Try and find something about Health Cooperatives on the internet and you will find exactly two successes,
"the two most successful modern examples of cooperative health systems are HealthPartners, based in the Twin Cities of Minnesota, and the Seattle-based Group Health Cooperative".
The number of failures is much, much larger,
"The cooperative landscape is certainly littered with failures. Group Health Association in Washington, D.C., for example, failed in the early 1990s after intense conflicts between consumer-led management and the medical group. Another large cooperative, Group Health Inc. (GHI), in New York City, is preparing to convert to for-profit status. Surrounded by a marketplace that provides substantial rewards to for-profit insurance and fee-for-service care, these organizations have moved away from the original consumer-led governance structure and mission."
Read more here:
http://www.commonwealthfund.org/Content/Blog/Health-Cooperatives-The-Way-Forward.aspx
We can have private option/health cooperative option/public option but the health cooperative option will not be a viable alternative to the public option for three reasons: 1) Viability. Health cooperatives success record is very spotty and can only succeed when they have sufficient critical mass in a particular area to generate cost savings. Even if that condition is met it can still fail. The two that work have over 600,000 (considered the 'break even point') in a relatively close geographic area so that they can own their own buildings and employ their own medical personnel. Ironically cooperatives will provide less options for those conservatives who don't want somebody to get between them and their doctor. You will have to go to cooperative employed doctors.
2) Universality. Extending from 1) above there will simply be areas that will never be serviced by health cooperatives. Health cooperatives that do not own their own infrastructure will not be able to compete with any advantage.
Rural areas and urban areas that have more than one cooperative will be as expensive as private plans and likely unable to sustain health cooperatives.
3)'Solidarity'. This is the moral issue. The issue that the current debate does not address. Why do other countries system work so well? Because they accept the moral principle that health coverage should be born equally among the whole population.
Germany - the inventor of modern social 'solidarity'.
This concept didn't 'pop' out of the air. It has a very particular history, originating in Germany hundreds of years ago:
But in Germany, the idea that employment and health care costs should be linked goes back centuries.
It originated in medieval craft guilds. Groups of blacksmiths, goldsmiths, carpenters and bakers banded together to make rules on who could practice their crafts. They also evolved a response to illness and injury — something that threatened every member's livelihood.
Each guild member paid into a fund to support the families of those who became sick or were injured and paid funeral expenses for those who died. These death benefits existed until 1989, when they were dropped much to the consternation of German undertakers.
Such early "sickness funds" gave rise to the nonprofit health insurers that today cover 88 percent of all Germans from childhood through their working lives and into retirement.
In a strange twist this concept, known as 'solidarity' was introduced by one of the most conservative and reactionary European leaders, Bismark;
Bismarck was no leftist. In fact, he got the Reichstag to pass laws against socialism, trade unions and the Social Democratic Party. But he realized the government needed carrots as well as sticks to win Germans' loyalty to the new state. The 1883 statute was Bismarck's first big carrot, followed by disability coverage and then old-age pensions.
In Germany everyone pays the same percentage of income for health care, whether they are pauper or Bill Gates. They do it willingly for the entire population has endorsed the principle of 'solidarity'. Read more about the history of solidarity
http://www.npr.org/templates/story/story.php?storyId=92189596http://en.wikipedia.org/wiki/Health_care_in_Germany
Canada incorporated the principle of solidarity into the Canada Health Act of 1962:
Since 1962, Canada has had a government-funded, national healthcare system founded on the five basic principles of the Canada Health Act. The principles are to provide a healthcare system that is: universally available to permanent residents ; comprehensive in the services it covers; accessible without income barriers; portable within and outside the country; and publicly administered.
You can find details of how other countries have incorporated the 'solidarity' principle into legislation here:
http://journals.democraticunderground.com/grantcart/188
Conclusion;
A public option, even a flawed public option (as some DUers have opined) is an important structural change.
Once established it provides a working tool to build public support for the idea of solidarity.
It establishes a track record of government effectiveness in handling health insurance.
It will create a political constituency for people who will want to expand its service in the future.
Finally it will inevitably lead to a single payer system and dramatically increase the quality of life for millions of people, including poor people and anyone who is burdened by major health catastrophe, and everyone will know that the Republican Party fought it and the Democratic Party made it happen.
If the health care bill does not have a strong public option it is better to pin the defeat on the Republican Party and campaign and win real reform in 2010. I say this knowing that my family would most likely benefit more with passage of a compromise bill with no public option.
The public option doesn't stand for simply being more practical, it opens the path for us to advance what many of us consider the basic principle of the Democratic Party:
Achieving a higher quality of life for the whole of society by advancing the principle of social solidarity and providing more social justice for the poor and the vulnerable.
Public Option and ultimately Single Payer isn't something we are for, it is who we are.
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