Self Employed Health Insurance Redux: Donation-Based P2P Health Cost Sharing Networks
Samuel Rose
I think previously, we tentatively figured out ( http://tinyurl.com/328dk8) (summarized at http://wiki.coworking.info/Healthcare ) 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.
I think we also tentatively figured out that local laws make creating one network-wide solution very problematic.
I think Chris, 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.
Earlier today, I was thinking back on a phenomenon that I research for the http://cooperationcommons.com project, and the http://p2pfoundation.net project. I came across the "Faith Based Health Insurance" phenomenon:
http://www.medicalnewstoday.com/articles/32630.php
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?
Well, 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? I think so.
The system that I envision here is:
- Participation is based upon the trust metrics of others who are already in the network (others "vouch" for you).
- Money is pooled on the scale of coworking spaces. Pariticpants pay a trusted volunteer in their local homebase coworking space
- Verification of medical need happens on the scale of coworking spaces, with the ability to appeal to the greater network shuld the local coworking network fail to assist or address for some reason. Participants may opt to bypass the network and send donations directly to people who are appealing this way
- Coordination of local spaces is done through a group of elected, term-serving network orchestrators, who are dispersed around the network, and who split up the labor in a diverse way, so that one local person does not become the "lord and master" of their own local region. Other people are elected to act as voluntary impartial mediators and conflict resolvers
- P2P open identity based trust metrics help keep trust issues transparent
- All donated monies are totally transparent and accounted for, 100%
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.
ย
--
Sam Rose
Social Synergy
Cel: +1-517-974-6451
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Linkedin Profile: https://www.linkedin.com/in/samrose
skype: samuelrose
email: samue...@gmail.com
http://socialsynergyweb.com/services
http://blog.socialsynergyweb.com
http://socialsynergyweb.net/cgi-bin/wiki/FrontPage
Related Sites/Blogs/Projects:
http://p2pfoundation.net
http://blog.p2pfoundation.net
http://www.cooperationcommons.com/cooperation-commons
http://smartmobs.com
http://barcampbank.com
Samuel Rose
> term-serving network orchestrators, who are dispersed around the network,
> and who split up the labor in a diverse way, so that one local person does
> not become the "lord and master" of their own local region. Other people are
> elected to act as voluntary impartial mediators and conflict resolvers
I should add to this that "coordination" and "orchestration" is really
not much more than message amplifying. Making sure that the whole
network is aware of where money is needed on any given month, or week.
So, there really is not much "power" in this role.
Graham Freeman
On 21 Aug 07, at 10:58, Samuel Rose wrote:
> 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.
What about people like me who are atheists and eminently trustworthy
and moral people?
Sorry, I don't mean to bash on your proposal, as health care in the
US needs all of the innovative thought and energy it can get, but I'm
also pretty darn tired of being assumed to be amoral/immoral just
because I've never needed the help of a bunch of old white men to
figure out what's right and what's wrong. I'm an atheist, and that
does not mean I'm a bad person. You may be a Christian, but that
doesn't mean you're a bad person either.
...getting back on topic...
FWIW, I don't think the current regulatory environment in the USA
makes health insurance coverage a good fit for a coworking group in
the USA. Real estate issues are different from health insurance
issues, and they take fairly different solutions, resources, and
skillsets. The only way I could see this kind of thing working is if
each coworking space took on its regulars as paid staff and insured
them that way. For most groups, that's much more commitment than
makes sense for other important aspects of the business model.
Graham
Geoff DiMasi
Alex Hillman
-Alex
-----
--
-----
Alex Hillman
web.developer.innovation.consultant
vocal: 484.597.6256
digital: al...@weknowhtml.com | skype: dangerouslyawesome
visual: www.weknowhtml.com | www.dangerouslyawesome.com
local: www.independentshall.org
Samuel Rose
thing as a network of non-religious people. There would be no religion
requirement of any kind in the idea I am talking about here. The only
requirement would be that other people in the network can verify that
you are real and trustworthy
Tara Hunt
Like a co-operative.
Sounds radically Canadian, really. ;)
It will just take time. And lots of research. And I'll just bet the insurance companies have some sort of great lobby against this kind of thing that seems to smack of communal thinking (the reds!).
Maybe we need to have a HealthCamp. Get Michael Moore involved, even. :)
Tara
tara 'miss rogue' hunt
co-founder & CMO
Citizen Agency (www.citizenagency.com)
blog: www.horsepigcow.com
phone: 415-694-1951
fax: 415-727-5335
Alex Hillman
Graham Freeman
On 21 Aug 07, at 17:17, Samuel Rose wrote:
> To clarify, the idea I was proposing is that people could do a similar
> thing as a network of non-religious people. There would be no religion
> requirement of any kind in the idea I am talking about here. The only
> requirement would be that other people in the network can verify that
> you are real and trustworthy
>
Sam, I apologize - I mis-read your message such that I thought you
were encouraging a religious tie-in.
I think I was touchy after recently hearing an insipid puff piece
masquerading as journalism on NPR about how parents' worst nightmares
are of their kids marrying atheists. The "reporter" went so far as
to devote an extended portion of her time to talking about an episode
of some prime-time TV show, as if that had any bearing on the real
world.
So, when I read something that I interpreted as meaning that only
Christians who are in good standing with church officials should get
health care, I got annoyed and only skimmed the rest of your post.
I'll try to read more carefully next time. :)
Graham
Geoff DiMasi
Samuel Rose
first things that I am doing right now is getting feedback from the
Cooperation Commons project (homepage here: http://cooperationcommons.com/)
Cooperation commons includes some of the best minds in the areas of
human cooperation/trust/socio-politics/human complexity and
cooperation as it relates to Anthropology, Biology, Poltical Science,
Law, Economics, Cultural evolution, Business, Education, History,
Information science, and more
I've posed the question here: http://tinyurl.com/yrfzyo and people
have responded on, and offlist.
