It is hard to know where to begin with Ezra Klein’s assessment of Sen. Kent Conrad’s “compromise” proposal to establish member-owned “co-ops” instead of a government-sponsored “public” health insurance option. Klein thinks the co-ops might work, but he fears Congressional progressives will not accept the idea as compromise. How did the debate get this confused?
You’d think we’d never thought of non-profits or the co-op model before, but the nation has some 29,000 different co-ops, most of them local and designed to help individual sellers or individual buyers aggregate their market power, pool risks and achieve economies of scale.
Moreover, we’ve had co-ops in health care for years in several states; they’re just called something else. [Updated: That's fine, but where's the evidence they've made a significant dent in the underlying problems in our national health care system?]
Conrad’s co-op approach adds nothing new to solve those problems. It’s a distraction, and meant to be one.
There are several questions I wish Klein had asked Conrad in his interview, because the answers to those questions are critical when comparing a robust public plan with the still unspecified details of Conrad’s co-ops. For example:
1. What entity would have the responsibility to ensure that one or more co-ops meeting the requirements (yet to be defined) were formed for every region in the country – and if it didn’t do that, how would you achieve universality? Would we leave that up to each state, and then watch co-op formation drag on in the worst states for the next decade?
2. Does anyone seriously believe that getting this approach applied on a universal scale would not involve major federal direction, mandates, sanctions and funding, followed by continuous/permanent federal oversight?
3. What entity would determine whether a co-op had sufficient scope and scale to achieve the (still undefined) criteria for viability, efficiency and bargaining power? Does anyone seriously believe that anything short of a full federal involvement in those questions would be essential?
4. Assuming we could overcome these enormous obstacles, what entity would be responsible for policing the policies and practices of the state/regional co-ops? Are the advocates suggesting, when they claim member-owned co-ops would get government control out of the picture, that every co-op would voluntarily establish and enforce solid non-discrimination and other fairness rules to protect consumers? Who would police the co-ops, and how effective would that system be?
5. If/once it became clear that co-ops would have to be huge – as Robert Reich notes — to achieve economies of scope/scale and to provide a strong competitive alternative to the increasingly concentrated private system, how could a member-owned and member-operated co-op system function without taking on all the attributes of national governance? It’s one thing to organize a co-op to sell New England cranberries or Wisconsin butter, but where is the successful model for a national-scope health care system?
6. Who would be eligible to receive co-op health insurance coverage? A robust public plan would be open to everyone, including those who did not like or want what they have and those who currently don’t have coverage. Real competition means that consumers could freely choose to walk away from what they have and choose something different, with no restrictions, waiting periods or other rules to discouraging shopping. No such open access requirement for the co-op concept has been promised. Why not?
7. If the co-op is only open to those who currently don’t have coverage, or who work for small businesses, as originally suggested, how does that limitation put any competitive pressure on the current private insurance system, which simply fails to cover these consumers today?
In sum, it is hard, to conceive of a viable, workable co-op model on the scale needed that does not de facto fail unless it turns into a robust government-sponsored public plan. It’s hard to conceive of a workable co-op model that deals with universality, while treating consumers fairly, without major federal direction and continuous oversight.
Even if there were a national co-op large enough to compete with the private plans, there is no reason to believe that the total system would solve the underlying problems of industry concentration, discrimination, private system rationing by price, exclusion of high-cost patients and – critically important — the perverse incentives of the existing for-profit compensation paradigm, the very problem for which the President said, "this is what we have to fix."
All of these problems will require strong federal direction and oversight to force genuine reform of how the system operates today. At a minimum, we need a robust government-sponsored alternative to keep the private insurers honest, and strong federal direction to change how the perverse incentive structure leads to excessive costs.
The co-op model falls woefully short in all the ways that matter. It is both dishonest and irrational to think that a proposal expressly designed to preclude federal oversight has any chance of achieving meaningful reform.
How about some answers to these questions, Congress.
