A Regulation of health plans in Congress served the interests of the financial system and complied with the government's objectives of removing its responsibility for the health of an important portion of the population, privatizing it even for those who have difficulty paying. Abramge (Brazilian Association of Group Medicine) prepared the project. It was placed in the hands of a rapporteur with no experience in the matter (they let the goat into the garden!) and defended by the government bench, with orders not to give in. This was done against the opinion of the National Health Council, all professional class entities and user associations that publicly expressed their opposition.

There was collusion between the government, bankers and health plans against society, making the plans to be sold to the portion of the population that the government wanted to get rid of very profitable. Partial plans, immoral exclusions and dishonest tuition increases were approved. As a deputy I fought to prevent this immorality, but I achieved very little. Now, after the proletariat and the middle class have purchased them and begin to need to use them – as real and serious illnesses occur –, the Procons, Idecs and newspapers are full of complaints and the governments that follow each other are taking episodic and palliative measures. which generally harm the user even more. There is not a single original article in the regulations, which has become a patchwork.

In reality, there are currently three major losers in the issue of health plans: users, health workers and hospitals providing services. Everyone is in crisis, without sufficient organization and resources to exert pressure. And who does the Federal Government help through BNDES and Banco do Brasil with huge loans and subsidized interest? Plans and operators, with strong lobbies, spared and protected by the National Health Agency (ANS), author of the loan proposal and concerned much more with the financial health of the plans and little with the health of users.

The Parliamentary Commission of Inquiry (CPI) on Health Plans, established at the beginning of the current legislature to evaluate their abuses and distortions – proven by Idec, the press and the CPI itself – concluded by gracing them with excessive “understanding and generosity”, including allowing the continuation of the abusive 500% adjustment between different age groups created by Provisional Measure 148 of the Federal Government, of December 2003, which expels retirees from their plans at the age they need them most.

Helpless – With unemployment at 20% and purchasing power falling, a considerable number of the 35 million Brazilians who purchased plans cannot continue paying, have nowhere to go and are returning to the SUS, which is currently underfunded, poorly managed and adapted to those who endure queues , lack of access, poor reception and repressed demand. Furthermore, health plans parasitize 15% to 20% of care in public hospitals, making their users carry out the most complex and expensive diagnostic and therapeutic procedures there, and not paying the compensation defined by Law 9656. If the ANS complied with this legislation, The plans should return at least R$1 billion per year to public coffers. In the last five years, not even 5% of this has been collected.

Doctors have not had a raise for eight years, while in the last six, plans, according to IPEA, increased monthly fees by 332% above inflation. The hospitals providing services are all on the verge of bankruptcy, as they receive payments several months late, have disallowed accounts and cannot make payments via bank slips. If they complain, both – doctors and hospitals – are deaccredited without explanation. The most serious consequence is the loss of quality of user service.

Operators claim that the accident rate exceeds 75% and, therefore, their profit decreases. To know if it is true, we should have an audit that the ANS does not carry out. What's more, to reduce this rate, plans should implement prevention and early detection, but they don't. It's easier to turn to the generous BNDES.
The government spends R$40 billion/year on 140 million Brazilians through the SUS; The plans already involve a higher amount for just 30 million users – five times more per capita – and with high subsidies from the public system itself. And there is no guarantee whether this is happening to satisfy users' needs and pay doctors and hospitals with dignity, or just to provide greater profit for operators.
This aid also means mergers, monopoly and internationalization of supplementary health, prohibited by the Constitution and paradoxically encouraged by the Government that offers private health plans to public employees, demonstrating a lack of confidence in its health policy while creating good-paying customers for the plans. .

Propaganda - The ANS even did false advertising in favor of the plans. Have you ever imagined how good it would be if the government, using public funds, paid for the advertising of your factory, your restaurant or your hospital, using every day several minutes of Rede Globo and other television networks, two pages of Veja and IstoÉ, wide spaces in the country's most widely circulated newspapers and radio stations? Even if your business sold illusion, you would become a millionaire.

