Was just thinking that there should be doctor clubs, where a bunch of people pool their money to hire a dedicated general physician. Or to have a shared tailor, or group cafeteria, or whatever.
The ratio of people covered to specialists would probably determine whether it’s feasible. You’d want the specialist to still get paid a healthy (and guaranteed) salary and to have a more satisfying relationship with customers. And the members of the club to get better service / product than they would otherwise with middlemen taking a cut.
Reading into your intention, this is actually more like health insurance than single payer healthcare. Not quite a million little coops, more like a few dozen. And it would end up having most of the same problems of modern US health insurance.
You’ll need someone to administer the program, so you have to give them some power over your money. That means they’d need the power to say “no” to people who are seeking healthcare resources for invalid reasons–things like Munchausen’s syndrome at first, but eventually they’d have to make calls about things that people actually need but can’t prove they need, just like health insurance does now.
If you don’t want do these things, I guarantee your neighbors will insist they be done (ever hung out on nextdoor? those are the people you’ll be pooling your money with). And you’ll go along, because it’s a hassle not to, and hey at least you’re getting your needs taken care of most of the time. If you manage to keep your program free of capitalist influences, you’re going to have to fight corruption instead: “Slip me some dough and I’ll make sure you get seen next.”
So in time you just end up with health insurance, and most of its flaws, if you don’t very carefully watch the people administering your program, if you don’t very carefully fight against the perverse incentives.
The biggest problem, of course, is that existing health insurance would fight it like penicillin fights bacteria. They have had decades to do regulatory capture in their benefit, and if another group comes along that’s almost-but-not-quite health insurance, they’re going to make sure that the regulations they captured keep it from going anywhere, up to the point of trying to make it explicitly illegal.
I think we’re in agreement about single payer, but this ^ is how it benefits us. The government has actual power to fight corruption and isn’t beholden to capital. Now if we only had a way to create a just government.
Not saying it would work, but what I’m describing is more bite size than a full health system. So if a group only committed to “everyone gets to see a general practitioner” then people are on their own for MRIs and chemo. Figure out how many patients a type of practitioner can handle in a year, then pool that many people to hire one. Same idea for any other role, like how many cars can one mechanic fix a year?
I’m not married to the idea, but more thinking about how could we take concrete steps towards universal health care, other common services, democratic workplaces. If people see a micro version working then it may inspire more ideas, attract more effort.