Would a member-owned co-op work for health care?

Republicans and some Democrats in Congress are resisting the public option being proposed as part of health-care reform. One alternative under discussion is the member-owned cooperative, along the lines of those used by dairy farmers. Based on your experience with other cooperatives, would a member-owned co-op work for health care?

My employer recently switched FROM HealthPartners to a for profit insurer due to HIGHER cost at HP. So, are co-ops less expensive as a rule? Apparently not. -Dan, St. Paul, MN

Coop health care will be no different than non-profit. More substantial change is needed. -Jerry Olson, Red Wing, MN

A Co-op solution will solve nothing. Universal public insurance is our only option to globally compete for high levels of national health! -John Laughlin, Stillwater, MN

  • Bill Dumler

    Yes, a member health care coop would work.

    In MN, there are many successful member coops. Those that would be similar include the many Natural Food member owned co-ops in the state. Among these co-ops include organizations that perform well above the avg for natural food companies, include all Whole Foods.

    Besides performance, the Co-ops provide product and service offerings not available at other similar retailers. I would suspect that this would be similar to a member-owned health care coop. Success of any co-op depends on quality management and board of directors who listen to the membership to ensure the co-op monitors the financials while support the co-ops values.

  • Mike

    Yes. Without the need to maximize profits, a co-op wouldn’t need to spend time and money looking for reasons to deny coverage, lowering the overall cost to health consumers.

    Modeled after credit unions, a system of co-ops would be a good way for groups to self-select membership.

  • Dave Barry

    I don’t know about coops, but I’ve been getting my care from the VA for 35 years. Not one complaint. Not one. Seems to be a pretty good system to me.

    Dave

  • Deb

    It is an option. But not the best option.

    The best option is a single payer/universal system, which is what most industrialized countries have.

    The next option is a ‘public option’.

    And if all else fails then consider a co-op.

    Most people if given all the information without fear tactics would welcome a single payer/universal system. The GOP wants to maintain the status quo and wants to see President Obama fail, so have used scare tactics to misrepresent the proposed changes.

  • Sheri

    Yes. With a public health care option. Of all the options a government run health care choice is the most one most accountable to the people – the one we will have the most control over. This after all is our lives we are talking about.

  • Mary

    I would love to see a health care co-op that focuses on homeopathic and naturopathic medicine!

    There is also a great need for self-employed groups like artists and non-profit arts organizations to be able to get affordable heath care. A co-op may be a great option for those groups.

  • Donna

    Huh, I’ve been a member of Health Partners for more than 20 years, back when it was Group Death. This is the first time I ever heard it labeled a coop. Must be cause it sucks just like all the other HMO’s. Are you kidding me, Health Partners is the new public option. Get real.

  • Anne

    No, how would a co-op work on the national level ? To cover the 40 + million uninsured, a public option is necessary.

  • Ian
  • Emily

    A co-op in theory is a great idea. However, it is not scalable to the national level….especially when the co-ops would be competing with profit-hungry “big business” insurance companies.

  • Thom

    Co-ops would not work as the members would vote for things that could not be afforded. Healthcare is just too complicated for the average consumer to understand…

  • Mary

    Co-ops could not replace the public option in insuring the 47 million uninsured.

    Co-ops could play a role in the health care system but a small one. Currently there are very few, they are not regulated and have not been studied.

    Co-ops are being suggested by some simply as a ploy to defeat the public option.

  • Jake

    Would it work as an alternative option for people who can already have insurance/can afford insurance? Yes, I do not doubt that. But, I am guessing that 4 to 5 years later after having gained some success, they would be absorbed by private insurance companies. And, Co-ops would not solve the issue of providing a basic human right to people that cannot afford it.

  • Deb

    The fact that the co-op’s would be non-profit would not be of benefit. Health Insurance companies in Minnesota are non-profit and look at the expensive premiums we have. Also, non-profit did not prevent United Health Care from paying it’s CEO $65,000,000. That’s alot of premiums

  • Dan

    I have my doubts of how a high deductible/ high out of pocket health care plan would help low income people or anyone for that matter.

    A local hospital told me that one of their biggest problems is collecting the deductible from patients with high deductible plans.

    The only way we can really judge what is a good plan is to know NOW what the coverage, cost ,co-pay and deductible is. Currently there is no standard of coverage.

    It is my opinion that the best option is for everyone to be able to participate in an plans such as Medicare or VA.

  • Steve

    No. It would be a half measure that might make some marginal improvement, with the result that real reform would be kicked down the road another decade or so.

    Why are we Americans so prideful that we refuse to learn from the successes of other countries? Many countries are getting better health results with less drag on their economies than we are, but we won’t go that way because we’re allergic to “socialized medicine.”

    Some things indeed work best when privatized, such as manufacturing and agriculture. But other things work best when socialized, such as law enforcement and highways. Still other things could be made to work well either way, such as education and mail delivery. The only debate should be about what would work best for producing good results in health care.

