Community approaches to health care.
Posted on Sep 14th, 2006
by 
FLOW
FLOW
The ongoing FLOW pod discussion about health care inspired me to seek out examples of positive innovations in health care, especially since health care is a stressful topic for many individuals and communities. Every time I fill out an insurance form, I am reminded of the incredible distance between the bureaucrats making the rules and designing the infrastructure and the health workers on the ground. In a system where on-the-ground knowledge is prevented from informing actual decisions, the outcomes will be skewed.
Economist Friedrich Hayek pointed this out in his essay, "The Use of Knowledge in Society", where he explains why central economic planning tends to fail. Hayek notes that bureaucrats and central planners lack the right sort of knowledge to make decisions which concern local circumstances-- "the knowledge of particular circumstances of time and place". In Hayek's words:
Economist Friedrich Hayek pointed this out in his essay, "The Use of Knowledge in Society", where he explains why central economic planning tends to fail. Hayek notes that bureaucrats and central planners lack the right sort of knowledge to make decisions which concern local circumstances-- "the knowledge of particular circumstances of time and place". In Hayek's words:
Today it is almost heresy to suggest that scientific knowledge is not the sum of all knowledge. But a little reflection will show that there is beyond question a body of very important but unorganized knowledge which cannot possibly be called scientific in the sense of knowledge of general rules: the knowledge of the particular circumstances of time and place. It is with respect to this that practically every individual has some advantage over all others because he possesses unique information of which beneficial use might be made, but of which use can be made only if the decisions depending on it are left to him or are made with his active coöperation. We need to remember only how much we have to learn in any occupation after we have completed our theoretical training, how big a part of our working life we spend learning particular jobs, and how valuable an asset in all walks of life is knowledge of people, of local conditions, and of special circumstances. To know of and put to use a machine not fully employed, or somebody's skill which could be better utilized, or to be aware of a surplus stock which can be drawn upon during an interruption of supplies, is socially quite as useful as the knowledge of better alternative techniques. And the shipper who earns his living from using otherwise empty or half-filled journeys of tramp-steamers, or the estate agent whose whole knowledge is almost exclusively one of temporary opportunities, or the arbitrageur who gains from local differences of commodity prices, are all performing eminently useful functions based on special knowledge of circumstances of the fleeting moment not known to others.
Local knowledge, another name for Hayek's "particularized" knowledge, matters in sound economic and social decision-making. If you want good health care as an outcome, you need to tap local knowledge as part of the process. As it now stands, bureaucrats lack the local knowledge to build the type of rules infrastructure that would create a top-notch product or outcome.
How can we manage the financial risk associated with health insurance while integrating local knowledge and providing more personal, user-friendly health product? How can we build the kind of health care plan we want? The Ithaca Health Alliance offers an encouraging model for a local, low-cost "cooperative health plan". Unlike most commercial insurance companies, the Ithaca Health Fund (past of the Alliance) guarantees that all members pay the same annual $100 fee, whatever their background or health status. There is no deductible and no soul-numbing paperwork. To file a claim, members only need to submit a receipt.
The founder, Paul Glover, started the Ithaca Health Fund in 1997 with inspiration from an informal Amish health system, which helps cover Amish medical bills through community auctions or pooled money. Glover's entrepreneurship is not limited to health care-- he also invented a local currency, Ithaca HOURS. Glover provides an excellent example of what happens when you combine social entrepreneurship with vision and commitment.
Hats off to the ladies and gentlefolk at the Ithaca Health Alliance for sharing their knowledge and experience in creating this alternative health care group in an enabling manner. Since the Alliance only serves local New York residents, those wanting to be members of a healthcare cooperative outside NY can get entrepreneurial and take the matter into their own hands with the free resource kit for starting a local cooperative health plan anywhere in the USA. The Ithaca Health Alliance does more than serve its members-- it serves anyone who has the dream and drive to DIY.
Posted by Alina / Visionista
Access: PublicTagged with: community, health care, hayek, local knowledge, insurance, ithaca health alliance, glover, fund, cooperative health alliance, co-op, resources, kit, ithaca
co-op
May 2008
A community based health practice, whether Amish, Vet, or social program such as medicaid or medicare all have one thing in common, that appears to have been overlooked. The model of a socialized program. True, the government programs are the most socialized programs we have in this country, but the private groups such as the one mentioned here, and other HMO programs, still function along the same principle. A “membership” in the program guarantees you health coverage. It also guarantees that you will see approved medical professionals, and guarantees that if needed, you will be afforded movement along the “supply” chain.
Although there is a significant movement here against socialized medicine, and although it gets a very bad rap in the business, there are some aspects of the ideal that need to be looked at seriously. An absolute socialized program would probably never work in this country, but we have already incorporated some of the basic tenents into our own government sponsored and managed care plans.
A new paradigm for health care - moving away from PPO, HMO etc and turning to
IHM - Improving Health Maintenance!
Please see the ABC4All Path of 8 Petals
Respectfully,
Burton Danet, Ph.D. (ABC4All / Faciliator on Zaadz)
Read the Interview of and by Burton Danet