ReligionDispatches.org

I belong to a food co-op; I have for several years. It's wonderful institution and I genuinely like visiting the place, as I do (at a minimum) several times a week. It's invitingly New-Agey, has wonderful organic and Fair Trade products, and several delicious items I can't seem to find anywhere else.

The thing is, I can't imagine going there for health-care, excepting certain herbal remedies they carry.

I know, I know; that's an unfair comparison. But since "co-op" is the term du jour, and since it's no more clearly described than the terms—like "socialized medicine," and "government control of health care," and "death panels"—that preceded it, I'm entitled to my confusion, and my demand for at least a little rhetorical clarification from the so-called Gang Of Six (their term, not mine).

I mean, somebody's gonna vote on all of this, and really soon.

Let's start with this odd item: I belong to my food co-op. I know that sounds creepy, but I do.

I agreed to pay a yearly premium to become a member, and was offered the option of paying the entire five-year balance and becoming a full member immediately… which, one year into it, I decided to do. It wasn't a lot of money, and it didn't seem like a big deal, so right there the comparison to the whole health care debate seems forced and unfair.

And I'm the first one to agree that it is. Except for one thing. I'm not being told explicitly what's different about the kind of insurance co-op I'm supposed to be imagining here. So far, that's how it sounds to somebody's who's not the brightest light on the medical marquis, but who's no dummy either. It sounds like a crass rhetorical ploy designed to escape the tag of "socialized medicine." Which is wrong in the first place because, well, because we're Americans, I suppose. I dunno.

So here's how my co-op works, as nearly as I can tell (I don't really give it a lot of thought, to be honest, not nearly as much as I give to national elections and national debates, and there a lesson there for all of the "starve-the-beast" anti-federalists among us. Oftentimes, what is handled at the national level matters more, and is easier to track. There is an active press corps in Washington, DC, at least, and relatively active accountability structures.).

In any case, I now have a stake in my co-op. There are no other stock holders, and there's no board of trustees. The store simply makes business decisions intended to please nobody beyond me and my fellow co-op members. That's no small thing.

And there are other perks.

Once a month, on the shopping day of my choosing, I get a 10% discount on all my purchases. Any co-op member can work a certain number of hours in the store and receive additional discounts. Again, I see no evidence that this is the kind of thing that's being proposed for the nation's health care woes.

So what kind of co-op are we being asked to imagine? It's quite simple, actually. The fundamental key is this: it's non-profit.

Period.

The whole flap about insurance co-ops reduces to one simple principle: that the business of medicine shouldn't be a business.

Which doesn't mean that nobody should make money out of it, or get paid, for God's sake. Everybody working at my co-op makes money in one way or another. The point is that doctors and employees get paid in a not-for-profit co-op, and pharmaceutical companies get paid to provide the pills (though likely nobody will get as much anymore). But instead of stockholders clamoring for dividends, and instead of hospitals running up costs to pay their other bills, the theoretical co-op sees itself as answerable only to the (relatively local) people it serves.

And it presumably acts accordingly. I'm not sure; I've never been to a co-op board meeting.

I'm not at all convinced that the rather sketchy record of health care co-ops reported to date bears out the sudden enthusiasm for them in the legislature. They do not seem to be able to grow past a certain point… which is pretty much the whole point of a co-op. They are designed to be small and local and (a word that is very important at mine) sustainable. But it is a fascinating story already, this idea of designing a system to limit growth and contain costs. The entire hullabaloo created by the proposal of a "public option" for health care provision comes down to pretty much the same thing, except the size. Call it a "public option"; call it a "co-op." It does not seem to matter. We are trying to imagine what a not-for-profit system of medical insurance and medical care would look like, and how to make that happen most efficiently.

And the insurance companies are quite legitimately concerned that this would sound the death knell to the current system. But let's drop the town hall vitriol and call this what it is. It is a pragmatic response to two problems We The People want our leadership to get real about.

1) Skyrocketing medical costs are bankrupting the US economy. and 2) Upwards of fifty million uninsured Americans is a national scandal, and an assault upon any meaningful conception of social justice.

All the rest is fluff.