unimed

ARTIGO A RT I C L E 999

UNIMED: história e características da cooperativa de trabalho médico no Brasil
UNIMED: history and characteristics of a Brazilian medical cooperative

Cristina Maria Rabelais Du a rte

1 De p a rtamento de Ci ê n c i a s
S o c i a i s , Escola Nacional de Saúde Pública,
Fundação Oswaldo Cruz.
Rua Leopoldo Bulhões 1480,
Rio de Ja n e i ro, RJ
2 1 0 4 1 - 2 1 0 , Bra s i l .
2 Faculdade de Medicina de Pe t r ó p o l i s . Rua Ma c h a d o
Fagundes 326, Pe t r ó p o l i s ,R J
2 5 7 1 6 - 9 7 0 , Bra s i l .
3 Faculdade Arthur Sá
Earp Ne t o. Rua Machado
Fagundes 326, Pe t r ó p o l i s , RJ
2 5 7 1 6 - 9 7 0 , Bra s i l . ra b e l a i s @ t e r ra . c o m . b r

1,2,3

Abstract This article describes the organizational characteristics of the UNIMED medical cooperative in Brazil. After an ove rv i ew of UNIMED’s share in the current health plan market, the author analyzes its organizational structure , historical evo l u t i o n , and contractual regimen with member physicians, including the formula used to calculate the payment schedule for physician s e rv i c e s . The plan currently includes 367 local member coopera t i ve s , o p e rating in over 80% of
Bra z i l ’s counties, with 41% of existing physicians to serve 7% of the population. The organization’s history began with local cooperatives and subsequently federations, the confedera t i o n ,a n d other companies in the gro u p. The organizational design and dynamics favor a high degree of d e c e n t ralization and autonomy, s u b o rdination of all components in the system to the physician c o o p e ra t i ve command, and the occurrence of internal disputes and conflicts between individual interests and those of the organization.
Key words Health Se rv i c e s ; Health Policy; Health Insurance

Resumo O presente trabalho busca descrever as características organizacionais da cooperativa de trabalho médico UNIMED no Bra s i l . Após uma bre ve