More on Conrad Co-ops:
mcjoan/DKos, Conrad against public option, pushes co-ops
Igor Volsky/WonkRoom, Baucus: We might replace public health option with a co-op
Robert Pear, NYT Caucus, Coop Plan emerging as Senate option
Robert Reich, The latest public option bamboozle, and how to recognize the real thing
Open Secrets, Sources of Kent Conrad’s campaign donations
Matthew Yglesias, UK Conservative Love Socialized Medicine
Rep. Lynn Woolsey, Progressive Caucus principles for robust public plan



38 Comments







Here is one answer: according to Open Secrets, Kent Conrad has taken $219,675 from the Insurance industry.
thank you. that’s going right in.
The whole health care legislation debate certainly shows very clearly that we need public finance of elections. The biggest complainers and heel-draggers over single payer are the ones who are the most on the take from the insurance industry is what it’s looking like to me.
I’d add further questions.
As you point out, coop members will be unable to oversee the day-to-day operation of such large organizations and will have to rely on professional, executive management and some sort of organizational rules. So how do we structure coop governance and management to avoid conflicts of interest and collusion with suppliers and nominal competitors?
Second, how are these coops different from mutual insurance companies or the old Blue Cross/Blue Shield? What new solutions re being offered and why will they work?
I have to wonder how happy the members of the agricultural coops and REAs that inspired this really are with the way their coops are run. From what I have heard and read, it’s like anything else: a few influential persons have a disporportionate say and reap disproportionate advantage, for which the membership pays. Somehow, the bylaws always seem to accommodate the bigshots by making it hard to enforce change with mere votes.
Link to background on health care coops
http://www.ncba.coop/abcoop_health.cfm
Another bit of info. about Kent Conrad and his top donor: according to Open Secrets, it’s DaVita Inc., which is “a leading provider of dialysis services in the United States.” Their donation to Conrad: $47,900.
Sorry. Thought I’d failed to post my comment.
This is it for me. Why join a co-op, that will most likely limit your choices…isn’t that what HMO’s do now?
Could a co-op operate on a members-by-election program…that is, could they discourage members who are sicker than most or more costly?
And, as robspierre notes, a few influential members have a disproportionate advantage.
And I just see more rivers of red tape with this kind of program…
Scarecrow, thanks for keepin’ on posting about this slimeballs crap; also see my response to your post about ‘Did Dem’s lie’ etc.
Conyer’s remark about ‘the most popular option being rejected/not discussed by the Democratic Party’ was so ‘on point’ yet no msm picked up on it.
Consider that if you erase the health insurance part of the industry and replace it with the gov’t as insurer that you eliminate a lot of the profits taken out of the system by private insurers, but it doesn’t directly affect the health care costs at all. Doctors & hospitals still set their prices. Actually, they might even increase their prices to soak up that ‘profit’ lost by insurers. What’s to prevent them from doing that?
If the current industry thinks it isn’t profitable (or that it’s a net loss) to cover some 50M people, then adding them to a single-payer insurance pool would increase cost to insure instead of saving money.
We already spend far more on the industry now than we need to cover everyone AND lower costs, so what we need is to use our health dollars better.
A public option (as currently described) ADDS dollars to the system and taxes the public who already pay for insurance. Why should someone who already pays for insurance be happy about being taxed to pay for another person’s new policy? It’s a losing proposition for politicians.
A co-op doesn’t guarantee more people getting insurance and doesn’t necessarily compete well and adds more money to the industry. That’s the wrong direction.
We need to directly cover everyone (as single-payer does), but without putting more money in the system. We need to simply force the industry to pay for the extra 50M people out of the current monies being paid for care.
Single-payer, so far as I know, doesn’t force better distribution of monies if you have care people refusing to work for the pay determined by a gov’t official. You could have a major disaster.
If private care people set their price then we have to pay it.
If some people still don’t get care, then we have to entice them or subsidize them. Where should that subsidy come from?
Does a co-op subsidize some people? Does it force care people to lower their prices? I don’t see it.
Belonged to a co-op, indeed one of the first medical co-ops in the nation. I no longer do. They became so bad, not allowing doctors to follow through on their diagnosis, medication, etc., that my doctor who had been with them for decades left them to work in a non-profit medical program where he said he could practcie “real medicine…” As a GP who was the doctor for my whole family, he was a good doctor and very practical about things like home remedies, children’s issues, older adult issues (he was also my parent’s doc), and the like. It was our loss and whomever’s non-profit’s gain.
