Similar age / life stage here. US resident. We’re young and healthy. First kiddo was a textbook, easy birth. A few years later my wife got pregnant again (identical twins!) and developed twin-to-twin transfusion syndrome. It’s not genetic — just terrible luck. Without treatment, both babies would have died.
She had fetoscopic laser surgery in utero, where they go in with a tiny scope and laser to seal off the abnormal shared blood vessels. Even with that, she went into labor at 25 weeks.
One baby died less than 24 hours after birth. The other twin spent over 100 days in the NICU.
Total bill was about $2,500,000. You read that right.
I love the idea, but be careful — never in a million years did I think something like this would happen to us. I’m incredibly grateful we had solid health insurance. We probably paid under $10k out of pocket for the whole ordeal.
was about to comment with a similar story. i’m sorry about your baby. similarly our newborn was diagnosed with a rare, aggressive cancer at 3 months old and died at 6 months old after chemo and then hospice. obviously a black swan event but wonder what would have happened without insurance.
I think it would be more risky vs traditional health insurance. I don't have enough experience with crowdhealth to make a prediction one way or another but personally I wouldn't be comfortable with it based on my lived experience.
The most likely outcome when you get a big medical bill like that is you just never pay. Hospitals rarely go after someone for this stuff. If there is no insurance they just write it off.
That said the ongoing health expense wound be he tricky part. But one can usually go and get on a policy with pre-existing these days whenever one wants (ACA, employer, Medicaid, etc).
Respectfully disagree. If you have assets (I do, and Nat probably does too) they will go after you. They will put it into collections, ruin your credit, etc. 100% guaranteed.
I literally do this for a living and I think the odds of people going after your assets is virtually zero. I'm aware you can probably google some sob story that's how it works in a country with 330M people. You're paranoid and uniformed.
It is also literally illegal to have medical debt impact credit scores and most of the credit score companies have realized there is very low correlation between unpaid medical bills and the likelihood to pay off other debts (the point of a credit score).
I myself was mis-billed for a pregnancy and simply didn't pay. It had zero impact.
If there's no consequence to not paying medical bills, why would anyone pay for insurance? I somewhat agree - it may work out - medical debt may be looked at differently - but I've let other smaller bills go unpaid (an out of state ER visit, for example) because I disagreed with the insane $ amount they charged for something tiny - and they DID go to to collections and seemed to be no different than any other unpaid bill (i.e. affects credit, etc). I had to work 1:1 with the hospital to get it resolved and off my credit.
ACA mostly doesn't pay, at least the ones that are getting their Silver plans heavily subsidized by the government in a kind of Medicaid lite type situation. Notice that now that they have to pay even a little people are fleeing the plans.
Employer group is subsidized by the tax deduction, and most single individuals get like 90% of their premiums covered by their employer.
Medical providers only care about insurance. Cash pay is a write off. For low cost bills like your PCP they collect, but a hospital treats it as pennies on the dollar collections. Some upstanding individuals haven't gotten the memo and pay, and they are glad to take your money, but I guarantee your cash pay medical debt is a write off from the moment its incurred.
If you're well off enough feel free to do what you do for peace of mind. But my advice on what you perceive as unjust medical billing is simply to not pay and ignore it.
Thanks for writing this Nat, very helpful overview.
Thinking of making the switch myself and working through it. Dropping a thought here with the hope someone else knows more than I do about it.
You noted in the black swan risk about them shutting down or not being able to make payments. I believe there is some history of this with these organizations. Liberty Health Share shut down and didn't pay out claims I think in 2020 and Trinity similarly did.
As I understand it, there was some fraud (or close to fraud behavior like spending contributions on things other than medical cost sharing).
Ultimately, I'm not sure how to underwrite this for a private, unregulated company. I love the dashboard showing they are paying things out, but that doesn't really give you a sense of the backstop.
I get that you could switch back to an ACA plan, but my understanding is that CrowdHealth going out of business would not be a qualifying event so you're waiting until open enrollment.
The concerning scenario is they go out of business or stop paying claims in March and you're basically uninsured for 9 months until Open Enrollment hits again. If you were already comfortable self-insuring then maybe not an issue.
In my mind, health insurance's purpose is to help an individual turn an uncapped, but diversifiable risk into a capped risk by pooling with other individuals. The odds of getting cancer at 40 are low, but it would be devastating financially so spreading that risk around is a win, win. The traditional model does this but pools you with a lot of higher risk people (among other issues).
