2.

A few things to know right off the bat:

Group Health Co-operative is not, technically, a co-op. It is instead a consumer-governed non-profit corporation (a distinction with important tax differences), and a large one at that. It currently covers about 600,000 members, and last year took in $2.7 billion in revenue while paying its president and chief executive officer, Scott Armstrong, a $1.2 million salary. Its main competitors are familiar private insurance names—Regence Blue Shield and Premera Blue Cross—and its rates have risen over the years just like those of any other health insurer.

Meaning it’s not a small, average-citizen-controlled health care co-operative of the kind that Maria Cantwell and other Senate leaders seem to be suggesting would appear all over the country through passage of the co-op compromise. It's also not jaw-droppingly unique (and certainly not as unique as it used to be). “To the average person or the average enrollee there’s not a lot of difference between Group Health and the average health plan,” said Stephanie Marquis, spokesperson for the Washington Insurance Commissioner’s office. She added, in reference to the co-op compromise proposal: “When I first heard it, and I thought of a co-operative, I have to be honest, my mind did not go first to Group Health.”

Certainly Group Health does have some attributes worth noting in the health care reform discussion. It runs its own facilities; employs salaried doctors (rather than contracting mainly with “preferred providers,” as other insurers do); and has been a leader in web-based medicine, electronic medical records, and the effort to promote contact with primary care physicians (rather than the see-a-specialist model that has helped drive up costs around the nation). Its quality of care is well-regarded, and the number of complaints about it to the Insurance Commissioner's office is far lower than the number for its competitors.

Diana Birkett, director of federal relations and policy for Group Health, said these are the attributes that naturally bring Group Health attention. “We’re being looked to as a model because we’re an integrated organization,” Birkett explained. “We’re not just an insurer. We’re not just a member-governed organization. We’re not just a provider. We’re all of those things.”

Notice what she didn't say: that Group Health is a small co-op of the kind that some in the Senate seem to want to create in communities all over the country. That's because, as far as can be determined from the still-sketchy details of the co-op compromise, it's not.

Previous part here, final part later today.