One of the most debated aspects of the current health care reform effort pending in Congress is how and to what extent any overhaul should foster market competition among managed care plans and insurers. Due to the high costs of paying for medical care for large numbers of people and the substantial capital barriers to entry, the market is oligopolistic with a relatively small number of players operating in each state.
Senate Finance Committee Chairman Max Baucus's (D-Mont.) solution unveiled today in his markup of America’s Health Future Act: purchasing pools for small businesses and consumer cooperatives. The Baucus bill appropriates $6 billion in seed money to help the coops cover start-up costs and to meet solvency requirements.
What does this have to do with advanced telecommunications infrastructure? Like health insurance, the market over the so-called "last mile" also tends to be uncompetitive due to the high capital costs of entry. In fact, it's even less competitive than health insurance from consumers' perspective as telecom infrastructure is a natural monopoly or at best, a duopoly. Here too, coops can provide a degree of competition and choice that's lacking.
Not only that, they can help the Obama administration fulfill its stated policy goal of extending broadband access to all Americans by building out advanced telecommunications infrastructure. As Sen. Baucus proposes, Congress and the administration should similarly seed fund telecom cooperatives that also face high start up costs and capital requirements.
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