posted on 01/14/2022 05:55 / updated on 01/14/2022 05:56
(credit: Júlio Lapagesse/CB/DA Press)
The young Isabela Ribeiro, 25, diagnosed with Turner syndrome, needs continuous treatment because of the disease, of genetic origin. Self-employed, she says she cannot afford the heavy costs of a health plan. “The plans have become more and more expensive, I can’t afford it. Unless I have a formal job that provides me with a health plan”, conditions. For the young woman, one of the great benefits of having a medical plan would be to perform exams more quickly, since, often, the dynamics of the public network takes longer.
At the beginning of the year, banks, traditionally, begin to do the math and signal the increases in the health area that are to come: according to Citi’s calculations, medicines will increase by 10%. Health plans, on the other hand, according to BTG Pactual’s projections, should be 15% more expensive. An impact on the pocket of all Brazilians.
Currently, Isabela Ribeiro is undergoing treatment at the Hospital de Base of the Federal District and seeks medication and care through the Unified Health System (SUS). But that does not make it immune from the impacts caused by the rise in drug prices. “My growth hormone is provided by the SUS, but I have to buy the other medicines that the doctors give me. Dealing with this financially is to look for coupons, discounts, SUS assistance in everything you are entitled to and try to minimize costs as much as possible” , reports.
The economist and professor of Specialization in Financial Market at the University of Brasília (UNB) César Augusto Bergo explains that the increases reflect inflation and input costs. “In the case of medicine, there is the aspect of importing inputs, which operates in relation to the dollar. When buying, sometimes you can’t find the generic, and you can’t stop taking it. But there are medicines today that are totally out of stock. of the family budget”, he analyzes.
Isabela regrets that, within the Brazilian reality, there is nothing that can be done to stop the rise in prices and vents: “Sometimes I spend R$300 or R$400 on the pharmacy per month. All that remains is to minimize costs the way we can”.
The adjustments that Brazilians make to reduce expenses are also present when it comes to health plans. There are those who opt for simpler plans to avoid exorbitant costs — and health care providers provide options. “Some plans use tricks to reduce coverage, hospitals, doctors, procedures so that there is not so much increase in the monthly fee. But the consumer needs to be aware, because all the coverage to which he has access, which he signed in the contract, cannot change in the middle of the period”, warns the economist.
The increase in the installments of health plans goes beyond the monetary issue: it impacts the quality of the service. “Health contracts with generic coverage imply an increase in cost for the consumer, because, in practice, coverage has been reduced. The quality of the plan worsens”, says Bergo. He points out that there are many operators in the market, and the plan needs to be chosen according to each person’s situation, so that, in the end, health costs do not weigh so much on the budget and actually meet the consumer’s reality.
The lawyer specializing in health plan contracts Marco Mota says that the 15% increase estimated for individual plans may give a scare at first, but they remain in the average of recent years. “If we look at the years prior to the pandemic, from 2015 to 2019, we will see that the average annual readjustment was 11.60%. were dammed”, he analyzes.
Traditionally, readjustments in individual plans also tend to increase collective agreements, which are the majority of contracts in Brazil. However, Marco says that it is difficult to stipulate how much the 15% increase in individual plans can influence a readjustment in collective plans: “Considering that readjustments in collective plans are always above the individual ones, since they are not regulated by the ANS, it is difficult to predict whether this percentage will also occur in these collective plans”, says the lawyer.
weight for the elderly
If it materializes, a 15% readjustment in individual health plans could bring risks to Brazilian public health, especially for the elderly population, observes the lawyer specializing in health plan contracts, Marco Mota. “The annual readjustments, always well above inflation and salary increases, end up expelling older beneficiaries from the system, as they cannot afford the monthly payment of the plan and end up migrating to the public system”, he observes.
Regarding the readjustments of health plans, the National Supplementary Health Agency (ANS) informs that the maximum percentage to be authorized for individual or family plans is being calculated and will be informed after completion of the calculations and manifestation of the Ministry of Economy. The Agency does not estimate the date for the disclosure of the percentages of increase.
Each type of contract, whether individual/family or collective (business and membership) plans, has specific rules. In individual or family plans, for example, the ANS defined that operators should reduce monthly fees by up to 8.19% between May 2021 and April 2022. Now, there will be an increase. The Agency also points out that consumers can ask the operator for the calculation memory and the methodology used to justify the correction of monthly fees. Companies have a maximum period of 10 days to provide the information.
*Interns under the supervision of Odail Figueiredo