How Argentina’s co-ops work with the state to provide health services

In Argentina, health co-operatives and mutuals serve two million members. The country, which has a population of 42 million, counts on 1,056 entities whose primary or secondary activity...

In Argentina, health co-operatives and mutuals serve two million members. The country, which has a population of 42 million, counts on 1,056 entities whose primary or secondary activity is related to the provision of health services. Of these, 62% are mutuals (861) and 18% are co-operatives (195).

Health co-operatives and mutuals offer a variety of services such as primary care, partial or full coverage, nursing and pharmaceutical services. Some co-operatives provide prepaid health coverage. Other enterprises are worker co-operatives of health professionals.

Health co-operatives form part of the Argentinian Federation of Health Solidarity Enterprises (FAESS) while mutuals are members of the Argentinian Federation of Health Mutuals.

FAESS was formed in 1999, at a time when around 50% of Argentina’s population did not have access to healthcare. The 2001 economic crisis led to an increase in the number of worker takeovers and now various hospitals function as worker co-operatives.

FAESS was set up by the Argentinian co-operative movement – the Cooperative Fund Mobilisation Institute and the Confederation of Cooperatives of the Argentine Republic, or Cooperar. It was inspired by health co-operatives in Spain and Brazil, which have the most developed health co-operative models.

The difference, however, is that universal access to healthcare in Argentina came before health co-operatives were set up. In the case of Brazil and Spain, health co-operatives were the ones that led the consolidation of the healthcare system. Universal access to healthcare services was granted
in these states  after the health co-operative sector had already been developed.

With support from local co-ops, the federation has developed more than 20 health campaigns and opened more than ten primary care health centres since 2000.

In an interview for the International Health Co-operative Organisation, Dr Ricado López, founder and president of FAESS, says the co-operative and mutual sector comprises many small and medium sized enterprises, and is less established than the public and private sectors.

“Health co-ops have organised numerous health promotion campaigns,” he adds. “For example, in the field of cardiovascular risk factors – the leading cause of death among men and women in Argentina – co-operatives stand out in that they are second only to the state in staging surveys and campaigns.”

Mr López, who is also secretary of Cooperar and board member of IHCO, adds that health cannot be provided for only by the state, while the market excludes the weakest economic sectors.

“As a result, the co-operative sector is the state’s best ally in health provision,” he says, “with
a concept tied to the promotion of health, rather than the business of illness.”

FAESS is now working to amend a new law that includes co-ops among private companies that provide of health services, meaning they need to comply to the same regulatory requirements as enterprises that aim to boost profits. While co-operatives exist to benefit members, not to make profit, the new law fails to recognise their specific nature.

“The sector aims to change this legislation,” says Patricio Suárez of Cooperar.

Special report: From Brazil to the NHS, co-operatives and healthcare – read more.

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