Contained Capitalism: Executive Summary

To understand the theory of contained capitalism, it is best to begin with the issue of health care. Not only is our health care system broken, it’s breaking us…our economy, our sense of fairness and justice…our very way of life.

Why can’t government manage health care?Top
Because government isn’t designed to manage our lives. Its purpose is simple – to create, execute, and protect the rule of law. Government management of health care is not only inappropriate - it’s dangerous. Government becomes too powerful and, by putting health care in the hands of politicians, the table is set for corruption, collusion, and mismanagement of this essential life need. The evidence is unquestionable when you consider the exorbitant costs of our own Medicare and Medicaid systems, and the struggles of government-run systems in Canada, Great Britain, etc. In other words, the costs in any socialized system are high and the challenges to providing cost-effective, quality care are many.
Why can’t corporations manage health care?Top
Because they are not designed to manage health care and other essential life needs. Corporations are created to make money for their shareholders. There is nothing wrong with this except when the service is essential to life. The corporate “system” eliminates risk in order to maximize profit. A corporation cannot have public or individual welfare as a central theme of its mission; to do so compromises its ability to not only thrive, but to survive. The company must care for itself and this simply equates to eliminating anything that poses a risk to its financial stability. Inevitably, insurance corporations will continue to contain risk by eliminating and restricting coverage. The health insurance industry, as a system, is decaying and, in an attempt to survive, it will continue to:
  1. Make health care increasingly unaffordable;
  2. Quietly and insidiously hollow out the coverage for untold millions;
  3. Lobby governmental representatives to
    • Limit regulations;
    • Limit enforcement of regulations;
Why can’t we find a “happy medium” between government oversight and corporate or privatized management of health care?Top
We can’t find a “happy medium” because there is no magical hybrid system that can somehow fix or address the fatal flaws inherent in each.
  • Our current health care system represents a dangerous mixture of socialized and privatized health care. It is risky because there is a natural tendency to move toward socialized or single-payer care. When made responsible for management of this essential life need, a socialistic system results in costly, increasingly limited services. In an attempt to avoid mismanagement, abuse, and escalating costs, these systems have no choice but to limit access to and privatize elements of service. Eventually, regardless of the original “model,” privatized and socialized systems mix and are in constant conflict with one another. Whether it is the United States (characterized as “privatized”) or Great Britain (characterized as “socialized”), the end result is the same: rationed care that favors those who can afford it.
So if government or corporations or a mixture of the two cannot provide for cost-effective, comprehensive health care for ALL Americans, then what IS the solution? Who can manage our health care and other essential life needs?Top
We Can!!
How do we come together to organize and manage our essential life needs?Top
By redefining community.
Why do we need to establish a different form of community?Top
  • Because the nature of community is different for each of us and can change given an event or a specific purpose. For example, you may typically see your community as the town or city in which you live. Let’s say you are one of 3000 people. Then a storm hits and your town is now part of a larger system - a “disaster community.” In this example, you may now be 1 of 200,000 people. When the storm passes and life returns to normal, you then may again perceive your community as just the town or city– you are one of 3000.
  • Community is abstract and does little to advance our lives. We often speak of it in times of crisis (i.e. “The community must come together”) and our leaders tend to direct us to support it in times of trouble. Outside of these instances, community is intangible, constantly changing, and does not have any consistent or concrete purpose in our lives.
How do we change the nature of community to better serve our needs?Top
By implementing Contained Capitalism
What is Contained Capitalism?Top
It is an economic theory that uses system mechanics to create a new form of community. By implementing this model, a number of complex social and economic problems are resolved. This new form of community is referred to as the “actualizing community” and it is initially formed by solving the health care crisis.

