Skip to main content

Little town in Rhode Island creates own health care system

By Howard B. Owens

In the little town of Scituate, Rhode Island, everyone has primary health coverage -- even the people who can't afford health insurance.

No, Scituate hasn't become an experiment in some single-payer scheme. People in the town banded together and figured out how to make it happen.

The people of Scituate, Rhode Island did it themselves.

No, we don’t give away health insurance – that’s too darn expensive. Instead, we make sure everyone who lives here has primary care (which only costs $25 a month). By coupling together grants, and a little money from the town, and doing bake sales and walk-a-thons, something called the Scituate Health Alliance decided, 10 years ago that we could fix the health care system ourselves – or, more accurately, build one from scratch — by providing primary care medical for everyone in town who doesn’t have insurance. (We also do flu shots for anyone in town who wants one and organize prenatal classes for anyone who is pregnant.)

While the effort isn't without taxpayer support (read, grants and money from the town), it does show how a community can come together to provide a service.

Bea McManis

It wouldn't work here. Too many people are against their tax money going toward grants to help everyone and their taxes being used to help those in need.
Nice idea though.

Oct 27, 2009, 12:37pm Permalink
Howard B. Owens

Bea, anything can work where enough people come together to make it work. And why not come up with something that requires no taxpayer subsidy, which is how it should be? The point of this post wasn't to get into grants or no grants, but to demonstrate a local community coming together to solve problems for itself -- though they used available resources, and it's kind of hard to fault them for that. It's a step in the right direction.

Oct 27, 2009, 12:50pm Permalink
Bea McManis

Many years ago, BOCES went self insured. It worked great for a long time. It isn't a new idea.
I was being sarcastic about the grant money, Howard.
We've read it too many times how people don't want their tax money going into grants that might help others.

Oct 27, 2009, 1:10pm Permalink
Chelsea O'Brien

The University of Rochester's workers health plan is self-insured. It's cheaper, keeps both the worker's and the company's costs down, and offers the same services.

Run things like a business, and it becomes a lot more efficient.

Oct 27, 2009, 1:37pm Permalink
Howard B. Owens

Just to put a fine point on it -- the Scituate group is not the same thing as "self-insured." It's a community organization insuring people who can't afford health care get it. Self-insured usually means you've got to work for the organization providing the insurance, and then it's insurance, not care.

Oct 27, 2009, 3:09pm Permalink
Peter O'Brien

The only problem I see with their plan is that in encourages you to dump your healthcare for the "free" care they provide which will eventually make it unaffordable.

Oct 27, 2009, 3:20pm Permalink

Possibly Peter. I can see what you're saying. On the other hand, isn't this just a fantastic illustration of individuals choosing for themselves!

Sure I can see the flaws, but it amazes me that when private individuals use their collective strengths they can do it better. Not that I'm suggesting Batavia should do this, but how is it that a LOCAL government and group of PRIVATE citizens can tackle this issue better than the Fed? Because they have more control.

Freedom of Choice! That is what makes this country great.

Oct 27, 2009, 3:46pm Permalink
Doug Yeomans

Bea, I just think that most people don't want tax dollars being spent on non productive projects. Personally, I don't have a problem with my tax dollars helping those truly in need. The problem I see is that there are a lot of needy people who really aren't needy. They're just lazy and manipulative, a burden.

I remember when Monroe county for example, decided that everyone receiving public assistance had to give their thumb print in order to reduce or eliminate double and triple dipping under multiple, assumed names. Liberals went insane over that one saying it was a breach of civil rights. In reality, this measure assured that there was enough money for those who actually needed it.

My problem with government proposed health care plans is that they'll turn into a system rife with fraud and inefficiency like Medicare and Medicaid. Both of those systems are abysmal failures. Medicare costs tax payers over $2trillion per year. Conservative estimates put fraud at 3% and as high as 20% or $60 BILLION to $400 BILLION. Fraud percentage estimates in the Medicaid system are even higher.

We need to put health care professionals such as doctors in charge of the health care industry and run it as a quality of life service rather a "for profit" service. There's no reason for the CEO of an HMO to rake in $millions in bonuses for keeping costs down in lieu of sacrificing health care for the sick and injured.

HMO's operate for profit so that share holders reap the rewards of dividend payouts. How insane is that?

Oct 28, 2009, 8:12am Permalink
Tiffany Barber

Just a few comments - first, Phil I think it's funny you think that Freedom of Choice is what makes this country great - however I doubt you think people should have the CHOICE of a public option. Oh and how is it OUR choice when you are given the option to take or not take the one insurance provider that your employer offers - oh and by the way that plan has a network and your doc isn't in network so you have to choose another doc - oh and that test you want - well even though your doc says you need it your insurance isn't so sure so...PLEASE could someone tell me how THAT isn't an insurance company coming between you and your doc. The next time I hear somebody say I don't want the government coming between me and my doctor I'll scream. Insurance companies CONTROL your healthcare - they tell you who you can see, what services you can have - how much of those services you can have etc. So SOMEONE already is coming between you and your doctor - who would you rather that be - the government who doesn't really care what you do - or the insurance company who sees you as just a cost coming out of their bottom line.

Doug - you don't seem to know where you stand yourself. You blast Medicare as a failure - where are you getting you facts from? Prior to Medicare the elderly population was incredibly poor - because they had limited if ANY access to health insurance. I'd also love to know where you get your fraud stats - not that there isn't fraud in Medicare - but you don't think there isn't fraud in any other system? You then go on to say that the health care industry shouldn't be for profit...businesses are in BUSINESS to make a profit (you said it yourself) so if you don't think that health care should be about profit then BUSINESSES shouldn't run it.

Oct 28, 2009, 9:59pm Permalink
Howard B. Owens

Tiffany, the point you're ignoring in your comment is how the government has screwed up health insurance in the first place. You point out all the problems with the current health insurance problem and they're all valid points, but ignore the fact that we're in the mess we're in because the government started messing in health care in the first place. Congress created the mess we're in. It didn't just happen because of some accident of the free market. It's regulation and government programs that brought about this stew, not "choice."

Further, how will public option be a choice once employers drop all their current health plans and require their employers to go on the dole? Because you know that's what's going to happen. Oh, sure, the companies will be fined if they do that, but what's a $100,000 fine compared to $500,000 a year in annual health care savings?

The best way to ensure affordable universal health care, like we once had in this country, is to get the government out of the health provider business, not dig us deeper into it.

Oct 28, 2009, 10:06pm Permalink

Authentically Local