Chlorophyll

I find your idea more appealing, and truer to the Key Values, than the official Green Party position. But you'll have to go beyond crossing your fingers and saying "it would be affordable to all" to ensure that low-income patients are covered. I don't see any way to do that without either removing the voluntary membership aspect or introducing means-tested fees (premiums) or both, and you might have a hard time convincing the Libs of either one.

I'll be the first to admit I'm not an expert, but I do think this model would be cheaper, at least in the long run, for several reasons.

First, costs would be defrayed over time, and also over different people. Just as with insurance, there would be more people who pay in more than they recieve, in return for the assurance that if they need serious care, they will recieve more than they pay in.

Second, there would presumably be an emphasis on preventive care. For example, it would be reasonable for the annual fee to include a check-up, which could catch maladies while they are still inexpensive to treat.

Third, a system accountable only to its members would be free to offer treatment options beyond conventional Western medicine, which are less expensive and/or circulate their pay back into the community, instead of buying pills from a pharmaceutical transnational.

Fourth, while you wouldn't have HMOs denying expensive treatment, you also wouldn't have administrators leaning on doctors to recommend expensive tests that aren't really needed.

Fifth, there could be a sliding scale of membership that didn't require means testing - you simply choose a payment plan that fits your health and income level. The less you pay in fees, the higher percentage of serious care you pay, and vice-versa.

I think that what Esteban is saying here is particularly important for two reasons. First of all, it addresses the inherent problem of bigness. Centralized authority over healthcare decisions is no more acceptable to Green Values than centralized banking or centralized militaries. We are indeed different than Dems and Repubs, and that's part of how we are different.

While Libertarians have a respect for personal property rights that goes so deep that they might consider the "value" of a medical practice in the patient based instead of the physical buildings and education of those in the practice, "small l libertarians" may see that physical assets are different from conceptual assets like "Good will" and "Community respect".

The point is, if we do go with a healthcare option that is truly Green we are likely to be so far afield that folks don't understand what we are talking about. In my town for example, the state is considering four applications to build a hospital. Libertarians might say "Let the market decide where to build the hospital and how big to build it." The Green approach might be more along the lines of conducting a sample survey of citizens, healthcare providers of all stripes, and government/academics to determine the community's health care needs, followed by a continuing development of a whole-health approach that might not even involve a hospital. That approach, involving the people in deciding where to go from here, is so different that it's almost incomprehensible to the average "authority" or "expert".

It is critical that the voters see us as politicians who care about what they think, and who act in ways that are consistent with a clearly defined set of real values. If we do that, we cannot help but win.

that is the beauty of the concept of the natural and social commons...it is the best of both private and public.

individual equal access opportunity rights
citizens dividends capitalized from the private enclosure that compensate for exclusion
the role of the state is a public trustee - set the limit based on the sustainable yield of the common assets & collect the dues and pay out the dividends.

I have a feeling that you said something important here that might change my thinking. Unfortunately I can't understand what you are saying. Can you try again, or have someone translate what you wrote?

Also, if what you've written is as important as it seems to me, I am sure your brief post hasn't covered all there is to know.

Let me try this specifically.

Here in York County SC, the state government regulates the size, location and features of hospitals. A company applied to the state to build a hospital, and upon hearing this, three other companies applied to do so also. The second hospital would be built in the richest and fastest growing part of the county, Fort Mill. Two applicants are for-profit and would pay property taxes. Three have a local presence while one is from Texas and has no nearby hospitals.

One already owns a hospital in the county. The company that owns that hospital is owned by a company under constant examination by courts, federal and state agencies, and has offered to move some of the Rock Hill beds to the Fort Mill facility, making their offer even more attractive tax-base wise.

Of course you can't say "The county should do this or that." but I would appreciate it if you could share with me some basic ideas about how to apply your points to my situation here.

My sense is it wouldn't help much. Our health care crisis has multiple facets. It is not primarily the middleman that is the problem, but the whole aspect of means testing. A given HMO has 1,000 different plans to meet 1,000 different companies. The hospital must itself create an enormous bureaucracy to handle these plans.

But just getting rid of the middleman will just put collection onto the hospitals. HSA's are the new thing now and companies are jumping on board. This has created a big crisis in Milwaukee for example where hospitals now have to collect fees from individuals rather than focusing on health care. If we take the idea of membership fees they could end up functioning much like the HSA's. Hospitals become more and more focused on fee collection than health care delivery.

It seems to me that with a cooperative approach there would be great motivation to keep sick people out. One big argument for single payer is that we are in the same pool, shared sacrifice. That is entirely the opposite of a voluntary system that promotes inequality.

Another big issue is infrastructure inefficiencies. In Madison we have several HMO / Hospital pair with clinics throughout the city. Most of the clinics are in the burbs with 'competing' clinics very close in vicinity. Rather than having clinics throughout the city they are located closely together and in areas that are becoming less accessible.

I don't think its feasible to take a non-federal approach. Just look at prescription drugs. American consumers have for years have been subsidizing most of the 1st worlds medication. But, the Bush years have taught be one thing I do not want simple medical procedures turning into hotbed political issues. In Wisconsin Doyle has not done much better. A fellow Green on the Badger Care program says she gets put on and off about 5 times a year. I think a broad approach which looks a which levels of government would be carrying this or that function would get better results in the end. My bottom line is that profit can have no place in the system.