It's fair to say that insurers can also deny claims anyway if they want, but there is some regulator body to appeal to and I believe most states have guaranty funds to backstop them.
This seems like the most critical issue, but I really have no idea how to underwrite it. If CrowdHealth was larger and had a publicly audited backstop of some sort, that would make me a lot more comfortable. Most anecdotal stories from both camps are good, it's all about what happens in the tails and I'm not sure how to evaluate that.
I could be wrong here, but I'm assuming most of CrowdHealth's existing & potential customer base are people who are getting their insurance through the Marketplace (i.e. people that don't have access to lower cost, employee-sponsored health insurance).
As a business owner, my fiancee and I get our existing health insurance through Marketplace. We are currently deciding between sticking with normal health insurance ($14-15k for a high deductible plan covering two people) and CrowdHealth. When you consider 1) tax deductibility of health insurance premiums to the business and 2) ability to contribute to an HSA (also tax deductible), the decision becomes a bit less clear. Especially if you're in the 32-37% federal tax brackets. This is obviously unique to my own situation, but if you're a business owner, I think some consideration to 1 & 2 above is relevant when making your decision.
Separate, I've had a call with CrowdHealth and didn't get adequate answers to the following questions, so I'm wondering if you or anyone else knows the answers:
1. How is "Bills Funded" being calculated? In the scenario where 100% of bills requested to be funded in a certain month are actually funded, BUT some were not fully funded & paid off, would this statistic still read 100%? If so, I think a statistic reflective of the % of total requested fundings that were actually paid off (I'll let more creative people think of a more succinct term) is more illustrative of what we as the end consumers actually care about. Not to mention it seems like something that can't be gamed so much - if 100 members request funding for bills of $100 each, but each receive only $1 and the "Bills Funded" stat shows as 100%, I think that's misleading.
2. I'm kind of skeptical about the "volunteer panel of five members from the community" who assist in the appeal process. Who are the five members? Did CrowdHealth send a blast email to all members asking for volunteers at some point? Or did these five members just randomly reach out expressing interest in volunteering for the a new appeals panel? Do they take new volunteers? Does the panel change? Are they are truly, 100%, unpaid volunteers with no incentive to deny appeals?
3. This one is my biggest area of concern & unfortunately, I think, can only be answered by becoming a member. Pre-existing conditions. For example, I go to a dermatologist for yearly skin checks. If I get diagnosed with skin cancer a year after becoming a member, are they going to say it's considered pre-existing because it falls under their "Symptomatic" bucket ("Previously Documented, Diagnosed, or Symptomatic")? If I had an EKG three years ago for chest pain I was experiencing & then have a heart attack in 1 year, is it going to be uncovered because it was "pre-existing"? The canned answer I've received from CrowdHealth is that their is no profit incentive for them to deny funding in these scenarios, but I'm asking the question from a downside perspective. If CrowdHealth has a black swan month of funding requests, it seems to me that they'd have a very high incentive to deny requests by finding very loose or non-existent relations between something in one's medical history & their current funding request.
The above questions probably make it seem like I'm anti-CrowdHealth, but in all reality, I still think it's likely the best course of action for my situation. Would just love to hear some discussion on the above, as I haven't seen it in the public sphere and it would go a long way in assuaging my key concerns, as well as hopefully help others.
The province eliminated medical payments for residents of the province.
If you were working for a company that paid health insurance, they would have previously foot the monthly premiums. The bill is paid by a tax on all employers in the province and general taxes from residents.
Our healthcare system is not perfect and many people do not have a doctor because in some areas there are not enough doctors.
So there is a wait for some services like MRI's or speciality tests.
Dental is usually covered by private insurance, as are prescriptions.
The only people who run into trouble with healthcare are people who do not have doctor, too poor to afford additional non covered services, or people who travel without health insurance to places like the US and encounter a health event.
Not having the possibility of bankruptcy or huge obligatory health plan bills is a huge relief for Canadians.
Our governments have taken to advertising to American health professionals to work in the great white north. Paperwork streamlined.
