Supplemental care from a bioethical perspective

Regina Ribeiro Parizi Carvalho , Paulo Antônio de Carvalho Fortes , Volnei Garrafa
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Abstract

Objective

To describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010.

Methods

Qualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board.

Results

There was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care.

Discussion

Private participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model.

Conclusion

It is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS).

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从生物伦理角度看补充护理
目的从干预生物伦理学的角度,描述和分析巴西自1998年监管法批准以来至2010年补充医疗的法律、制度和伦理背景、冲突和法规。方法以干预生物伦理学为理论参考,进行定性研究。对立法、法规和辅助框架的文献和文献研究,以及对补充健康委员会成员的采访。结果私营健康公司的记录和行动规则以及向消费者提供的信息流、合同和财务担保都有所改善。在获得服务和程序、价格上涨、自治政策和医疗费用方面的冲突依然存在。与公共部门在医疗服务网络方面存在争议,成本不断上升,医疗质量没有改善。讨论私人参与卫生需要对公私医疗监管进行比较评估和改进,并促进医疗模式的资金和重新评估之间的更大平衡。结论有必要审查监管框架,考虑援助的补充性、补充性或重复性、所涉及的社会行为者、补充医疗保健与国家卫生系统之间的关系的生物伦理和政治问题。
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