Solidarity Not Charity

December 7, 2017 11:48 AM

What Is Mutual Aid and how does it differ from charity or Not-For-Profit? The Mutual Aid Toolbox.
posted by The Whelk (23 comments total)

Something I've never understood, why don't more membership organizations offer health insurance? What prevents a group like the Masons, or the Rotary, or Metafilter, or heck, the Democratic Party, from offering group health insurance? The bigger the group, the better the deal, right?

You could even organize like a Kickstarter (if 1,000 people join you get X benefits for Y dollars, if 10,000 people join you get XX benefits for Y dollars).
posted by leotrotsky at 12:25 PM on December 7, 2017 [7 favorites]

I mean you could effectively jump-start the public option through the Democratic Party, while increasing membership and party identification. You could provide a real tangible good to party members.

Republicans are taking your healthcare away, while we're literally providing healthcare to our members.
posted by leotrotsky at 12:37 PM on December 7, 2017 [13 favorites]

why don't more membership organizations offer health insurance?

I have health insurance through my employer. My cost next year will be $521.79/month. My employer pays $2,459.85/month, not to mention internal costs to administer the benefit.

The model only works if (1) you're making a lot of money off of every person who's eligible for coverage, or (2) you're passing all expenses on to the individual.
posted by NotMyselfRightNow at 12:43 PM on December 7, 2017 [5 favorites]

This is basically what a mutual is—please correct me if I am mistaken.
In fact, it is wholly bizarre and counter-intuitive that health care is somehow tied to employment status—particularly employment at white-collar work. It is a system that I cannot understand except for being designed to disenfranchise the poor.
posted by koavf at 12:44 PM on December 7, 2017 [9 favorites]

Some of the fraternal organizations, like the Moose, started for this. It's too bad they seem so irrelevant now. I think the problem with doing this for just healthcare is the same as with the ACA- everyone has to participate for it to work.
posted by Maxwell's demon at 12:46 PM on December 7, 2017 [3 favorites]

In fact, it is wholly bizarre and counter-intuitive that health care is somehow tied to employment status—particularly employment at white-collar work.

koavf: It's historical, stemming from wage controls in WWII resulting in the growth of fringe benefits to attract workers in a competitive labor market. Truman proposed a national health care system back in 1945 (around the same time the UK started the National Health Service) but was shut down by the AMA and Republicans who called it "socialism."
posted by leotrotsky at 12:48 PM on December 7, 2017 [6 favorites]

What prevents a group like the Masons, or the Rotary, or Metafilter...from offering group health insurance?

haha, imagine the MetaTalk threads
posted by roger ackroyd at 1:10 PM on December 7, 2017 [4 favorites]

Where can I sign up for MetaCare?
posted by Faint of Butt at 1:16 PM on December 7, 2017 [5 favorites]

Where can I sign up for MetaCare?

You jest, but I proposed this once. I could actually feel cortex's full body shudder through the screen.
posted by leotrotsky at 1:18 PM on December 7, 2017 [9 favorites]

the Meta Tontine is still accepting applications, though
posted by roger ackroyd at 1:33 PM on December 7, 2017 [14 favorites]

Yeah, there's a big skydiving party this year. I'm unable to attend, so I packed all the chutes by way of apology.
posted by leotrotsky at 1:44 PM on December 7, 2017 [4 favorites]

I have health insurance through my employer. My cost next year will be $521.79/month. My employer pays $2,459.85/month, not to mention internal costs to administer the benefit.

Further: the flip side of these arrangements is that if you opt out of health insurance? You save your employer money. Your employer does not then give you an extra $2000 a month. If you wanted to get together with 500 of your closest friends to buy insurance, you don't have the $2500 a month; you have 1/5 of that--but you've also saved your collective employers a million dollars every month that they will happily pocket.

Health insurance basically works out to be a relatively bad thing for a group like this to be trying to manage if it wants to provide real insurance, at least at this stage. (Fake health care ministries can manage financially only by being terrible.) But there's tons of other things that don't have such spectacularly broken systems where people can more easily help each other, and if nothing else, other savings might open up more funds that could be used to get people in the group health insurance who don't have employer plans available. Food, shelter and child care are big rocks there.
posted by Sequence at 1:52 PM on December 7, 2017 [3 favorites]

Yes, unemployment insurance, for example, used to be totally administered through the unions and in many countries still is--that's something that works really well as a locally-administered good (although there are absolutely benefits to doing it through the state!)
posted by peppercorn at 2:06 PM on December 7, 2017

Anyway, not responsive to the Whelk's good good main post. Mutual aid is the bomb. Community farms are where I invest my mutual aid time atm, mostly. Alemany Farm, for example-- which is not quite sustaining on mutual aid alone, and is running an indiegogo campaign to fund a full-time employee and scholarship programs for local kids.
posted by peppercorn at 2:09 PM on December 7, 2017 [2 favorites]

Where can I sign up for MetaCare?

