"Giving each other a helping hand"
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Examples
Putting wasted assets to work requires effort, and it costs money. But the leveraging power and the rewards can be huge. A few examples provide illustration:
- The Sentara group of hospitals in Richmond, Virginia, managed to cut the cost of treating asthma patients by more than 70 per cent in two years by paying them in Time Dollars to befriend other asthmatics on the phone - making sure they were taking their medication and assuring that they knew the early warning signs of an attack and what to do in case of one. Not only did their own symptoms reduce because of the sense of achievement, but the number of asthmatics brought into ER was also considerably cut.
- In Vietnam , Doctors Without Borders found itself facing a runaway AIDS epidemic with just enough medicine to treat 300 individuals. They decided to use Co-Production principles to maximize the potential impact of that medicine, making it known they would treat only those individuals who would commit to becoming AIDS prevention activists. The medicine became the payment for activism, and the activists spread through their communities showing pictures of themselves as emaciated AIDS sufferers and as healthy individuals. They explained to their fellow citizens that AIDS was not an inevitable death sentence, but that it could be cured by medicine, or better yet by prevention. The rate of new infections plummeted.
The following illustration comes from No More Throw-Away People. It involves a program in Miami for women immigrants, many of whom were being subjected to spousal abuse:
- Unsure of their status and fearful of what would happen to them if they went to the authorities, these women failed to report the abuses against them. When immigration assistance led to the uncovering of the abuse, it was decided that there would be a Co-Production fee - one that would cross the divide between the monetary and community economies - for the assistance provided.
- The fee? The women were required to take a course that would teach them their rights in cases of spousal abuse and then provide mutual self-help to other victims. That "fee" empowered the women. Operating from their strengths, they forged a new extended family. They learned to conduct the clinic workshops that professionals initially ran. These have become so well attended that workshop attendees arrive early and wait in line. The women also host a talk-radio call-in program which they initiated to help others. This is what Co-Production is all about - building strengths and community through exchange and contribution.
- Other examples include the squatter camps of Orangi in Karachi , where residents successfully provided themselves with drainage and water mains faster and at a far lower cost than the more accepted top-down method. Partners in Health, a Boston-based charity, has found a method of successfully treating multi-drug resistant tuberculosis when all medical expertise said it was too expensive in developing countries - they enlist neighbors to check in on patients and administer the drugs. Habitat for Humanity has made houses more affordable by incorporating work building and repairing other people's homes into the mortgage payments.
Some programs - notably Bolsa Escola in Brazil , where mothers are paid to make sure their children attend school - make direct payments to clients or their families to recognize the efforts they are making. Normally, this is too expensive, however, and a powerful alternative is to pay clients with Time Dollars, a tax-exempt local currency whereby one hour of service earns one Time Dollar. This strategy provides much of the flexibility of money without the many drawbacks.
Experience using Co-Production has shown that it can:
- Save Money: Research at Member to Member in Brooklyn , NY has shown that it can cut the cost of caring for customers to the social HMO Elderplan. Local networks and support allow members to care for one another, resulting in the ability to remain in their own homes and out of nursing homes longer. Similar efficiency has been shown in a range of other Co-Production programs.
- Involve Hard-to-Reach Groups: Government-funded research in the UK has shown that rewarding individuals with Time Dollars attracts community involvement from some of the hardest to reach sections of the population, including people from immigrant and ethnic minorities, refugees, and people with mental and physical disabilities.
- Create a Sense of Trust and a Supportive Community: Programs that successfully incorporate Co-Production have been praised by participants and foundations alike for their ability to increase a sense of local trust and safety and cross racial divides.
- Improve Health: Research has shown over and over again that people who are active in their community are healthier, and Co-Production promotes active engagement in the core economy of family, neighborhood, and community.
- Accelerate and Sustain Involvement: Most traditional volunteer programs show a fall-off of involvement over time. When Co-Production is involved, the opposite is true. Both in London and Maine , research has shown that involvement grows the longer participants have been involved. At the Maine Time Dollar Network, research showed that member engagement (number of hours put in by participants) leapt by 150% in the fifth year of membership.