League of Uninsured Voters (LUV)
51
MILLION
Americans
have no
health insurance

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UNITED STATES HEALTH ALLIANCE

When fully developed, the United States Health Alliance provides every resident of the United States quality access to free preventive, diagnostic, emergency and longterm health care. Clinics, medical centers and healers would offer standard allopathic treatment for those who prefer it, while providing holistic therapies for others. Folk traditions and latest technologies would serve together.

There's more to healing than pills and surgery. Clean air, clean water, clean fuel and clean food are the public foundations of personal health. Likewise necessary are creative work, balancing exercise and rest; safe transportation; nonviolent conflict resolution between neighbors and nations. The Alliance's public health committees will promote healthy job creation for a genuinely healthy economy.

Health Democracy encourages all these transitions, and works especially to lower the costs of health care. Health co-ops can pay health costs for small membership fees.  Health co-ops make members owners of health clinics and medical centers, and put members in control of prices as well.

Our aim is to enable the United States to achieve the world's lowest infant mortality rate, the lowest cancer rate, the greatest longevity rate and exemplary population stability. We'd export the American model to help heal the world.

A national network of health alliances will broaden access to preventive care, and retain money locally for further expansions of service by making members owners of health clinics and medical centers. Health co-ops can also provide interest-free loans for rebuilding large cities and small farms. Community health systems grow to become capable of influencing public policy by investing in clean energy technology and alternative mobility.

And our long-range agenda is to effectively pressure the federal government to follow our example, funding a national health system which meets standards set by the Health Democracy movement. We'll contrast the multi-trillion dollar sickness industry (which feeds on the stresses and diseases of civilization, on car crashes and crimes) with networks that are simple, efficient, user-friendly, non-profit, inexpensive, fiscally transparent.

The co-op system serves more reliably because it is owned and managed by the people who rely on it. Just as it's better to own your own home than to rent, or occupy public housing, it's better to own your health system than to rely on HMOs or government. Rather than depend on remote legislatures motivated by power, or corporate directors motivated by profit-- giving or taking at whim-- health alliances are nonprofit community-based groups coordinated in a decentralized manner.

The diagram below shows a grassroots-controlled national Health Democracy plan. Members rule directly by powers of referendum, and indirectly by electing members of Local Alliance Boards (LABS). Elected boards of directors are firmly accountable to members and can be easily replaced. These boards operate within bylaws which limit the amount they can charge members, and limit the amount they can pay staff. Therefore, while nobody gets wealthy working for a health alliance, they're connected to communities which enrich them.

Authority over the United States Health Alliance is retained within communities by procedures which require maximum member permission.

Authority is shared voluntarily among regions in exchange for credentialing and for mutual discounting and for emergency funds.

Wealthier regions within the national network agree to distribute surplus wealth to less wealthy regions. This is not charity. This builds a healthier nation within which to travel and trade.

Democracy means more than voting. Members are asked to serve on commmittees, like PAYMENT CATEGORIES, OUTREACH, APPEALS, COMMUNICATIONS, FINANCE, CLINICS, LOANS, GRANTS.

United States Health Alliance graph
0  = member     LAB = Local Alliance Board     ✪ = clinic     F = Fund     L = loans     E = education

MUNICIPAL FEDERALISM

Health Democracy is structured to ensure that authority stays with the members rather than strays to boards or staff.

Local Health Alliances:
• establish multiple LABS in one metro area
• define spinoff procedures and election process
• decide local policy (via paper ballot or email ballot w/access code)
• collaborate with other locals directly (sharing experiences, best practices, staff, accounting)
• coordinate with other locals statewide via State Alliances
• make policy for local, state and national (referenda initiated by 100 members or 5% whichever smaller)
• hire regional/federal staff
• abide the following irreducible guidelines: maximum wage, adaptive reuse rather than new building

Regional Health Alliances:
• serve locals based on policies established by local congress.
• no independent policymaking authority
• lobby for favorable state legislation
• lobby to increase services/access for members
• send press releases
• sector grants offered
• send press releases
• compile and distribute accreditation and compliance reports
• file suit on behalf of LABS against a LAB violating Alliance policy
• abide irreducible guidelines: maximum wage, adaptive reuse rather than new building

National Health Alliances:
• execute national policy established by locals
• no independent policymaking authority
• advocate for favorable legislation promulgated by locals
• maintain web page linking all state Alliances
• organize Congresses
• link to International Alliance
• distribute local contributions to other affiliated national Alliances
• abide irreducible guidelines: maximum wage, adaptive reuse rather than new building

International Health Alliance
• Distribute funds provided by locals, regionals, nationals

This co-op sector, known also as the Health Democracy movement,  intends  to rebuild the health care system so that, when universal coverage begins, federal funds go to nonprofit medical centers, clinics and staff.

We intend, moreover, that health care become truly universal-- that holistic healing modalities be welcomed alongside allopathic, that preventive care be emphasized.  We are as well an environmental movement, addressing the public foundations of personal health-- clean air, clean water, clean food, and alternatives to war.

And when universal coverage is enacted, some day, the nonprofit clinics and medical centers of the United States Health Alliance could defend the national plan against inevitable attacks, much as organic standards are defended by grassroots campaigns.

Co-op health plans have long history in our country.  Between 1890 and 1930 most health insurance was provided by hundreds of fraternal organizations like Moose, Elks, Shriners, Odd Fellows-- the funny-handshake people.  They hired doctors, built medical centers, orphanages, old folks' homes, and sanataria.  They paid survivor benefits.  Then corporate lobbyists pushed laws that shoved these groups to the side, until today such insurance plans are illegal.

