Health Profession
publicado em 18/05/2012 às 18h43:00
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Cremesp points gap between billing plans and the amount paid to doctors

Industry says that in nine years of health insurance revenues grew three times faster than the average medical

 
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Foto: Assembleia Legislativa de São Paulo
Renato Azevedo Júnior, presidente do Conselho Regional de Medicina de São Paulo
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Renato Azevedo Júnior, presidente do Conselho Regional de Medicina de São Paulo

According to a survey of the Regional Council of Medicine of São Paulo (Cremesp) in nine years (2003-2011) medical and hospital plans had 197.8% growth in sales across the country. The market has annual revenues of $ 28 billion to $ 83.4 billion in the period. The average medical consultation in the same period rose only 64.7%. That, in the mean values ​​calculated by the National Health Agency (ANS), according to data provided by the operators themselves.

The average of R $ 46.12 for medical consultation in 2011 was much lower just beyond half the minimum of $ 80.00 claimed by medical authorities.

If the index had been applied for adjustment of medical fees corresponding to the economic growth of the sector, the average query today to reach R $ 83.40. In 2012 the records of medical organizations have plans that still pay less than $ 30.00 consultation.

About 160,000 doctors working in the health care market in Brazil hold per year, about 223 million queries. Each user of a health plan goes to the doctor on average five times a year. In 2011, 47.6 million Brazilians were insured health plans.

For the president of Cremesp, Renato Azevedo Junior, the discrepancy shows just how urgent and urgent issue of a new normative instruction of ANS to regulate contracts between physicians and health plans. In addition to correcting the imbalance, hereafter the fees need to be adjusted at least annually, even with rates that reflect the robust growth of the sector.

On April 25 there was further mobilization of doctors working in the health insurance. In addition to demonstrations and public events in various states, medical leaders gave the NSA proposals to regulate the employment of professionals by the operators. In addition to annual adjustments of the amounts paid were required parameters for setting fees and for accreditation / accreditation of physicians by health plans.

Source: CREMESP
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health plans    medical consultation    Cremesp    Regional Council of Medicine of São Paulo    NSA    National Agency for Supplementary Health   
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