sharing ministry committed to restoring the sacred doctor-patient relationship, bringing transparency into medical pricing, and ensuring our Members aren’t crushed by unreasonable medical bills.

We do this by:

• Educating providers on how healthcare sharing ministries work.
• Benchmarking against transparent rates, like Medicare, to assess fairness.
• Negotiating in good faith to ensure Members can access the care they need.
• Fighting for consistency so patients are not surprised by shifting quotes or unpayable demands.

A Better Way Forward

What happened to our Member should never happen to anyone, but it happens every day in the US sick care system. Whether insured, uninsured, or part of a healthcare sharing ministry, patients are too often caught in the crossfire of a system that lacks price transparency, consistency, and fairness.

At Solidarity, we’re building a different path—one that empowers patients, educates providers, and aligns with the values of compassion, truth, and stewardship. Healthcare should serve the person, not the profit model. And while we can’t fix the system overnight, we are proving that advocacy, integrity, and community can protect people, one Member at a time.

If you’re a member, know this: we will fight for you. And if you’re a provider, know this: we’re here to partner with you in delivering fair, compassionate care to those who need it most.