    The experience of other countries (not to mention Medicare and the VA) shows that socialized medicine can work very well. The only reason we don’t see this truth is that we’re blinded by ideology and distracted by fear mongers.

  • Kelli

    The co-op suggestion is from the insurance industry by way of conservative congress members. The insurance industry wants the “public option” to go down in defeat.

    Insurance companies already know how to take market share from any co-op so that’s exactly the kind of ‘competition” they want to see legislated. They’ve paid a great deal for their seats at the table on the health care debate. So far, I’d say their investment is paying off for them. Too bad for the rest of us but corporate money talks in our system of goverment. They’ve been paying through the nose for years for the day when this fight would come again. I’m not sure we ever even had a chance.

  • BILL TESKA

    Yes. It works just fine here (Group Health Plan of St. Paul, now Health Partners). CEOs paid reasonably, pr4ventive care, and pay for quallity, not quantity (no fee-for-service) and therefore no incentive to over-treat. Consumer- ownership means incentive not to under-treat.

    National system could be decentralized into state or regional co-ops, receiving block-grants from the single-payer fed, based on number of patients covered..

    This could be a REAL, homegrown, American system, which favors the people rather than the insurance and hospital industries.

  • Jack May

    Cathy Worser mentioned farm cooperatives as an example to illustrate what a Health Cooperative might look like. Others mention the freedom from ‘having’ to make a profit or provide a return on investment. Farm Cooperatives were never very successful until they gradually realized they needed to operate ‘for profit’ like any private company. Many are successful today but they do operate to maximize profits- the only difference from private companies being the ownership structure. Our society’s lack of understanding of economics can make a person want to scream. Profit is not simply and added unnecessary cost. It IS simply a necessary ingredient to get any enterprise off the ground and to sustain it- much like laws of physics. When farm cooperatives started out, they also thought of profits as an UN-necessary evil – And either languished or failed. It’s too bad we have to re-learn so many lessons every 75 years or so! You cannot fight the laws of economics any more successfully than you can fight the laws of physics!

    .

  • Daniel

    I believe that, as usual, we are faced with imperfect options and then given a short, frenzied time to make a decision. I would be interested in health co-op option but I’m also interested in the idea of a health savings account. Insurance is for profit, so as people make claims, someone has to pay more than their share. If insurance companies can dump me when I get “too expensive”, I should be able to dump them. I’m afraid that in the frenzy I’ll be mandated to purchase a service I don’t need or want. I don’t know what choice I would make, but I should have the choice. Why not inform people about the choices and then offer resources to find the services that work best for them. If you like your insurance, keep it! I don’t trust the insurers to be there when I need them and I can’t afford a comprehensive plan. That means I pay a good portion of my medical expenses anyway. I feel like purchasing insurance is like paying someone to take my money.

  • Jack May

    The only enterprise that can operate without a profit, is one that can create money out of thin air. And money- dollars for instance- are simply tokens that represent resources. Can you think of any person or entity has figured out how to create resources out of thin air?

  • Daniel

    I earn my wages. I decide what I need and want. I don’t owe anything to the insurance companies. If I need a money manager, I’ll pay a money manager. I believe insurance is a veiled scheme to fleece people who don’t do the math for themselves.

  • Steve Klingaman

    The infatuation with co-ops reflects a naïve, romantic notion of some frontier “let’s stick together” mentality that has nothing—nothing—to do with the realities of the health care marketplace. You can bet health insurance CEOs are laughing right now, incredulous at their good fortune that some benevolent Democratic senator from North Dakota would have handed them such a perfect canard with which to deflect real reform.

  • daniel

    All of this talk implies that what’s best for some is best for all, whether they like it or not. I want a choice about my investment. I feel I can do better with options other than traditional for-profit health insurance. Co-ops still make money, a personal health account also exists in the market, so I’m having trouble seeing how either of these options will affect people who still want to purchase for-profit insurance. The competition will likely help drive down medical costs as well, which is what this is all about, right?

  • angela

    I heard the story that tells of HealthPartners and it’s structure. If it’s a Co-Op then I would say no it will not work. We have HP coverage at work and the premiums are the same if not higher than the others we have had in the past. (BC/BS Medica Preferred One) These premiums are NOT affordable and the doctors cost the same when we go to the “Co-Op vs the for profit companies. Each year the premium bids come in and they are raised as much as with a for profit co because the pool of enrollees is just too small. Increasing the pool (joining a LARGE federal or whole state pool of people would average out the experience ratings of everyone and lower the prices for all.

  • Mac

    As a fiscal conservative, this is one of the worst ideas being considered.

    Co-ops would be very expensive, and very complicated, especially considering the quick startup period.