We are exploring similar ideas in BarCampBank (see:
http://www.wikiservice.at/fractal/wikidev.cgi?EN/BarCampBank) and at
http://communitywiki.org, at least in terms of trust and exchanging
currency. It's a brave new world to tread into, for sure, but so far,
many educated and knowledgeable people agree that exchanging donations
in the way that I describe is internationally legal, and almost
universally unregulated (depending on what you say the gift is for, in
some areas).
One bit of feedback I've received from Cooperation Commons folk is
that it is more likely that gift exchanges will succeed among people
who are connected through a common interest (in this case, co-
working). I think our http://communitywiki.org/en/communityWikiBank
experiment is one real world example that shows how a trust exchange
like this can work on a small scale. And, on the flip side this shows
how things can quickly fall apart when a system designed with good
intentions begins focusing more on money and short term profits
(especially when p2p money systems are run by traditional
corporations): http://blog.socialsynergyweb.com/2007/08/16/the-prosper-lender-rebellion-and-the-us-creditborrowing-black-hole/
Prosper is having problems because they lost their focus on trust
among small groups of people. To get a loan on prosper, it is
"recommended", though not required that a borrower join an affinity
group, like a group of people who are borrowing to buy apple
computers, etc. The prosper design was that these groups would help
ensure payback of loans, by creating a reputation/trust group rating,
which puts social pressure on individuals to help maintain the group
rating, and also can optionally reward existing group members for
helping sustain good group ratings. This all used to be right on the
"about" page of Prosper. However, now if you look there, there is
little if anythign mentioned about "groups": http://www.prosper.com/borrow/about_borrowing.aspx
And, not surprisingly, payback rates have plummeted on Prosper in
recent months. Lenders are leaving, people are starting to game the
system. Prosper is now more focused on getting new borrowers and new
lenders in, then on maintaining and growing the community, in my
opinion. Jessica Margolin pointed this out to me here:
http://future.iftf.org/2007/08/finance-prosper.html
Now, if Propser had focused on the groups more, and on building and
sustaining more quality groups under their original vision, and on
creating and encouraging lots of communication, things could be
different.
So, this suggests to me a possible direction for people interested in
donation based P2P exchange networks: make as much of the nitty gritty
dirty detail work happen on the small local scales as possible, then
let communications about locally verified need happen on a group-to-
group scale, but let actual money exchanges happen on an individual
scale, with each person inputting their donation out to the network.
And, let as much as possible be transparent. I suggest systematized
trust based donation to solve this problem, because it is the least
subject to stringent local regulation, and because there are existing
examples of systems like this actual working on large scales.
Also, HealthCamp would be awesome, with or without Micheal
Moore :)
On Aug 22, 8:33 am, "Alex Hillman" <dangerouslyawes...@gmail.com>
wrote:
> Flip the system on a large scale from the inside out? Count me in :-)
>
> On 8/21/07, Tara Hunt <horsepig...@gmail.com> wrote:
>
>
>
>
>
> > I really love Sam's idea. Personally, and after many bad experiences with
> > the health care insurance companies down here (I'd like to know what they DO
> > cover, really...'cause it seems like nothing), I'd love to subvert their
> > system and create a truly community based approach to this.
>
> > Like a co-operative.
>
> > Sounds radically Canadian, really. ;)
>
> > It will just take time. And lots of research. And I'll just bet the
> > insurance companies have some sort of great lobby against this kind of thing
> > that seems to smack of communal thinking (the reds!).
>
> > Maybe we need to have a HealthCamp. Get Michael Moore involved, even. :)
>
> > Tara
>
> digital: a...@weknowhtml.com | skype: dangerouslyawesome
Samuel Rose
Atheism, too, while driving.
It's culturally interesting to note that in the US, a lot of the
support for quite a few people came from churches and religious groups
for many years. Then, after WWII, although many people still were
active in their churches, the new support system became the large
companies and industries that people worked for. This new supportby
these companies created a social and economic pathway in the 1960's
and 1970's for many people to isolate themselves from all other
communities besides their employer (including traditional religious
communities). Now that industries have largely withdrawn this support
(in the form of donating less to local civic development, scaling back
on health insurance and retirement, removing pathways to lifelong
employment), many people are cut adrift with out much of any community
to attach to. So, Coworking communities offer one very promising
emerging way for people to build new support communities, that can
adapt and change to volitile conditions, and that can still focus on
positive values like trust, sustainability, social equity, and to
avoid some of the negative focuses and mistakes of past socio-cultural
support systems.
Derek
before a new model is created for coworkers - I would also suggest
checking with any organizations you may have any vague connection
with. We've actually been surprised by the number of organizations we
know that have plans available for individuals and small companies.
It may provide you with what you need and provide negotiating leverage
if needed. Our Chamber of Commerce has pre-negotiated health care
packages and has shown an interest in making it work for the coworker
members in our space (It might work. It might not.). The National
Trust for Historic Preservation has rates for its members. The rates
and/or benefits have been better than what we could get on our own.
Derek Young
(We'll be announcing our new coworking space in the next few days...)
Tara Hunt
willing to insure us...
But it isn't getting the insurance that is an issue here. It's what
happens when you get sick. I was paying $500/month for a full-blown
kickass plan that covered, what I thought was, everything. Now I'm
still wading under over a thousand dollars worth of bills for pretty
routine stuff because they didn't think a woman my age should have
tests of those types. They also didn't cover an emergency room visit
(wrong hospital I guess) that resulted in being sent away (they didn't
do anything, but I'm looking at a $500 bill for waiting for 2 hours).