Great, informative write up. Thanks for taking the time. Two things people will want to consider when doing the math for themselves if considering a switch:
1. If you are self-employed (i.e. S-Corp owner-employee), then your healthcare premiums are actually lower than the top line thanks to the tax rules (exemption from Social Security, Medicare, or FICA taxes + deductibility on personal return)
2. If you have a HDHP with an HSA, and you are making contributions to that HSA, then you are able to lower your taxable income by ~8500 per year (for a family) with those contributions (which can also grow tax free).
So, while traditional insurance sucks, depending on how you set it up, the real cost is often lower than the "top line"
“Insurance for the healthy is cheap.” Of course it is, insurance is risk mutualization, so if high risk people are screened out the costs being spread are obviously lower.
This has the opposite effect as well, of course. If low risk groups are cheaper, high risk pools are more costly. Put everybody with kidney disease in a pool that nobody without kidney disease is in and the costs are prohibitive.
Most countries have accepted that 1) it is a societal good to cover everybody and 2) the only way to do that is to spread costs among the low risk AND the high risk.
The US is unique in that while Repubs claim their concern is issue #2 - how to cover everybody - that’s a lie. It’s really #1, in that they don’t care that many people will go without coverage but they can’t admit that.
I live in Colombia, an underdeveloped country. Nobody here has to worry about any of these conditions. Every person is insured even when they don't have a job. Everybody. Paid by the taxes on payroll and using most of the VAT.We are not communists. It is not perfect but it works. It is crowd health insurance but using the tax system. There is no VIP treatment. Everyone gets in the line to access the system. Drugs are covered. All of them. All procedures, all preexisting conditions. No exclusions. Once I was on a vacation in the US. My daughter had an abdominal pain. We took her to the ER. We were there for 3 hours. Nobody examined her. I had a $1,500 bill for nothing. Horrible. And every vehicle owner must have a special insurance for accidents. Beyond that insurance coverage, we rely on the national health system. Transplants, dialysis, open heart surgery. Everything is covered It is not perfect but it works.
Great writeup. One question - why is funding other people bills optional? Seems like it would be easier to just make this mandatory and collect the full amount each month. Plus, they could build up a fund to cover "bad months" in the future.
This would make it "Insurance" and would immediately get the system shut down. I've been a CrowdH member sins 2022. It's on autopay for "Green" rated requests. I never think about it. The generosity score incentivizes contributions so mandatory is not actually necessary.
Let me make a different suggestion: Since you work online and not physically tied to the US for work reasons, why not move to Europe?
We live in Cyprus. Not only we pay no capital gains tax (it's capped to a maximum of $4k/year), no estate tax, and basically no income tax, health insurance is really great and costs nothing.
I pay 190 EUR ($220) per month for social security which includes health insurance, for my entire family.
Even if I had 10 kids, it would still be only 190 EUR per month. It includes everything, also child birth, and the country can't refuse to treat for any reason as long as you're in the system.
If I travel anywhere in the European Union, I also don't pay anything out of pocket, it is charged to my Cypriot national insurance. You could save on health insurance alone, not to mention a fortune in tax.
Beware if you cancel your insurance. I tried that, had a minor procedure that should have cost $4000. The hospital charged $20,000. They did so gleefully because they have agreements in place with insurance companies. If you have some random insurance company a hospital can and will jack up the price.
the price is fake. you don't have to pay that. crowdhealth has a negotiations team that negotiates on behalf of members. sometimes no negotiations are necessary because the hospital or doc just gives a reasonable self pay price. I went to ER this year and got bloodwork and fluids and told them i'm self pay. They charged $685. Not bad. I paid it. Crowdhealth reimbursed 10 days later.
Similar age / life stage here. US resident. We’re young and healthy. First kiddo was a textbook, easy birth. A few years later my wife got pregnant again (identical twins!) and developed twin-to-twin transfusion syndrome. It’s not genetic — just terrible luck. Without treatment, both babies would have died.
She had fetoscopic laser surgery in utero, where they go in with a tiny scope and laser to seal off the abnormal shared blood vessels. Even with that, she went into labor at 25 weeks.
One baby died less than 24 hours after birth. The other twin spent over 100 days in the NICU.
Total bill was about $2,500,000. You read that right.
I love the idea, but be careful — never in a million years did I think something like this would happen to us. I’m incredibly grateful we had solid health insurance. We probably paid under $10k out of pocket for the whole ordeal.
was about to comment with a similar story. i’m sorry about your baby. similarly our newborn was diagnosed with a rare, aggressive cancer at 3 months old and died at 6 months old after chemo and then hospice. obviously a black swan event but wonder what would have happened without insurance.
