Sector news: ICMIF members feature in international report on healthcare cooperatives & mutuals

Friday, 13 February 2015

An international survey of cooperatives and mutuals at work in the health and social care sector was written and published for the 2014 Québec International Summit of Cooperatives, held in Canada in October last year. The Summit was hosted by ICMIF member organization Desjardins and the International Co-operative Alliance (ICA).

The report Better health & social care: How are co-ops & mutuals boosting innovation & access worldwide? was coordinated and edited by Jean-Pierre Girard, LPS Productions. Girard has over 30 years’ experience in the cooperative and healthcare sector.

Why this research?

The report sought to investigate what is important about the engagement of cooperatives and mutuals in the health and social care sector? How do these organizations improve access to health care? How are they innovative?

How was the research carried out?

A global survey was conducted by an international research team from February to August 2014. It covered 59 countries from the five major regions of the world.

A number of ICMIF member organizations are mentioned in the report including Benenden Healthcare (UK) a mutual providing complementary health insurance and which owns a hospital; COOPENAE, the largest savings and credit cooperative in Costa Rica;  and Harmonie Mutuelle (France) which not only provides healthcare insurance but also an impressive network of clinics, hospitals and day-care centres. The report also mentions the existence of insurance cooperatives which offer a health plan at an affordable cost, such as the Co-operative Insurance Company of Kenya (CIC), another ICMIF member organization.

Speaking to ICMIF about the report Girard said “Too often we are “binocular” when thinking about health systems. On the one side, there are public organizations, and on the other, there are private ones, based on capital (not on members). In other words, we think of systems with two major actors, each with its own set of values and principles. Unfortunately, this perspective totally overlooks millions of persons the world over, South and North, in high-, middle-, and low-income countries, who are engaged in health organizations of a different sort: organizations based on the values of equality, equity, and solidarity and which, day-in day-out, work hard to improve access to health care for their members, their members’ dependents, and more widely still – for the whole community. Such people are not shareholders, but stakeholders in an organization they own and control, a cooperative or a mutual.”

Key figures from the research

  • Total number of persons worldwide using the facilities of cooperatives and mutuals engaged in the health sector: 81,000,081
  • Total number of cooperatives and mutuals engaged in health activity: 4,961
  • Number of countries with cooperatives and mutuals which own and/or manage such facilities as clinics, medical centres, hospitals: 43
  • Number of social care cooperatives worldwide: 14,806
  • In developing countries, health plans provided by cooperatives or mutuals frequently are the only affordable option for millions of people


  • Health cooperative contractors provide high quality, efficient services for Costa Rica’s social security system
  • Continuum of care offerings by diverse types of cooperative in Italy
  • The Espriu Foundation network in Spain runs hospitals in collaboration with the government. This has led to cost savings for the national health system and to higher satisfaction among users
  • Mutuals provide health care to indigenous people in Paraguay
  • Women’s Health Cooperative has become a model of community empowerment due to its provision of easily accessible and affordable health care services in Tikathali village in Nepal

Major players

  • UNIMED (Brazil) (the insurance arm of which, Seguros Unimed, is an ICMIF member) brings together 354 medical (doctor) cooperatives which represent up to 110,000 doctors and provide services to more than 19 million people
  • In Italy, 10,836 cooperatives operate in the social sector, mainly in social assistance and individual services
  • Close to 90% of Rwandans have a health plan with a Health Mutual Organization
  • ACHMEA (Netherlands) provides health and other insurance to about half of all Dutch households and is also active in seven other European countries as well as Australia

The report can be downloaded here.

The Executive Summary of the report (in various languages) can be downloaded here.

Image above/right is of the Benenden Hospital. Reproduced with kind permission.