What is HSACoop?
HSACoop is an acronym for “Health Savings Account Co-operative.” It is our proposal for a comprehensive national healthcare reform and the opposite of the government proposed Universal Healthcare Plan. It is, in short, an unprecedented effort to develop a new, massive and private, “people-owned healthcare system,” whereby doctors and patients both own and thereby have control by vote of all aspects of care and management of the hospitals and other healthcare systems and investments within the organization.

Control
The advances we have made in medicine has been remarkable, but often the question can be boiled down to whether one can afford it. But to solve this problem, the last thing this nation needs is more government control and regulation of healthcare that stifles innovation and competition for the sake of cost control. Even great systems can be improved and it takes a “free market” to continue to not only stimulate innovation and push the science of medicine but also to develop ways to cut cost without compromising care.

This one word – “control” - is fundamentally the most important factor in any true, lasting healthcare reform and perhaps in no other enterprise is the cliché “he who has the gold, makes the rules” more relevant. The fact is – “we the people” do not now have control of our healthcare system, nor is it provided in the proposed "universal healthcare" plan, which only further takes away control from the doctor-patient relationship. The only way to get true control is through direct ownership.

What does ownership mean for HSACoop members?
This means that every member becomes an owner of every HSACoop hospital and healthcare system investment (outpatient surgery center, dialysis center, radiology, laboratory, research and development, etc.). Therefore, not only will all HSACoop’s members have a vote in the management of all HSACoop investments, but they share in the monthly profits. Unless we own and control hospitals (and other healthcare services), we will always be fighting an uphill battle, and we will never accomplish the broad sweeping changes that we, as physicians and our patients, desire in both local and national healthcare reform.

How do we propose to accomplish this?
First, we propose to convince as many people as possible to open Health Savings Account, which in our opinion is the best and most affordable type of “health insurance.” Second, we then propose to pool all of these accounts into one massive fund for the unique and sole purpose of purchasing (or developing new) as many hospitals and other healthcare services nationwide, and as soon as possible, thereby giving us the immediate control of essentially all aspects of healthcare in our system, such as accessibility, quality, cost, research and development, peer review, expenditures, etc… and even revenues and profits. Third, once large enough there is no reason to expand this ownership of Independent Physicians Association and even become “self insured.”

The Law
USC 26, section 223(d)(1)(D) clearly states that: “The assets of the trust will not be commingled with other property except in a common trust fund or common investment fund” (underline added for emphasis). There it is! Undeniably, it states that HSAs can be pooled into one account. This law was patterned under the same laws that govern retirement accounts, which as we all know, have been for decades, allowed to be pooled into common investment funds (mutual funds). Then, why not HSAs? HSACoop plans to do exactly this.

Why hasn’t this been before?
1) Despite the recent surge in new enrollees, HSAs still remain a relatively new and difficult concept for the 300 million people in the US, with only 8 million (about 2.6% of the population) having signed up for HSAs as of Jan. 2009 (http://www.ahipresearch.org). It’s no wonder that HSAs have not attracted financiers to take HSAs into the next logical level of a viable investment fund.
2) If an investment fund were developed, for the sole purpose of taking over the control of healthcare, the existing powers (big hospital corporations, health insurance companies, etc.) can be expected to fight tooth and nail to stop this because of the resultant loss in their profits.
3) Lastly, despite its simplicity, it is a VERY, VERY big project! The best example we can give is the analogy, “If you don’t like your car, then develop your own car company!” Yet it must be done.

Common Trust Fund
The proposed first phase of the project is the immediate pooling of HSAs into a “common trust fund (CTF)” that is deposited into a financial institution of HSACoop’s choice. This CTF will contain the “reserves” for the day to day and catastrophic withdrawals from its members. As a "savings account," members will earn interest for their deposited funds.