I’m sorry for your loss too. Yeah, health insurance sucks - so many problems - but after my experience I would never be without it.
is you're assumption that the crowdhealth network cannot cover a 7 figure bill?
I think it would be more risky vs traditional health insurance. I don't have enough experience with crowdhealth to make a prediction one way or another but personally I wouldn't be comfortable with it based on my lived experience.
i dont understand
based on my lived experience, i would not trust an insurance company to buy me the healthcare i need
The most likely outcome when you get a big medical bill like that is you just never pay. Hospitals rarely go after someone for this stuff. If there is no insurance they just write it off.
That said the ongoing health expense wound be he tricky part. But one can usually go and get on a policy with pre-existing these days whenever one wants (ACA, employer, Medicaid, etc).
Respectfully disagree. If you have assets (I do, and Nat probably does too) they will go after you. They will put it into collections, ruin your credit, etc. 100% guaranteed.
I literally do this for a living and I think the odds of people going after your assets is virtually zero. I'm aware you can probably google some sob story that's how it works in a country with 330M people. You're paranoid and uniformed.
It is also literally illegal to have medical debt impact credit scores and most of the credit score companies have realized there is very low correlation between unpaid medical bills and the likelihood to pay off other debts (the point of a credit score).
I myself was mis-billed for a pregnancy and simply didn't pay. It had zero impact.
If there's no consequence to not paying medical bills, why would anyone pay for insurance? I somewhat agree - it may work out - medical debt may be looked at differently - but I've let other smaller bills go unpaid (an out of state ER visit, for example) because I disagreed with the insane $ amount they charged for something tiny - and they DID go to to collections and seemed to be no different than any other unpaid bill (i.e. affects credit, etc). I had to work 1:1 with the hospital to get it resolved and off my credit.
Most people don't pay for insurance.
Medicare doesn't pay.
Medicaid doesn't pay.
ACA mostly doesn't pay, at least the ones that are getting their Silver plans heavily subsidized by the government in a kind of Medicaid lite type situation. Notice that now that they have to pay even a little people are fleeing the plans.
Employer group is subsidized by the tax deduction, and most single individuals get like 90% of their premiums covered by their employer.
Medical providers only care about insurance. Cash pay is a write off. For low cost bills like your PCP they collect, but a hospital treats it as pennies on the dollar collections. Some upstanding individuals haven't gotten the memo and pay, and they are glad to take your money, but I guarantee your cash pay medical debt is a write off from the moment its incurred.
If you're well off enough feel free to do what you do for peace of mind. But my advice on what you perceive as unjust medical billing is simply to not pay and ignore it.
Thanks for writing this Nat, very helpful overview.
Thinking of making the switch myself and working through it. Dropping a thought here with the hope someone else knows more than I do about it.
You noted in the black swan risk about them shutting down or not being able to make payments. I believe there is some history of this with these organizations. Liberty Health Share shut down and didn't pay out claims I think in 2020 and Trinity similarly did.
As I understand it, there was some fraud (or close to fraud behavior like spending contributions on things other than medical cost sharing).
Ultimately, I'm not sure how to underwrite this for a private, unregulated company. I love the dashboard showing they are paying things out, but that doesn't really give you a sense of the backstop.
I get that you could switch back to an ACA plan, but my understanding is that CrowdHealth going out of business would not be a qualifying event so you're waiting until open enrollment.
The concerning scenario is they go out of business or stop paying claims in March and you're basically uninsured for 9 months until Open Enrollment hits again. If you were already comfortable self-insuring then maybe not an issue.
In my mind, health insurance's purpose is to help an individual turn an uncapped, but diversifiable risk into a capped risk by pooling with other individuals. The odds of getting cancer at 40 are low, but it would be devastating financially so spreading that risk around is a win, win. The traditional model does this but pools you with a lot of higher risk people (among other issues).
It's fair to say that insurers can also deny claims anyway if they want, but there is some regulator body to appeal to and I believe most states have guaranty funds to backstop them.
