Tuesday, May 14, 2013

Communities Self-insure for Cooperative Healthcare

From Shareable.net
May Day at Sandhill Farm, an egalitarian community
Obamacare is changing the game of private health insurance, but private health insurers are still in it to make profit. And while they are in the game, they will do their best to rig the game in their favor. Ask anyone who has had a significant health problem. So why do we continue to give control over health care and our money away to companies that don't have our interests at heart in a matter that is literally life and death?
I wanted to look at alternative, community-based models and see if they actually work. One model is the Ithaca Health Fund, operated by the Ithaca Health Alliance since 1997. This nonprofit, inspired by the Canadian health system and the Amish Church Aid self-insurance program, runs several health-related programs. The Ithaca Health Fund reimburses medical costs for certain categories of preventive and emergency health care and its free clinic provides conventional and complementary primary care visits to the uninsured, as well as classes and a newsletter on preventative medicine. They rely on member fees and grants for funding and local college students to fill the many needed volunteer roles.
Ithaca Health Alliance
Ithaca Health Alliance
The Ithaca Health Fund was challenged by the New York State government as an noncompliant health insurance provider but restructured to work around the laws partly by making “grants” to uninsured patients, rather than reimbursements and restricting their boundaries to New York State. They are still struggling to get official nonprofit status from the federal government even though they are a charitable organization that depends significantly on grants to meet the needs of its low income clients while maintaining fee levels that they can still afford.
Even more intriguing was my encounter with PEACH (Preservation of Equity Accessible for Community Health) at Sandhill Farm in rural Missouri. On a visit there, I asked the residents of this intentional community how they made it without health insurance and they glowed about the benefits and low cost of PEACH. I recently interviewed PEACH's initiator, Laird Schaub, about this little known program to get the inside scoop.
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