Cooperativism in the United States
Health insurance and care cooperatives re-entered the collective mind of the United States' citizenry at the end of July 2009, when they were suggested by the Barack Obama administration as an alternative strategy to democratize and cheapen the health care infrastructure at the federal and subordinate levels, as well as an alternative advocacy point to bring the conservative Blue Dog Democrats and some Republicans into more conciliatory negotiations over health care reform. To those who are in the know, the proposed government-sponsored and government-regulated (not government-owned) health care cooperative initiative by the Obama administration, which awaits the next move by the administration and the Democratic majority in both houses of Congress regarding its verification and promulgation, will be the latest in a line of curious creatures of similar structure which have been implemented (and have experienced wildly various degrees of success) throughout a number of industries in the United States and other countries: the cooperative.
Cooperatives, generally speaking, are companies which are structured so as to make all of their individual members co-owners of the profits made from sales of products and services: this member body can be limited to just the workers inside the company (hence known as a worker cooperative or an employee-owned corporation) or it can be extended to all consumers and workers in the cooperative (hence known as a consumer cooperative). Because of the joint ownership of shares which is shared among all members inside the cooperative, the member body also possesses greater governing power over the decisions taken by the executive, and all worker members or all consumer members are free to vote and participate in the shareholder assemblies which make or break any executive decision. In most theoretical cases, the cooperative allows for a more democratic, more humane structure of governance and behavior, and it defuses some of the traditional acrimony that exists between unions and employers; however, unions may also often participate in the representation of worker interests within the cooperative to ensure that the executive of the cooperative is reminded of its duties to its shareholders and co-owners while it concurrently seeks to maintain profitability. Despite the temptation of comparison, cooperatives are usually not the same as collectives, as cooperatives are organized for mutual benefit from exchanges of products and services while collectives are organized for mutual production of products and services (voluntary collectives such as Israel's kibbutzim, however, are also cooperatives, while worker cooperatives and autogested factories also fit the technical definition of collectives). Most of all, the member body of the cooperative is not forced to participation or tribute by the barrel of a gun, making it a voluntary body.
Most in the United States may know of, or may even be intimately involved with, at least one such cooperative in their local area, such as the credit union, or the mutual insurance company, or the utility cooperative, or maybe the occasional agricultural and/or food cooperative or the student-owned housing cooperative which are situated in close, cheaper proximities to a few major universities as alternatives to the dormitory system. Cooperatives have figured with somewhat greater prominence in other countries, such as the United Kingdom's Cooperative Group, Spain's Mondragón Cooperative Corporation, Israel's kibbutzim and moshavim shitufiim (voluntary collective agricultural settlement movements), and India's Indian Coffee House.
Cooperatives and other mutual organizations are most valued by their proponents for their insurance of a voluntary, free-market-based social safety net and people-over-profit ideology which, theoretically, prevents members from falling into the most abject poverty during its existence. However, cooperatives may often fall prey to infighting over decisions by the executive which are resisted or rejected by the member-owner body (as in the case of the Consumers' Cooperative of Berkeley), or may collapse due to the surrounding economic climate of the time; in the United States, this most often occurred with agricultural and food cooperatives, many of which collapsed during such trying downtimes such as the onset of the Great Depression and the early Cold War period.
Furthermore, the US government's approval of the consumer cooperative as a more palatable alternative to the long-running top-down hierarchical semi-feudal model of corporate governance may, to some economic libertarians and anarchists, smell of a plot for greater political involvement in the governance of the cooperative corporation; indeed, while mutualization (the process of converting a privately- or nationally-governed entity into a cooperatively-governed entity) is not the same as nationalization, it does make the decisions of the corporate executive more open to influence by pro-government or political lobbies (and even by religious lobbies, given the prominence of religiously-motivated consumer boycotts of corporations in the past) if a substantial amount of the member-owners are won over as willing ideological foot soldiers by these lobbies, while still maintaining a degree of separation between the company and the state. Workplace and consumer democracy would look alot like the more familiar democratic systems installed within the most sophisticated political architectures in the world.
So, it seems, the further mutualization of health insurance (and, perhaps, other insurance institutions) in the United States through health insurance unions may be the start of health care reform and the spread of insurance coverage ubiquity on a more even and democratic playing field. Perhaps the strengthening of interstate portability mechanisms, as proposed by the Republican Party opposition, could increase transparent networking between health insurance co-ops and privates alike. But HICs, given the relative novelty and scarcity of their presence in the United States, may need further explanation and education to the public regarding their roles, functions, benefits and shortcomings, so that they would seem less like stop-gaps for further health care reform and more like genuine, confidence-retaining, locally-appealing, publicly-empowering institutions for health insurance and health care. Already, a full-fledged backlash against the idea of co-ops as an alternative to partial nationalization is building from the Democratic Party's progressive and left-wing with as much intensity as the conservative and right-wing backlash against health care reform altogether.