# Why Isn't non profit co-op health care as good as a public option? **URL:** \ **Category:** Great Debates\ **Created:** [August 20, 2009, 2:36am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024 "2009-08-20T02:36:44Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![cosmosdan](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@cosmosdan](https://boards.straightdope.com/u/cosmosdan)\ **Post date:** [August 20, 2009, 2:36am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/1 "2009-08-20T02:36:44Z")
I hear Howard Dean and others saying that a co-op is crap and we must have a public option, but I’m wondering why a non profit co-op isn’t as good or isn’t the right step in the right direction at this time. Sure, blue cross and blue shield started off as a co-op and then got messed up. That doesn’t mean that’s going to happen now, especially if we know and structure it differently with better safeguards and add insurance reform in the mix. If the general public can get off their ass and offer enough support for a public option then great. If not, then why not a non profit co-op offered to force insurance companies to compete. ---
**Author:** ![picunurse](https://avatars.discourse-cdn.com/v4/letter/p/7bcc69/32.png) [@picunurse](https://boards.straightdope.com/u/picunurse)\ **Post date:** [August 20, 2009, 2:46am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/2 "2009-08-20T02:46:08Z")
We belong to a healthcare co-op, Group Health. We get great care, for a fair price. ---
**Author:** ![Gary\_Robson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/gary_robson/32/3448_2.png) [@Gary\_Robson](https://boards.straightdope.com/u/Gary_Robson)\ **Post date:** [August 20, 2009, 4:30am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/3 "2009-08-20T04:30:24Z")
\ I’m shipping this one off to a happier home in Great Debates. \ ---
**Author:** ![cosmosdan](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@cosmosdan](https://boards.straightdope.com/u/cosmosdan)\ **Post date:** [August 20, 2009, 12:31pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/4 "2009-08-20T12:31:42Z")
okay, Howrd Dean was the guest on NPRs on point. He talked about what he did in Vermont to improve Health Care which is insurance reform that is contained in the bill. I can support a single payer system but I don’t see that happening now. I’d like to make what progress we are able to now and then continue the fight. So, anybody, why wouldn’t co-ops offer a similar benefit, non profit alternatives to big insurance along side insurance reform? If non-profit co-ops gain widespread popularity wouldn’t that have the same effect? What happened to blue cross and blue shield? Do we need to assume it will happen again or can we prevent it from happening this time around? Can the Dems use this to demonstrate that the GOP doesn’t support health care reform at all? ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [August 20, 2009, 1:56pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/5 "2009-08-20T13:56:22Z")
Well, several Republicans, especially ones from the Midwest where coops have a pretty long history, have already said they support them. As always the devil is in the details. Incidentally, I just read a wonderful article in the new Atlantic. It contains some fascinating insights into American medicine and possible solutions, and should be read by anyone interested in the topic. [How American Health Care Killed My Father.](http://www.theatlantic.com/doc/200909/health-care) ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [August 20, 2009, 2:01pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/6 "2009-08-20T14:01:12Z")
But, of course! The big insurance companies will fall all over themselves to welcome this bright new addition to the marketplace. Most of the bigger execs are Republicans, I expect, and their devotion to entrepreneurship and competition is the stuff of legend! And if it costs them a slice of their profitabillity, I have no doubt that they will be eager to perform this sacrifice to the common good. Me? Tequila and bongwater, why do you ask? ---
**Author:** ![Sateryn76](https://avatars.discourse-cdn.com/v4/letter/s/a88e4f/32.png) [@Sateryn76](https://boards.straightdope.com/u/Sateryn76)\ **Post date:** [August 20, 2009, 5:22pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/7 "2009-08-20T17:22:20Z")
> [@Mr.Moto](#): > > Well, several Republicans, especially ones from the Midwest where coops have a pretty long history, have already said they support them. As always the devil is in the details. > > Incidentally, I just read a wonderful article in the new Atlantic. It contains some fascinating insights into American medicine and possible solutions, and should be read by anyone interested in the topic. > > [How American Health Care Killed My Father.](http://www.theatlantic.com/doc/200909/health-care) I just finished it, and this should be required reading for everyone. It lays out the issues with both the current system, and the Obama plan, and points out all the flaws. It’s not conservative - it’s just reasonable, and relies heavily on economics and the problems of low-income citizens. Just fantastic - I have bee looking for something like this… ---