The issue so far for me and for many others I know isn't getting
health care (nor at a reasonable rate), it is getting our costs
reimbursed. HMO's and PPO's are for profit entities who have a stake
in getting your money, then not paying out.
Of course, I'm Canadian, so I'm perplexed at the entire system and why
it is that every one of you aren't so angry about being treated like
this that you aren't storming the whitehouse with pitchforks. I simply
don't understand, but I suppose if I was treated like I should be
thankful that I get something (anything!) covered after paying $6000 a
year all of my life and wasn't raised believing that basic healthcare
is a right, not a privilege, I wouldn't be angry, either.
Thank goodness you have angry people around. ;) Be prepared to be
pampered someday and realize what your health is worth....
Tara
David Doolin
> don't understand, but I suppose if I was treated like I should be
> thankful that I get something (anything!) covered after paying $6000 a
> year all of my life and wasn't raised believing that basic healthcare
> is a right, not a privilege, I wouldn't be angry, either.
Some background, followed by opinion:
The current situation is partly due to the fact that the AMA
is the most powerful labor union in the US. With the supply
of doctors strictly limited by admissions policy, the legislative
clout to enforce licensing, the ruinous cost of medical school
and the liability risk of practicing medicine independently, the
current situation will only get worse.
I remember when the legislation passed to allow HMO's
to operate. They were touted as providing "economies
of scale" to "drive down the high cost of medical care."
It all sounded great at the time. But anyone (not me at
that time) with a basic sense of economics must have
known that inserting a middleman into every health care
transaction could only raise prices in the long run. Now,
the middleman must be present, either by market
force or by law, with the usual result: out of control
pricing.
Probably the only long term solution is forming a
formal non-profit collective, and growing it to be
large enough to go mano-a-mano with the likes
of Kaiser. Large as in UC size large.
FWIW, I am philosophically opposed to "positive
rights" such as a "right" to health care. But I
am also *very* much opposed to collusion by
state- and federal-funded medical schools to
limit admissions thus limit the number of
doctors in the work force. My tax dollars should
not be supporting such an educational system.
Given the "right" of state-funded schools to
perpetuate a monopoly on the labor supply,
we as consumers don't have any other recourse
than to demand stricter regulation on health
care pricing. On the other hand, if there were
a lot more doctors looking for work, perhaps
the current situation would resolve itself more
equitably.
There is also the fact that a very large number
of people are supported by the "health care
industry." People that manage health care
services rather than providing medical care.
As the industry grows, so will the number of
people receiving paychecks for performing
"work" sans providing a service to the consumer.
These people are dependent on your big
monthly payment, and they vote too. Downsizing
the health care industry will put many of these
people out of work with the usual consequences
of risk to the economy and an increased load
on local government services. Hopefully
temporary.
I feel strangely compelled to spin some Floyd
at the moment: http://www.pink-floyd-lyrics.com/html/animals-lyrics.html
Please take all of the above for what it's worth:
an opinion, tempered by experience (I'm practically
fossilized), but still, just an opinion.
-d
Samuel Rose
I wanted to point out that I came across an interesting system that
could facilitate p2p donation-based economies:
Donorge: http://bfwatch.barcampbank.org/?q=node/186 see also http://donorge.org
Right now, this is a Drupal based system, that incorporates the type
of "vouching" or advocating for other people. (This tool could be used
for many types of donation-based projects, not just for a p2p
healthcare donation system)
I can see that this system would need some modification to do what
we've talked about here, but it possesses most of the needed
ingredients already.
Also, see response from Jessica Margolin at cooperationcommons group
here:
http://groups.google.com/group/CooperationCommons/browse_thread/thread/9eecef31d81e745
On Aug 22, 9:48 pm, "David Doolin" <david.doo...@gmail.com> wrote:
Samuel Rose
On Aug 22, 9:05 pm, "Tara Hunt" <horsepig...@gmail.com> wrote:
> Oh yes. All of the HMO's have plans for small business. They are very
> willing to insure us...
>
> But it isn't getting the insurance that is an issue here. It's what
> happens when you get sick. I was paying $500/month for a full-blown
> kickass plan that covered, what I thought was, everything. Now I'm
> still wading under over a thousand dollars worth of bills for pretty
> routine stuff because they didn't think a woman my age should have
> tests of those types. They also didn't cover an emergency room visit
> (wrong hospital I guess) that resulted in being sent away (they didn't
> do anything, but I'm looking at a $500 bill for waiting for 2 hours).
Exactly.
The Greeks and Romans had an early donation-based funding system for
health care , and funeral costs, that was tied to their guild system.
Modern "insurance", as a service in general was originally designed to
be a hedge fund, which means that it is an market enterprise. Our
modern insurance system was originally designed and formulated by
Lloyd's of London to hedge financial losses in shipping disasters.
Entrepreneurs would make a contract with the insurer to spread risk
out among everyone in the fund, no different fundamentally, than any
other hedge, or mutual fund. This is a equitable solution for people
who launch into business ventures that contain a certain amount of
risk. They are launching into these ventures for profit first and
foremost, and they can employ the insurance hedge fund as an agent to
collectively spread risk across all of the people in their market
segment. They are at the whim of the greater market place, but both
sides are making decent bets, usually, and the insurer is guaranteeing
against to disaster up to a certain point, at a certain market rate.
To me, this does not sound like a good way to fund my health care
costs. I don't want to buy a share in a hedge fund that it pitted
directly against the market place, because what happens is that, as
the cost of health care increases, it costs more money to hedge our
bets against the health care markets. One problem is that health care
providers, and drug providers inflate costs, of course. But the bigger
problem is that volatile markets are no place for a vital need like
heatlh care funding. When health care funding is market driven, then
the fund managers are forced to start cutting out more and more
coverage to balance their hedge fund against the health care market
place. This is why they cover less and less, while you pay more and
more. The same dynamics apply as someone calculating the current costs
of replacing a ship and all of it's cargo, should it capsize and sink
in the ocean. Under US and State Laws, this type of hedge fund
commerce is understandably regulated like any other market. It is a
market!
