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The ABCs of healthcare: a glossary of the key plans

Understanding co-ops, public options, and single-payer plans is central to understanding the debate.

A protester holds a sign outside a building in Dallas on Monday where two lawmakers were holding an event on healthcare reform.

Jessica Rinaldi/Reuters

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The healthcare debate revolves around three different forms of healthcare: a single-payer option, a so-called “public option,” and, most recently, healthcare cooperatives. At times, interest groups have sought to create confusion about what is actually in play or what each form of healthcare would or wouldn't do.

Here is a primer:

Healthcare cooperatives

This option has become more prominent in recent days, because it is seen as perhaps the only reform plan that could win support from Republicans as well as Democrats.

In healthcare cooperatives, payers would come together to run their own insurance in a nonprofit system.

To begin, these cooperatives would be initially funded by start-up money from the government. This option's primary backer, Sen. Kent Conrad (D) of North Dakota, said about $6 billion would be needed to establish nonprofit cooperative networks at the national, state, and local levels.

Proponents say healthcare cooperatives would create competition for private insurers – potentially driving costs down – without expanding the size and scope of the federal government significantly. There are already existing healthcare models in Washington State, California, and Minnesota, as well as other successful cooperative models in other industries, such as electricity and agriculture.

But the fact that cooperative systems are already legal and operational is a strike against them, critics say. They occupy only a tiny sliver of the existing healthcare market and are best as smaller organizations. As they grow, cooperatives tend to become “unwieldy,” says William Dow, chair of the health services and policy analysis group at the University of California in Berkeley. “It’s a hard model to scale up to any large size, so that it would be large enough to cover a nontrivial portion of the community.”


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