**Author:** ![Richard\_Parker](https://avatars.discourse-cdn.com/v4/letter/r/35a633/32.png) [@Richard\_Parker](https://boards.straightdope.com/u/Richard_Parker)\ **Post date:** [August 20, 2009, 9:37pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/8 "2009-08-20T21:37:41Z")
One difference between a non-profit co-op and a public option is simply the scale. The public option will be a massive insurance organization that will be able to negotiate lower prices like Wal-Mart does. ---
**Author:** ![TheMadHun](https://avatars.discourse-cdn.com/v4/letter/t/53a042/32.png) [@TheMadHun](https://boards.straightdope.com/u/TheMadHun)\ **Post date:** [August 20, 2009, 10:45pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/9 "2009-08-20T22:45:35Z")
Giant insurance companies can and do crush each other all the time. It’s called “shaking out the marketplace”. A new co-op would be easy to crush. Only if it started big could it hope to stay big. ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [August 20, 2009, 11:48pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/10 "2009-08-20T23:48:37Z")
> [@TheMadHun](#): > > Giant insurance companies can and do crush each other all the time. How do they achieve this? By poaching each other’s customers? If so, I imagine the customers of a co-operative, being the _owners_, would have more likely than most to stick with their current insurer. ---
**Author:** ![treis](https://avatars.discourse-cdn.com/v4/letter/t/bc79bd/32.png) [@treis](https://boards.straightdope.com/u/treis)\ **Post date:** [August 21, 2009, 12:06am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/11 "2009-08-21T00:06:03Z")
> [@Mr.Moto](#): > > Well, several Republicans, especially ones from the Midwest where coops have a pretty long history, have already said they support them. As always the devil is in the details. > > Incidentally, I just read a wonderful article in the new Atlantic. It contains some fascinating insights into American medicine and possible solutions, and should be read by anyone interested in the topic. > > [How American Health Care Killed My Father.](http://www.theatlantic.com/doc/200909/health-care) Articles like this annoy the piss out of me. For example: > [@](#): > > By contrast, consider LASIK surgery. I still lack the (small amount of) courage required to get LASIK. But I’ve been considering it since it was introduced commercially in the 1990s. The surgery is seldom covered by insurance, and exists in the competitive economy typical of most other industries. So people who get LASIK surgery—or for that matter most cosmetic surgeries, dental procedures, or other mostly uninsured treatments—act like consumers. In comparison, he offers his wife’s pregnancy: > [@](#): > > Several years later, when we were preparing for the birth of our second child, I requested the total cost of the delivery and related procedures from our hospital. The answer: the hospital discussed price only with uninsured patients. What about my co-pay? They would discuss my potential co-pay only if I were applying for financial assistance. He uses this to show his main argument, but he misses the glaringly obvious and most important point. If someone can’t afford LASIK they won’t get it because they can always wear glasses or contacts. If they couldn’t afford for his wife to be taken care of during delivery what exactly would they do? Not deliver the baby? Of course not. That is the major reason why health care isn’t a free market. The consumer has no realistic option of not purchasing care. Then there are the bizarre things: > [@](#): > > Insurance is probably the most complex, costly, and distortional method of financing any activity; that’s why it is otherwise used to fund only rare, unexpected, and large costs. Imagine sending your weekly grocery bill to an insurance clerk for review, and having the grocer reimbursed by the insurer to whom you’ve paid your share. An expensive and wasteful absurdity, no? Of course not. Insurance pays for routine care because encouraging their customers undergo routine care drives down their payouts in the longrun. Other types of insurance give you a discount for actions that reduce the insurance companies payout in the long term. It isn’t a unique or market distorting aspect of health care. > [@](#): > > Cost control is a feature of decentralized, competitive markets, not of centralized bureaucracy—a matter of incentives, not mandates. Oh really? So that’s why our decentralized, competitive market pays 50-75% more for similar heath care than other comparable countries with a centralized beraucracy. > [@](#): > > From 2000 to 2005, per capita health-care spending in Canada grew by 33 percent, in France by 37 percent, in the U.K. by 47 percent—all comparable to the 40 percent growth experienced by the U.S. in that period. Cost control by way of bureaucratic price controls has its limits Of course we wouldn’t want to look at raw numbers. No, lets obscure the fact that the growth in U.S. health care expenditures vastly outstripped our “socialist” brethren by hiding it in percentage growth. There are two assumptions (1) Government makes things more expensive and (2) free market makes things cheaper. Therefore how can I show that health care is expensive due to the government. It doesn’t even consider the possibility that in the case of health care a single central bueracracy is more efficient than the market. It doesn’t explain why or how other Industrialized countries can deliver comparable care for 60% of the cost, and it doesn’t attempt to explain why our administration costs are so much higher. It’s dogma, not a fair and honest look at health care systems. ---