So, in my mind, the solution is simple, roll back to the ancient greek
and roman system of group/trade/community-based donation. Take the
money we putting towards health care costs off of the market, and give
it directly to people who need it. The same could be said for certain
types of disaster insurance. Look at how many people got screwed by
the insurance companies down in the Gulf after Hurricane Katrina. The
insurance companies scrambled to readjust to the markets, because they
are pitted against the markets, and the contracts people made with
them let the insurance companies loosely interpret what types of
"damage" happened, and whether they should pay claims or not. Frankly,
this is insane. What is the use of a group of people pooling money, if
some of them will be discluded from the the help they need, when it is
needed? This is the wrong way to leverage the power of groups for
solving vital human needs. It's time to take our health and personal
welfare off of the market place, and into our own hands.
>
> The issue so far for me and for many others I know isn't getting
> health care (nor at a reasonable rate), it is getting our costs
> reimbursed. HMO's and PPO's are for profit entities who have a stake
> in getting your money, then not paying out.
>
> Of course, I'm Canadian, so I'm perplexed at the entire system and why
> it is that every one of you aren't so angry about being treated like
> this that you aren't storming the whitehouse with pitchforks. I simply
> don't understand, but I suppose if I was treated like I should be
> thankful that I get something (anything!) covered after paying $6000 a
> year all of my life and wasn't raised believing that basic healthcare
> is a right, not a privilege, I wouldn't be angry, either.
>
> Thank goodness you have angry people around. ;) Be prepared to be
> pampered someday and realize what your health is worth....
>
> Tara
>
Samuel Rose
artificially limiting the "supply" of doctors, egged on by the AMA. I
guess I am not surprised, but I wasn't aware of this.
On Aug 22, 9:48 pm, "David Doolin" <david.doo...@gmail.com> wrote:
Samuel Rose
On Aug 22, 9:48 pm, "David Doolin" <david.doo...@gmail.com> wrote:
>
> Probably the only long term solution is forming a
> formal non-profit collective, and growing it to be
> large enough to go mano-a-mano with the likes
> of Kaiser. Large as in UC size large.
>
I don't know, I think people do not realize what the current legal
system allows them to do, in terms of giving money to one another for
legal purposes. And, i think people don't realize that increase
knowledge about cooperation, and improving tools to facilitate
decentralized voluntary cooperation, offer alternatives other than
centrally controlled, monolithic organizations for solving problems
like this.
Tara Hunt
What does the current legal system allow me to do in terms of giving money to one another...? (You may have explained it, but I think I missed it).
T
Samuel Rose
on simply giving money to one another. Other than donating to
soemthing like a terrorist organization, or something bad and illegal.
It is legal for me to send you $100 towards the cost of your health
care. It is also legal for everyone at Citizenspace, or another
coworking group to pool $100 each every month, and then give it to
other people in other coworkign groups, to fund their health care
costs. If you create an insurance hedge fund, or even a not-for-profit
cooperative-group managed insurance hedge fund, you are subject to
state laws. But, if yo simply give the money directly to people who
need it, then you are not subject to this regulation. This is how the
"church fund" example that I discussed earlier works. They funnel
millions of dollars around, basically from donors directly to people
who have medical bills to pay, mediated pretty much mostly by a group
who publish a newsletter directing people where to send money to next.
The system works amazingly well, and costs each participant very
little in comparison to insurance available from commerical or other
providers. And, everyone gets all of their costs paid.
I am not suggesting that we would actually mirror-emulate the "church
plan" system, but I think a good amount of the fundamental mechanics
can be used. Although, instead of a "newsletter", people might be
signaled as to where to send there donations based on a website, for
instance. Donation requests get listed on the site by being vetted
locally, by local coworking groups, for instance. The http://donorge.org
system actually is a good model for what I am thinking of.
On Aug 25, 11:54 am, "Tara Hunt" <horsepig...@gmail.com> wrote:
> RE: I think people do not realize what the current legal system allows them
> to do, in terms of giving money to one another for legal purposes.
>
> What does the current legal system allow me to do in terms of giving money
> to one another...? (You may have explained it, but I think I missed it).
>
> T
>
David Doolin
[]
> Entrepreneurs would make a contract with the insurer to spread risk
> out among everyone in the fund, no different fundamentally, than any
> other hedge, or mutual fund. This is a equitable solution for people
> who launch into business ventures that contain a certain amount of
> risk. They are launching into these ventures for profit first and
> foremost, and they can employ the insurance hedge fund as an agent to
> collectively spread risk across all of the people in their market
Indeed.
> segment. They are at the whim of the greater market place, but both
> sides are making decent bets, usually, and the insurer is guaranteeing
> against to disaster up to a certain point, at a certain market rate.
>
> To me, this does not sound like a good way to fund my health care
> costs. I don't want to buy a share in a hedge fund that it pitted
> directly against the market place, because what happens is that, as
This system works pretty well provided the risks are unknown,
and the cost of care relatively low.
Now, with modern medicine and actuarial science, the amount
of risk for the insurer is much, much lower, while the costs for
care much, much higher.
The market is very efficient, and is an excellent way for
economic activity to self-organize. Unfortunately, there
really isn't any such thing as a free market; there is
always a tendency to monopoly control in an unregulated
system (ATT anyone?).
Excellent discussion.
My interest is high as Kaiser just denied me corporate
group care: my company is too small.
-dave
David Doolin
> on simply giving money to one another. Other than donating to
> soemthing like a terrorist organization, or something bad and illegal.
