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Not-for-Profit, Award-Winning Community News and Views for Windham County, Vermont • Since 2006

Health care in your own hands

Organizers explore cooperative health care model

BRATTLEBORO—Like many people, Cheryl Connor doesn’t care for her health insurance or what she sees as regulatory bias against alternative health care.

So she and others have come up with a model for people of like minds that could appeal to a wide range of the community, from reiki practitioners to libertarians: to create their own community-owned and operated health insurance.

In the scramble to develop health-care delivery options in the wake of the federal health care reform bill and Vermont’s Act 128, the new initiative, called Holistic Health Opportunities (H2O), proposes using the cooperative model to deliver health care to its members.

Organizers looking for equal treatment of alternative health care options under the new laws are working to get H2O’s structure in place by the new year.

Conner, the mastermind behind the initiative, said the co-ops allow like-minded members to design holistic health care delivery systems.

“Everyone feels disempowered. But everyone has power within themselves and the insurance statutes,” said Conner.

According to Connor, a teacher at the Marlboro College Graduate School with a background in law, finance and management, H2O would act as an alternative to buying the commercial health insurance based on Western medicine mandated by the recent federal health care reform bill.

Co-ops won’t save money, organizers point out, but they’ll use available funds differently.

Within the co-op structure, members pool their resources, receive equal shares in the organization and split the benefits and savings equally. With a health-care co-op, members collectively buy physicians’ services, equipment and supplies.

The minimum amount of out-of-pocket and insurance rates are rising, doubling in some cases, yet customers see their available benefits diminishing, said Hilary Cooke, a Brattleboro-based consulting health insurance broker involved with H2O.

“We are motivated now [to make changes],” Cooke said. “It’s exciting.”

Driven by values

The idea behind H2O is health-care reform coupled with services that reflect the values of its members.

In Windham County, people want alternative-health options, like acupuncture, not included in Blue Cross-Blue Shield benefits, Cooke said.

H2O hosted a forum at the World Learning campus on Nov. 20, serving as a matchmaker among participants interested in developing, and ultimately joining, a health-care co-op.

Conner gave her first presentation in April at the Peace Abby in Sherborn, Mass., and forums in Rhode Island, New Hampshire and elsewhere in Vermont followed.

“Our research indicates that placing considerable emphasis on a home- and community-based model can result in considerable cost savings, as compared with traditional approaches. Many aspects of personal wellbeing can be optimized to help offset the costs of traditional care. Beyond the home, additional health resources can be accessed through both traditional and holistic service providers. This model is akin to whole-person based hospice care, applied through the entire lifespan,” said Conner.

Frustration spurs change

Conner, who lives in Massachusetts, said she committed herself to the health-care co-op initiative after the state’s health care bill “forced” her to buy unwanted health insurance. She feels the new federal health care bill is worse.

According to Conner, 40 percent of Americans use complementary medicine like herbal remedies, but the federal Affordable Care Act, passed in March, does not reflect either the numbers or the preference.

“We’ve got to energize people. There will never be a one-size-fits-all [insurance plan],” said Conner.

Conner feels it is her job to catalyze the holistic community. She believes many people are forced to pay for health insurance that does not provide their exclusive care choice.

A patch of common ground for everyone involved in the H2O initiative is “we all see the current system as bloated, fragmented and unsustainable, focusing on profit not health,” Conner said.

Cooke joined the H2O initiative out of frustration as a consultant, witnessing people also frustrated with “how out of reach the peace of mind of health care is to working people.”

“And if I work my way out of a job, so be it. I’ve reinvented myself before,” Cooke said, smiling.

“We have to find a medical home for everybody,” he added.

Wendy Webber, a psychotherapist, life skills coach and part of the core group working with H2O, said that at Saturday’s forum, everyone participated equally as co-creators without the presumption that any one person was the expert.

“I’m excited to be part of an initiative that’s trying to change things at a foundational level,” said Webber, who joined the initiative after attending a previous Windham County meeting.

Webber, inspired by Conner’s vision, said she could see a “real shift of the paradigm on many levels.”

She believes a co-op system fosters the natural human capacity to collaborate, care for one another, and to know how to be healthy.