After he left I went into an appointment I had made weeks before, but had sustained a bad burn (3rd degree) about an hour before the appointment. So I went there thinking I would just have to deal with both issues. She run into the room and told me, “I have exactly 15 minutes. I can either treat your wound or I can deal with why you made your appointment, but I don’t have the time to deal with both things …” I felt so sorry for her because she was obviously stressed and felt bad about it.
I now go to a public clinic, one of those ones that in the early ’70s began as a “free clinic” with dedicated doctors who really care about their patients. The doc I have now, you couldn’t find any better, and I trust her not only for myself, but she has also been with my entire family
However, thanks to the co-op this good doctor’s care is sans my mother who died early from a cancer the co-op “forgot” to follow through with and where they are known to do this, allowing the cancer to run its course and then provide hospice because it is cheaper than early treatment, and my father who suffered elder abuse from his wife who had married him merely for his money and the doc did little or nothing to report even though after my and other family members’ calls of concern, she admitted she knew it was going on. No we aren’t going to sue her. She in many ways had her hands tied legally and with the co-op that did not allow her to follow through and we understand, but unfortunately, my (by then) elderly father did not understand soon enough to leave the co-op where he had been for almost 1/2 a century …
Co-ops can be good and the one I mention for a long time WAS good. Until it began to act like all insurance cos and deny “expensive” treatments and diagnosis’s, while merely treating the symptoms, not allowing the docs to actually test for the reasons, and denying medication that is “too expensive”.
It is a shame what Conrad is doing. A damn shame!
Cat In Seattle
That is horrible. Sorry to hear how you and your family suffered.
Thanks much for sharing your experiences, Seattle Cat. As I’ve said before, the concept of a co-op is fine as far as it goes, and as you note, some can work well for time. But there’s no record on which to assume one with sufficient scale to be nationally competitive could work, nor reason to believe the idea could push the rest of the industry to change.
We’re thinking of running one or more “tell your story” posts, all from commenter contributions, so I hope you’ll watch and share your story again when that happens.
here’s another story you shouldn’t miss.
these experiences are the kind of thing that drive passion for universal health care and taking private insurance companies out — being insured is not the same thing as having access to life saving health care.
far too often it’s a matter of life and death and too close to home for this to be only an interesting intellectual exercise in policy making.
Don’t have a real high opinion of Ezra Klein, seems a little to comfortable with very minor improvements.
Just another lesson re why we DFH/bloogers are putting the traditional media out of business: they have no interest in asking the right questions, don’t do their homework.
Yeah, if you come across any critical analysis of these concepts, in the trad media or elsewhere, lemme know. I really fear we’re backing into a non-solution without asking any tough questions about how it works.
The details matter, always.
MOre ammo to throw at the politicians against single payer or a ‘public option that competes with private industry’:
“it would expose and show as clearly as anything the fact that the insurance industry is primarily concerned about making money, not about insuring people’s health and well-being.”
This sounds like an industry divide and conquer tactic.
I belong to a co-op. If fact it’s the one Conrad mentions repeatedly as a great example of how co-ops will solve all our problems. Group Health is alright, I prefer it to the 3rd party insurance model, but it is absolutely not the solution to the healthcare crisis. First of all, it still costs a lot of money. I’m lucky I have a good plan through my work, but my part to pay is still $160 per month for me, my wife, and one child. My employer pay $300 per month. If I were going to buy coverage independently, it would be nearly $500 per month. That does not include vision or dental either. This is a co-op that has plenty of competition with private insurers, but prices are still unaffordable to anyone who doesn’t get employer paid benefits.
As far as the service, I love Group Health when we need to bring our 2 year old in for every little scare we have. But when things are really bad, you still have to pay through the nose since Group Health doesn’t have it’s own ICUs, emergency rooms, surgeons, etc. You have to go through a different facility. GH will help cover the costs, but we’re still in debt from our son’s bout with pneumonia earlier this year.
How disconnected from reality would you have to be to think that this model is going to solve the problem?
Thank you very much for the insight.
Thanks much for your story. Does the co-op simply aggregate buying power, and then select a private insurer to cover the co-op members? or does it have it’s own “co-op plan”? How does that work?
