Prairie health-care companion

By TIMOTHY EGAN

Posted: August 23, 2009 at 4:15 a.m.

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SEATTLE — Finding Democrats in the north of Idaho can be like panning for gold in the East River of New York. The area is white, rural and extremely conservative.

But if you get sick in that land of deep lakes and ponderosa pines, a consumer-governed, nonprofit health-care provider - Group Health Cooperative of Puget Sound - offers extensive coverage at some of the lowest premiums in the nation. And if you need advice on bailing twine or baby chicks, the Co-op Country Store, now in its 75th year, can provide service that the nearbyHome Depot cannot.

I mention these successful member-owned businesses in a deeply red state because as the public healthcare option gets hammered by a campaign of disinformation, the coop model deserves a fair hearing.

Co-ops may not work as the best way to extend care to the morethan 45 million Americans without coverage. But they do tend to keep private insurers honest, are fairly good at controlling costs and will be harder to demonize. When Sarah Palin starts making things up about co-ops, as she did with the famous nonexistent death panels, she'll be lying about a familiar model for many Alaskans.

Plus, co-ops are built around something that's been missing thus far in a debate dominated by ill-informed shouters: the consumer.

The West is the native ground of co-ops. It's in our collective DNA.

People buy their tents, sleeping bags and bikes from the nation's largest consumer co-op, REI, founded in Seattle in 1938, now with 3.5 million active members. It's consistently rated one of the best places to work in the United States.

Yes, people wince at paying $20 for a water bottle, but they can bring it back anytime - and usually count on part of the purchase price returning to them in the form of an annual dividend. Last year, REI paid the highest dividend in its history: $73 million.

By way of disclosure, I should say I belong to REI, not out of any political conviction, but because I can get stuff there that I can't find anywhere else, the sales people are not commission-motivated, and I like that dividend check.

Group Health, founded here in 1947, serves nearly 600,000 people in Washington and northern Idaho, with doctor-choice and an emphasis on preventive care. It's consumergoverned and nonprofit.

But perhaps because those consumers who run Group Health are less cold-hearted than insurance company bureaucrats, Group Health is sometimes seen as too generous, and thus unable to control costs as much as it would like. Still, the business model has much to contribute.

All over the West, people get their electricity, their hardware, their water from co-ops, and sell their apples, their wheat, their medical services in the same way. I can see why Sen. Kent Conrad, the Democrat from North Dakota, has been pushing co-ops. They come out of the prairie progressive tradition.

For now, Republicans have decided to wage a scorched-earth policy on health reform, a strategy that may restore them to power but won't do a thing for the majority of Americans concerned about thefuture. Palin, auditioning for the role of most willfully ignorant politician in America, and Sen. Chuck Grassley of Iowa, the grumpy old man who is supposed to be a serious voice for bipartisan legislation, have told whoppers about killing grandma, and have become heroes to their base because of it.

They will lie about the co-op model as well. "You can call it a coop," said Sen. Orrin Hatch of Utah, "which is another way of saying a government plan."

But it's not, as hikers and farmers in Utah can tell him, or as Mormonrun welfare and retail outlets in Salt Lake City could attest.

Here in Seattle, a city known for a certain kind of caffeinated capitalism, Group Health is a major market player, and a big reason why our health-care premiums are cheaper than those in most cities. We also have public power, giving us some of the lowest electrical rates anywhere, and a chain of co-op grocery stores, which I find a bit too granolacrunchy for my tastes, but whichothers swear by.

In order for the co-ops to get beyond the vague outlines that Conrad has put forth, they will need some government seed money, $4 billion to $6 billion by most estimates - a mere week in the life of bank bailouts. They will also need to be large enough to compete, as Group Health does here.

But if there's any doubt a health care co-op can work, ask the people who own one, including more than 11,000 consumers in the sparsely populated, deeply Republican north of Idaho.

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Timothy Egan writes for The New York Times. He won a Pulitzer Prize in 2001 and is the author of five books.

Opinion, Pages 11 on 08/23/2009

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