This seems like the most critical issue, but I really have no idea how to underwrite it. If CrowdHealth was larger and had a publicly audited backstop of some sort, that would make me a lot more comfortable. Most anecdotal stories from both camps are good, it's all about what happens in the tails and I'm not sure how to evaluate that.
I could be wrong here, but I'm assuming most of CrowdHealth's existing & potential customer base are people who are getting their insurance through the Marketplace (i.e. people that don't have access to lower cost, employee-sponsored health insurance).
As a business owner, my fiancee and I get our existing health insurance through Marketplace. We are currently deciding between sticking with normal health insurance ($14-15k for a high deductible plan covering two people) and CrowdHealth. When you consider 1) tax deductibility of health insurance premiums to the business and 2) ability to contribute to an HSA (also tax deductible), the decision becomes a bit less clear. Especially if you're in the 32-37% federal tax brackets. This is obviously unique to my own situation, but if you're a business owner, I think some consideration to 1 & 2 above is relevant when making your decision.
Separate, I've had a call with CrowdHealth and didn't get adequate answers to the following questions, so I'm wondering if you or anyone else knows the answers:
1. How is "Bills Funded" being calculated? In the scenario where 100% of bills requested to be funded in a certain month are actually funded, BUT some were not fully funded & paid off, would this statistic still read 100%? If so, I think a statistic reflective of the % of total requested fundings that were actually paid off (I'll let more creative people think of a more succinct term) is more illustrative of what we as the end consumers actually care about. Not to mention it seems like something that can't be gamed so much - if 100 members request funding for bills of $100 each, but each receive only $1 and the "Bills Funded" stat shows as 100%, I think that's misleading.
2. I'm kind of skeptical about the "volunteer panel of five members from the community" who assist in the appeal process. Who are the five members? Did CrowdHealth send a blast email to all members asking for volunteers at some point? Or did these five members just randomly reach out expressing interest in volunteering for the a new appeals panel? Do they take new volunteers? Does the panel change? Are they are truly, 100%, unpaid volunteers with no incentive to deny appeals?
3. This one is my biggest area of concern & unfortunately, I think, can only be answered by becoming a member. Pre-existing conditions. For example, I go to a dermatologist for yearly skin checks. If I get diagnosed with skin cancer a year after becoming a member, are they going to say it's considered pre-existing because it falls under their "Symptomatic" bucket ("Previously Documented, Diagnosed, or Symptomatic")? If I had an EKG three years ago for chest pain I was experiencing & then have a heart attack in 1 year, is it going to be uncovered because it was "pre-existing"? The canned answer I've received from CrowdHealth is that their is no profit incentive for them to deny funding in these scenarios, but I'm asking the question from a downside perspective. If CrowdHealth has a black swan month of funding requests, it seems to me that they'd have a very high incentive to deny requests by finding very loose or non-existent relations between something in one's medical history & their current funding request.
The above questions probably make it seem like I'm anti-CrowdHealth, but in all reality, I still think it's likely the best course of action for my situation. Would just love to hear some discussion on the above, as I haven't seen it in the public sphere and it would go a long way in assuaging my key concerns, as well as hopefully help others.
I canceled health insurance about 4 years ago. One of the best decisions I ever made
nice. do you have any protection plan or just running raw? Just curious
Raw for the most part. The protection is that I invest in my own health all the time (food, gym, etc).
yeah it's one of those things where you don't need it til you really need it
Clever workaround. If it spreads it will be outlawed. (It shouldn't be, but it will.)
How sad is it as a country that we need great businesses like crowdhealth?
I love the model. I could never stomach the risk for my family personally but its a great option.
I live in BC, Canada.
The province eliminated medical payments for residents of the province.
If you were working for a company that paid health insurance, they would have previously foot the monthly premiums. The bill is paid by a tax on all employers in the province and general taxes from residents.
Our healthcare system is not perfect and many people do not have a doctor because in some areas there are not enough doctors.
So there is a wait for some services like MRI's or speciality tests.
Dental is usually covered by private insurance, as are prescriptions.
The only people who run into trouble with healthcare are people who do not have doctor, too poor to afford additional non covered services, or people who travel without health insurance to places like the US and encounter a health event.
Not having the possibility of bankruptcy or huge obligatory health plan bills is a huge relief for Canadians.
Our governments have taken to advertising to American health professionals to work in the great white north. Paperwork streamlined.
Surely some of the 3 million Indian immigrants to Canada in the last 10 years are doctors?
