Challenges in the Regulation of Brazilian Private Health Insurance PDF Download

Author: Carlos Octávio Ocké-Reis
Publisher:
ISBN:
Category :
Languages : en
Pages : 30

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Author: Marcia Regina Godoy
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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INTRODUCTION: The Brazilian private health insurance sector has operated since 1940's without regulation. In 1998, the Brazilian Government stating the regulation of this sector. The reform improved the health insurance coverage level, stating no limit to physician visits and proibition to cream selection. OBJECTIVE: We aim at evaluating whether private health insured individuals have exhibited changes in their behavior on medical services consumption, it is whether the regulation augmented the moral hazard in this market. We also evaluated the effects the regulation in demand to health insurance. METHODS: We used three econometric methods to count data: Poisson Regression, Negative Binomial Regression and Count Data Quantile Regression. Also we used the Probit regression. The data come from the National Household Survey Sample (Pesquisa Nacional de Amostra de Domicilios-PNAD) for 1998 (before regulation) and 2003 (after regulation). The estimator of difference-in-difference (diff-in-diff) are used to estimate the impact of regulation. RESULTS: The results showed that before and after regulation there are moral hazard in health insurance. The dummy variable diff-in-diff (year*regulation) was negative and significative stastistically suggesting its that after regulation the physician visits is lower than before. The results of Probit regression showed that after regulation there are adverse selection, since the number of chronical diseases variable after regulation is positive and significative statistically. CONCLUSION: The results this paper apponted that after the regulation there are two important problems in Brazilian private health insurance: adverse selection and moral hazard. Only after regulation there are adverse selection.These problems can may generate inefficient outcomes in Brazilian private health insurance market.

Author: Carlos Octávio Ocké-Reis
Publisher:
ISBN:
Category :
Languages : en
Pages :

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The idea of regulating private health plans so as to favor major players and the "managed care" is incompatible with the guidelines of the National Health System [Sistema Único de Saúde (SUS)] and for this reason we defend instead a regulatory action aiming to strengthen the public sphere. In particular, we discuss how this alternative could improve the regulatory capacity of the National Supplementary Health Agency [Agência Nacional de Saúde Suplementar (ANS)] to face the economic crisis in the health plan marketplace, dispelling the mistaken notion that the market, once strengthened, will cooperate with the SUS rather than contaminate it.

Author: Gregory P. Marchildon
Publisher: University of Toronto Press
ISBN: 1487508085
Category : Health care reform
Languages : en
Pages : 235

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This book provides insight into how the Canadian health care system is financed and organized, how it has evolved over time, and how well it performs relative to peer countries.

Author: Carlos Octávio Ocké-Reis
Publisher:
ISBN:
Category : Health insurance
Languages : en
Pages : 40

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Author: Michele Gragnolati
Publisher: World Bank Publications
ISBN: 0821398431
Category : Business & Economics
Languages : en
Pages : 132

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It has been more than 20 years since Brazil's 1988 Constitution formally established the Unified Health System (Sistema Unico de Saude, SUS). Building on reforms that started in the 1980s, the SUS represented a significant break with the past, establishing health care as a fundamental right and duty of the state and initiating a process of fundamentally transforming Brazil's health system to achieve this goal. This report aims to answer two main questions. First is have the SUS reforms transformed the health system as envisaged 20 years ago? Second, have the reforms led to improvements with regard to access to services, financial protection, and health outcomes? In addressing these questions, the report revisits ground covered in previous assessments, but also brings to bear additional or more recent data and places Brazil's health system in an international context. The report shows that the health system reforms can be credited with significant achievements. The report points to some promising directions for health system reforms that will allow Brazil to continue building on the achievements made to date. Although it is possible to reach some broad conclusions, there are many gaps and caveats in the story. A secondary aim of the report is to consider how some of these gaps can be filled through improved monitoring of health system performance and future research. The introduction presents a short review of the history of the SUS, describes the core principles that underpinned the reform, and offers a brief description of the evaluation framework used in the report. Chapter two presents findings on the extent to which the SUS reforms have transformed the health system, focusing on delivery, financing, and governance. Chapter three asks whether the reforms have resulted in improved outcomes with regard to access to services, financial protection, quality, health outcomes, and efficiency. The con

Author: National Research Council
Publisher: National Academies Press
ISBN: 0309222222
Category : Medical
Languages : en
Pages : 142

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Motivated by the explosion of molecular data on humans-particularly data associated with individual patients-and the sense that there are large, as-yet-untapped opportunities to use this data to improve health outcomes, Toward Precision Medicine explores the feasibility and need for "a new taxonomy of human disease based on molecular biology" and develops a potential framework for creating one. The book says that a new data network that integrates emerging research on the molecular makeup of diseases with clinical data on individual patients could drive the development of a more accurate classification of diseases and ultimately enhance diagnosis and treatment. The "new taxonomy" that emerges would define diseases by their underlying molecular causes and other factors in addition to their traditional physical signs and symptoms. The book adds that the new data network could also improve biomedical research by enabling scientists to access patients' information during treatment while still protecting their rights. This would allow the marriage of molecular research and clinical data at the point of care, as opposed to research information continuing to reside primarily in academia. Toward Precision Medicine notes that moving toward individualized medicine requires that researchers and health care providers have access to very large sets of health- and disease-related data linked to individual patients. These data are also critical for developing the information commons, the knowledge network of disease, and ultimately the new taxonomy.

Author: Collectif
Publisher: OECD
ISBN: 9264266445
Category : Social Science
Languages : en
Pages : 239

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This report discusses the need for an integrated and cyclical approach to managing health technology in order to mitigate clinical and financial risks, and ensure acceptable value for money. The analysis considers how health systems and policy makers should adapt in terms of development, assessment and uptake of health technologies. The first chapter provides an examination of adoption and impact of medical technology in the past and how health systems are preparing for continuation of such trends in the future. Subsequent chapters examine the need to balance innovation, value, and access for pharmaceuticals and medical devices, respectively, followed by a consideration of their combined promise in the area of precision medicine. The final chapter examines how health systems can make better use of health data and digital technologies. The report focuses on opportunities linked to new and emerging technologies as well as current challenges faced by policy makers, and suggests a new governance framework to address these challenges.

Author: Carlos Octávio Ocké-Reis
Publisher:
ISBN:
Category :
Languages : en
Pages :

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This paper aims to show that regulatory actions could work as an instrument to correct the shortcomings of the private health insurance market. However, despite the rules that defend both consumer rights and competition, these actions can, paradoxically, bring about a more marked concentration of the market if the power of the oligopolies is not challenged. To criticise this sort of management, considering both the regulatory conflicts and the economic crisis facing the market, we suggest that the Agency play a key role establishing a benchmark, particularly supporting public health principles and reducing the price of private health insurance.

Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309477891
Category : Medical
Languages : en
Pages : 399

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In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.