Mara Gordon | A dose of nonprofit medicine

Lorenzo Buffa is like a lot of young people in West Philadelphia. He wears skinny jeans and carries a messenger bag; he takes art classes and does face painting for kids to earn a living.

And of course, he doesn't have health insurance.

I've written columns before about what it's like to be a twenty-something without insurance. It's scary, and it's a reality for thousands of Americans. Buffa is always worried about getting into bike accidents on his way around the city - and about how he would pay for his hospital bills if he does.

But what makes him different is that he's trying to change things.

Buffa is part of PhilaHealthia, a grassroots organization that's trying to provide uninsured Philadelphians with a nonprofit alternative to our current broken health care system.

The group got its start in Ithaca, N.Y. with a man named Paul Glover.

Now living in Philadelphia, Glover is an aging hippie - he has white hair and wears sandals with socks, hanging out with hipsters like Buffa in West Philadelphia coffee shops. They made an unlikely pair - I met them earlier this week at a community acupuncture clinic on Baltimore Ave.

But the two men are both uninsured, a fact that binds them with a growing number of similar activists around the city.

In New York, Glover started an organization about 10 years ago called the Ithaca Health Alliance. It's a co-operative model for health coverage that works entirely outside of the system. Several hundred members pay $100 annually, and the Health Alliance pays for emergency treatments that they need.

The state tried to shut it down a few years ago, but Glover and his fellow activists hired a lawyer.

Today, the Ithaca Health Alliance functions essentially as a nonprofit organization - and when its members have emergencies, it pays.

It covers very little compared to traditional, for-profit insurance companies. For transparency, the Ithaca Health Alliance lists all of its members' claims on its Web site and notes which ones are covered. It pays for broken bones and emergency stitches, not Botox or teeth whitening.

But as Glover says, "You don't get social justice by asking nicely."

When he moved to Philadelphia a few years ago, he started organizing PhilaHealthia, the Philly version of what had worked so well in New York.

Philadelphia, of course, is not a left-wing college town like Ithaca. It's a city where thousands of people live without insurance, a city with public health problems ranging from obesity to sexually transmitted diseases.

Glover has struggled to get people here to pledge their support to the co-op model, which needs at least several hundred people to function.

The health care revolution is slow, he argues.

"The situation is right. You have not only millions uninsured, millions struggling to pay the premiums . More who are taxpayers, to insure public employees and to pay for Medicaid for the indigent.

And you've got people by the millions having jobs they hate just so they can pay for health insurance," he says. We have an "orderly, honorable, superior alternative."

It's not clear whether or not the PhilaHealthia model will succeed here. The Pennsylvania Insurance Department has agreed to meet with Glover and other PhilaHealthia members in the coming weeks, but some health policy experts say a nonprofit insurance scheme like this one is too naive to work on a large scale.

I admit that Glover and his colleagues did seem a bit too idealistic, with their talk of a world where anyone can get whatever treatment they want, whenever they want it - whether it's chemotherapy or herbal medicine.

But PhilaHealthia also shows lawmakers that there is demand for nonprofit, universal coverage - and it shows them that its members will do whatever it takes to get there.

PhilaHealthia may not be the solution, but it may be the first step to a genuinely functional health care system.

Mara Gordon is a College senior from Washington, DC. Her e-mail is gordon@dailypennsylvanian.com. Flash Gordon appears on Wednesdays.

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