Why 20 million Brazilians rely on a co-operative for healthcare

The largest system of medical co-ops in the world – and the largest healthcare network in Brazil – is run by Unimed. Founded in 1967, Unimed consists of...

The largest system of medical co-ops in the world – and the largest healthcare network in Brazil – is run by Unimed.

Founded in 1967, Unimed consists of 354 medical co-operatives, which offer health services to more than 20 million customers. It has over 110,000 active physicians and 113 hospitals, as well as emergency care, laboratories and ambulances.

Dr Eudes de Freitas Aquino, president of Unimed, said the medical co-op was born from the “need to improve medical working conditions, the quality of the equipment and installations for patient care”.

Unimed began when doctors gre tired with problems in the system, and mounting levels of professional disatisfation, he said.

“Doctors who worked in public health decided to join the union of doctors from Santos, on the coast of São Paulo state, and started to discuss alternatives,” he added.

“A lawyer who had read about the co-operative movement suggested the creation of a co-operative. The idea was accepted and the first co-operative was created.”

Today, around 12% of Brazil’s population is a client of Unimed while the medical giant covers 83% of the national territory and accounts for 32% of the health insurance market. About a quarter of Brazilian doctors are members.

Unimed’s approach is different from other providers, says Dr Aquino, because it sees the co-op model as an effective alternative  model of healthcare in Brazil.

“Unimed provides a worthy service to areas where the public system is precarious,” he said.

“The co-operative is not driven by a desire to increase profit, since its revenue is constantly reinvested in buildings and extensions to hospitals and laboratories.”

Unimed also wants to strengthen primary care and is promoting different actions to achieve this.

“In recent years, Unimed registered improvement in the health of more than 100,000 patients,” said Dr Aquino. “It is a model that values the integration of medical services offered to patients throughout their life, considering family history, community and region.”

Despite its growth, Unimed continues to face barriers. One is the need to invest in the sector while staying within the guidelines of the National Health Agency, which regulates health providers in Brazil and sets limits to the price of insurance coverage.

Another challenge is that, while health services used to focus on hospitals, demographic changes mean Unimed has to strengthen preventive medicine.

“Unimed has access to government at all levels for the development of public-private partnerships in service to the population,” says Dr Aquino. “Open and collective discussions are taking place with government and civil society to define the best model. A uniform network of Unimed can do much to serve the population.”

Priscila de Oliveira Muniz, a client of Unimed in Rio de Janeiro, explains why its approach matters.

“I felt the difference of being an Unimed client after being pregnant with my first child,” she said.

“A nurse at Unimed Petrópolis Hospital looked after me before the delivery and in maternity, and helped me with breastfeeding.

“Because I produced a lot of breast milk, I decided to donate for the hospital milk bank. To breastfeed my son was an incredible experience and it’s good to know that by donating my breast milk I was supporting children and mothers that needed help.”

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

In this article

Join the Conversation