Common Investment Fund
The proposed second phase of the project is the formation of the “common investment fund” (CIF), which is the “mutual-fund” type investing arm of the project. This is where the “discretionary funds” from the CTF are invested to purchase the hospitals and other healthcare systems. This CIF is monitored by the Securities and Exchange Commission. Members will obtain the monthly distribution of profits from these investments.

The Fiduciaries
HSACoop is proposed to be a “third party administrator,” for both the CTF and CIF. It will function as the fiduciary (the entity contracted to manage the funds). CTF funds will be deposited into a chosen trustee bank and HSACoop will perform the needed banking services such as online banking, statements, customer service, management of the investments, etc.

How will HSACoop lower hospital and other healthcare costs?
First, HSACoop proposes to immediately slash the costs of services in our hospitals and other healthcare facilities. We believe that we will be able to do this simply by eliminating a number of wastes inherent in most of today’s healthcare systems. Patients (including our members) who chose to have their healthcare needs provided in our facilities will get the benefit of these lower charges. In our opinion, the primary cause of the increasing cost of healthcare is due to hospital charges, not physician and other professional outpatient fees, or even outpatient supplies (prescriptions, DMEs [durable medical equipment], etc.), thus our priority to take control of hospitals.

Second, we aim to provide price transparency thus making our prices readily known for comparison with competing hospitals and other healthcare systems, thereby, we believe, the automatic motivation for more people to join HSACoop. It follows that increasing membership will increase deposits into the fund, allowing for even greater investing power and rapid expansion of our healthcare facilities.

Lastly, because of direct ownership, we believe it will provide the much needed incentive for both our physicians and patient members to actively participate in cost control, preventive health, quality of care, accessibility, proper peer review, medical research, and essentially all other healthcare issues and, thereby, further driving the cost of healthcare down to a reasonable level.

What about the uninsured?
One of HSACoop’s goals is to educate and convince as many of the uninsured and “underinsured” to open an HSA (which we wholeheartedly believe to be the best form of “health insurance”) and join HSACoop.

How is HSACoop better than the universal healthcare proposal/Public Option?
Simple. The “Public Option” touts “free healthcare for all”. Sound good and unbeatable, right? On the other hand, as stated above we propose a “people owned healthcare system”.” Which is better? Really now folks, how “free” do you think “free” will be when someone else “controls.” How long will “free” be? What will be free? How long will you have to wait to get this “free” service? What free services are going to be rationed? Where is the money coming from to provide these free services? Do you really believe that this free healthcare isn’t going to cost you anything? Will you have any say in this free healthcare? Further, is “free” healthcare, the only component of healthcare? What about quality, accessibility, etc.? Will you have a say in any of these? Years down the road, will you have anything to show for the blind faith that you are putting into this government controlled healthcare system? Without ownership, you have no control. Period. Don’t fool yourself, the richest and most powerful people in this country as well as in the world all know that “control” is the key. We propose to put this control in the hands of “the people and their physicians.” We believe in accountability and responsibility. Those who take an active role in taking care of their health should reap the benefits of their diligence by having more money in their savings account when it’s all said and done, with the freedom of choice to manage their healthcare account.

What are HSACoop’s future goals?
Extension into the Medicaid program: Much like former Governor Jeb Bush did in Florida, we propose to encourage states to give Medicaid patients the ability to opt into HSAs and thereby choose to join HSACoop. However, we intend to improve the concept by developing a foundation for employer matching funds to stimulate Medicaid recipients to become employed in order to receive a matching fund to every dollar contributed by the government into the patient’s HSA. This would speed the Medicaid patient’s transition out of the Medicaid program and into their own HSACoop private health insurance. Imagine, actually getting Medicaid patients out of the Medicaid system and saving billions of dollars.

Numerous Other Possibilities
Other possibilities are too numerous to include in this short summary. However, the HSACoop idea is ripe for development now in view of the public outcry against the rising cost of healthcare, the general distrust regarding the current healthcare system, and the threat of socialized medicine via the current push for a Universal Healthcare and more government control.
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