Medical Insurance Peer Plans

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Description

A proposal by Sam Rose at http://groups.google.com/group/coworking/browse_thread/thread/668715b7b3114588

"For background, see this article on the "Faith Based Health Insurance" phenomenon at http://www.medicalnewstoday.com/articles/32630.php

The way this works is that "members send a monthly check, or "share," that ranges from $200 to $400 to the plan or to members the plan designates with "needs," or medical bills. The plans subtract overhead and administrative expenses from the total collected and use the remainder to pay claims"

Members are "vetted" or qualified to join the "plan" based on a letter from their clergy person verifying they are an active church member, and trustworthy person." (http://groups.google.com/group/coworking/browse_thread/thread/668715b7b3114588)


Commentary

Why such peer-based reform is needed for health care

Sam Rose [1]:

"The Greeks and Romans had an early donation-based funding system for health care , and funeral costs, that was tied to their guild system.

Modern "insurance", as a service in general was originally designed to be a hedge fund, which means that it is an market enterprise. Our modern insurance system was originally designed and formulated by Lloyd's of London to hedge financial losses in shipping disasters. Entrepreneurs would make a contract with the insurer to spread risk out among everyone in the fund, no different fundamentally, than any other hedge, or mutual fund. This is a equitable solution for people who launch into business ventures that contain a certain amount of risk. They are launching into these ventures for profit first and foremost, and they can employ the insurance hedge fund as an agent to collectively spread risk across all of the people in their market segment. They are at the whim of the greater market place, but both sides are making decent bets, usually, and the insurer is guaranteeing against to disaster up to a certain point, at a certain market rate.

To me, this does not sound like a good way to fund my health care costs. I don't want to buy a share in a hedge fund that it pitted directly against the market place, because what happens is that, as the cost of health care increases, it costs more money to hedge our bets against the health care markets. One problem is that health care providers, and drug providers inflate costs, of course. But the bigger problem is that volatile markets are no place for a vital need like heatlh care funding. When health care funding is market driven, then the fund managers are forced to start cutting out more and more coverage to balance their hedge fund against the health care market place. This is why they cover less and less, while you pay more and more. The same dynamics apply as someone calculating the current costs of replacing a ship and all of it's cargo, should it capsize and sink in the ocean. Under US and State Laws, this type of hedge fund commerce is understandably regulated like any other market. It is a market!

So, in my mind, the solution is simple, roll back to the ancient greek and roman system of group/trade/community-based donation. Take the money we putting towards health care costs off of the market, and give it directly to people who need it. The same could be said for certain types of disaster insurance. Look at how many people got screwed by the insurance companies down in the Gulf after Hurricane Katrina. The insurance companies scrambled to readjust to the markets, because they are pitted against the markets, and the contracts people made with them let the insurance companies loosely interpret what types of "damage" happened, and whether they should pay claims or not. Frankly, this is insane. What is the use of a group of people pooling money, if some of them will be discluded from the the help they need, when it is needed? This is the wrong way to leverage the power of groups for solving vital human needs. It's time to take our health and personal welfare off of the market place, and into our own hands." (http://groups.google.com/group/coworking/browse_thread/thread/668715b7b3114588)

Peer Plans and Co-Working

Sam Rose [2]:

"So, what does this have to do with Coworking?

Well, this "church plan" shows a plausible legal international route to sharing health care costs among a network of people, religious or otherwise. These "church plan" participants are really just donating money to one another, facilitated by their churches, and by "plan" coordinators. Might a non-religious network of people also think about a way to pool money, and route it to people who need it in this way? I think so.

The system that I envision here is:


1. Participation is based upon the trust metrics of others who are already in the network (others "vouch" for you).

2. Money is pooled on the scale of coworking spaces. Pariticpants pay a trusted volunteer in their local homebase coworking space

3. Verification of medical need happens on the scale of coworking spaces, with the ability to appeal to the greater network shuld the local coworking network fail to assist or address for some reason. Participants may opt to bypass the network and send donations directly to people who are appealing this way

4. Coordination of local spaces is done through a group of elected, term-serving network orchestrators, who are dispersed around the network, and who split up the labor in a diverse way, so that one local person does not become the "lord and master" of their own local region. Other people are elected to act as voluntary impartial mediators and conflict resolvers

5. P2P open identity based trust metrics help keep trust issues transparent

6. All donated monies are totally transparent and accounted for, 100%

The idea here is that it is legal for us to give money to each other for pretty much anything we want to, so it becomes a matter of figuring out how we can give each other money in an equitable, not-for-profit way, that can systematize some aspects, and can buil on inherent trust." (http://groups.google.com/group/coworking/browse_thread/thread/668715b7b3114588)