“It brings [things] back to the basics of caring for each other,” said Webber.

How the H2O works

“It’s all about power to the people,” said Conner, who teaches a course on equity, ownership and control at the Marlboro College Graduate School.

Conner believes people should have the right to choose their own health care. For her, it’s a matter of liberty and sovereignty.

Conner believes communities can create economically viable co-ops if they break through the limits placed by the federal government and insurance companies.

Under the H2O initiative, communities would customize their own structure, model and coverage. A health-care co-op could employ herbal remedies or traditionally western medicine or both.

Regarding health-care co-ops, Conner defines “community” as whoever shows up to participate in the process and, eventually, the co-op. In general, she said, the people who have participated are the ones “inspired to think outside the box.”

As a whole, the Brattleboro community is receptive to the idea of co-ops, said Conner, who presented the idea in Brattleboro in August and October.

Conner said the H2O initiative is about shifting the health-care paradigm.

The first shift, according to Conner, requires moving away from the “illness model” of modern medicine, a system focused on symptoms and crisis management, to a system focused on “holistic, integrative and alternative” health care.

The next shift entails releasing profit-driven insurance companies and opting for a cooperative structure built around benefiting its members.

Economically, said Conner, people have acclimated to Washington D.C. and the insurance companies deciding “who gets what care at what price.” Under H2O, communities will shift to a new paradigm of designing their own menu of pay scales and care coverage.

With H2O, co-op members, not an outside insurance company, make these decisions. Right now, said Conner, people choose only from insurance companies offering the same services.

“But really, they’re offering the same brand of cereal and if you want granola you’re not getting it,” Conner said.

The final change requires prying power from the grip of “experts” and pharmaceutical companies.

“Our bodies are our own and sovereign” and it’s “our individual liberty to control them,” said Conner.

‘All about freedom’

Connor said co-op members could take advantage of different co-op structures to meet their needs.

Members could, in theory, convert an existing health clinic to a worker- or consumer-owned clinic. This traditional cooperative could be set up immediately and stand independently from other systems.

At the other end of the spectrum, said Conner, members could set up a “network” or  “multi-stakeholder” co-op among multiple hospitals, food co-ops, clinics, gyms and practitioners across Windham County.

Multi-stakeholder co-ops rely on members culled from all parts of the health-care process. A multi-stakeholder food co-op could have consumers, producers, workers and other investors as members.

Conner envisions a multi-stakeholder co-op for Windham County, but said the H2O members would choose a model that best suits the collective need.

Financially, said Conner, co-ops can connect with current federal or state funds like Medicare or finance themselves separately where members’ premiums pay for the co-op.

A group of holistic providers in Rhode Island recently founded a worker-owned co-op at their holistic health center, said Conner.

“I’m all about freedom,” said Conner.

Cooke said that in mainstream medicine, “preventative” means catching a disease early. But to the H2O participants, preventative means being motivated to prevent disease through actions like proper nutrition.

“It isn’t for everybody. Not everyone is motivated to take this sort of ownership of their health,” Cooke warned.

Cooke said the health care co-ops are one solution out of many rather than an attempt to “corner the market.” They’re about finding a home for like-minded people frustrated by today’s health-care costs.

“Start small, because we have to start somewhere,” he said.

A long tradition

Ralph Meima, director of Marlboro’s MBA in Managing for Sustainability Program, feels health-care co-ops will work in Windham County because of the high level of interest in universal health care, general interest in holistic health and a realistic understanding of current funding situations.

Vermont historically has a well-developed sense of community, a number of successful co-ops and a strong libertarian streak, making it well-suited for such a model, Conner said.

Conner sees the federal health-care mandate as a violation of individuals’ civil liberties — and that it is not just a Tea Party issue.

Co-ops are nothing new, said Pat Csurny,  a Marlboro MBA in Sustainability candidate from East Dorset, facilitated the development and collaboration committees Saturday with team member Wendy Webber.

Benjamin Franklin first suggested the co-op model. What’s new is applying it to the delivery of health care, she said.

“Vermont looks for local solutions,” she said.

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Originally published in The Commons issue #77 (Wednesday, November 24, 2010).

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