Medical Co-ops – Vermont Lags Behind

Cross-posted from www.asrblog.com

The Green Mountain State is often cited during national conversations about progressive ideas: local food production, CSAs, green technology, recycling programs and energy efficiency are all areas that Vermonters hold in high esteem and for which we receive recognition.  Co-op models are also present all over the state in the form of numerous credit unions and food cooperatives, engaging members and returning profits to them rather than shareholders, which is the case with banks and supermarkets.  So what about healthcare?  We have Bernie Sanders leading the charge on single payer, even requesting that Vermont be the pilot state for such a project, yet it has not gained traction.  I believe the reason lies with the old fashioned private vs public sector difference: entities like food co-ops and credit unions are privately run and provide good service to those who choose to invest, opposed to government initiatives which get tied up in beaurocratic BS, spending money they didn’t earn and get no where.

So how are we to address healthcare reform if the public option can’t pass the Senate, medicare will be bancrupt in less than a decade, and people remain uninsured?  Democratic Senator Kent Conrad of North Dakota proposed and has been advocating for Medical Co-ops, arguing that there’s the interest for such entities across the country (especially in the North East and North West) and his sources say they would insure 12 million people while driving down price through increased competition.  Well, I like the sound of that, locally based co-op models providing free market competition is double whammy Libertarian, though Senator Conrad has not explained exactly how he envisions Washington DC encouraging and nourishing these entities, which leaves me with skepticism about him.  The principle is good though and he references the success of small co-op models in his own state, large co-ops like Ocean Spray, and the one successful medical co-op in the country GroupHealth.

GroupHealth was established in Washington state in 1947 and now provides medical care to 580,000 residents of Washington and Idaho.  They have their own medical facilities to provide general and specialized care and 2/3 of their members use these facilities exclusively.  There are in-network doctors at many other locations and out-of-network coverage is reasonably priced.  Research is also conducted at the Group Health Center for Health Studies, having published over 1800 scientific articles since 1983, funded by both private and public grants.

This highly successful co-op is the one example that proves wrong all those who dismiss Conrad’s suggestion as impossible to accomplish, stating that established insurance giants have too much control of the landscape to allow such entities to thrive.  There is some truth there, for instance the state of Iowa passed legislation to encourage the development of health co-ops in 1990 and the one that attempted to open died after two years.  But GroupHealth exists and the question that blares out in my mind is “why is it not in Vermont?!”

Perhaps it is because many Vermonters love medical doctor Howard Dean who believes in the government solution public option, or because many Vermonters love Bernie Sanders who champions single payer.  I believe these are poor leads to follow and that Vermonters need to address their healthcare needs the same way many have addressed their agricultural and banking needs.  I’ll repeat, GroupHealth has 580,000 members, which is just shy of the entire population of Vermont; we need to apply the co-op model to our health system, leaving Montpelier out of it as much as possible and certainly DC completely out of it.  Howard Dean and Bernie Sanders are too far removed from the state and jaded by big government philosophy, it’s time for Vermonters to take care of Vermonters.

9 thoughts on “Medical Co-ops – Vermont Lags Behind

  1. If GroupHealth, arguably the only (moderately) successful medical coop in the country, “has 580,000 members, which is just shy of the entire population of Vermont” what’s the difference between that model, versus a publicly financed, state-wide single payer system – coupled with state-administered medical facilities – for Vermont?  And why “leave Montpelier out of it” when that would ensure that the system is ultimately accountable to the voters – i.e. “members”?  There’s no reason why a single payer system couldn’t have a publicly accountable board of directors, commission, whatever-you-want-to-call-it, decision-making body, to ensure “member” (i.e. voter) input, just like a co-op has.  Furthermore, since Vermont already has a relatively (albeit imperfect) progressive income tax structure, a sliding-fee payment structure would already be built in for this taxpayer financed, single payer, universal Vermont health care system.

    Your knee-jerk, unsupported, public-sector-bashing notwithstanding, perhaps you have more in common with Bernie than you care to admit.

  2. Medicare is NOT going bankrupt. It is a tax funded program, and as long as tax revenues are appropriately raised there is no such beast as bankruptcy in Medicare’s future.

  3. Group Health in Washington and Health Partners in Minnesota (660,000 members) are basically health maintenance organizations (HMOs).  They employ their own doctors and nurses, and operate their own clinics.  Rather than the traditional fee-for-service model, they accept negotiated and fixed payments for which they provide all the care necessary for their members.  Neither group has been immune from problems. Both HMOs have been referred to as “Group Death” for their practice of withholding or denying care. While this characterization may be unfair, both groups have raised premiums faster and higher than the rate of inflation.  Last month, for instance, rates for Group Health individual policies jumped by an average of 13 percent. That followed a 9.7 percent increase the year before.  Trying to replicate this model in various geographic locations around the country would not create the power necessary to limit costs, and negotiate effectively with drug companies, hospitals, etc.  They do emphasize preventive care, but so would any public option being considered.  

  4. by and large the refuge of the Dems taking the insurance industry $$$ that want to give some sort of facade of some sort of “public” thing. What we should really be asking is what right does the private sector even have to be entrusted with healthcare delivery (and no, I don’t mean doctors or people that make equipment- I mean insurance companies)? We go from this de facto position that this is the way it should be, without any evidence. Kinda like creationists.

  5. Perhaps it is because many Vermonters love medical doctor Howard Dean who believes in the government solution public option, or because many Vermonters love Bernie Sanders who champions single payer.  

    Or perhaps in this case many Vermonters actually know what the hell they’re talking about and know it’s the best solution to the problem, not the so-called “free” market bullshit that’s running this country into the ground.

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