The following is wiki post that I made recent to the coworking wiki, in it’s entirety. Feedback is most welcome
ContextAs detailed at HealthCareArchive, previously, we tentatively figured out (http://tinyurl.com/328dk8) that creating a formalized health care entity might:
- push Coworking into territory that could be detrimental to the core values/principles of this decentralized movement.
- local/state laws make creating one network-wide solution very problematic.
ChrisMessina, TaraHunt, and maybe others were thinking about the idea of
group-buying, to help coworkers leverage their numbers. This is a good idea,
yet, if I recall correctly, we also seemed to find geography is still an
issue, because one provider cannot cover many different states, in many
cases.
Inspiration from “Church Plan”Thinking back on a phenomenon that I research for the
http://cooperationcommons.com project, and the
http://p2pfoundation.net project. SamRose came across the “Faith Based Health
Insurance” phenomenon:
The way this works is that “members send a monthly check, or “share,” that
ranges from $200 to $400 to the plan or to members the plan designates with
“needs,” or medical bills. The plans subtract overhead and administrative
expenses from the total collected and use the remainder to pay claims”
Members are “vetted” or qualified to join the “plan” based on a letter from
their clergy person verifying they are an active church member, and
trustworthy person.
So, what does this have to do with Coworking?This “church plan” shows a plausible legal international route to
sharing health care costs among a network of people, religious or otherwise.
These “church plan” participants are really just donating money to one
another, facilitated by their churches, and by “plan” coordinators. Might a
non-religious network of people also think about a way to pool money, and
route it to people who need it in this way? Some of us think so.
The idea here is that it is legal for us to give money to each other for
pretty much anything we want to, so it becomes a matter of figuring out how
we can give each other money in an equitable, not-for-profit way, that can
systematize some aspects, and can buil on inherent trust.
The System Evisioned:1. Participation is based upon the trust metrics of others who are already in the network (others “vouch” for you on the local CoWorking level). Each participant joins a local group made up of people they actually know. Each group votes on whether it will participate with other groups, based on an AggregatedRating for each group.
2. Each donor is given a mechnism for splitting their donation up and paying out to all others in the network who have donation requests
3. The system calculates the minimum that each donor would need to pay to ensure that all donation requests in the network or the month are fulfilled. (When possible, larger lump sum requests are split up across as many months as possible per donation request)
Goal: 100% coverage for all users.
Factors that impact use of system - Items To Do- The IRS holds donor responsible for gifts, you may
currently give $12,000.00 US per year, $1,000,000 ove lifetime before paying these taxes (don’t
know what state laws are) [www.irs.gov]
1. You would not be able to write off your contributions into the
system
2. You would not have to pay taxes on your contributions into the
system, because even if you contributed as much as $500 per month,
you would only have contributed 6000.00 per year (this would of course
eat into you ability to give other gifts, except to qualifying
charities, which would then allow you to claim a deduction)
3. It would appear that you would still be allowed to write off your
health care costs off of the top of your income, even though they
would all presumably be payed by the donation system. This is because
the recipient does not have to declare the gift as income. This needs
further research, but I believe I am right about this.
This also does not factor in what you state government may do with
regards to taxing gifts, if anything.
4. Total actual healthcare costs for US citizen (not monthly insurance premiums, but actual billed costs from care providers) per capita (average) in 2005 is $6401.00 (from http://www.oecd.org/dataoecd/46/36/38979632.xls) about 533.00 per month. So, given that this is average, monthly minimum donation to create 100% coverage for all involved could range from roughly $50-$500 per month. Donation requests might need to be “throttled” to a maximum per month to keep system stable. These are only quick rough numbers. Full research needed to create accurate picture of system dynamics.
5. 50 state legality needs to be researched, and vetted by lawyer before any actual exchange of money takes place
Example tools that can facilitate exchange- http://donorge.org (modified or recreated from scratch)