News in private health plans – Economy

Private health plans began to take shape in the 1960s, when the industry looked for more efficient alternatives to replace the care offered by the public network, which was corrupt, anachronistic, poorly equipped and slow, which increased the cost of employees, who were on leave for long periods, the result of medical certificates invariably made without much discretion.

In the beginning, the companies had agreements with nearby hospitals, which served their employees with obvious advantages, such as the quality and speed of service, which satisfied the company and the employee. The company had fewer leaves and employees had a better health service. Then, families were included and, as a result, the first health and medical assistance cooperatives emerged, professionalizing the service.

It is not here to tell the story of private health plans in Brazil. Between the first steps and the current scenario, a lot of water passed under the bridge, with advances and setbacks shaping one of the great consumption dreams of Brazilians.

The big watershed was the Private Health Insurance Act, which came into effect in the late 1990s, laying the foundations for what we have today. It was one of the worst laws voted by the National Congress, so much so that it was profoundly modified by an interim measure, followed by several others, enacted in subsequent months, all aiming to improve its text and make the health care originally intended viable.

From the end of the 1990s until now, the system has evolved a lot and currently, private health plans stand out in the care of their beneficiaries contaminated by covid19. Without its performance, the SUS framework would be much more serious and, for sure, Brazilian public health would not have gained society’s recognition for the relevant services it has been providing in the fight against the pandemic.

Due to the Law on Private Health Plans, socioeconomic advances and the performance of the ANS (National Supplementary Health Agency), private health plans, even being operated by legal entities with different designs and requiring plans with different particularities, were getting more and more alike.

One of the most perverse consequences was the almost disappearance of individual plans, massacred by rules that practically rendered them unfeasible. In its place, collective membership plans emerged, a figure that does not exist in the law, but which came to occupy an important gap, offering coverage for orphans of individual plans.

The result is that, until now, the sector has offered collective corporate plans and collective membership plans with practically the same design. But the scenario is starting to change. And the change is welcome, because it ignites the flame of competition, not only on terms and prices, but due to new designs, focused on market niches, such as target audience, age, new designs from accredited networks, partnerships with service providers, telemedicine, beneficiary participation, etc.

Since the entry into force of the Law on Private Health Plans, it is the first time that new brands have started to appear in advertising campaigns and in specialized publications, analyzing and pointing out the differences, strengths and weaknesses of these products compared to traditional designs. And this is very positive.

Certainly, at this moment, they are far from being a threat to traditional health plans and to the large Brazilian private health plan operators.

The mere fact of being innovative does not guarantee all of them the certainty of success. But the important thing is that his arrival shows that there is room to work on an indispensable product for Brazilian society. With the use of new technologies, creativity, focus and professionalism, these plans are offering unprecedented solutions that can be the path for the sector’s growth, not least because, among other things, they affect the price of the product.

*PARTNER OF PENTEADO MENDONÇA AND CHAR ADVOCACY AND GENERAL SECRETARY OF THE ACADEMIA PAULISTA DE LETRAS