Cooperatives in Brazil: A successful model in the healthcare sector

The Brazilian cooperative movement is a highly significant socio-economic force, spreading through 15 different sectors. In 2021, the country had 4,693 cooperatives, with an impressive base of 18.8 million members. This sector generated around 493,100 million BRL in revenue, which underscores its crucial role in the national economy. The body in charge of defending the interests of this enormous conglomerate is the Organisation of Brazilian Cooperatives (Organización de las Cooperativas Brasileñas -OCB), which promotes the continuous development of the cooperatives in different economic and social areas.

Dual public-private model

The Brazilian health system operates using a dual model, combining the public Single Health System (SUS in its Brazilian initials), with a strong private sector. This coexistence generates a considerable demand for supplementary health services, a niche where the cooperatives have prospered. However, the sector is facing up to some significant challenges, such as the constant increase in medical care costs, fast-moving technological evolution and the need to hold onto professional talent. For many years now, these factors have promoted the search for innovative and efficient solutions.

Within this complex situation, healthcare cooperatives in Brazil stand out due to their differentiated model, centred around the benefits for their members and the community needs. Unlike traditional providers, these organisations belong to, and are managed by the healthcare professionals themselves, such as the doctors. This structure promotes professional independence and places the incentives in line with care quality and the efficient use of the resources, which is translated into greater satisfaction for both patients and healthcare professionals.

Over 19 million stakeholders

The Unimed system is the most prominent example and the largest medical cooperative system in the world. Founded in 1967, it covers 84% of the Brazilian districts, taking care of 19 million stakeholders. Its vast infrastructure includes 126,000 cooperative doctors, 2,400 hospitals and 114,000 employees. This unprecedented scale turns it into a de facto national medical care network, complementing the public services and improving general access to healthcare all over the country.

The healthcare cooperatives, headed by Unimed, make a significant contribution to the expansion of accessibility to medical care, particularly in the regions where there is no public care available, and it is based on a model that promotes quality and efficiency by way of investment in technology and innovation. During periods that are particularly problematic, such as the COVID-19 pandemic, they showed an incredible capacity for resilience, adapting their services to the changing needs during this unprecedented situation. Additionally, they have a considerable economic and social impact, contributing to the GDP and generating employment, placing a spotlight on local development and social inclusion.

The governance of healthcare cooperatives such as Unimed is characterised by the fact that they belong to the doctors, giving them direct control over the operations. They work using a decentralised, but integrated structure, allowing local flexibility and national scale benefits. However, they are facing up to challenges such as the complex regulations imposed by the National Agency of Supplementary Health (ANS in its Brazilian initials), the important competition of the market and the constant need to manage the increase in costs and to hold onto specialised talent.

In spite of the challenges, the healthcare cooperatives have important opportunities for growth. Digital transformation is a key element, with investments in remote medicine, artificial intelligence and digital management systems to improve efficiency and accessibility. Inter-cooperation will continue to be essential, allowing the cooperatives to share resources and knowledge, strengthening their collective capacity. The future will depend on their ability to embrace these trends, turning the challenges into opportunities for innovation and resilience.