Axis I: Healthcare

What are the initial steps that we need to take to achieve affordable, comprehensive health care for all Americans?Top
  1. Conduct an objective assessment of the nation’s health care infrastructure, including hospitals, outpatient clinics, primary care physicians and specialists, diagnostic services, rehabilitation and long-term care facilities, hospices, and other services deemed necessary and important to quality, patient care.
  2. The nation will then be divided into approximately 300 separate communities or “Regional Alliances;” the exact number of regional alliances will be determined by the previously mentioned assessment.
  3. Each Regional Alliance will be self-contained and self-sufficient regarding the provision of health care services for its members. The assessment will determine what changes need to be made within each regional system to insure the health care infrastructure is adequate.
  4. Implement Axis I - The Health Care Mechanics.
Axis I: Healthcare
Axis I diagram
What are the basic components or “mechanics” of the Health Care Axis?Top
  1. Consumer Mechanics - which are made up of:
    1. A Consumer Coalition - composed of:
      • Small Business - every small business within a defined region joins the coalition. Health care is managed by the regional alliance and made affordable for small businesses through tax subsidies.
      • Corporations - Each office or manufacturing site of large, national corporations will join the regional alliance where the plant or office is physically located. In this way, corporations are theoretically “divided” into small businesses with each site’s health care managed by that respective regional alliance. As a result, corporations will no longer need to manage employee health care benefits.
      • Government - government employees, the military, and those individuals and families dependent on social services will all join the regional alliance where they live. As a result, government will no longer be in the business of managing health care. The shift to regional system management will provide a unique opportunity for government to significantly downsize.
      • Individuals - individuals who wish to change careers, return to school, or pursue creative or business interests will be able to simply purchase health care from the regional alliance where they live. By doing so, opportunities for business development and entrepreneurship will be increased.
    2. The Board and its Officers – the Board is composed of approximately 300 volunteers who serve as delegates and advocates on behalf of the consumers. Their limited responsibilities include the election of the Officers. The Officers are selected through democratic process; they are responsible for overseeing and managing health care on behalf of the consumers.
    3. The Consumer Management system – the purpose of the management system is to manage finances and services on behalf of the Consumer Coalition.
  2. Provider Alliance Mechanics - are composed of:
    1. Provider Alliance - the Provider Alliance is organized into three levels of intervention:
      1. Primary (i.e. diagnostic exams, physicals, wellness and education programs, etc.)
      2. Secondary (i.e. case management of chronic conditions, treatment of at-risk indicators, etc)
      3. Tertiary (i.e. management and treatment of illness)
      4. Providers will contract with the Consumer Coalition and, in doing so, agree to on-going and timely evaluation of services to promote quality and efficient care.
    2. The board and its officers - the Board is composed of approximately 300 volunteers who serve as delegates and advocates on behalf of the providers. Their limited responsibilities include the election of the Officers. The Officers are selected through democratic process; they are responsible for organization of provider services to promote the effective delivery and management of health care within the regional alliance.
    3. Provider Alliance Management System - the purpose of the management system is to offer administrative support and related functions on behalf of the providers. These services include initial contracting, coordination of patient care, and billing and payment.
  3. Research Mechanics - are composed of:
    1. Research Center Bracket - composed of colleges and universities within the region. The purpose of the Research Bracket s to provide consistent and comprehensive oversight through evaluation and outcomes assessment. The system must be objectively evaluated and timely changes made as a result of what is learned from systems assessment.
    2. Consumer and Provider Outcome Rings - For assessment to be effective, it must be understood and correctly utilized. To meet these goals, specialized assessment teams will provide vital information, expertise, and intervention specific to the Consumer and Alliance Board Officers.
What are some of the important points regarding the Research Mechanics?Top
  1. The overall purpose of the research mechanics is to provide a comprehensive and transparent assessment or evaluation system designed to minimize corruption and maximize efficiency.
  2. The quality of the research is based on three guiding methodologies:
    • Flow of Information: information must constantly be made available to anyone and everyone – the system must be transparent;
    • Points of Observation: Observations that are made from the perspective of the consumer, the researcher, and the provider must be effectively included and integrated into the overall assessment of the system;
    • Submerged Board of Directors (SBOD): Each Regional Alliance will have a number of Submerged Boards of Directors or special teams that are created to investigate and manage central themes or issues within the system. For example, an SBOD dedicated to patient safety will investigate incidents, establish protocols, and monitor areas of concern regarding patient safety. SBODs are composed of individuals from every aspect or component of the system, including the consumer coalition.
  3. The combination or “triangulation” of these three research methodologies allows for true transparency and comprehensive, unobstructed Systems Outcomes Assessment.
Is there a National System that oversees or assist the Regional Alliances?Top
Yes. The national system is composed of the following:
  1. The National Institute - the Institute is an accrediting body that supports the regional alliances in the delivery of health care services. It functions as a clearinghouse for best practices and, when called upon, provides consultation services. It is important to note that, unless there is a serious violation of the rules and standards, the Institute does not interfere with the management of services within any given region. Regional autonomy and self-sufficiency is critical to the success of this system.
  2. The National Assemblies of Consumers and Providers - each Regional Alliance will have representation in both Assemblies; the principle purpose of the National Assemblies is to negotiate the National Health Benefit Structure or plan of services that are covered and guaranteed to every American. Additionally, the National Assemblies are designed to address larger, national issues and challenges which confront every Regional Alliance within the country (i.e. the negotiation of prescription drug costs).
  3. The Foundation - the principle purpose of the Foundation is to collect fees from the Regional Alliances which fund the National Institute. The Foundation’s Board of Directors (The Tribunate) serves as an oversight body to the National Institute.
Is this new healthcare system a form of "socialized medicine?"Top
No. The government will have absolutely no involvement in the management of the health care system. In addition, there is no single-payer system and no central command structure – each region or community manages its own health care.
Will this new system save money?Top
Yes. The model saves billions of dollars as it is non-profit, significantly reduces (if not eliminates) waste and corruption, and maximizes efficient utilization through the early detection of conditions and effective management of chronic conditions.
Will I be able to leave my job or move and still keep my healthcare?Top
Absolutely. The National Health Benefit Structure will be available to everyone, regardless of where you live or what kind of work you do. While it is expected that every Regional Alliance will develop “regional-specific services,” each must offer the same basic benefit package to its members.

