Rural Healthcare Facilities: Monopolies to Cooperatives

U.S. Legislation around the turn of the 19th Century was created to prevent large companies from influencing prices. This net loss to society came in the form of misallocated resources and increased prices. Notwithstanding the societal costs of a monopoly structure, some monopolies are government mandated, such as rural electric and water service. Monopolies have benefits (and are sometimes the only business structure that will work) especially in rural America. In rural healthcare, the monopoly structure is sometimes the only business organization that effectively serves a community or rural area and makes sense. A healthcare monopoly can have the same negative characteristics associated with the monopoly-structure, like increasing costs and misallocation of resources. A cooperative is a viable alternative to monopoly. The rural community would participate in the monopoly profits and decisions. A self-imposed tax could be levied on the area the rural healthcare facility would serve offset by charitable donations; thus, making the community stakeholders in the healthcare facility. The people who make up the tax base would be benefactors for the facility’s profits and the whole community would benefit from access to expanded services otherwise unavailable to underserved areas.