It has it’s own co-op plan and you pay into it like a regular insurer. You have co-pays, deductables, set ammounts for certain services, etc. I really don’t want to make it out like it’s all bad. I definitely would choose it over a company like Aetna (which, in fact, I did, since my employer offers the choice between the two). They have the consulting nurse service, where you can call 24 hours a day and speak with a knowledgeable nurse and get advice. The people are friendly and are genuinely interested in patients, at least in my experience. When my son had pneumonia, we had to take him to urgent care, which is a service Group Health provides (BTW, Conrad is refering to Group Health when he says Puget Sound Co-op, or whatever he called it). It’s not quite an emergency room, but is for unscheduled off-hours visits that may or may not be an emergency. They did a great job there and ended up taking us over to Mary Bridge Children’s Hospital where we spent the next 2 days. The service overall was great, but it was definitely expensive. If you make an appointment, it’s likely you won’t be seeing a MD, but rather a PA (physicians assistent).
I absolutely disagree that it’s the solution to the current problem. Most people can’t afford to pay that much for Health Care, and they should not be expected to. If I had lost my job I wouldn’t have been able to afford it. And if this had happened and I didn’t have coverage, we probably wouldn’t have been so vigilant in taking our son in since the urgent care option wouldn’t have been there. We took him in as an after-thought after we had all laid down to bed and noticed he was breathing rough and we said ‘Let’s take him in, just in case.’ Who knows what would have happened if we hadn’t, his Oxygen absorbtion was in the 70’s so it could have turned out very bad. But the whole experience showed me that what-if scenario where you realize that people can easily die or get sicker than necessary because they don’t have easy access to Healthcare.
Thanks for the follow up. I sounds like a somewhat more humane alternative to the private plans. There would be questions to ask:
Has it’s existence had a material beneficial effect on the private alternatives?
Is the model sustainable if the coop takes everyone, while the private one discriminates to weed out/discourage people with higher costs?
Is the co-op plan modeled on the fee for service private system or is it different — e.g., doctors on salaries; hospitals with annual budgets, and its the expect cost overall that forms the basis for premiums?
Anyway, thanks much for the information and contribution.
Has it’s existence had a material beneficial effect on the private alternatives?
No. I’m sure someone could provide more insight than I can here, but it seems more like the private insurers have a detrimental effect on the co-op, since the co-ops cost is about the same, if not more, as a company like Aetna.
Is the model sustainable if the coop takes everyone, while the private one discriminates to weed out/discourage people with higher costs?
Group Health doesn’t discriminate based on pre-existing conditions, so that is definitely better. But see my note above on what effect that has on competitive prices.
Is the co-op plan modeled on the fee for service private system or is it different — e.g., doctors on salaries; hospitals with annual budgets, and its the expect cost overall that forms the basis for premiums?
As far as I can tell, the doctors are salaried. I checked their website to see if they provide that, but I couldn’t find it. Since I’ve never had an experience where they were pushing services, tests, etc, and are, it seems, more likely to take a cautious approach to referrals then I can only guess that they do not get kickers for pushing services that aren’t necessary.
Incidentally, while I was at their website, I found out they have an official statement on HC Reform, which you can read here if you’re interested:
http://www.ghc.org/about_gh/He…..ndex.jhtml
It’s not 100% clear, so I can’t really figure out what they’re advocating. If anyone can, I’d be interested to know where they stand now that their model is being touted as the solution by Conrad.
That’s a decent list, and more or less compatible with what the Dems have been using as rhetoric. Another encouraging sign is that the private and co-op prices are about the same. Since the co-op is supposedly non-discriminatory, that would suggest two possibilities:
1. The co-op is treating higher-cost population, but is achieving efficiencies and thus keeping it’s premiums no higher than the private, or
2. The option to choose the co-op is forcing the private option to maintain a comparable price.
It’s hard to tell, and some studies of the “market” between private insurers tends to be dominated by the largest insurers, who become price leaders — so it’s not a competitive price; it’s a leader’s price, and everyone follows the leader. There is no way to tell what the competitive price would be.
Thanks again for the information.