**Author:** ![cosmosdan](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@cosmosdan](https://boards.straightdope.com/u/cosmosdan)\ **Post date:** [August 21, 2009, 1:52am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/12 "2009-08-21T01:52:20Z")
> [@elucidator](#): > > But, of course! The big insurance companies will fall all over themselves to welcome this bright new addition to the marketplace. Most of the bigger execs are Republicans, I expect, and their devotion to entrepreneurship and competition is the stuff of legend! And if it costs them a slice of their profitabillity, I have no doubt that they will be eager to perform this sacrifice to the common good. > > Me? Tequila and bongwater, why do you ask? Sarcasm noted. Anything else? ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [August 21, 2009, 9:40pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/13 "2009-08-21T21:40:32Z")
> [@treis](#): > > He uses this to show his main argument, but he misses the glaringly obvious and most important point. If someone can’t afford LASIK they won’t get it because they can always wear glasses or contacts. If they couldn’t afford for his wife to be taken care of during delivery what exactly would they do? Not deliver the baby? Of course not. That is the major reason why health care isn’t a free market. The consumer has no realistic option of not purchasing care. Uh huh. But I remember what we did when my wife was pregnant - we chose a preferred hospital, found an OB/GYN practice that suited us, made decisions about childbirth classes and childbirth after cesarean. All of these things were available through a marketplace - except for pricing information that was kept totally in the dark. While there were itemized bills there was no guarantee that these prices reflected reality in any way - they were negotiated rates between insurer and hospital. Indeed, we know the hospital wanted more money that insurance wouldn’t pay - they settled for less. I do not think in an ideal world people would not purchase care - but they might price it out. We do this on a limited basis now, since for most of the year we have to pay essentially full retail for our prescription drugs out of our medical savings account. This does give us an incentive to ask the doctor for cheaper alternatives, which have been available from time to time. Americans are pretty sophisticated consumers - it seems to me that they could handle decisions like this pretty well as long as the prices were known. And incidentally, preventive care needn’t suffer - my plan covers it 100%. ---
**Author:** ![elucidator](https://avatars.discourse-cdn.com/v4/letter/e/8edcca/32.png) [@elucidator](https://boards.straightdope.com/u/elucidator)\ **Post date:** [August 21, 2009, 9:53pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/14 "2009-08-21T21:53:29Z")
> [@cosmosdan](#): > > Sarcasm noted. Anything else? Sarcasm intended, and in spades! Look, **Cosmo** , the right is totally in the bag for the insurance companies on this. They cannot, repeat, cannot accept any viable compromise, because any viable compromise will benefit people who vote. And its far, far too late for the Pubbies to turn around and try to glom credit. The more people it benefits the worse it gets for the Pubbies, and the worse for insurance companies. Big Money hates anything that might cause any disadvantage to itself. If the right is pressing the co-op option, sure as you’re born, they know it will be nothing. Because nothing is all they can accept. In fact, if they can pass something that’s actually bad for the people, they win, because people will blame Obama! Their self-interest as a party is in direct conflict with the public good. Got any doubts about what they’ll choose? ---
**Author:** ![Rumor\_Watkins](https://avatars.discourse-cdn.com/v4/letter/r/d9b06d/32.png) [@Rumor\_Watkins](https://boards.straightdope.com/u/Rumor_Watkins)\ **Post date:** [August 21, 2009, 10:00pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/15 "2009-08-21T22:00:20Z")
> [@Mr.Moto](#): > > All of these things were available through a marketplace - except for pricing information that was kept totally in the dark. I hope the atonal internet made your sarcasm come across as seriousness. ---