>
> It is legal for me to send you $100 towards the cost of your health
> care. It is also legal for everyone at Citizenspace, or another
> coworking group to pool $100 each every month, and then give it to
> other people in other coworkign groups, to fund their health care
> costs. If you create an insurance hedge fund, or even a not-for-profit
> cooperative-group managed insurance hedge fund, you are subject to
> state laws. But, if yo simply give the money directly to people who
You are subject to state laws in any case. These donations are gifts,
and there is a large body tax code regulating gifts, including the
size of gifts, what the gifts result from, what they apply to, etc.
> need it, then you are not subject to this regulation. This is how the
> "church fund" example that I discussed earlier works. They funnel
> millions of dollars around, basically from donors directly to people
> who have medical bills to pay, mediated pretty much mostly by a group
> who publish a newsletter directing people where to send money to next.
> The system works amazingly well, and costs each participant very
> little in comparison to insurance available from commerical or other
> providers. And, everyone gets all of their costs paid.
No, not everyone. The state *will* insist on their "fair" share.
Coworking and related social experiments do not draw regulatory
attention, yet: you can't get blood from a turnip. That is, there
isn't enough money changing hands among people with enough
assets to justify applying current tax code, develop new tax code,
or audit. If coworking "takes off," the tax man will be at the door
PDQ. This is sure as the sun rises in the east.
Any "solution" that doesn't make sure the state gets paid is doomed.
Barter is taxable, on both federal and state level.
Buying from out-of-state is taxable (use tax).
Health care is solveable at the current coworking scale
of operations, but not without meeting all the state and
federal regulations. The system can be hacked, but
hacking requires intimate knowledge of the system.
I am not trying to be discouraging here, but I won't
commit any money to anything until I know there
won't be any trouble from federal or state tax
bodies. I can write health care off the top of
my income, if I can't write off donations into
a p2p system, I can't afford to use it.
David Doolin
the federal and state governments reserve their right to regulate
and tax the transaction. They can do this because because
they have all guns. It's that simple.
http://www.irs.gov/businesses/small/article/0,,id=164872,00.html
Health care is solvable, no doubt, but not without meeting
all appropriate state and federal regulations.
Whoever takes this on, and cracks it, will be able to
make a very respectable living providing consulting
services to like-minded organizations. I believe that
time donated to this enterprise could be deducted
for AGI, provided the necessary paperwork was
handled up front.
Here is an offer: $150 donation to get a CA or
DE non-profit incorporated to formally explore
health care options for the coworking model.
CA does not charge 1st year franchise fee
($800), so this can be done reasonably
inexpensively. As a bonus, I need to make
a trip to Sac this fall for other state-related
business, and would be delighted to have
someone ride. In my experience, doing
business in Sacramento is faster than
doing state business in San Francisco,
even with the drive involved.
-d
Chris Johnston
Christopher M. Johnston
http://techchris.com
http://twitter.com/chrisjohnston
http://chrisjohnston.jaiku.com/
http://www.linkedin.com/in/chrisjohnston
http://www.primerica.com/chrisjohnston
"I came here to win. I didn't come to hit a few balls, or to walk around on a nice day, or to drop a few pounds. I came here to win."
-Tiger Woods
Samuel Rose
On Aug 26, 3:03 pm, "Chris Johnston" <cmjohns...@gmail.com> wrote:
> When I received my insurance license I specifically remember that large
> employers fraternal organizations were allowed to offer health insurance to
> their employees as a group and the insure could spread the risk out over the
> entire group. In fact, the National Association of Realtors just started
> doing this. I also remember that is not allowed for any group to join
> together for the specific purpose of lowering their insurance cost. There
> must be some other compelling or logical reason for you to be banded
> together. I think that this health insurance fund idea runs afoul of this
> regulation.
It could very well be possible that there are regulations that stop
people from pooling money to buy insurance at a lower cost, or to
create a group specifically to lower health insurance costs.
*BUT*, these regulations do not apply to people *giving money directly
to each other*. There is no law that stops me from *giving* you money,
for most purposes. And, there is no law that stops you from using the
cash that I give you to pay for health care. There just isn't. There
also is no law that stops people from constantly giving each other
money. Giving money *is not* insurance. Insurance is a hedge fund that
is regulated thusly. Insurance is a *contract*. There is no contract
involved in what I discuss here. What I propose is not insurance of
any kind. Again, I *do not want my health care costs pitted against a
volatile market by way of insurance*. This is precisely why I propose
some **other than** insurance. Plus, I offer you an example of an
existing nation wide system of people doing exactly what I describe
(giving each other money). Here's one of many examples on
fundraising sites that are online right now:
http://www.fundable.org/groupactions/groupaction.2007-07-22.6231047500/view?searchterm=health%20care
There is no regulation on donation-based health care.
In other news:
An idea that I though of today could actually suggest the amount of
minimum donation each user should submit, per-month or otherwise, to
fully cover costs for the whole network. The same tool could also give
the user the option to automatically split up each donation across all
of the requests for donation, based on where the funds are needed.
>
> Christopher M. Johnstonhttp://techchris.comhttp://twitter.com/chrisjohnstonhttp://chrisjohnston.jaiku.com/http://www.linkedin.com/in/chrisjohnstonhttp://www.primerica.com/chrisjohnston
> "I came here to win. I didn't come to hit a few balls, or to walk around on
> a nice day, or to drop a few pounds. I came here to win."
> -Tiger Woods
>
> > On 8/25/07, Tara Hunt <horsepig...@gmail.com> wrote:
> > > RE: I think people do not realize what the current legal system allows
> > them
> > > to do, in terms of giving money to one another for legal purposes.