Every state regulates health insurance, and most states require that, to get into the insurance poker game, you've got to put millions of dollars on the table.  You've got to cover all the mandates, especially big pharma.  Growing incrementally and honestly toward holistic care, is not permitted.  The Ithaca Health Alliance survived through political pressure, while dozens of other communities are seeking legal approval.

As we advocate universal health coverage we need to also advocate for grassroots ownership of health care, and for a healthy health system to replace the medical technology sickness system, and for the building of healthy cities.

To do so we'll need to violate existing law, enforced by state regulators who work for HMOs.  In New York, for example, former Superintendent of Insurance Gregory Serio quit at the beginning of 2005 to become a lobbyist for HMOs.  In Pennyslvania, former Commissioner of Insurance Diane Koken, former VP of an HMO, allowed Blue Cross to keep $6 billion of surplus rather than transfer it to Medicaid as planned.  Her Department is being investigated for fraudulent administration of Medicaid.  Such corruption prevails nationwide, at all levels of administration.

Civil disobedience then asserts the right of Americans to help one another.  As Martin Luther King Jr. said, "There is nothing wrong with a traffic law which says you have to stop for a red light. But when a fire is raging, the fire truck goes right through that red light...  Or, when a person is bleeding to death, the ambulance goes through those red lights at top speed... Disinherited people all over the world are bleeding to death from deep social and economic wounds. They need brigades of ambulance drivers who will have to ignore the red lights of the present system until the emergency is solved."

We believe Dr.King's declaration applies to health care as a civil right.  The health insurance crisis has become a crime, and the time to rebel, in this form, has arrived.

How to start a
HEALTH CO-OP


Glover is founder of the Ithaca Health Alliance and author of Health Democracy


BUILDING DEMOCRACY
We Americans have yielded much control of our lives to experts who have led us to dead ends: consider the problems of fuel supply, food quality, banking, economics, religion, culture, war, education, taxation, health care.

Health Democracy is part of a far larger movement that enables people to create together lives that are healthy and secure.

Every choice we make gives our power away or takes it back. Voting happens every day. Joining mutual aid systems makes us strong again.  Here are several methods for enacting co-op democracy:

INTERNET:
We use the web to promote membership, then to keep members informed via email, inviting them to control their co-op. This allows unprecedented transparency.
The website provides notice of meetings, newest benefits, links to financial statements (monthly and cumulative), board of directors candidate statements.

LISTSERV:
Nearly all Alliance members have email, even if they don't have a computer at home. We may sooner see universal email coverage than universal medical coverage.
Sending Alliance monthly newsletters via email cuts the cost of printing and mailing toward zero. It's one-way, so that members receive few emails from the list.
   The listserv also enables members to vote on referenda or for board of directors. We send members an annual ballot which, when returned to the list manager is instantly folded so that the header verifies that membership is current, while protecting voter privacy. After verification the header is torn off and votes counted.
Much of board of directors business is prepared by email.

MESSAGE BOARD and/or BLOG:
Enables members to talk with one another about health insurance, compare personal experience with doctors, offer health advice, encourage one another during health crises, advocate for preferred board candidates and new grant categories, organize referenda to change Alliance bylaws, etc.

NEWSLETTER:
Print edition may be mailed to members only, or may be distributed free in tabloid newsprint format to a broader public. Newsprint editions are cheap to print and give great visibility. You can also sell ads to more than cover costs.
     Here are suggestions for newsletter content: list of current and new payment categories, financial conditions, articles and cartoons about health care crisis and solutions, testimonials from satisfied members and from respected community members, graphs of payments in and out, graphs of expansion, list of committees and contacts, enrollment form, contact information.

PUBLIC MEETINGS:
Address issues of general public health concern, or gather members to share their views.

BOARD ELECTIONS:
Find candidates annually for one- or two-year terms. Allow them to publicize their views about your alliance's direction. Place ballot boxes in prominent places, and send email ballots.

REFERENDA:
This is the most powerful tool of grassroots democracy. Members who gather a small number of signatures from fellow members can change alliance policy. Shall the alliance purchase a building? Shall the alliance offer a certain category of medical reimbursement? Shall the alliance move its money into another bank?

TAKING POWER

Of course it is outrageous that our wealthy nation does not provide universal health coverage.  What is more antiAmerican than profiting from the misery of Americans?   Lack of health insurance, costly services, and corporate pills and have killed far more Americans than terrorists.

During the past twenty years thousands of articles have been written about our health insurance "crisis."  Millions of Americans and dozens of states have advocated single-payer.  Presidents Theodore and Franklin Roosevelt, Truman, Nixon, Johnson and Clinton each advocated some form of comprehensive coverage.

But the industry has been tough, buying Congressmen left and right.  Universal coverage has been proposed in a dozen states and seen partial success in one.  Medicaid eligibility has been tightened rather than expanded, and Medicaid/Medicare payments have been reduced.

We millions of uninsured can't wait another 3, 5, 10, 15 or hundred years for full access to best care.  Nor can the under-insured and those suffering ever-higher premiums.  Nor can the middle class, whose children are being kicked out of family plans and who are paying ever-higher taxes for indigent care.  Nor can small businesses, unable to find plans that retain employees.  Demanding nonprofit protection now, some of us have started co-op medical plans.

The Ithaca Health Alliance, for example, reimburses members for everday emergencies like broken bones, ambulance rides, emergency stitches, burns, ER access, some dental, etc, and has started its own free clinic.  Membership is $100/YEAR, and it has served for 14 years.

It's the most honest and transparent of health plans.  Members vote for their board of directors and serve on committees; every payment and denial of payment is listed on the website.

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