Great, informative write up. Thanks for taking the time. Two things people will want to consider when doing the math for themselves if considering a switch:
1. If you are self-employed (i.e. S-Corp owner-employee), then your healthcare premiums are actually lower than the top line thanks to the tax rules (exemption from Social Security, Medicare, or FICA taxes + deductibility on personal return)
2. If you have a HDHP with an HSA, and you are making contributions to that HSA, then you are able to lower your taxable income by ~8500 per year (for a family) with those contributions (which can also grow tax free).
So, while traditional insurance sucks, depending on how you set it up, the real cost is often lower than the "top line"
All great points.
“Insurance for the healthy is cheap.” Of course it is, insurance is risk mutualization, so if high risk people are screened out the costs being spread are obviously lower.
This has the opposite effect as well, of course. If low risk groups are cheaper, high risk pools are more costly. Put everybody with kidney disease in a pool that nobody without kidney disease is in and the costs are prohibitive.
Most countries have accepted that 1) it is a societal good to cover everybody and 2) the only way to do that is to spread costs among the low risk AND the high risk.
The US is unique in that while Repubs claim their concern is issue #2 - how to cover everybody - that’s a lie. It’s really #1, in that they don’t care that many people will go without coverage but they can’t admit that.
This is an asinine take that reveals a lack of critical thinking. The current system came from the honorable Obama (PBUH).
The problem with the US system is the graft and administrative bloat. It doesn’t help that Americans are being poisoned at every turn.
I live in Colombia, an underdeveloped country. Nobody here has to worry about any of these conditions. Every person is insured even when they don't have a job. Everybody. Paid by the taxes on payroll and using most of the VAT.We are not communists. It is not perfect but it works. It is crowd health insurance but using the tax system. There is no VIP treatment. Everyone gets in the line to access the system. Drugs are covered. All of them. All procedures, all preexisting conditions. No exclusions. Once I was on a vacation in the US. My daughter had an abdominal pain. We took her to the ER. We were there for 3 hours. Nobody examined her. I had a $1,500 bill for nothing. Horrible. And every vehicle owner must have a special insurance for accidents. Beyond that insurance coverage, we rely on the national health system. Transplants, dialysis, open heart surgery. Everything is covered It is not perfect but it works.
Great writeup. One question - why is funding other people bills optional? Seems like it would be easier to just make this mandatory and collect the full amount each month. Plus, they could build up a fund to cover "bad months" in the future.
This would make it "Insurance" and would immediately get the system shut down. I've been a CrowdH member sins 2022. It's on autopay for "Green" rated requests. I never think about it. The generosity score incentivizes contributions so mandatory is not actually necessary.
Does CrowdHealth exclude people who received or continue to receive the C19 injections (or any other vaccines)?
The price is not fake. It happened to me.
Very interesting.
Let me make a different suggestion: Since you work online and not physically tied to the US for work reasons, why not move to Europe?
We live in Cyprus. Not only we pay no capital gains tax (it's capped to a maximum of $4k/year), no estate tax, and basically no income tax, health insurance is really great and costs nothing.
I pay 190 EUR ($220) per month for social security which includes health insurance, for my entire family.
Even if I had 10 kids, it would still be only 190 EUR per month. It includes everything, also child birth, and the country can't refuse to treat for any reason as long as you're in the system.
If I travel anywhere in the European Union, I also don't pay anything out of pocket, it is charged to my Cypriot national insurance. You could save on health insurance alone, not to mention a fortune in tax.
What are the residency requirements? IE how many months a year do you have to be present in Cyprus?
It's hard to leave America! America is a special place!
Beware if you cancel your insurance. I tried that, had a minor procedure that should have cost $4000. The hospital charged $20,000. They did so gleefully because they have agreements in place with insurance companies. If you have some random insurance company a hospital can and will jack up the price.
the price is fake. you don't have to pay that. crowdhealth has a negotiations team that negotiates on behalf of members. sometimes no negotiations are necessary because the hospital or doc just gives a reasonable self pay price. I went to ER this year and got bloodwork and fluids and told them i'm self pay. They charged $685. Not bad. I paid it. Crowdhealth reimbursed 10 days later.
You sure go to the ER a lot for someone who is so healthy…
How do they know if you smoke or not? Sounds like a good faith question.
honors system