Axis II: Non-Profit Competition

Axis II diagram
What is non-profit cooperative competition?Top
It is a form of social cooperation in which non-profit, human service agencies are collectively organized within a defined region while maintaining individual autonomy and self-management.
Why is this form of competition necessary for human service organizations?Top
Simply put, traditional open-market competition places undue stress on these agencies.  Non-profits are specifically designed to serve the community; limited human and financial resources should not be expended on competing in ways that do not benefit the public.  If non-profit, human service agencies are efficiently organized within the context of community, consumer-driven competition between agencies remains.  However, the unnecessary financial struggle resulting from an inordinate number of non-profits competing for the same service market is eliminated.  This excess becomes particularly problematic when other areas of need/service are neglected.  In this new organizational structure, regional planning, cooperation, and support will facilitate the service provider’s mission to effectively serve the needs of the community.
How is this new form of competition achieved?Top
Similar to implementation of Axis I, the process begins with a full assessment of the Regional Alliance’s non-profit human service agencies and their programs. The region then categorizes the agencies into the following four developmental groups, depending on the services or programming offered within that particular agency:
  1. Infant and early childhood services;
  2. Child and adolescent services;
  3. Adult services; and
  4. Senior services.
Each developmental group or “Sphere” is represented by a Board of Directors and its Officers. In addition, just as in Axis I, an assessment team (Research “O-Ring”) will continuously evaluate the functioning, efficiency, and relevance of programming within each of the Developmental Spheres.
Will some services be eliminated? Some services added?Top
Yes. Again, the purpose of nonprofit cooperative competition is to assess and efficiently organize the human service programming within a defined regional system. Within that goal, redundancy and duplication of service as well as deficiency in particular service areas will be continuously identified. It is important to recognize, however, that no agency will ever be forced to change its programming or move its location. Voluntary cooperation is an essential element of the success of this model – every agency has the right to self-determination.
What kind of non-profit services will be provided in any given regional alliance or community?Top
Many of the services that are currently available in a given community will continue to be offered. In general, each community is different; each will constantly develop and innovate regarding delivery of services that best meet the needs of the members within that given community.. Here are some examples of services that could be available:
  • Infant and Childhood Services – universal pre-kindergarten; parenting classes; infant with disabilities programming
  • Childhood and Adolescent Services – teen violence initiatives; teen pregnancy programs; teen service and volunteerism
  • Adult Services – financial planning; contract and legal services (i.e. mortgage contract review); small business development; retirement planning
  • Senior Services – Senior activities and day programs; financial resource management
What are Educational Values or Themes and what role do they play in this system?Top
Currently, every human service agency, educational institution, and corporation has a “mission statement.” The Education Values shown in Axis II provide the basis for each community to create its own mission statement. In doing so, any action, service, or intervention developed should be designed as a reflection of these values and their meaning within the community.