    The Government would have to provide the startup capital. Then where do you get the employees to run it — most likely it would require experienced insurance and operations managers including some pretty intensive computer information systems. Keeping any co-op of size in financial balance would rely on the Government being the guarantor … unless they hand it off to AIG to offset the catastrophic risk.

    Wasn’t something similar to this tried in California in a program called Pacific Business Group on Health (PBGH) ? It folded in the summer of 2006 when Blue Shield of California, Kaiser and Health Net – the three biggest insurers – refused to participate.

    The only way this will pass is if Republicans support it and that is doubtful considering their opinion of Government involvement with Fannie Mae, Freddy Mac, AIG, GM, etc.

    The only solution that makes sense is a Single Payer system that would reduce the overhead. Paying for it could be accomplished with a National Sales Tax which would then terminate the employer provided programs and correspondingly reduce the costs of the products we buy. Republicans call this concept a Flat Tax, but there has not been anyone advocating it for Healthcare Reform.

  • Dave

    The idea of health care co-ops as a “compromise” is laughable. The proposed “public option” was already an attempt at finding a compromise instead of pushing all the way toward a single-payer system. The co-op proposal is a ruse to distract us from the real problem and to prevent real reform.

    The fact is, we have a health care system that’s based on extracting profits from sick people. No part of the system– not doctors, hospitals, pharmaceutical manufacturers, or even insurance companies– has a financial incentive to keep people healthy so they don’t need care in the first place. The sytem only gets paid when people either get sick, or fear getting sick, or can be persuaded that they’re sick. Without radical reform, talk about such things as co-ops is just so much rearranging of the deck chairs on the Titanic.

  • sue

    To Jack May;

    What are you talking abuot? Spend a moment with websters.com and look up some words. Non profit doesn’t mean free, it doesn’t mean no one charges money. Maybe you like handing over your money for the PROFIT of the overpaid CEOs and shareholders. Seriously, don’t comment if you don’t know what you are talking about.

  • http://www.LPNH.org Howard L. Wilson

    A coop might work.I am a member of 2 coops, both of which work rather well.

  • Kelli

    My first preference would be single payer. I think if we could get it through, there wasn’t this fear and politicking, we would all like it in the end.

    But since that doesn’t look like it’s going to happen, I would support the public option over co-ops. What makes up my mind is hearing that – to my surprise! – my insurance is a co-op (HealthPartners). I feel the premiums are too high and the coverage is the same or worse than I had with Medica.

    With either one I am now more convinced that the other elements of reform, like not being able to deny coverage and also requiring everyone to have insurance, will be more important in making either one work or not. Just to create co-ops in the current system? Nope.

  • jonerik

    Co-ops do work but not for health care. We tried health co-ops in the 1980’s and 1990’s. They were called HMOs and everyone hated them. Who belongs to an HMO any more?

    The co-op model is being offered as some kind of alternative to the public option without considering that some of the most successful co-ops, the rural electric and rural telephone co-ops were heavily subsidized by the federal government and were part of a multifaceted approach to public power in the 1930’s through the 1960’s. This included municipalization bt it also included the big dam building projects like the TVA, subsidized building of coal plants and nuclear plants. Few people know this but the federal government has paid for buiding most of the mileage of power transmission lines in this country, much of which was to transport public power to electric co-ops.

    Politicians like Baucus and Kent Conrad are trying to promote this model for health care without the public subsidy which is either misguided or dishonest. In my mind, these “blue dogs” are selling out the country to the moneyed insurance industry in the hopes of future lobbying sinecures. Their proposals are not good faith proposals for reform of health care.

  • Mary C Miller

    I think a true cooperative might work. However, I do not believe Health Partners is an example of a cooperative. A coop would be like the cheese factories in Wisconsin that are owned by the farmers, who employ the staff at the factory.

    I think it could work if we buy into the cooperative with our “premiums” and then we employ the doctors, nurses and office staff. Then we, as members, share in the profits at the end of the year so the patients are the stockholders of the cooperative, NOT THE DOCTORS. I adore my doctor and I’m sure he doesn’t realize he and the insurance company put such a squeeze on me that I no longer have health insurance.

    The way I see it, the doctors own the clinics and they want to make money. The health insurance companies take our premiums but don’t want to pay for our health care. All they try to do is get out of it which makes them pretty CROOKED. The bottom line is we, the patients are fueling the system with our money and getting squeezed out of the benefits between the two profit-making ends of the deal. By the way, I don’t think there is such a thing as a non-profit in MN. That just means they don’t pay taxes. What a deal!

    Oh, and by the way, Health Partners is a system of clinics and insurance in one. That also seems like a conflict of interest there — among other things

  • http://www.healthdemocracy.org Paul Glover

    Members of the Ithaca Health Alliance are secured from costs of 12 everyday emergencies, to specified maximums, anywhere in the world, for $100/YEAR. They also own their own free clinic, providing standard and holistic care.