Much attention has been paid to GoFundMe’s unlikely role as the go-to fundraising platform for medical care over the last year or so.

But that’s not the only alternative to health insurance that’s been cropping up for Americans struggling to pay for care in the most expensive health system in the world.

• GoFundMe has said that medical fundraisers generate $650 million in donations each year.
• At least 1 million people have signed up for health care sharing ministries, up from an estimated 200,000 people who participated in the groups prior to the passage of the Affordable Care Act in 2010, according to The Wall Street Journal. Members pay into a general account each month and can submit their medical bills to the group to be covered by other members. They are also exempt from the requirement to purchase health insurance. But some members are complaining that not all bills are being paid.
• Christian churches are increasingly stepping in to help their congregants and others pay off medical debt, reported Kaiser Health News. Eighteen churches have scratched out $34.4 million of medical debt since 2018, for example.

What’s your take on this trend? Will more “alternative” forms of health insurance continue to gain steam among consumers?

News I’m Watching

1. Should we rethink physician non-competes in the consolidation era? When a doctor decides to switch practices, non-compete agreements can prevent them from sharing that information with their patients, a strategy that hospitals say protects their investment in physicians. But as health systems grow through merger and acquisition, and also expand their geographic reach via telemedicine, it is raising questions about the scope of such clauses. An expert told The Washington Post that non-compete clauses “are going to become an even thornier and less clear issue going forward.”

“Those clauses may impede your access to your choice of physician should they pivot to a new facility or clinic.” - Dale Gauthier, director of billing and collections, Amedisys

2. Nurses file complaint against Chicago hospital over understaffing. The National Nurses Organizing Committee/National Nurses United alleges inadequate staffing and forced mandatory overtime at the University of Chicago Medical Center. A union analysis found the hospital does not meet its staffing standards about half of the time. Concerns over understaffing of nurses are mounting; nurses across the U.S. are striking or threatening to strike over concerns about understaffing.

3. Generic drug production went global. Then came the quality issues. That’s according to Katherine Eban, the author of “Bottle of Lies: The Inside Story of the Generic Drug Boom" in her #WeekendEssay. In a bid to save money on manufacturing costs, brand-name and generic drug companies began acquiring manufacturing plants in China and India. However, allegations of data fraud and poor sanitary conditions in the plants have raised questions about the quality of generics produced in certain markets. “It’s like ‘The Jungle,’” one pharmaceutical consultant said.

*Comments have been lightly edited.

What’s your take on this week’s stories? Do alternatives models to health insurance have lasting power? How should providers approach non-compete clauses in today’s market? Why has understaffing become an important issue for nurses in 2019? How can quality concerns for generic drug production be better addressed? Share your thoughts in the comments, using #TheCheckup.