South Africa is ready for healthcare cooperatives to radically reduce the cost of healthcare

SA needs affordable private healthcare (2)South Africans are worried about debilitating medical aid costs. Many South Africans don’t trust the public healthcare system and are forced to use expensive private healthcare. South Africans have been squeezed for so long that they feel mostly powerless. The future unfortunately holds no promise. There is no indication that someone is going to save us from the healthcare nightmare.

What if we united to create a medical care approach that is more affordable, sustainable and less burdensome? What if we designed a system that can benefit us as well as practitioners and service providers? What if we united beyond colour lines to bring the current exploitative healthcare system to its knees, replacing it with a more just cooperative owned system?

Healthcare cooperatives are popular across the world. In a healthcare cooperative, consumers and healthcare practitioners co-own the system (hospitals, laboratories and ambulances), share the costs but also share in the profits. A cooperative healthcare model is a win-win model for its members and society. The cooperative healthcare model followed in Brazil offers a fascinating insight into what is possible when the just arise to create new models.

South Africans will be surprised to learn that Brazil’s largest private healthcare provider is a cooperative. This healthcare cooperative, Unimed, was founded in 1967 by a man of great vision, Dr Edmundo Castilho. This gynaecologist was so disillusioned by the commodification of Brazil’s healthcare system that he sought an alternative to the capital-based health plans. Together with 22 other doctors, he started the first healthcare cooperative; this cooperative (a big innovation at the time) was based on principles of professional excellence and fairness. Over the years Unimed has grown to comprise a network of 360 cooperatives and they own around 100 hospitals, 54 laboratories and 456 ambulances. They have a further 3 033 associated hospitals in their network and their 110 000 doctors serve a total of 19 million patients.

Dr Edmundo Castilho is a shining example of what is possible when the just arise to fight an unjust system. Today, Unimed is still leading the way with quality and affordable healthcare.

With this article, the middle class and all the role-players in the healthcare ecosystem are being challenged to take up the urgent call to make healthcare more affordable for South Africans. An appeal is made to those who have innovative ideas that could bring about a more equitable healthcare system (including solutions to dramatically reduce medical aid fees) to share their ideas on public platforms. Many hardworking tax paying South Africans are looking forward to either free/reduced medical care at good public hospitals, a far lower premium at private hospitals or a hybrid solution where ordinary consumers can share the costs in a government-private-consumer partnership.

Lasting solutions centred on affordability, equality and sustainability can only come from having a multitude of healthcare cooperatives in South Africa. We need South Africa’s own Dr Edmundo Castilho to rise up and lead the charge; the harvest is ready.

Please share this post widely and email us at to contribute to discussions on creating new cooperative healthcare models in the country.

(Excerpt from: A new vision for South Africa by James Truter.)


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