How cooperative businesses can answer tough business challenges: Julia Hutchins at TEDxMileHigh

How cooperative businesses can answer tough business challenges: Julia Hutchins at TEDxMileHigh

Translator: Rhonda Jacobs
Reviewer: Ellen Maloney Wow, it’s great to see so many people here especially for a topic
like health insurance. Very riveting. (Laughter) I thought I’d start by talking
about the history of the co-payment, and then a little bit about co-insurance and whether it applies before
or after the deductible, and how it relates
to out-of-pocket maximums. (Laughter) Yay! (Applause) You guys- I’m not really going to talk about that,
but I hope it makes you think a little bit about your own experiences
in using health insurance. I’m here because we’re starting
a health insurance co-op that’s going to be- Yes! Yes! That never happens. (Laughter) Wow! Wow! (Laughter) No seriously, usually when I say that
people kind of get this blank stare and they say, “Okay, yeah, so what? How are you going to be different, and how are you going to compete
with the big guys?” And… And it misses the point. I can talk about all the great things
that we’re going to do with benefits and great customer service, but the cool thing
really is that we’re a co-op, and that there’s
this intrinsic nature of a co-op, and something you can’t feel
or touch that’s really cool. So, my job here
is to make sure you all get it, so I’m going to do a little Co-op 101,
and then I’m going to talk about how we think
it’s going to work in health insurance, and then even more importantly, how we think we can leverage
some of the connectedness that comes out of the co-op model to affect even broader
change in healthcare. So I’m going to start with the 101 bit. So all co-ops- I mean co-ops is just a business model and there are three things
that all co-ops need to be successful, and the better that they do these things
then the more impactful that they are. So the first one is a compelling need. There has to be a compelling need. And then you need an ownership structure,
and then you need some intrinsic values. So to illustrate compelling need, I think a good example
is the rural electric co-ops, kind of harkening back
to our western heritage. In the 1930s, rural people
had a very compelling need and this was it! Yeah. (Laughs) Is it obvious? Rural people were united
around their need for light. (Laughter) And it felt weird! But they were very connected, and in the 1930s, FDR put out
a low-interest federal loan program for people in rural communities
to band together and develop cooperative businesses
in their communities to help solve the problem and bring electricity
and telephone service to rural America. And it’s one of the best co-op stories, and those entities and co-op
businesses still exist today. So, in health care, there’s also
a really compelling need, and it’s even more compelling
than electricity, and it has to do with
being able to access healthcare. It’s one of those things
that is so fundamentally important for our ability to live, and to think,
and to be productive in society. This isn’t perfect, but there are ‘haves’
and ‘have-nots’ in health insurance, and about one in seven
people in Colorado don’t have access to health insurance. And about one in three either
don’t have access to health insurance or don’t have health insurance that really enables them
to get the care that they need. And so this guy, he’s your neighbor,
he’s your coworker’s spouse, he’s your brother,
and we’re all related to him because when he can’t get care,
then he goes to the emergency room and we all pay for that care
through higher premiums. Health insurance, it’s a big deal, and it is something that we need
to do better in this country. And it’s not as easy as electricity because the people
that don’t have health insurance or don’t have adequate health insurance
aren’t as well connected to be able to naturally band together
to do something about it. So that’s it. It’s a compelling need,
we definitely have that in health care. The second component that really
makes a co-op is ownership structure. This is real simple but the first triangle is how a typical investor-run
organization is built. And it really starts with the CEO
who makes decisions and promulgates them down
through management, and then eventually to consumers, and really all with the goal
of maximizing shareholder value. And the consumers in that model
really become a means to an end. In the co-op, it flips it on its head, in that the organization exists
and was formed by consumers, and the consumers themselves
pool together to create a consumer board, which then selects its leadership,
or its general manager, which in our co-op is me, and really
serve at the will of the membership, and that all decisions are made with the goal of maximizing benefit
and return to the members. So it’s this ownership structure
that enables a co-op to be able to capture and create a really different kind
of value proposition and affect change. So, back to values. This is a term that we coined
in our little co-op, and we’re a little different because we,
