PAUL GLOVER ESSAYS: community control of food, fuel, housing, health care, planning, education, finance.

Ithaca's Homegrown
Health System

by Paul Glover   *   Ithaca Journal, November 2004

The lucky minority of Americans enjoying affordable health insurance have probably noticed that America's health system is falling apart, and that the public and private sectors are failing millions more Americans yearly.

Many of those without health security live in Ithaca.  And thousands more Ithacans struggle to pay insurance premiums that increase while coverage falls.  Many keep jobs they don't like, just to maintain health insurance coverage.

In the meantime, one of the reasons that taxes rise is to insure municipal employees.  HMOs are retreating from risky markets. Many employers cut or cancel coveage.  Hiring declines, and the economy lags.

At the same time, Medicare and Medicaid are becoming mor restricted and costly.  Medicare is expected to be depleted as the baby boom generation retires.  If such an event occurs, health costs could consume most of their Social Security checks.

Many doctors and dentists today don't accept Medicaid.  Preventive care costs so much that emergency rooms are relied on for minor illnesses.  Hospitals and emergency rooms close.  And the news gets worse daily.

The federal government cannnot be expected to solve this crisis, since HMOs sponsor legislators and were the second-largest category of contributor to both Gore and Bush in 2000.

Even if Washington were to enact universal "single-payer" coverage, middle class taxpayers would be expected to fund our technologized pills-and-surgery sickness system.  Increasingly, the federal budget is dedicated to war.

"I see no other scenario than health-care costs continuing to outdistance wage increases and inflation by a very wide margin," said Drew Altman, president of the Kaiser Family Foundation.  "We're stuck with no big new idea."

Scott Serota, chief executive of Blue Cross and Blue Shield of Chicago, said, "There isn't going to be a magic bullet at the national level.  We're going to have to return to some level of community accountability."

Therefore the seed of a national solution has begun in Ithaca, which is creating a community health system.  The Ithaca Health Alliance is a co-operative owned by members paying $100 per year and $50 per year, per child.

The Alliance is an act of self-protection, serving members several ways.  Medical expenses are paid from the Ithaca Health Fund program, for specifiec emergencies, as well as some dental, regardless of health provider.  The Alliance is organizing a free clinic, and sponsors free massage at special events.  Interest-free health loans are available.  Discounts for health care are negotiated with local health practitioners.
A tax-exempt charitable organization, the Alliance was established "to promote community health and wellness in general and specifically to support activities which will increase the availability to the public of low-cost, quality health care."  It serves the public under NYS Insurance Law 4522.a.3.  The Alliance's broader understanding of health care inspires its public health committee, which addresses environmental concerns.

Alliance membership payment remains the same year after year, even while benefits expand.  Overhead is kept low so that nearly every dollar is available to members.  Every member has a vote to decide who's on the board of directors.

The Ithaca Health Alliance is an honest and transparent health system.  Monthly financial reports, including each payment and each denial of payment from its Health Fund, are placed on the website.  Monthly board meeetings are open to all.

We've been grateful for powerful encouragement.  For example, Dr. Rob Mackenzie, CEO of the Cayuga Medical Center said, "The Alliance's free clinic services promise to reduce dependence on our emergency room for non-emergencies. Their other programs likewise contribute to community well-being."

Internationally known activist Dr. Patch Adams said, "Everyone should join the Health Alliance even if they have health insurance, just to support it."

Jean McPheeters, President of the Tompkins County Chamber of Commerce, said, "The Ithaca Health Alliance is a Chamber member serving several Chamber businesses.  I believe it is providing necessary and honest aid for many people otherwise unable to access health coverage."

Pete Browning, co-owner of Viva Taqueria, enrolled 32 employees in the Alliance.  "It just makes good business sense."

Assemblywoman Barbara Lifton said she will "strongly vouch for the important health care safety net that they are providing in our area."

Mayor Carolyn Peterson declared May 11 as "Ithaca Health Fund Day," and said "I've heard much praise and no complaint about the Fund."

Jim Seward, Chair of the NYS Senate Insurance Committee, wrote, "The Fund fulfills an important need through a membership organization."

"This is how the Canadian single-payer plan began," according to David Steele, a professor at the University of British Columbia.  He explains, in an article about Ithaca's Alliance, how another small city, Swift Current, Saskatchewan, in 1948 started a local health plan so successful that it spread throughout Canada by 1971.

"At the national level, there is far too much entrenched power.  The Ithaca Health Alliance is young and it's growing, but it's working and it has immense potential," Steele said.

Glover is founder of the Ithaca Health Alliance and author of the book "Health Democracy," which explains how to start a community health plan.

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