Readjustment in health plans can cause abandonment of treatments, says study

The readjustment authorized by the National Supplementary Health Agency (ANS), of 15.5% in individual and family health plans for 2022 — the biggest increase since the beginning of the historical series in 2000 — could bring the treatment of patients in the country to an early standstill. , according to a study by the Brazilian Medical Association (AMB).

Currently, the service of individual and family plans covers more than 50 million Brazilians, about 20% of the population. The expectation is that the new adjustment, announced last week, will be applied between May 2022 and April 2023.

According to the AMB study, 88.3% of doctors working in Brazil have already seen patients abandon treatments due to adjustments to the monthly fees of the insurance plans – a number that may increase with the record high in the cost of the service in the country, according to the entity. .

“Increases in monthly fees, well above inflation every year, not only lead thousands to abandon treatments halfway through, but also increase the queues of the Unified Health System, which is underfunded and already insufficient for a decent reception”, highlights the pediatrician and APM director Marun David Cury.

The survey had the participation of approximately 3,000 physicians throughout the first half of this year. The AMB study was conducted in partnership with the Associação Paulista de Medicina (APM).

The margin of error is plus or minus 2 percentage points.

The study also pointed out that 80.6% of Brazilian doctors have already been restricted from health plans, after asking the patient to perform laboratory tests.

Within them, 19.8% of professionals say that control by the plans happens “frequently”.

Among the most common medical procedures among patients in Brazil are treatments for diabetes and cancer.

For the endocrinologist and clinician Ricardo Oliveira, the lack of an adequate procedure can cause serious complications to patients affected by these diseases.

“We are talking about millions of patients who had interrupted their treatment because of the pandemic and now, due to the high price of the plan, they will have to stop medical procedures again. An example is diabetes, which affects 16 million Brazilians, which requires a very specific and rigid follow-up and treatment”, Oliveira argued to the public. CNN .

In a note, the ANS stated that the readjustments of health plans are necessary so that the monthly fees accompany the variation in the price of procedures and in the amount of services used, and that, with this, there is continuity of provision.

The statement also says that the agency used the calculation methodology that has been applied since 2019 to carry out the most recent adjustment.