Em debate na comissão que analisa mudanças na lei do setor, representante de planos de saúde sugere medidas para conter aumento de custos
O diretor-executivo da Federação Nacional de Planos de Saúde (FenaSaúde), José Cechin, informou nesta terça-feira (20) que, de 2007 a 2016, o reajuste de preços feitos pelas operadoras de planos de saúde foi de 115,4%, diante da inflação de 74,7% (IPCA), mas destacou que a despesa assistencial per capita paga pelas operadoras aumentou 158,7%.
Em audiência pública na comissão especial (PL 7419/06 e 139 apensados) que analisa mudanças na atual lei do setor (9.656/98), Cechin listou medidas que poderiam conter esse aumento de custos, como uma rede hierarquizada com direcionamento, com um médico de família coordenando os cuidados – modelo similar ao Sistema Único de Saúde (SUS).
Além disso, Cechin sugeriu a coparticipação do usuário nas consultas, reduzindo desperdícios, e protocolos clínicos bem definidos, iguais aos do SUS. Ele defendeu ainda a possibilidade de planos regionalizados e a obrigatoriedade de segunda opinião médica em casos de maior complexidade.
Cechin também citou os itens mais judicializados: contratos antigos; reajustes anuais e por mudança de faixa etária; negativas de coberturas; mudanças na rede credenciada; aposentados e demitidos; carências; e reembolsos. E sugeriu alteração na lei para mitigar a judicialização, como o aclaramento das situações de urgência e emergência; e a exclusão de cobertura de tratamentos não-contratados ou de caráter experimental.
Mudança de modelo
O vice-presidente da Confederação Nacional de Saúde (CNS), Marcelo Moncorvo Britto, afirmou que os planos privados de assistência de saúde perderam usuários, e logo aumentou a sobrecarga do SUS. Ele também ressaltou que os usuários criticam sobretudo a cobertura, que seria responsável por mais de 2/3 das reclamações. Ele apontou ainda que o mercado está muito concentrado nas mãos de poucas empresas e reclamou que o custo assistencial para as operadoras está subindo mais do que a receita.
Britto sugeriu a mudança do modelo – hoje focado na “relação prestador x operadora, com exclusão do usuário” – para um “focado na relação usuário x prestador, com participação necessária da operadora”. Além disso, ele acredita que os prestadores e médicos devem ser direcionados à saúde básica e preventiva, e não à saúde de alta complexidade, como é hoje.
O deputado Vitor Lippi (PSDB-SP) concorda que o modelo deve ser alterado para se focar na prevenção, e não na doença. “Temos que atuar na promoção da saúde”, disse.
Judicialização
Especialista em questões ligadas a planos de saúde, o desembargador aposentado do Tribunal de Justiça de São Paulo Maury Ângelo Bottesini afirmou que a judicialização da saúde no País é causada pela constitucionalização da saúde. A Constituição diz que saúde é direito de todos e dever do Estado.
Segundo ele, o Brasil é um pouco dos países do mundo que garante essa universalidade, gerando diversas demandas judiciais. Ele ressaltou que o País não tem recursos para garantir essa universalidade. “O SUS é uma maravilha no papel, no entanto falta o mecanismo econômico-financeiro para que se cumpra a Constituição”, disse.
Além disso, o desembargador defendeu a reforma da lei para divida-la em capítulos e facilitar a regulamentação pela Agência Nacional de Saúde (ANS), e sugeriu que seja retirada da legislação a parte que traz “um verdadeiro código penal para conselheiros e operadores de planos de saúde”.
O deputado Jorge Solla (PT-BA) acredita que o caminho não pode ser desconstitucionalizar a saúde, mas criar políticas públicas para garantir que esse direito seja efetivado. Ele disse que o principal problema do setor é o subfinanciamento e criticou a Emenda Constitucional 95 aprovada pelo Congresso que estabelece um teto para os gastos públicos nos próximos 20 anos.
Fonte: http://www.segs.com.br
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