From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil

Bahia, Lígia; Scheffer, Mário; Tavares, Leandro Reis; Braga, Ialê Falleiros

doi:10.1590/0102-311x00154015

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…(22) These characteristics have led to inequalities that are translated into the availability of healthcare resources, including ICU. (14) However, although these characteristics are unique to Brazil, other countries face similar challenges.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, Brazil has a unique health system in that, although there is a Unified Health System ( 21 ) that is government-led with no direct payment from users, there is also a private sector that covers a smaller proportion of the population. ( 22 ) These characteristics have led to inequalities that are translated into the availability of healthcare resources, including ICU. ( 14 ) However, although these characteristics are unique to Brazil, other countries face similar challenges.…”

Section: Discussionmentioning

confidence: 99%

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Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians

Ramos¹,

Passos²,

Baptista³

et al. 2017

Revista Brasileira De Terapia Intensiva

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Objective To evaluate the factors potentially associated with the decision of admission to the intensive care unit in Brazil.Methods An electronic survey of Brazilian physicians working in intensive care units. Fourteen variables that were potentially associated with the decision of admission to the intensive care unit were rated as important (from 1 to 5) by the respondents and were later grouped as "patient-related," "scarcity-related" and "administrative-related" factors. The workplace and physician characteristics were evaluated for correlation with the factor ratings.Results During the study period, 125 physicians completed the survey. The scores on patient-related factors were rated higher on their potential to affect decisions than scarcity-related or administrative-related factors, with a mean ± SD of 3.42 ± 0.7, 2.75 ± 0.7 and 2.87 ± 0.7, respectively (p < 0.001). The patient's underlying illness prognosis was rated by 64.5% of the physicians as always or frequently affecting decisions, followed by acute illness prognosis (57%), number of intensive care unit beds available (56%) and patient's wishes (53%). After controlling for confounders, receiving specific training on intensive care unit triage was associated with higher ratings of the patient-related factors and scarcity-related factors, while working in a public intensive care unit (as opposed to a private intensive care unit) was associated with higher ratings of the scarcity-related factors.Conclusions Patient-related factors were more frequently rated as potentially affecting intensive care unit admission decisions than scarcity-related or administrative-related factors. Physician and workplace characteristics were associated with different factor ratings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians

Ramos¹,

Passos²,

Baptista³

et al. 2017

Revista Brasileira De Terapia Intensiva

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“…Capital's financial logic prevails in this scenario, with the leading companies' clear hegemony in the innovation standard in terms of the search for new products and in orienting R&D activities, generating asymmetries between Cad. Saúde Pública 2020; 36 Sup 2:e00154519 regions, countries, and populations 18,22,23 . Investors that connect public and private funds in various forms of risk capital, public banks, and international funding agencies also participate in this process.…”

Section: Global Vaccine Market: Research Development and Innovationmentioning

confidence: 99%

Acesso a vacinas no Brasil no contexto da dinâmica global do Complexo Econômico-Industrial da Saúde

et al. 2020

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Este estudo investigou as principais tendências econômicas, da estrutura de mercado, e da produção e inovação em vacinas contra doenças infecciosas, em âmbito global e nacional, observando os reflexos no acesso à vacinação no Brasil e sustentabilidade do Sistema Único de Saúde. Para atualização do panorama mundial de P&D e de mercado, foi realizada uma pesquisa bibliográfica, e, utilizada a base de dados de inteligência competitiva. Para a compreensão da inserção do Brasil nesse contexto, segundo enfoque estrutural do Complexo Econômico-Industrial da Saúde, foram levantadas informações da Agência Nacional de Vigilância Sanitária, do Programa Nacional de Imunização e da base Questel Orbit Intelligence, referentes à proteção patentária no país; identificadas as tecnologias transferidas para as instituições públicas nacionais; e investigada a evolução do déficit da balança comercial em saúde. A análise efetuada evidenciou a tendência global de concentração da produção em poucas empresas farmacêuticas líderes e de acirramento de assimetrias econômicas e tecnológicas também no segmento de vacinas. No Brasil, a pesquisa identificou fragilidades tecnológicas, riscos e gargalos produtivos que recaem sobre a garantia à imunização no país e revelou que, a despeito da base industrial instalada, as políticas públicas e ações dos produtores nacionais não têm sido suficientes para enfrentar e superar o contexto global de dependência estrutural. Em conclusão, o estudo indica a necessidade de se avançar na estratégia nacional de vincular produção local, capacitação tecnológica e de inovação no segmento de vacinas para contribuir na garantia do acesso universal à saúde no país.

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“…The coverage of private health plans and insurance continued to grow. As the subsidies for the private sector and fragile state regulation persisted, health care companies extended both their political and market strategies 26 . Following Dilma's reelection, a new law was enacted authorizing the entry of foreign capital into health, including in service provision.…”

Section: Brazil: Universal Public System and Strong Private Sectormentioning

confidence: 99%

Políticas de Saúde na Argentina, Brasil e México: diferentes caminhos, muitos desafios

Machado

2018

Ciênc. saúde coletiva

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Over recent decades, several Latin American health systems have undergone reforms. This paper analyzes health policies in Argentina, Brazil and Mexico from 1990 to 2014. It explores the reform strategies, explanatory factors and effects on the configuration of each health system. The analytical framework was based on the historical-comparative approach and considered the following aspects: political and economic context; health reform agendas, processes and strategies; changes in the health system configuration in terms of social stratification and de-commodification. The research methods involved literature review, document and data analysis and interviews. In the period, Argentina maintained an employment-based and fragmented healthcare system, expanded specific public programs and private health plans. Brazil created a public and universal health system, which coexists with a dynamic and growing private sector. Mexico maintained the employment-based health care and created a popular health insurance. Although the reform influences and strategies varied between the countries, social stratification and commodification persisted in the three health systems, under different arrangements.The transformation of these characteristics is essential to build universal health systems in Latin America.

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From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil

Abstract: From health plan companies to international insurance companies: changes in the accumulation regime and repercussions on the healthcare system in Brazil

Cited by 9 publications

References 10 publications

Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians

Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians

Acesso a vacinas no Brasil no contexto da dinâmica global do Complexo Econômico-Industrial da Saúde

Políticas de Saúde na Argentina, Brasil e México: diferentes caminhos, muitos desafios

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