Theory and practice regarding participation in the Brazilian National Regulatory Agency for Private Health Insurance and Plans

Abstract

Starting with the premise that Brazilian national public health systems (SUS) and private healthcare system are inter-related institutions, this study experiments with participatory models in the regulation of healthcare plans by Brazilian National Regulatory Agency for Private Health Insurance and Plans (ANS). First, from a theoretical perspective, the legislation and documentation on the subject is analyzed. Next, from a practical perspective, that is analytical and opinionated in style, the focus turns to the 2011-2012 Regulatory Agenda exam and the participation in health plan implementation of the users’ representatives, especially concerning consumer rights organizations. In this analysis, the agency’s website was consulted to obtain information on the mechanisms of participation used during the discussions on the agenda, meeting minutes, attendance lists, etc. The research period ended in June 2012. Among other conclusions, it is clear that the influence possessed by the representatives of health plan users in the agency is still limited. Finally, suggestions are presented for increasing participation in the ANS.