>
> > > What does the current legal system allow me to do in terms of giving
> > money
> > > to one another...? (You may have explained it, but I think I missed it).
>
> > > T
>
Samuel Rose
On Aug 26, 12:55 pm, "David Doolin" <david.doo...@gmail.com> wrote:
> On 8/25/07, Samuel Rose <samuel.r...@gmail.com> wrote:
>
>
>
> > Well, so far as I know, there is not a lot of regulation/restriction
> > on simply giving money to one another. Other than donating to
> > soemthing like a terrorist organization, or something bad and illegal.
>
> > It is legal for me to send you $100 towards the cost of your health
> > care. It is also legal for everyone at Citizenspace, or another
> > coworking group to pool $100 each every month, and then give it to
> > other people in other coworkign groups, to fund their health care
> > costs. If you create an insurance hedge fund, or even a not-for-profit
> > cooperative-group managed insurance hedge fund, you are subject to
> > state laws. But, if yo simply give the money directly to people who
>
> You are subject to state laws in any case. These donations are gifts,
> and there is a large body tax code regulating gifts, including the
> size of gifts, what the gifts result from, what they apply to, etc.
Every individual is of course required to rectify their income with
all governing bodies. But, there is very little regulation on the
exchange of gifts itself. You don't need formal licenses or governing
bodies to set up an exchange of donations, so far as I know.
>
> > need it, then you are not subject to this regulation. This is how the
> > "church fund" example that I discussed earlier works. They funnel
> > millions of dollars around, basically from donors directly to people
> > who have medical bills to pay, mediated pretty much mostly by a group
> > who publish a newsletter directing people where to send money to next.
> > The system works amazingly well, and costs each participant very
> > little in comparison to insurance available from commerical or other
> > providers. And, everyone gets all of their costs paid.
>
> No, not everyone. The state *will* insist on their "fair" share.
As far as I know, the state does not tax the "church plan" example
that I talked about previously. But, this could be because they are
religious organizations, which are usually not subject to tax....
>
> Coworking and related social experiments do not draw regulatory
> attention, yet: you can't get blood from a turnip. That is, there
> isn't enough money changing hands among people with enough
> assets to justify applying current tax code, develop new tax code,
> or audit. If coworking "takes off," the tax man will be at the door
> PDQ. This is sure as the sun rises in the east.
>
> Any "solution" that doesn't make sure the state gets paid is doomed.
>
> Barter is taxable, on both federal and state level.
>
> Buying from out-of-state is taxable (use tax).
>
> Health care is solveable at the current coworking scale
> of operations, but not without meeting all the state and
> federal regulations. The system can be hacked, but
> hacking requires intimate knowledge of the system.
>
> I am not trying to be discouraging here, but I won't
> commit any money to anything until I know there
> won't be any trouble from federal or state tax
> bodies. I can write health care off the top of
> my income, if I can't write off donations into
> a p2p system, I can't afford to use it.
I am not really asking anyone to commit any money to anything at this
time, at least not without rigerous research about the legalities,
plus trust issues etc. I am only proposing nad brainstorming ideas at
this time, and hoping for feedback.
Under the framework/idea that I was suggesting, people would still be
responsible for paying their own taxes, and there would be no formal
organization from which the government could extract taxes. Actual
payments would be from one person, to many others...
Samuel Rose
with any existing regulations. The idea that I propose is a place
where people post requests for donation, and then pay each other the
money directly, possibly using a third party payment provider. It is
basically an information provider about people who are seeking
donations, and how those people may be paid, plus an aggregator of
total amounts of money sought among all people who list requests for
donation. Not much different than the http://donorge.org model
> On 8/25/07, Tara Hunt <horsepig...@gmail.com> wrote:
>
> > RE: I think people do not realize what the current legal system allows them
> > to do, in terms of giving money to one another for legal purposes.
>
> > What does the current legal system allow me to do in terms of giving money
> > to one another...? (You may have explained it, but I think I missed it).
>
> > T
>
Samuel Rose
currently give $12,000.00 US per year before paying these taxes (don't
know what state laws are)
http://www.irs.gov/businesses/small/article/0,,id=164872,00.html
Samuel Rose
(apparently you can give 1,000,000 over your lifetime, also detailed
on IRS site)
Samuel Rose
>
> I am not trying to be discouraging here, but I won't
> commit any money to anything until I know there
> won't be any trouble from federal or state tax
> bodies. I can write health care off the top of
> my income, if I can't write off donations into
> a p2p system, I can't afford to use it.
You raise a great point, because we all have a complex reality to deal
with when it comes to balancing personal taxes and income.
Incidentally, here's another site that talks about Gift Tax
http://www.fairmark.com/begin/gifts.htm
I think that the apparent overall reality of the idea I presented here
is that:
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. My state (MI) apparently does
not have any "gift" tax as of yet... So, I would say that with a
lifetime limit of 1 million dollars, the government has given people a
way to potentially utilize that "gift" leeway in the manner I
describe.
Chris Johnston
Donations would not be regulated except, as previously mentioned, by gift tax rules if you are in the US. I just joined this group on Friday.ย I'm interested in bringing this idea to the New Orleans area but I don't know if there is enough market demand. I'm going to keep reading and testing the market.
Chris Johnston
David Doolin
You are making some very good headway here
on the necessary background research.
It really sucks that it isn't legal to band together
for the express purpose of obtaining health care.
That just just sounds really wrong. No free market
there. In fact, it sounds unconstitutional frankly.
Thanks so much for looking into this, and for
posting your findings here on the coworking list.
I am looking forward to reading more. My
offer to help financially underwrite an appropriate
non-profit vehicle still stands.
-dave d
On 8/26/07, Samuel Rose <samue...@gmail.com> wrote:
>
>
> >
Samuel Rose
the idea further.
