A largely insular community since their initial settlement in the United States, the Amish community presents unique challenges for healthcare workers. The Amish eschew modern technology, including many of the tools and techniques used in modern medicine. In fact, the Amish community also forbids higher education (Adams & Leverland, 1986). Misconceptions and misunderstandings about the Amish further complicate healthcare decisions and relationships between healthcare providers and Amish patients. For example, it is commonly assumed that the Amish “lack the preventive practices of immunizations and prenatal care,” (Adams & Leverland, 1986, p. 58). While the rates of immunizations are relatively low among the Amish, the Amish church does not forbid immunization (Adams & Leverland, 1986). The Amish also have a keen interest in disease prevention, health education, and lifestyle choices that prevent health problems (Talpos, 2016). Although Amish attitudes towards health, wellness, and the healthcare system may be at odds with those outside their communities, there are important points of convergence that nurses can incorporate into a transcultural model of care.One of the hallmarks of Amish healthcare is the community’s internal insurance program. The Amish have been exempt from paying Social Security on religious grounds since 1965, and the same principles have also exempted the Amish from participating in the Affordable Care Act and its mandated health insurance provision...

92). Instead of participating in mainstream health insurance schemes, the Amish provide fully for the healthcare needs of members of their community. The Amish community manages healthcare costs internally by reducing or eliminating spending on non-essential services, while pooling community resources to pay for essential or emergency care. In some cases, the Amish communities have agreements with local hospitals for bulk discounts or special rates for services (Kelley, 2013). This “community-based” model of “reciprocal assistance without government interference” has been much admired and provides insight into how Americans outside of the Amish community can consider public healthcare ethics (Roher & Dundes, 2016, p. 92; Talpos, 2016).
The Amish view healthcare largely as a matter of personal responsibility. Each person has a personal responsibility to follow a minimalist lifestyle in general, which essentially prevents some of the healthcare problems plaguing Americans. For example, smoking and drinking are prohibited in Amish communities (Cleveland Clinic, 2017). Surgical procedures, dental work, anesthesia, blood transfusions, and even some organ transplants are permitted but only when absolutely necessary (Cleveland Clinic, 2017). Relying on medicine, treatments, and interventions as little as possible, the Amish keep their collective healthcare costs down, and use complementary, folk, or herbal treatments on their…