The Senate Finance Committee has passed a health care bill relying heavily on membership cooperatives. A half million Georgians have electricity from member-coops. But some Georgia health providers say, extending health care isn't as easy as extending electricity.
On a dusty stretch of road in rural Liberty County, Mike Foreman and his crew are installing a new electric line. It starts with lifting a 17-ton concrete pole with a crane and tipping it into a hole the width of a car.
"Okay, we're going up with it," Foreman shouts, as the 100 foot pole dangles precariously above workers' heads. A lot can go wrong in the process.
"A big crane like that sure makes it look easy," Foreman says.
For Democrats, fixing health care is starting to seem like a precarious balance frought with heavy lifting. But if you want to take this power line image farthest, ask Mark Bolton how he thinks health care reform should go. Bolton is Vice President for Marketing for the company installing the electric line, Coastal Electric Membership Cooperative.
"When I first heard the health care debate, I turned to my wife as we watched television and discussed politics," Bolton says. "And I said, 'The ideal solution to this is the cooperative business model.'"
Electric Membership Cooperatives have electrified Georgia since the 1930's. They're basically small and non-profit electric companies. They serve rural areas. The Senate Finance Committee used them as a model for reform. Bolton says, the relevance of E.M.C.'s to health care is how they lower costs and extend coverage by forgoing profit.
"We don't have to balance what is best for the customer with what is wanted by the stockholder," Bolton says.
Bolton says, small E.M.C.'s also lower costs by joining forces on the state and national levels, to make power, for example. But whether health coops can lower health costs isn't a simple question.
Many Georgia health providers say they're confused by health coops. Two Savannah hospitals and two Savannah doctors groups all passed on commenting for this story, saying, they had no clue what health coops are.
Providers appear to be waiting to take their clues from industry spokesmen, like Kevin Bloye of Georgia Hospital Association. "There's just been so few details released," Bloye says. "It's really hard to comment."
A Georgia doctors group, however, is openly skeptical. The Medical Association of Georgia's Todd Williamson says, he doubts coops get to any real means of cost containment. He supports Republican ideas for health care reform.
"The main way to control costs is to make sure that patients are involved in the first dollar that's spent, and the last dollar that's spent, and all dollars in between," Williams says.
Armstrong Atlantic State University professor Joey Crosby also doubts cooperatives can control costs. He's been following health care policy and prefers a more comprehensive change. He says, not even the public option goes far enough at bending the cost curve.
"The 800 pound gorilla in the room is changing the culture of the way care is provided," Crosby says.
It's still unclear if coops will be in a final bill. Democrats may push for the public option. If that happens, Georgia doctor and hospital lobbies say, they'll fight it with every kilowatt they have.
Links to more information about Cooperatives:
National Cooperative Business Association http://www.ncba.coop/
Letter to Senator John D. Rockefeller from NCBA http://commerce.senate.gov/public/_files/NCBACoopResponseLetter080509.pdf
Senator John D. Rockefeller links to correspondence with his office http://rockefeller.senate.gov/press/record.cfm?id=317885
Senator Conrad Comments and Resources regarding Health Care and Health Care Coops http://conrad.senate.gov/issues/healthcare.cfm
America’s Healthy Future Act of 2009 (Baucus) (Go to page 35) http://finance.senate.gov/sitepages/leg/LEG%202009/091609%20Americas_Healthy_Future_Act.pdf
University of Wisconsin Center for Cooperatives http://www.uwcc.wisc.edu/info/i_pages/health.html
Health Related Coops http://www.uwcc.wisc.edu/links/healthcarelinks.html
Georgia Cooperative Development Center http://hosting.caes.uga.edu/gacoop/cooperatives.htm
Click here to hear Joey Crosby, Armstrong Atlantic State University professor of Health Services Administration, talk more about cooperatives:
Contributors: Thanks to Clayton Duel of the Savannah Primary Care Physicians Independent Practice Association for providing the research links in this story.