The “Third Option” for Healthcare: Health Co-ops in Atlantic Canada

By Ainslie Pierrynowski (AIMS on Campus Student Fellow) 

A number of AIMS reports and op-eds have delved into how Canada’s health services—and access to them—might be improved, both in Atlantic Canada and across the country. This inquiry into the region’s healthcare system is no idle concern. A declining tax base, a growing population of seniors in need of care, staff shortages, long travel times to centralized health services locations, and limited access to mental health services, among other issues, point to an uncertain future for patients in Atlantic Canada. A recent AIMS study drew attention to a new mode of health services delivery which could mitigate some of these challenges: health co-operatives.

The term “co-operative” or “co-op” refers to an organization owned by consumers (like a credit union), producers, workers, inhabitants (like a housing co-op), or in the case of multistakeholder co-ops, a combination thereof. Health co-ops, in particular, are typically community-based organizations that deliver medical services to their customers and may vary in their size, scope, ownership, and services provided.

While health co-ops are certainly no substitute for a public healthcare system, as the aforementioned AIMS study notes, they can provide numerous advantages to patients in Atlantic Canada. For instance, as community members have a stake in the provision of health services to their area, health co-ops owned and funded by community members—say, via an annual membership fee, as the AIMS study proposes—could be tailored to local medical needs. For example, Multicultural Health Brokers in Edmonton provides translation services in twenty-two languages, while Winnipeg-based health co-op NorWest serves Indigenous and immigrant communities. This ownership structure would also enable local consumers, who control the co-op’s revenue, to keep staff members accountable for the level of services which they provide.

Additionally, health co-ops could deliver otherwise difficult to access services, including mental health support, and cut wait-times for house calls and homecare for the nearly 50% of Atlantic Canadians who live in rural areas. Indeed, North Shore Ambulance Co-op in rural Newfoundland and Labrador has managed to dramatically reduce wait times for patients. Further, in light of the region’s aging population, homecare co-ops, housing co-ops, and residential co-ops could broaden healthcare options and shorten waiting lists for seniors. Moreover, as this report and this study note, health co-ops could serve as key sites for delivering preventative initiatives tackling social determinants of health to small or isolated communities, including first aid courses; classes on nutrition, injury prevention, and other topics; food security programs; and flu vaccinations.

Faced with mounting health challenges, Atlantic Canada must look beyond conventional health care options to the over one hundred health co-ops currently in operation across Canada. As this study notes, the health co-op model “inspires citizens to support their own health care and the health of their communities using a client-centered, holistic, and interdisciplinary approach to health care.” It is time to take charge of our health and pursue this innovative, community-based health strategy.

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