A company model that is extending all around the world

The solidity of the Unimed system

Brazil has the largest cooperative of doctors in the world. As described by Dr. Fabio Leite Gastal, Manager of Strategy, Management and Innovation at Seguros Unimed, the organisation “was started in 1968, within the context of the Brazilian social and industrial revolution.” This promoted the fact that many companies contracted healthcare services. “At this moment,” he affirms, “as doctors we realised that we had to organise ourselves to offer an ethical alternative that placed value on the doctor-patient inter-relationship.”

The health system in his country underwent an important transformation from the nineteen eighties onwards. “The democratic process brought the prioritisation of the right to health along with it,” Leite Gastal explains, which helped Unimed to continue growing. Today, it is now formed by 340 medical work cooperatives present in nine out of every ten municipalities in the country. They have twenty million health insurance customers and they offer around 30,000 services under contract. The cooperative also has its own network of 163 hospitals and around 120,000 cooperative doctors. It has also extended its activity to other insurance areas, such as life or retirement, which to begin with were created to take care of the needs of the professionals themselves. 

In Brazil, around 150 million inhabitants are only covered by the national health system, while private healthcare takes care of another 50 million users. One of the peculiarities of its model is that “when the user buys healthcare insurance or their company does this, the citizen leaves the public health service. This means that the private offer must guarantee them all the services that they could have in the public service,” Leite Gastal adds. Thanks to Unimed, the doctors managed to improve their conditions; at the same time, the healthcare system itself has also evolved, bringing increasingly better quality to the services. 
 

Cooperativa de Profesionales de Panamá: a multifactorial service

As Dr. Marisol Ng de Lee, a director on the Board of Directors of the Cooperativa de Profesionales de Panamá tells us, this association was founded when a group of doctors and dentists decided to come together to “provide a decent retirement for healthcare professionals, once they had left the work system.” To begin with, they centred on encouraging savings and giving credits, but they then started to administrate medical insurance, which led them to build their own professional hospital. 

The intention was to offer, in a country with a considerably expensive healthcare system,  “our members, third parties and to the population in general, the possibility of being cared for in a hospital with high technology, at reasonable prices and seeking the stabilisation of our health plans,” adds Dr. Ng de Lees. This cooperative model has led them to request, through the organisations they belong to, such as the IHCO, “support to discover the experiences of these important models, and to be able to identify the pros, the contras, the advantages, the technology they have or the administration model, in order to maximise our processes.” The Cooperativa de Profesionales de Panamá has been used, according to this prestigious professional, to create “a multifactorial healthcare model, based on evaluation, diagnosis, treatment and monitoring; in short, a project that contributes to improving the quality of life of the patients, who we look after quickly, accurately and with some fair costs.”  

Uganda: healthcare for the underprivileged 

KAMACOS (Kampala Medical and Allied Health Workers Cooperative Society) is a small cooperative which, since 2019 has grouped together the healthcare professionals from the capital city of Uganda. Dr. Atuwaire Kagaha Dan, its Chairman, explains that its main mission is to “provide services through medical camps and extension programmes that can reach the rural communities.” In one of these camps, which usually remains in one place for a week, they take care of between two and five thousand patients. 

Since its creation, KAMACOS has already helped over 80,000 people all over the country. They usually mobilise resources from the Government, civil society and the private sector to reduce the costs of the medical care, particularly in the case of the most vulnerable people. As Kagaha Dan explains, “for this we use doctors who are usually also members of the cooperative. At the same time, they represent us in the regions.” They also work “closely with the Government, often using their own installations.” 

When we ask him if the cooperative model is essential to guarantee affordable access to healthcare in his country, the Chairman of KAMACOS does not hesitate to affirm: “The answer is yes, yes and yes. It is a truly very effective, responsible and democratic system which, also displays accountability.” 

The cooperative of pharmacies in Greece

Pharmaceutical cooperatives are very usual in Mediterranean countries such as Spain, Italy or Turkey, reaching market shares of over 50%. The Cooperative of Pharmacies of Greece is a good example of this. As its Chairman, Vasilis Birlirakis explains, its history dates back to the nineteen thirties. “The association was founded to cover the needs of active principles and also of some of the first medicines of the industry. Thanks to the cooperative, the pharmacies that were members could have the necessary drugs available in their community.” 

In recent years, the organisation has adopted a much more clinical profile, which has led it to build specific structures. In the worlds of Birlirakis, “the Cooperative of Pharmacies has made different contributions to the country. It has improved the quality of the products, guaranteeing their storage in optimum conditions. It has also provided transport and a streamlined, fast supply, showing its capacity to reach the furthest village in the country.” 

The Japanese model, promoted by users

The Japanese Federation of Health and Well-being Cooperatives, a network that groups together over one hundred healthcare cooperatives formed by around 40,000 employees, has a singularity: originally, the cooperative members were the users themselves, not the medical professionals. 

As Noriaki Taguchi, Secretary of the institution explains, often these organisations were formed “when the residents in remote regions or that were difficult to reach, which did not have any medical installations, decided to invite doctors and other professionals to set up in these places.” The cooperatives are, in the end, the result “of the collaborative effort amongst the citizens and the professionals to be able to carry out social and commercial activities in an effective way,” he adds. 

The goal is to promote the consolidation of a society where people can live long, healthy lives. To do this, the Secretary of the Federation observes, it is necessary to take care of the health of all the people who form part of the community, as well as the environment that surrounds them.