You may wonder at this very bold title. Those of you who have stepped up and joined our new model of healthcare need some applause and appreciation. You also are well deserving of an update on our progress in the first "100 days".  I will keep it short to respect your time.

We have a little over 400 members, and memberships continue to flow as more women discover the need for this type of care. We are open to a few hundred more. I do not anticipate arbitrarily limiting enrollment, but there is a practical limit on the number of people I can care for. We may reach that limit later in the year.

A Woman's Wellspring is essentially a consumer co-operative.  REI is the nation's largest and some of you may have shopped at their new store in Marina. It is worth a moment to digress on the nature of cooperatives. There are many models, especially in agriculture. We tend to think about business and politics in polarizing terms, such as the Right and the Left and capitalism and communism/socialism. It should be clear to us by now that neither extreme has the answers and on many levels are "not working". The wisdom is always somewhere in the middle. The Cooperative economy has been quietly growing world-wide. More Americans hold membership in a co-op than hold shares in the stock market.  The business structures of co-ops are as diverse as the people who create them. In the most recent financial crisis, they have proven very resilient when the bigger players failed. The top five financial sectors for co-ops are agriculture, insurance, food, finance and electricity-things that are essential to life. Health care also falls into that category. The Affordable Care Act (Obama Care) created funding for private, non-profit health insurers called Consumer Operated and Oriented Plans designed to operate in each state. Unfortunately, the "fiscal cliff" settlement terminated funding after only 24 states applied for and were approved for funding. California was not one of those 24. Colorado will have one of the most vigorous Co-Ops, the Colorado Health Insurance Cooperative, and it will be very interesting to see how they develop in the coming year.

Capitalism is a useful model in some situations but not usually optimal for the essentials of life. It is successful in health care if you are interested in measuring stock market returns, but it has fallen short in terms of delivering the product, healthcare. We have a very high level of technology (good thing) but are ranked below more than 30 other countries in quality measures and cost-effectiveness (bad thing). Our current health insurance business model makes the insured person (you) a commodity, to be evaluated and ranked by an actuary according to your ability to make or lose money for the corporation. That is wrong. Doctors have been criticized for naming the patients by their disease (the Gall Bladder in room 200) or, worse, by their insurance type. That language reflects the commodity market in health care. You all know this but we also need to deeply accept this reality and take action to find a better way to take care of our people. A cooperative model unmakes the "person as commodity" and puts them in their proper place as a co-owner and a vital member of a living community. A Woman's Wellspring functions as a consumer responsive cooperative. Your annual membership, which breaks down to $21/month, gives me the time to create a healing environment. The office visits are unhurried, and I have the time to do a really good job of being a doctor.  I keep the overhead low, and peg my salary in the lower 20% of OB GYNs nationwide. You voted for the topics in the Mini-Medical School Series, and that was a rousing success. Our first April session on Food was both educational and a tremendous amount of fun. There is nothing more essential to health than nutrition.

I look forward to 2013. I thank you for having the foresight to join. Please do not hesitate to influence your friends. I am always happy to have word of mouth referrals. They are the best!

"If many of us fail to recognize an emerging ownership shift as a sign of progress, it may be because it arises from an unexpected place-not from government action, or protests in the streets, but from within the structure of our economy itself. Not from the leadership of a charismatic individual, but from the longing in many hearts, the genius of many minds, the effort of many hands to build what we know instinctively what we need". Marjorie Kelly, Fellow of the Tellus Institute and director of Cutting Edge Capital. Quoted from "Yes!" Magazine, Spring 2013.