Health regulation in the private sector: The case of ANS in Brazil and ERS in Portugal

Abstract

In Brazil, the Unified Health System (SUS) has been consolidated as a public health subsystem that coexists with a solid private subsystem supplementary and complementary health. The Portuguese health system, similarly, is characterized by the presence of three health subsystems: the National Health Service, private insurance and rising private sector. For both countries, the issue of the private health sector is a dilemma and a challenge to their respective regulators, the National Supplementary Health Agency (ANS) and the Regulatory Authority of Health (ERS). Thus, we aim to understand how regulatory institutions act on the private sector, demonstrating the growth of this sector, the segmentation of health systems, and the profile of complaints of beneficiaries. To this end, we carried out a systematic literature, survey of health expenditures on the basis of the OECD, IBGE, ANS and ERS. It With the consolidation of a pattern of private health business created a dispute over client segments and specializations; the private sector preserves its public funding base through its strong presence and increasingly organized in public decision-making arenas, with the State, and market flows.

Keywords:
Market; public spending; State