Relocalizing Health

American healthcare consumes nearly twice what other developed nations spend while delivering worse outcomes - wasting more annually than the entire Russian economy. Yet communities across America have already solved this crisis, and this book shows you exactly how they did it.

Dave Chase identifies two structural flaws at the heart of U.S. healthcare dysfunction: the rigid separation of healthcare and social care funding, and governance stuck at the wrong scale. These flaws interlock, ensuring that reform efforts - regardless of ideology - consistently fail. But a proven solution exists. Community-Owned Health Plans address both flaws simultaneously, drawing on the same cooperative principles that transformed rural electrification a century ago.

This is not theory. The evidence spans decades. Rosen Hotels in Florida has saved $570 million over 30-plus years while managing a workforce where 65% of pregnancies are high-risk. Alaska's Nuka System cut emergency visits by 50% and hospital admissions by 53%, sustaining 97% customer satisfaction for over a decade. Ashtabula County, Ohio - one of the state's poorest regions - saved $2.4 million in year one while eliminating deductibles and preventing teacher layoffs. More than 10,000 employers covering over five million Americans have adopted these approaches, with track records spanning 5 to 30-plus years and cost reductions of 20% to 50%.

Guided by the cooperative wisdom of Father José María Arizmendiarrieta - the Basque priest whose vision built the Mondragon cooperative network of 100-plus worker-owned enterprises - Chase maps a practical path from broken system to community ownership. If cooperatives could transform a war-scarred town under fascism into a thriving democratic economy, American communities can reclaim their rivers of healthcare dollars.

With AI poised to displace millions of jobs, this book reveals how communities can capture the "AI Catalyst" - redirecting healthcare waste into workforce development and social investment rather than paying an "AI Tax" of unemployment and decline.

The blueprint exists. The tools are democratized through Nautilus Health Institute. The success stories are multiplying. What's needed now is the courage to act - community by community, until the transformation becomes unstoppable.