Senator Kent Conrad (D-North Dakota) is stirring up his fellow Democrats by suggesting that perhaps Washington shouldn’t grant itself a monopoly on providing health insurance. Conrad proposes that the inevitable health care reform set up a system of nonprofit insurance cooperatives (co-ops). It is thus far sketchy on details, but according to an outline released to the press,

the “consumer health cooperatives (co-ops)” would operate “at the state level or regionally” to “provide a non-profit, non-government, consumer-driven coverage option in every state to deliver maximum value for consumers.” “The democratic nature of co-ops could encourage increased quality and appropriate utilization and could help foster care integration and other delivery system reforms,” […]

• Co-ops would be required to be non-profit
• Co-ops would provide a coverage option for individuals and micro-businesses (< 10 employees)
• All exchange rules and state laws that apply to other plans also would apply to co-ops
• Strong governance standards would be required to ensure a strong consumer focus and democratic structure.

When I hear the word cooperative, I imagine myself banding together with my neighbors to create a community-based solution.  But Conrad’s approach is not the kind of organically emerging network of local civil society organizations that many conservatives could endorse.  Such a decentralist approach to filling the gaps in health care could never come from a top down Washington plan that requires “strong governance standards” (and most likely a large regulatory bureaucracy).  Conrad envisions co-ops of at least a half-million people.  This seems far too large for a genuinely “democratic structure,” for example far exceeding the number of “consumers” provided for by another (albeit tax funded) locally controlled institution, the average local school board.

But while Conrad’s version of health co-ops would likely result in heavily regulated companies chartered by Congress (along the lines of Fannie Mae), his proposal is useful in shifting the debate away from plans resembling single payer. This has caused most of the Left to denounce Conrad’s plan as a “cop out,” and “more like capitulation than compromise.”  This crackup among the Democrats—a distraction from their long planned Washington takeover of the health care sector—creates an opening for the Right. Conservatives should articulate that state control of health care is only the exchange of one monopoly for another, and encourage policy that enables both individuals and local communities to create flexible and effective solutions for increasing access to health care.