It may turn out that there is not enough interest among CoWorkers to
actually try out this idea in reality, but either way the feedback and
discussion has really been helpful and useful in thinking about this.
I think that it is legal to band together to create a health care
funding entity in some states that have thrown people a "bone", like
Wisconsin: http://www.commonwealthfund.org/innovations/innovations_show.htm?doc_id=278334,
but very limited (Wisconsin, for instance, allowed a total of 5 such
cooperatives, and only after there was an apparent dire need among
farmers).
But, it should be a right, like the right to unionize, or it should be
at least on the same level as forming a credit union, which is more
possible than forming a health care union/cooperative. It's pretty sad
when people are willing and able to solve problems on their own, but
the law prevents them from doing so. In my mind, the freedom for any
group of people to form cooperatives for the purpose of funding health
care is probably one of the best long-term solutions to problem of
health care funding.
Although, as you can see, I also personally think there is some real
promise in donation-based networks for solving certain problems.
Chris wrote:
I apologize. I jumped to a conclusion based on information in one post
and I
didn't read the entire thread. I tend to scan through threads without
fully
reading them.
Donations would not be regulated except, as previously mentioned, by
gift
tax rules if you are in the US. I just joined this group on Friday.
I'm
interested in bringing this idea to the New Orleans area but I don't
know if
there is enough market demand. I'm going to keep reading and testing
the
market.
Sam writes: No problem. No apology necessary, please. I do understand,
and this is a reason why I kind of fell out of many mailing lists a
few years ago: too much reading, and too little time to read it
all! :) This time, I am the source of the information overload, and
probably the very least that I should do is to summarize this whole
thing into the coworking wiki site as a concise, easy-to-read page.
So, I'll start doing that today.
Your feedback is greatly appreciated. I think there could definitely
be some demand in New Orleans for a general donation exchange among
trusted people, perhaps not just for health care, but also for a huge
laundry list of vital infrastructure needs that lacing there. I think
that in some cases, in New Orleans, in applications where it is legal,
it would be possible for people with shared interests to create
formalized for-profit and not-for profit cooperatives, which could
help them create permanent self-help infrastructures. I am thinking
here about credit unions, but also investing circles, like those
proposed in the Solari investing "club" model http://solari.com/articles/SolariRiseRuleLaw.htm
which is a model that was created by C. A. Fitts http://solari.com/about/ca_fitts.html
who was Asst. Secratary of HUD under Bush Sr. in the 1990's and has
created a fully legal, tested and real-world applicable model for
local-investing-based self-governing cooperatives. I think that New
Orleans and similar stricken areas that have a void of infrastructure,
could become a new market place for very practical, useful sustainable
ideas, technology, business models, etc, (local food growing/
production, green and sustainable energy design, creating technical
production cycles, internet mediated communication, learning, decision
making/governance, ect if there were people who could coordinate those
who are there locally, and help them pool their money legally, and
help them to seek investment directly as communities based around
location and areas of interest. But that is getting way off of what we
talked about here. I'll give this all a rest for now, and rework this
conversation into the coworking wiki.
Lastly, I'll let coworking people know that these are the types of
ideas and conversations we are exploring in http://barcampbank.org ,
and at http://bfwatch.barcampbank.org, recently also hosted and well
attended in Seattle http://barcampbankseattle.pbwiki.com/ also coming
soon to London, and possibly Philadelphia. There' s still a lot to be
learned and explored about the law/regulations plus trust and human
cooperation dynamics as it applies to creative new ways to finance
different human needs. But, there are also a lot of new ideas, and re-
inventions of old ideas emerging and being tested and experimented
with, so please don't hesitate to engage BarCampBank, if you are
interested...
On Aug 27, 12:03 am, "David Doolin" <david.doo...@gmail.com> wrote:
> Sam,
>
> You are making some very good headway here
> on the necessary background research.
>
> It really sucks that it isn't legal to band together
> for the express purpose of obtaining health care.
> That just just sounds really wrong. No free market
> there. In fact, it sounds unconstitutional frankly.
>
> Thanks so much for looking into this, and for
> posting your findings here on the coworking list.
> I am looking forward to reading more. My
> offer to help financially underwrite an appropriate
> non-profit vehicle still stands.
>
> -dave d
>
Tara Hunt
- Only Americans really need this (as far as I know, there is no other country in the world where the HMOs, etc. have such a black-hat capitalist approach)
- The people that really need this haven't been in a situation where they were screwed by their HMO yet, so they don't have a point of pain to respond to
- Even if the people who need this have been screwed, most don't have any experience with anything better and have been told all of their lives that this is the best way
- And even if you can get past 1-3, there is skepticism that this would ever be able to happen (gov't won't allow it, tax stuff, we aren't big enough, etc.)
- And, lastly, people see these really long messages and don't have a chance to dive into the conversation
Tara
David Doolin
Some points to consider:
* The black hat aspect of this is as driven by
large institutional investors (think, your pension
or 401 plan) as any nefarious scheme to screw
people out of their money. Having, say, $$$ in
a health care mutual fund or ETF provides a little
more perspective, as such an investor may well
recoup health care costs from one side on
the other side.
* IMO, The US tort system is the biggest risk factor
in health care. I'm neither for nor against large
torts, I can see arguments both ways, but either
way the risk of billion dollar torts is a part of
doing business. Any health care union will need
to have a plan for dealing with potentially
of large lawsuits.
* The capitalistic side of this equation is actually
broken, given the situation with medical schools
and legal prohibition against forming a health
care union. In a freer market, neither of these
prohibitions would be allowed.
* This last point concerning forming a union might
provide some serious leverage on the legislative
front, on both sides of congress. The dems will
be interested for obvious reasons, but strangely
enough, the more right repubs would back it because
it allows people more freedom for individual
initiative, with commensurate personal responsibility.
