How one doctor tried to take the profit motive out of health insurance

[NJCher]

Let’s learn from the Affordable Care Act’s failed experiment with nonprofit insurance.

December 24, 2024 at 7:15 a.m. EST

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Evergreen Health was one such co-op. The brainchild of Peter Beilenson, a physician and one of my predecessors as Baltimore’s health commissioner, Evergreen was intended to be a national model of patient-centered care. Beilenson hired clinicians, paid them a fixed salary regardless of how many patients they saw and opened four health centers where patients could have all their needs tended to in one visit. When they arrived, a health coach would counsel them on nutrition and mental health before a primary-care physician or nurse practitioner would treat them. If they needed further care, a specialist would come to the clinic to see them.

The idea was that such a “one-stop shop” prioritizing prevention would help patients stay healthier and avoid costly services down the line. Those cost savings would translate to revenue to enable more Evergreen clinics to open across Maryland.

Unfortunately, Beilenson’s grand vision never became reality. In 2017, five years after Evergreen started enrolling patients, it was forced to cease operations. And it’s not alone: Of the 23 co-ops that came out of the ACA, only three remain in operation. Combined, they serve just 140,000 patients.

Why did co-ops struggle so much? Start with money. The ACA was supposed to provide $10 billion in grants to help co-ops get off the ground in every state, but that was changed to $2.4 billion in loans with a tight repayment schedule.

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No paywall link.

There are 650+ comments at the time I posted this. I read many of them--you'll get some interesting input, like the one about how much the health insurance companies spent $1.2 million a day in 2009 to defeat the public option.

Caution: they have a new comment structure, which looks to be good if they get the bugs out. There is a rating system at the bottom of each comment, but if you use it, it bounces you out of the comments and you have to go back in again from the article.


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[LastDemocratInSC]

1. Health insurance companies were required to be non-profit

until the early 1970s (I think that's the right era).

[HUAJIAO]

2. Mine still is non-profit.

[LymphocyteLover]

3. A reminder that Republicans/Red states completely undercut the ACA as much as they could

because they are racist assholes who don't want minorities to have healthcare. The most blatant example was refusing to expand Medicaid in so many red states. But they also undercut ACA subsidies as in the OP.

[Midnight Writer]

4. I think it is time for Democrats to push for a public option for health insurance.

In fact, I think it is past time. I know very few people who are not frustrated with their private policies, who are not shocked by the rising costs of coverage, who are satisfied with the "status quo".