Healthcare Reform: Reconciliation and Cooperatives

It seems that after the initial sit-down of all interested parties in this healthcare reform debate, the gloves have finally come off. Republicans have drawn a line in the sand on a public (government) plan option. Which has Democrats scrambling to put together something that has a chance of passing.

The way things work in Washington, Congress needs 60 votes to move forward on final health plan changes. With all Republicans and even some Democrats dead-set against a public-plan option, some options have surfaced. At first glance, two options, reconciliation and cooperatives look to be mild-mannered with positive connotations. Webster’s describes the first, reconciliation as “to bring into agreement or harmony; make compatible or consistent:” while cooperatives’ root word, cooperate, is familiar to most people. When used as a government process to get health reform passed, nothing is further from the truth. One wonders why they came up with these terms to describe processes that are anything but their inherent meanings—a reasoned attempt by both sides to find common ground through the power of compromise.

Because of the resistance to a public plan, one old idea has resurfaced. It was put forth by the head of the Budget Committee, Senator Kent Conrad. For me, “cooperatives” (or co-ops) bring forth visions of hippies living in communes, all working together, but the idea is much older than that. In essence, cooperatives are a group of like-minded persons, who share in the ownership and expense of the “cooperative.” The idea is that the more people they have, the greater “pull” they’ll have to negotiate rates with medical providers. What they have in their favor is that they won’t be burdened with the responsibility of making a profit, so theoretically they can use most of their revenues for claims-paying and the inherent administrative expenses that go along with running a co-op.