Ok, I found the answer on physician pay. Group Health frowns on incentifying treatments so that physicians aren’t creating financial waste. Funny thing is, as I’ve been in here today engaging in this conversation, I’ve been learning more and more about them and like them a little more now. That’s really only a comparison to our current system. Under a better system, they would not seem so great.
http://www.ghc.org/about_gh/20…..ndex.jhtml
As the Gawande article in the New Yorker emphasized, there are successful systems around the country, some non-profit, some not. But they are few and far between. There are also lots of non-profits that have many of the same problems as the typical for-profit. So the policy question becomes, how do you create a national model that becomes the national norm? The fact that our system allows a few good examples to emerge isn’t enough, unless there are powerful financial incentives (or regulation) to induce all the others to adopt the better approach. And that’s what’s missing.
So my posts on the co-op model haven’t attacked co-ops per se but rather questioned how using that can be an acceptable substitute for a strong national public plan that defines the model, backed by national oversight/regulation to push natinal acceptance. I don’t see the incentive/enforcement mechanisms, particularly when the proponents set out to avoid government control/oversight.
It’s like saying the way to fix Wall Street is to allow people to create and join co-operative savings and loans. Well, we have those, but it didn’t stop the banksters.
Great analogy. When you think about it, the whole idea of pulling the co-op model into the discussion as a solution makes no sense. Like boogiecheck pointed out, it does nothing to solve the main issue, which is that the poor, unemployed, AND self-employed cannot afford HC. The fact that there are non-profits that are currently succeeding within a for-profit system is just a way to point the other direction and say, “See, it’s not ALL bad!” My reaction is “So what?” In order for them to succeed, they STILL have to works within the broken system which excludes people on the basis of income.
It’s the same disconnected approach that Republicans are using. Their solution is to give people a tax rebate, but what the hell does that do for you if you barely have any taxable income? It’s like saying the root of the problem is that the poor and unemployed aren’t able to afford insurance because their taxes are too high, which is so ridiculously stupid it doesn’t even deserve to be acknowledged.
You/WE need you to share your story with single payer advocates like Conyers and Sanders as well as with other groups.
Another problem that was alluded to above is how is a coop going to be able to cover people who can’t afford to join? When you are at the poverty level or slightly above, it is going to be more than you can pay. And Medicaid doesn’t cover everyone at that level. The Children’s Health bill that passed this year doesn’t even cover all the kids whose parents can’t afford medical insurance, not to mention the parents themselves.
Co-ops work great for traditional products like cranberries and butter, but health insurance is a product that simply does not conform to market strategies, since the more that people actually use your product, the less money you make. Health insurers will always have to have a dumping ground for the people who actually want/need healthcare. Competition does nothing to ameliorate this situation, it only exacerbates it.
Let’s just rid the system of the basic problem: private health insurance plans. They aren’t necessary, they don’t add anything of value. One comprehensive, quality, affordable plan that covers one single risk pool that contains everybody. Simple, effective, efficient. A no-brainer.
Jane is upstairs!
Speak Out: Write Letters To Your Local Papers and Urge Members of Congress to Vote “No” On Supplemental
Kent Conrad D-ND
North Dakota
State uninsured is 11%.
State population 641,000 or less than the city of Charlotte, NC.
Demographics 93% white.
I just don’t think there are too many in ND clamoring for a public option or single payer program. Conrad needs to be persuaded by a constituent grassroots phone calling effort.
I wonder how much it would affect the current industry to have a handful of changes like more med school slots with lower student costs, no insurance co interference in doctoring, no contesting of doctors prices by insurance cos, “Best Practices” to standardize around the country, tying malpractice awards reductions to use of Best Practices and any other minimalist changes which could introduce more competition, less over-treatment and less interference with doctors and less price-gimmickry.
Would things like that make a significant dent in the system before we even tried to implement another component to deal with uninsured individuals?
Would things like that make a significant dent in the system before we even tried to implement another component to deal with uninsured individuals?
So would you rather have the uninsured individuals go on being uninsured until the new, slightly less expensive doctors have finished med school and internship? And for the other structural changes to have some effect?
Kent Conrad..traitor to the Dem Party, uninsured, poor, unemployed, America.
Correct me if I’m wrong, but doesn’t the co-op still miss on providing care to the poor and unemployed? How would one join if one couldn’t pay?
And another thought in that direction–if an area in a city is known for poverty…would a co-op even *think* of going to neighborhood/area knowing that the possibility of paying doctors, nurses, hospitals was nil? How could it operate?