Axis III: Community Privatization and Volunteerism

Axis III diagram
What is privatization?Top
It is the act of transferring services or resources from public or government control or ownership to private enterprise.
Is Privatization beneficial? Does it align with the fundamentals of capitalism?Top
Absolutely. Nationalism or the governmental management of important products or services compromises the central tenets of capitalism. Additionally, government is not designed to manage our lives and the essential needs of our communities. However, privatization in its current form is not only problematic – it’s dangerous.
What are the problems with Privatization?Top
  1. Privatization of war - in modern warfare, corporations have been established to supplement our government’s military actions. The use of “battlefield employees” or mercenaries dangerously manipulates the dynamics of war, including the decisions made by our Commander in Chief.
  2. Inappropriate Corporate Diversification - while it is natural for corporations to diversify in product and service development, it is critical that a fair and objective contract and bidding process be employed to effectively assess a business’s readiness and expertise regarding services that are essential to the community.
  3. Lack of Regulation - the only way to secure unfettered, open-market competition IS through the implementation of effective regulation, which constitutes the “rules of the game.” Over the past few decades, de-regulation has created an environment conducive to corruption, governmental collusion, and waste.
If Privatization is an important element of capitalism and an open society, how can we modify or transform it to address these and other problems?Top
Community Privatized Competition - A form of competition that effectively organizes and manages the use of privatization through community oversight and consumer knowledge.
What is important to understand regarding the concept of regulation?Top
The debate regarding the type and amount of regulation required to effectively contain business conduct has distracted us from the real problem – lack of oversight. While “rules” need to be in place to secure fair and open market competition, the community must play a central role in the oversight of any service or product that has been privatized. It is oversight, from initiation of the project through to its completion that is vital to the safety and security of the community and its members. For example, if a community needs to build a bridge or repair a levee, the people of the community must take charge of this important project. While local inspectors remain vital to code enforcement, the community and its volunteers can provide assistance throughout the life of the project to ensure that the company building the structure is in compliance with its contractual obligations.
What are the three functions of Axis III?Top
  1. Community Projects and infrastructure – assessment and cost-effective repair of our debilitated infrastructure; development and implementation of new “green” technologies, etc.
  2. Disaster Preparedness and Relief – each Regional Alliance will be responsible for assessing and developing a plan of preparedness and action in the event of a disaster. Again, the community must take charge of its own affairs, assisting the police, emergency response, and other officials in the preparedness and execution of a disaster plan.
  3. Community Service – at the heart of the theory and its mechanics is the importance of civic duty or the obligation each of us has to one another and to the whole of the community. The success of any given regional alliance or “actualizing community” is dependent upon average citizens taking action and recognizing the necessity of contribution. Axis III provides the mechanical structure necessary to efficiently organize and coordinate volunteerism.

Contained Capitalism: The Three Axis Model

3 axis model diagram

Contained Capitalism, through the interaction and balance of these three important axes, promotes community self-management of the essential life needs of its members. Government and private industry have their place of importance, but our country requires each and every one of us to connect with and contribute to the community in which we live. In this way, a new form of community is created, promoting care, safety, and security.