In depth comparison: the traditional business model vs. the cooperative

From outside, a hospital managed by a traditional company or by a cooperative might seem the same: uniformed healthcare staff and patients accompanied by family or friends passing through the installations. However, there are many differences between the management of these two centers. 

A cooperative company is an independent association of people who have voluntarily come together in order to deal with their common economic, social and cultural aspirations by way of a company that is jointly owned and democratically controlled, as is defined in the Statement on the Cooperative Identity.

Using this definition, cooperatives are companies, in the same way as the traditional model, but they are centered around the people and they are managed in a democratic, equal way, which creates significant differences between these two models that can be seen in the way the patients are treated. 

Healthcare cooperative model 

In a cooperative, the members are the people who own the property, and not the investors as occurs in a traditional company.  This is the case, for example, of the Cooperative owner of the Hospital de Barcelona (SCIAS), which forms part of the Fundació Espriu, being the owner of the Hospital de Barcelona and responsible for its management. 

For the Hospital de Barcelona, the members are the ones in charge who must obtain, along with the cooperative of health professionals, a satisfactory medical system. 

Additionally, as owners of the cooperative, the members are entitled to take part both in its governing bodies and in the activities that the institution organizes in a social area. Furthermore, the cooperative Asisa, the largest private health group in Spain, has 18 hospitals in the HLA Group, managed by its members.

Cooperative companies are governed in a democratic way, following the principle of “one member, one vote”; while in a conventional company, the investors manage it in terms of the volume of their investment. In the case of SCIAS, the Governing Board is formed by 15 people who are democratically elected for a period of 5 years: 12 of them from the consumer members group and 3 belonging to the work group. 

Aims of the cooperative model

In a cooperative, the main aim is not to obtain returns and increase the profits for the shareholders, but rather, it is a model based on reinvestment and in the case of healthcare cooperatives, it is centered on caring for people’s health and wellbeing. For these healthcare cooperatives, it is essential to have a social, satisfactory medical system for both the professionals and the users, with the opinions of the former being given to the healthcare cooperatives, based on a constant dialogue with the users.

In a cooperative company, the long-term objectives are placed at the heart of the management system, and the ways of measuring the success are different to those used for conventional organizations. With regard to a healthcare cooperative such as Asisa or Asistència Sanitaria, the efficiency is best measured by the satisfaction of both doctors and patients. 

Cooperative values in the management

Cooperatives have a series of values that are passed on to the daily management and these values distinguish them from traditional companies, with differentiated organisation and orders regarding priority. 

Cooperatives are independent organisations managed by their members,  therefore, if the share capital is increased using external sources, this must be done in such a way that the democratic control of its members is guaranteed, whilst also maintaining the independence of the cooperative. 

In addition, cooperatives offer education and training to their members, such as the doctors, in order for them to be able to contribute to the cooperative’s development. It is also easier to work in local structures, while at the same time, belonging to a movement with global alliances.