A win/win.
* Some points to consider for legislation... meeting
the following makes for a no-brainer bill:
1) Stirs up strong emotions in a large voting bloc. In this
case, almost every believes Something Must Be Done.
2) Almost impossible to articulate a good argument against it.
Who could argue against less expensive health care without
coming across as anti-consumer?
3) Relatively weak and unfunded opposition who rely only on making
logical arguments, but don't have a political war chest behind them to
give large contributions to Senators and members of Congress.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
This is the hard one: the health care industry has some of the
most powerful backers existing.
4) Allows the proponents to easily score cheap, low-risk political
points. Politicians who oppose the bill on principle can be branded
as against consumers. In this case, opposition is ridiculous.
People can form credit unions for banking, but not health
care unions? Ridiculous.
5) NO DEBATE in Congress -- Both parties needing to
Do Something About Health Care, with the added benefit
of Republicans get "smaller government" out of it.
6) Revenue-neutral. All costs are thrown on the consumers.
Government bears little or no costs. Can this be done?
Almost certainly there will need to be some limited form
of regulation, to the same extent credit unions have at least.
The whole situation is ripe for totally left-field thinking,
so let's keep going!
-d
On 8/27/07, Tara Hunt <horse...@gmail.com> wrote:
> Sam...don't give up...there are probably many people on this list that would
> be interested in a new type of health care coverage...a couple of issues
> that face us right now that may stop people from replying:
>
> Only Americans really need this (as far as I know, there is no other
> country in the world where the HMOs, etc. have such a black-hat capitalist
> approach)
> The people that really need this haven't been in a situation where they were
> screwed by their HMO yet, so they don't have a point of pain to respond to
> Even if the people who need this have been screwed, most don't have any
> experience with anything better and have been told all of their lives that
> this is the best way
> And even if you can get past 1-3, there is skepticism that this would ever
> be able to happen (gov't won't allow it, tax stuff, we aren't big enough,
> etc.)
> And, lastly, people see these really long messages and don't have a chance
> to dive into the conversationSo, what I propose is that you move forward
Samuel Rose
different things have emerged out of these exchanges:
1. An idea about p2p donation-based exchanges
2. A discussion about the issues surrounding creating some form of
equitable formalized healthcare cooperative/union type of organization
that is governed/owned by it's users
I am interested in both, and I am interested in exploring and working
on both, for sure. I think that Dave Doolin is more interested in #2
at this time.
I think that #2 is the optimal solution. But, I think that
accomplishing #2 means creating the political momentum to change the
laws, since most states seem to stringently govern health care
cooperatives. It seems to me that this would take quite a while. Also,
#2 has some issues that conflict with the decentralized nature of
CoWorking in particular. Creating a monolithic organization leaves a
point of failure that can be exploited later. Although, sometimes it
can work out great. One example is http://www.ghc.org/about_gh/index.jhtml
see also http://www.ghc.org/about_gh/co-op_overview/index.jhtml in
Seattle. I am personally interested in exploring this, although my
impression is that it might clash with the coworking model
So, so this is what led me to think about #1, which I think is more
immediately able to be formulated into a working system, because it
doesn't run up against laws and regulations (as much as #2 does). I
was under the impression that you and Factory Joe were interested more
in #1, for these decentralized reasons. Do I have that right? If so,
I'll work these ideas into two separate development tracks.
Sam
On Aug 27, 1:04 pm, "Tara Hunt" <horsepig...@gmail.com> wrote:
> Sam...don't give up...there are probably many people on this list that would
> be interested in a new type of health care coverage...a couple of issues
> that face us right now that may stop people from replying:
>
> 1. Only Americans really need this (as far as I know, there is no
> other country in the world where the HMOs, etc. have such a black-hat
> capitalist approach)
> 2. The people that really need this haven't been in a situation where
> they were screwed by their HMO yet, so they don't have a point of pain to
> respond to
> 3. Even if the people who need this have been screwed, most don't have
> any experience with anything better and have been told all of their lives
> that this is the best way
> 4. And even if you can get past 1-3, there is skepticism that this
> would ever be able to happen (gov't won't allow it, tax stuff, we aren't big
> enough, etc.)
> 5. And, lastly, people see these really long messages and don't have a
> chance to dive into the conversation
>
> So, what I propose is that you move forward with this with David and Chris
> and FactoryJoe and I, who are excited about your initiative on this. If we
> can build a bit of a framework around this and try to make it happen, I'll
> bet that people would be game to give it a try. Hell, we have a contact with
> the Freelancer's Union who probably could use this type of proposal as well.
>
> Tara
>
> On 8/27/07, Samuel Rose <samuel.r...@gmail.com> wrote:
>
>
>
>
>
> > Thanks to all of you for your feedback, and for driving me to research
> > the idea further.
>
> > It may turn out that there is not enough interest among CoWorkers to
> > actually try out this idea in reality, but either way the feedback and
> > discussion has really been helpful and useful in thinking about this.
>
> > I think that it is legal to band together to create a health care
> > funding entity in some states that have thrown people a "bone", like
> > Wisconsin:
> >http://www.commonwealthfund.org/innovations/innovations_show.htm?doc_...
> > and athttp://bfwatch.barcampbank.org, recently also hosted and well
> > attended in Seattlehttp://barcampbankseattle.pbwiki.com/ also coming
> --
> tara 'miss rogue' hunt
> co-founder & CMO
Samuel Rose
http://wiki.coworking.info/Healthcare
There are links on that page to all related pages
I'll keep combing though and reworking. Hopefully, this gives an
easier way to engage than this long thread...
> > > attended in Seattlehttp://barcampbankseattle.pbwiki.com/also coming
> ...
>
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