India’s healthcare system has long placed a heavy financial burden on ordinary citizens. The Health in India 2016 report, based on the 71st round of the National Sample Survey (2014), revealed that over 70% of illness episodes were treated in the private sector, financed mainly through household savings and, for many families, through borrowing. For non-hospitalised care, the cost of medicines alone accounted for the largest share of expenditure. More than a decade later, this reality has changed little.

Public healthcare services, while vital, continue to face capacity constraints and are often unable to meet the growing expectations of the population. As a result, households are frequently pushed into a fragmented and largely unregulated private healthcare market—one where patients have limited information, little bargaining power, and few safeguards against unnecessary or inappropriate care.

Evidence from Assam has further highlighted these challenges. Findings from the COHED Project indicate a high frequency of referrals for diagnostic tests, often to specific laboratories. In many instances, such investigations may not have been clinically necessary. Studies and public discourse have also documented entrenched practices within parts of the healthcare system, including financial incentives linked to referrals, which distort clinical decision-making and inflate costs borne by patients.

It was in response to these structural failures—high out-of-pocket expenditure, information asymmetry, limited accountability, and erosion of trust—that Assam Healthcare Cooperative Society Ltd. was established in 2016. The cooperative was conceived not as a critique alone, but as a practical, citizen-led alternative: a model that restores balance by pooling the collective strength of members, partnering with ethical providers, and placing affordability, transparency, and patient interest at the centre of healthcare delivery.

Assam Healthcare Cooperative exists to demonstrate that healthcare can be organised differently—through cooperation rather than exploitation, and through trust rather than opacity.

Assam Healthcare Cooperative Society Ltd. (AHCSL) was established in 2016 under the Assam Cooperative Societies Act to address this challenge through a simple but powerful idea: Healthcare works best when citizens act together.

AHCSL’s cornerstone strategy is to leverage the combined strength of its members—their shared needs, numbers, and collective voice—to negotiate fairer prices, promote ethical practices, and improve access to care. What individual patients cannot achieve alone, a cooperative can achieve collectively.

Today, AHCSL members benefit from discounted services across hospitals, diagnostic centres, and pharmacies, as well as preventive health initiatives and community outreach. Thousands of beneficiaries have already saved significantly on healthcare expenses—while gaining the confidence that comes with belonging to a people-owned system.