I was on it. Turns out when you need surgery they give you a plane trip to your nearest Canadian city and a borrowed Canadian health card card.
posted by Talez at 2:31 PM on December 7, 2017 [4 favorites]

> What prevents a group like the Masons, or the Rotary, or Metafilter, or heck, the Democratic Party, from offering group health insurance?
Insurance regulations vary by state, so insurance is always specific to a state. Some years ago, when I had a business, it was prohibited to join a group just for insurance. I suspect this was promoted by insurance companies. As much as everyone loves to hate insurance companies, the cost of medical care in the US seems driven more by the many corporations that profit from it. The issue is not so much finding a plan, as affording a plan.

Charity is one of the 7 Cardinal Virtues Charity is concern for, and active helping of, others. Currently, in the US, there is a dearth of compassion. Paying people fairly so they can afford food and shelter, nope. Sharing the profit from labor with those who labor, nope. Caring for the disabled, nope. Protecting the vulnerable, children, etc. Mutual Aid sounds like asking people what they really need, and helping them get it. I'm on board with most any system that cuts out the profit. I'm more on board with rejecting oligarchy and making things more fair. Clearly I'm in the wrong country
posted by theora55 at 2:50 PM on December 7, 2017 [5 favorites]

Yeah, there's a big skydiving party this year. I'm unable to attend, so I packed all the chutes by way of apology.

The banhammer is an actual hammer.
posted by GenjiandProust at 4:02 PM on December 7, 2017 [1 favorite]

"What prevents a group like the Masons, or the Rotary, or Metafilter, or heck, the Democratic Party, from offering group health insurance? "

It's a pain in the ass, is what. When I was on the school board, our workforce of 2500 had an "insurance committee" that negotiated on behalf of all six unions to get a health insurance plan for our employees; it took 12 people around 20 hours a week for 12 weeks to negotiate a satisfactory contract with an insurer (and we had a great relationship with our insurer and their negotiators, and our "insurance committee" was enormously sophisticated and did a great job). And then, yeah, our employees paid around 20% and considered it expensive to the point of unfairness; the district picked up the other 80%. Then, you need multiple full-time employees who administer the plan. There's no way a private mutual could provide plans cheaper than an Obamacare exchange plan, even with the GOP fucking up the subsidies.
posted by Eyebrows McGee at 7:58 PM on December 7, 2017 [2 favorites]

The bigger the group, the better the deal, right?

Right. Which is exactly why the NHS works. You can't get a bigger group than The Entire Populace.
posted by flabdablet at 12:35 AM on December 8, 2017 [1 favorite]

Yeah, I belong to the Eagles and the Elks, both of which were originally organized as mutual aid societies in a time when the Dr. costs were much lower. Like pay with a chicken lower. Now the only insurance we offer to members is life insurance, but that's a totally different bag. We still do devote most of our fund-raising to per instance medical issues to try to make up the difference for co-pays and other costs like travel since my town is in Alaska. Both the clubs here are thriving in growth in comparison to the lower 48 clubs, but there's no way we could operate insurance like an employer does. Part of it is the town-region-state-nation organizational situation that gives levels of autonomy. Even if working with the national organization as a whole taking all of our fund-raising capacity would guarantee each and every one of us great insurance, I have a very strong feeling on an individual (by town) club basis, the clubs would all reject it. The whole, why should I pay for that person from that place, etc. kind of bias. Not to mention administration would be a nightmare. Most administration for the clubs until you get to the national level is done by volunteers.

If only there was a national organization that specialized in collecting money from everyone to distribute it for needed projects and programs around the nation, where that was like, the only job they did.
posted by Belle O'Cosity at 3:21 AM on December 8, 2017 [5 favorites]

The thing about organizations like the Masons or Metafilter offering group insurance is that it's not really about the size, it's about the average cost of healthcare of the people in it. Sure, big groups are a bit better able to negotiate, but that's not knocking off most of the price (unless we're talking about a country or something so big it can change the rules of the game to make the care itself cheaper or cut out the insurance company entirely). But until that kind of scale, if Metafilter offered insurance it would be used by people on Metafilter without employer-provided insurance. Which might be a relatively sick group compared to say "all the people on Metafilter, including those who would never select this insurance because their employer already provides insurance" or compared to a "tennis coaches mutual aid society".

Basically employer-based health care crushes most group insurance concepts just because most of the people in the group who would be young and healthy but want the insurance already have jobs providing them insurance. That facet of our health care system makes it pretty hard to fix health care without going to a true universal coverage system.
posted by Easy problem of consciousness at 5:11 AM on December 8, 2017

Employer-provided health insurance is a scourge. There are *literally* no upsides.

Bargaining power is split and weakened...true costs are obfuscated, allowing providers to essentially commit massive fraud by charging insane prices...people are locked into shitty jobs for fear of losing coverage...before the ACA unemployed people were not even acknowledged as people worth thinking about...companies can spin health coverage as part of their compensation package instead of just paying their employees more, while also getting it deducted from their taxes...
posted by steamynachos at 9:46 AM on December 8, 2017 [5 favorites]

That facet of our health care system makes it pretty hard to fix health care without going to a true universal coverage system.

That would be because "fixing health care" and "going to a true universal coverage system" are different words for the same action.
posted by flabdablet at 4:07 PM on December 8, 2017