This is not a bad joke. This is exactly what the National Supplementary Health Agency – ANS (public body) did in favor of health plan operators, right at the beginning of this government, encouraging the 18 million Brazilians who purchased their health plans before 1999 to sign a new contract and pay, from the outset, 15% to 25% more in their monthly payment and everyone falls into the trap of age groups that up to 59 years of age will increase this monthly payment by six times. A young citizen who paid R$300/month for his plan, upon reaching 59 years of age, will pay R$1.800, in addition to the migration increases. With a retirement ceiling of R$2.400, he will have no other option: he will be forced to abandon the plan at the moment he needs it most.

ANS propaganda, using public resources, omitted these facts when it would have had an obligation to clarify them, they were relevant to users. What's more: it should also be said that anyone who signed health plans before 1999 – if they are not covered by the benefits of Law 9.656 – has a legally perfect contract, supported by the Consumer Statute and all jurisprudence formed by hundreds of people's lawsuits. who complained about the limitation of hospitalization time or exclusion of certain diseases, contrary to what is determined by the Constitution and which were corrected by Law 9.656. The plans, therefore, even those prior to 1999, contrary to what the advertisement said, are legally protected. Procon, Idec and Pro Teste are there to help users.

The ANS, carrying out propaganda without telling the entire truth, did so dishonestly, demonstrating excessive solidarity with health plan operators and little concern for the health of users who, when migrating, in addition to paying exaggeratedly more, will have new needs. unfair (because they have already been complied with in the past) to comply with the new procedures. Judge Roberto Wanderley Nogueira, from Recife, acted correctly in preventing, through an injunction, this advertising throughout the national territory as he considered it misleading.

All of this occurred with the knowledge of the Presidency of the Republic, as Provisional Measure 148, of December 2003, gave the ANS total freedom to regulate migration and this Agency did so just seven days later, on the eve of Christmas, through two Resolutions Regulations (No. 63 and No. 64) – which contain all these perversities, without discussion with any of the numerous interested entities and before the vote on the MP in Congress.

I was rapporteur for this MP and proposed a conversion measure – extensively discussed with all the sectors involved – that corrected these exaggerations, including those affecting hospital providers and doctors. All the speeches in the plenary were in favor, the government spoke against it and the measure was not approved.

Sad country – The government was not embarrassed: it ran misleading propaganda, guided a disastrous vote, continued to show solidarity with operators and banks, and did not improve the SUS to provide coverage for those who defaulted on their plans. I fulfilled my duty, without the ANS advertising space, to warn the unwary user: do not migrate before checking your new contract in full, especially the increases that will result from age groups and, if it is worse than the one you have, do not sign . He was not required to do so.

This is a sad country where the ANS spent enormous money on advertising to defend plan operators, without considering the huge resources that are not reimbursed by them to the SUS, due to the ineffectiveness of the ANS, which does not even comply with Law 9.656. In reality, as incredible as it may seem, the poor and insufficient SUS is financing health plan operators to the detriment of their users, who are the most in need, while operators protect their profits, serve beneficiaries with disabilities and exploit doctors and hospitals. . All of this, without any interference from the ANS.

The middle class is expelled from the Public Health and Education System, forcing them to buy their tax-paid citizenship on the market and, even so, they are poorly served. Alongside this, it offers – using targeting theory – poor health and education for the poor.

The solution becomes more difficult every day and this government does not seem to know the limits of the surreptitious privatization of fundamental public policies and the usurpation of rights. If we want to resolve this, it is necessary, in addition to diagnosis, creativity, efficiency and a lot of courage to improve the quality of these public policies, even to shelter the impoverished and needy middle class within them. When this happens, we will begin a virtuous circle, as the middle class has the power of social control. The lack of organized reaction from society, politicians and the press to these facts, ethically as serious as the Mensalões, is a sign of submission, hopelessness and alienation. Nothing worse than this for democracy.

Because he was traveling, the author of the article on this page was unable to prepare it in time to serve as a counterpoint to the interview with doctor Fausto Pereira dos Santos, director-president of ANS, published in the previous edition.