HIROC exists because of a crisis in Ontario healthcare in the mid-1980s. Liability premiums for hospitals rose sharply, and one major commercial insurer stopped covering them altogether. For a publicly funded hospital, that is not a budgeting problem. A hospital cannot operate without insurance.
Two commissioned reports looked at the same question: could hospitals insure themselves instead? Both recommended the same answer. Form a reciprocal.
A reciprocal is an insurance arrangement where the members are all in the same business and agree to share each other's losses. In practice, it means the customers are also the owners. HIROC was created on that model in 1987, starting with 53 healthcare organizations under the name HIRO, the Hospital Insurance Reciprocal of Ontario.
Today it insures roughly 95% of healthcare in the country outside Quebec and British Columbia, which run their own programs. It is the largest reciprocal in Canada, and it went on to launch the Canadian Association of Insurance Reciprocals to advocate for the model and help smaller, newer reciprocals find their footing.
The ownership structure is the whole point. There is no daylight between what is good for the company and what is good for the client.
“It's not like we've got to look after the shareholders. The shareholders are the subscribers. So we're an honest broker, always trying to act in their interests.”
Gareth Lewis, HIROCGareth Lewis was employee number 41. He joined as a junior file examiner before he finished university, mostly because he needed a job and didn't entirely know what a file examiner was. This September marks 24 years. He is now a Vice President on a senior leadership team of six.
This is the part worth being clear about, because it shaped everything that followed.
Gareth was not in trouble. He had completed an Executive MBA at Queen's, which he describes as transformational, and plenty of formal leadership training before that. His department already had a culture he was proud of and had helped build. HIROC invests seriously in developing its people, and Gareth had taken advantage of that for years. His own summary of what he was after: good to great.
He wanted something courses had stopped providing.
“I'm fine with courses. Courses I'm good at; I was always a strong student. It's more so executive coaching, just having someone I can talk to about this, about that. Not that I think I was struggling, but there's always an opportunity to be better.”
Gareth Lewis, HIROCReal pressures drove the interest. Work volume at HIROC has been growing at a pace Gareth describes as almost unsustainable, which is a good problem right up until the moment you fail to deliver on it. He had a newly promoted director finding her feet in the role. And after a long stretch in the VP seat, he had the sense of having gotten himself about as far as he could get on his own steam.
“I don't think stuck was the word. I was just sort of lagging.”
Gareth LewisHIROCGareth was not the only one at HIROC working with Unicorn Labs. His director and all of his leads went through the program as well, four people in the department in total.
The effect he points to is not a dramatic culture change. HIROC's culture was already strong, and he has spent two decades helping build it. What shifted was precision.
“Even just terminology. Team 1 vs. Team 2, certain things we're able to talk about. Everybody knows it. A stronger baseline understanding for all.”
Gareth Lewis, HIROCA shared vocabulary means less time spent establishing what you mean before you can discuss what you think. Gareth describes the department as more efficient and more effective as a result.
Ask Gareth what changed in him and he starts by refusing to overstate it. Then he lands on the word.
Confidence. Not the loud kind.
“There's an irony where the smartest of us are so full of self-doubt and the dumbest of us are always so cocksure. I'm not saying I'm not aware of it. I'm just more comfortable with how I arrived at whatever decision it was.”
Gareth Lewis, HIROCPart of that is having a sounding board. Part of it is the toolkit. He compares it to the MBA, where hitting the edge of what he knew meant enrolling in something and waiting. Now he brings the gap to a biweekly call and usually leaves with an answer, or with Jordan going to find one.
The original engagement was scoped at six months. It has run past twelve, extended each time Gareth asked HIROC to keep it going, which the organization has consistently supported.
“It's such a bonus, having that person there who you know is in your corner, and who has the training and the knowledge to be like, oh, try this, it should work.”
Gareth Lewis, HIROCHe describes it as the cartoon character on your shoulder, the one saying keep going, say that, you're doing the right thing.
Gareth has recommended Unicorn Labs to a number of people, and keeps a stack of Jordan's cards on his desk for when it comes up. He is careful about how he frames the pitch.
“I'm not saying you need the help. I'm saying it'll just take you further. It's not a deficiency. It's quite the opposite.”
Gareth Lewis, HIROCThat framing came into focus for him through something HIROC's CEO said recently about resilience, a word Gareth had always understood to mean toughing it out.
“She said no, resilience isn't just being tough and dealing with it. Resilience is knowing when to put your hand up and say I could do with some help, and getting that help. Proud people have a hard time with that.”
Gareth Lewis, HIROCTwenty-four years in, having built a career at one organization from junior file examiner to the executive team, Gareth had every reason to conclude he had this figured out. He put his hand up instead.
“I had never had a coach before, and I am converted. This is how you do it.”
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