**Author:** ![cosmosdan](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@cosmosdan](https://boards.straightdope.com/u/cosmosdan)\ **Post date:** [August 22, 2009, 2:41am UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/16 "2009-08-22T02:41:32Z")
> [@elucidator](#): > > Sarcasm intended, and in spades! Look, **Cosmo** , the right is totally in the bag for the insurance companies on this. They cannot, repeat, cannot accept any viable compromise, because any viable compromise will benefit people who vote. And its far, far too late for the Pubbies to turn around and try to glom credit. > > The more people it benefits the worse it gets for the Pubbies, and the worse for insurance companies. Big Money hates anything that might cause any disadvantage to itself. If the right is pressing the co-op option, sure as you’re born, they know it will be nothing. > > Because nothing is all they can accept. In fact, if they can pass something that’s actually bad for the people, they win, because people will blame Obama! Their self-interest as a party is in direct conflict with the public good. Got any doubts about what they’ll choose? OKay. Can I point out my question wasn’t about the pubbies or the Dems per say. I heard the co-ops spoken of as a possible compromise to the public option. Dean says the co-ops won’t work and the public option is the only real reform. Without supporting either party or either alternative I’m asking why is that so. Why aren’t non profit co-ops a reasonable alternative, not based on what the pubbies want but based on the facts and perhaps what the public seems to support. Dean said the GOP won’t support the co-ops either which only gives further evidence that they don’t want reform at all in any form {like you said} OKay, so screw them. My question is about the two alternatives and what are the specific reasons non profit co-ops won’t work? ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 10, 2009, 1:31pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/17 "2009-09-10T13:31:09Z")
I would welcome the co-op-ization of health care. We could confiscate the health insurers & transfer ownership to their clients, who would become members. Short of that, I’m not sure why we a bill to create co-ops. Is it not legal to form a co-op now? ---
**Author:** ![YogSothoth](https://avatars.discourse-cdn.com/v4/letter/y/8edcca/32.png) [@YogSothoth](https://boards.straightdope.com/u/YogSothoth)\ **Post date:** [September 10, 2009, 4:10pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/18 "2009-09-10T16:10:13Z")
> [@foolsguinea](#): > > Short of that, I’m not sure why we a bill to create co-ops. Is it not legal to form a co-op now? This wins the topic. The whole pedantic case for co-ops are irrelevent. Its legal now, people can join them now, and if it were a better alternative, it would have been done already. But its not. The reasons are many and myriad, but it mainly comes from the fact that a small start-up is much more vulnerable than an established corporation ---
**Author:** ![Kearsen](https://avatars.discourse-cdn.com/v4/letter/k/82dd89/32.png) [@Kearsen](https://boards.straightdope.com/u/Kearsen)\ **Post date:** [September 10, 2009, 4:16pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/19 "2009-09-10T16:16:07Z")
> [@elucidator](#): > > But, of course! The big insurance companies will fall all over themselves to welcome this bright new addition to the marketplace. Most of the bigger execs are Republicans, I expect, and their devotion to entrepreneurship and competition is the stuff of legend! And if it costs them a slice of their profitabillity, I have no doubt that they will be eager to perform this sacrifice to the common good. > > Me? Tequila and bongwater, why do you ask? I hear this same stance from you, repeatedly. What does big insurance have to do with how we structure health care? Big Insurance be damned. Many times over, republicans, conservatives and libertarians have ‘put forth’ discussion on why it HAS to be this one way and you have yet to dispute any of it. Sarcasm flows forth with no input into the discussion at hand. Yet again, it holds true. As to the OP: I personally feel many conservatives (libertarians as well) would enjoy the prospect as it goes along the lines of health care reform without governmental control. And has been stated earlier, it is legal now and would require little government intervention. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [September 10, 2009, 7:54pm UTC](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024/20 "2009-09-10T19:54:26Z")
> [@YogSosoth](#): > > This wins the topic. > > The whole pedantic case for co-ops are irrelevent. Its legal now, people can join them now, and if it were a better alternative, it would have been done already. But its not. The reasons are many and myriad, but it mainly comes from the fact that a small start-up is much more vulnerable than an established corporation The sort of people who can run a large co-op can also run a large corporation, these guys want things like stock options. Co-ops cannot become big without state support. Is the OP suggesting state supported co-ops? [Next page](https://boards.straightdope.com/t/why-isnt-non-profit-co-op-health-care-as-good-as-a-public-option/507024.md?page=2)