The third path is older than either of them……People’s Capitalism……….. local control, personal responsibility, voluntary association, government staying out of your business.
By Dave Chase
Sit through just about any healthcare policy panel. You’ll watch the same fight unfold: capitalism versus socialism. Medicare for All on one side. Employer-sponsored coverage and ACA exchanges on the other. Two camps, both certain the other is destroying the country.
What if we’ve been arguing the wrong question?
The most American economic structure this country has ever produced usually isn’t in the discussion.
It’s the cooperative. [Some call it mutualism.]
Plymouth Colony started as a cooperative arrangement. The Capper-Volstead Act of 1922 protected farmer co-ops from antitrust because Congress understood they were foundational to rural life. Rural electric co-ops lit up the countryside when commercial utilities refused to serve it. Credit unions serve over 40% of Americans today, with loan default rates under 1%. Mutual insurance has been here since Benjamin Franklin co-founded the Philadelphia Contributionship in 1752. All grassroots grown from the bottom-up at human scale. [Top down “cooperatives” would be an oxymoron.]
Ronald Reagan called cooperatives “people’s capitalism”: local control, personal responsibility, voluntary association, government staying out of your business. Bernie Sanders champions their democratic structure: one member one vote, wealth circulating locally, workers and members holding power instead of distant shareholders.
They’re both right. Cooperatives are private enterprises competing in markets AND democratically governed by the people they serve. The framers would have recognized this instantly. It’s federalism applied to economics.
To be clear, I’m talking about health insurance specifically. Not who owns the hospital. Not who employs the doctor. The financing layer. The thing that decides whether a teacher in Ashtabula County can afford her insulin or whether a manufacturing family in Alabama gets crushed by an out-of-network bill.
Community-owned health plans already exist. Ashtabula County Schools saved $2.4 million in year one while funding teacher raises. SEIU 32BJ brought the all-in cost of pregnancy and delivery to $40 for its members. Operational, not theoretical.
The current model is breaking on its own terms. Stop-loss carriers buckling. Premiums up 24% in a single year. The reset is already underway.
Every collapsing system creates space for something better to emerge.
The question for the next decade isn’t capitalism or socialism. It’s whether American communities remember they invented the third path, and whether they’re willing to build with it again.
What do you think?
