Encarando um mundo instável e incerto: experiências regulatórias face aos riscos relativos aos seguros saúde

Abstract

This dissertation aims to study the automatic dampers to the crises of health insurance systems, in order to protect consumers of health plans and insurance from uncertainties. The survey chose two predominantly private health insurance systems, Dutch and American; it examined the methodologies employed in these countries to damp potential crises of insolvency in order to, compared to private insurance subsystem in Brazil - the so-called supplementary healthcare sub-system - think what measures can be adopted in Brazil to face the uncertainties and instabilities that arise in the setting of securing private health care. The most suitable buffers for the Brazilian case are the guarantor insurances, represented by a guaranty fund mecanism, which ensures that in case of insolvency of health insurance companies, it will provide continuity of care, transient, until a healthy company can absorb the portfolio of the insolvent one. This work also examines the duality of the Brazilian health system, with a public-private mix represented by the SUS and by supplementary healthcare sub-system. The presence of such duality, in spite of the disconnection between the two fields, suggests that SUS, universal, will be the 'welcoming last resort' to offer protection to the potential outsiders of the Brazilian private sub-system reason why the SUS should be strengthened