This is a preliminary draft of the idea of fair healthcare system, compatible (as I imagine it) with the founding values of FairCoop. I provide it as an outsider's perspective, based of shared values and goals.
I skip as much reasoning as possible, to make it concise. If there is a political will to discuss it, I will be happy to elaborate.
A. General assumptions.
1. Axioms.
1.1. The supreme goal of FairCoop is to co-create areas of new social life within "gaps" of current model.
1.1.1. Current model can be defined as capitalist reductionism, narrowing social relation to "market transactions" and making money the leading vehicle of it. On the micro level it makes individuals to aim for financial efficiency of consumptions: "getting the most out of your money".
1.1.2. New model can be defined by different economic goal: optimal fulfillment of (not only material) needs for all people involved, within the limits of sustainablility and resilience.
1.2. The way FairCoop is trying to achieve its main goal is to use tools of economy and financial "soft power".
1.3. FairCoop should support and network local independent initiatives, rather than incorporate them under one global brand. The confederated "ecosystem" should be defined by shared values, goals (affinity) and solidarity, not by unified procedures, software and identity.
2. Rules of engagement.
2.1. Financial resources shared within the global network should be primarily used as "seed" or investment money, not for consumption. They should be used to build infrastructure for new social organization. Non-financial resources, especially knowledge, should be disseminated openly, under "viral" licences ("Share alike").
2.2. Standard form of local initiative supported by FairCoop should be a cooperative association (as economic, not necessarily legal form), working along guidelines of self-management, sustainability and resilience.
2.3. FairCoop should never compete with local initiatives of similar kind, even if they do not wish to participate in the network.
B. Healthcare in a cooperative way.
1. The goal of healthcare is not to treat ilnesses. It is to keep people healthy.
One of the most successful and influencial popular healthcare systems was "Barefoot Doctors" poject in China (http://factsanddetails.com/china/cat13/sub83/item1652.html). One of fundamental features associated with it was focus on preventive, not curative medicine. Another one was the multi-tier organisation, where majority of care and treatment was provided at local and regional level.
2. The health of community is the challenge for all members, not just doctors.
This is the major change, compared to professionalised (and commercialised) mainstream medicine. It means that healthcare cooperatives have to group both practitioners and patients, so the community heathcare system would be managed by all interested parties.
3. Sustainability means bringing money from outside (and keeping them inside).
As long as the cooperative healthcare has to operate within capitalist environment, there will be interactions. Some services and goods will (in foreseeable future) always be available only from outside. To keep the cooperative healthcare sustainable, there must be a way to generate income (in "capitalist" money) to balance expenses. For a medical cooperative, having active medical practitioners as members, it is natural to start selling medical services to the general public (according to local legal and economic context).
Also, through skillful propaganda, external patients may be attracted to the idea of cooperative healthcare and become members of the coop.
4. Resilience means expanding the base and ability to serve members' needs.
Money and other resources coming from the FairCoop network should be used to expand the operational base of the coop, mostly by purchasing equipment and providing eduction to the members (especially practitioners). If the coop takes care of its medical members, there will be more and more young practitioners interested in joining the system, either as members or cooperative partners (spin-off cooperatives).
5. Solidarity is part of the economy.
The economy we are trying to build is called "solidarity economy" for a reason. It's goal is no more the financial efficiency and accumulation of wealth. In economic terms, solidarity means that some resources (usually part of the surplus, generated by the coop) would be used to help people or communities in need, whether locally, or remotely -- even if they are not members of the FairCoop ecosystem. This kind of support should be decided by the cooperative itself. But, as one of great cooperatists of 20th Century said: "A cooperative that has no political or social [solidarity] goal is no different for a capitalist partnership of traders" (E. Abramowski).
C. Conclusion.
FairCoop was conceived as a tool to change the world for better. Community healthcare system is one of the most important aspects of it. But it cannot be created in alienation from the social and political context. The benefits of FairCoop activity should radiate outwards, not be contained within its limits. Leading the way, setting standards and sharing the benefits are the best methods to make people join the ecosystem -- and join for good reasons.
This text is sourced from my pad, where you may find the newest version.
