During the debate over health insurance reform, Health Care for America Now created a list of principles for â€śComprehensive Health Care Reform.â€ť (They are listed on the organizationâ€™s web site (www.healthcareforamericanow.org). The second principle listed is:
â€śA choice of a private insurance plan, including keeping the insurance you have if you like it, or a public health insurance plan that guarantees affordable coverage without a private insurer middleman.â€ť
Health Care for America Now is among the progressive organizations that have cheered the passage of health insurance reform, having accepted the reality that, even with its flaws, the new system will be an improvement over the previous, even more deeply flawed system. There is something to be said for that point of view, but if we succeed in forming not-for-profit health insurance cooperatives, we can achieve a much more dramatic reform.
To keep health insurance as affordable as possible, a health care cooperative should work the way insurance is supposed to work â€” covering only major medical events. Since the plan would need to be self-funded, there is an inverse relationship between premiums and deductibles. The higher the deductible amount, the lower the premiums and vice versa. Keeping premiums low and the deductible relatively high would reduce the cost of health care significantly by doing away with any middleman in most doctor-patient interactions.
A separate type of cooperative (or plan) could also be offered with higher premiums and a very low (or no) deductible. Such a plan, modeled closely on the â€śMedicare-For-Allâ€ť model that many progressives favored, would cover most, if not all, medical expenses. Such a plan could more accurately be described as a health care cooperative. (As opposed to a health insurance cooperative.) If such a cooperative was managed as efficiently as Medicare, it would also be an improvement.
Establishing not-for-profit health care cooperatives can be done under existing laws. We donâ€™t need a super-majority in the Senate. We donâ€™t even need Congressional approval. Can we do it? Yes we can
Angry tea-partiers and disappointed liberals unite We have nothing to lose but higher health care costs. We have a much-improved health insurance system to win.