like the rural electric co-ops, are started by low-interest federal loans. And so we don’t have any members yet. We’re going to have
a lot of members on January 1, but we’ve been building a health insurance
company for over a year. We’re really excited about being a co-op,
but with no members, and so we’ve been trying
to shed the existing values that we had coming from other parts
of the health insurance industry, or providers, and to say, okay, let’s really figure out
how do we foster these values of collaboration and also self-
and social responsibility. One of our staff members
came up this term, and I was looking back at my emails
before coming here to see how it was being used. We definitely use it
to describe how we interact; some of our PR campaigns
we say are very, very co-opy. And it’s often being used to describe
somebody’s behavior in the office. So we might say, “Ooh, very, very co-opy.” And I even noticed one email
said something like, “Women show up in business attire
and men can wear co-opy metro.” Whatever that means! I did not dress very co-opy tonight,
so I apologize for that. But anyhow, we’re really trying hard
to capture these values. And it’s this co-opiness that is how we think our co-op
is going to work in health insurance. So this is the circle of a co-op
and how it works. First, you’ve got to sign up, and then you’ve got to engage. And we really expect that people
who join our health insurance co-op are going to engage. And it doesn’t have to be big; it just can be as simple
as providing us feedback. I mean, is it working? Or it can be- we ask
everyone who signs up to commit to maintaining their own health, and that is a behavior change
that we really expect our members to have because they own the company, not technically – we’re a non-profit – but that they have an ownership
relationship with our company. And then also we want people to be engaged and we’ll provide tools for people
to use healthcare wisely, and so to look at their options, and look at things like cost and quality
before choosing where to get care. That engagement, because there’s so much
inefficiency in the healthcare system, it’s not that hard to deliver a benefit, and that benefit really is
a reduction in cost. And that’s one of the major reasons why people can’t
get health insurance today, is because it’s so hard to afford. The second engagement is really the place
where we can leverage this cycle, and do something even more impactful
than just reduce healthcare costs for people who sign our co-op. This is the innovation part,
the edginess part, of the co-op culture, is how do we take this connectedness
that this model creates among consumers and users and do something to make
healthcare that much better? And there’s lots of room for that. I mean, imagine a healthcare system
that was created for consumers. We’d probably be able to sign up
for doctor’s appointments online. We might even get a text message
if our doctor was running late because he had to go into surgery so that we wouldn’t have to sit there
for a couple of hours. We’d be able to access care after hours. We’d be able to have virtual visits
and email our doctor, and not have to go into the office
just because we needed our drugs filled. So there’s a whole lot of potential
to do things better, and really believe that the culture
and the values of the co-op, and the connectedness that it creates allows us to do this
in really unusual ways. And, you know, as I was
thinking about this talk, while the co-op is something
that helps make this easier to do because of the ownership structure, there are a lot of other opportunities
to be creating connectedness, and it’s even more important today
as we become less connected, that we really find ways
to foster these values of co-opiness and connect ourselves
and unite our diffuse voices around bigger issues and social change. So, I really hope that you’ll leave
and think about the work that you do, and the values that you’re cultivating
in your lives and in your businesses, and find ways to allow us
to be more connected around those things
that are really important. Thanks for listening,
thanks for being here. (Applause)

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About the Author: Oren Garnes


  1. 7:21That word engage is up there twice for good reason. Active, informed and compassionate engagement is only one of the untouchable qualities that set the co-op apart. Engagement is what gives the #cooperative it's life, it's culture and it's continued success. The whole of human history is evidence that we work best (for better or for worse) when we work together. Cooperation is simply the quality within us that allows our species to survive and flourish. Cooperation is the tool that is held not with the hand but within the heart.

  2. This is about cooperative enterprise and not just a Co-op (lots o' baggage on that term depending upon your age cohort). Co-ops are businesses that are formed to meet the social, cultural and economic needs of its members.

  3. This was posted in 2013… Has any progress been made based on this GREAT idea my fellow Americans? 🤔… (Rhetorical) 😑

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