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SÃO PAULO – After the popular clinics it is now the turn of prepaid card companies or health discounts to attract customers who lost the medical convention or who gave up stay in the long waiting lines of the Unified Health System (SUS) . At least 8 million Brazilians are already using this service, according to a survey conducted by the state from leading companies in the sector. For comparison purposes, the number exceeds the number of clients of the country's two largest health care plan operators combined.
Generally, prepaid cards and discount cards charge a low monthly fee (starting at R $ 14.99) in exchange for discounts on an agreed network. The particularity of the prepaid service lies in the fact that in addition to the monthly fees, the procedures must be settled with the credits deposited on the card.
Health experts and consumer advocates view expanding service as a sort of convention with basic coverage, but without adequate regulation because it is not clbadified as a health care plan. The National Supplementary Health Plan (ANS) which regulates the scheme's operators, created a booklet explaining the differences between the two services and the care that the consumer must have when choosing from the cards. . Critics include the fact that cards do not guarantee unlimited participation or a minimum list of covered procedures.
Service users and companies operating in this industry claim that the model is an alternative for those who want to quickly access consultations and exams, but can not afford the monthly payment of a plan.
The largest company in the sector, Tarjeta de Todos (which offers discounts in educational and leisure facilities) has seen the number of monthly foreclosures triple this year. "Last year, we had 30,000 per month, and this year the number reached 100,000," said Altair Vilar, president of the company, which has 7.8 million users. In the network that offers discounts to cardholders, the medical consultation with a GP departs for $ 20.
This is what drew the prices that the housewife Maria do Carmo Rocha Souza, 55, has card for her mother, Joana, 87 years old. "We had an agreement, but we canceled because of the price and we started using only the SUS, she is the only one suffering from diabetes, high blood pressure and Alzheimer's disease. public consultation takes too much time, and at his age you can not wait, "he says.
For Antônio Eduardo de Carvalho Brigagão, CEO of Vale Saúde Always, a prepaid card company with more than 200,000 customers, consultations and exams are more important for card users, as companies in the industry negotiate with clinics. in the same way as health care providers. "They agree to lower the price because we are taking more customers."
Business Customers The low cost of monthly card fees has encouraged companies active in the sector to offer the product not only to individuals, but also to corporations interested in giving the card to their customers. employees. These are usually small or medium businesses that do not provide health insurance to workers.
Focusing on this market, Doctor Al already serves 50 companies with 6,000 workers. "Some of them only offer the discount card, while others offer a monthly amount allowing employees to pay for their procedures," says Gustavo Valente, CEO of Dutor Já.
Ticket, renowned for its benefits in terms of meals and food, Health, which also allows both modalities: only a reduction or credits for the employee. "The average cost for the company is R $ 28 per employee," says Adriana Serra, Ticket Product Manager.
Ultrafarma is another giant entering the prepaid health card market. In October, the company launched the Sidney Oliveira card, which also qualifies for discounts on the network's medical and dental procedures.
Despite the discounts granted by the cards, Protest warns that the service can not always be advantageous. "The person has to pay the monthly fees plus the procedures to follow.If you do a lot of consultations and exams, it will not compensate," says Luiz Costa, business badyst of the entity.
For Marília Louvison, professor at the School of Public Health of USP cards can leave patients unprotected. "This format does not guarantee the continuity of care or its resolution, because care goes to the point where the patient can pay. "
Interviewed, industry says service is focused on primary care, with complexity and weak action, prevention and health promotion [19659016] Lower price, but all is not so cheap
Hypertensa, the retired Maria Gonçalves, aged 79, had no cure for the disease when she went to take a new prescription with his SUS doctor and discovered As he had left the position.
In the absence of prediction regarding the arrival of a new professional at the Basic Health Unit (UBS) where he is consulted, in the northern part of the city of São Paulo, the elderly woman decided to join a discount card after seeing a product advertisement on television, presenter Ana Maria Braga.
"I asked my son to make the map for me on the Internet because the consultation was cheap.I made the card one day and the other, I already managed to check to the geriatrician, "explains Maria.
For the retiree, it was the only option she thought was not being without treatment for hypertension. "The SUS could not wait and a health plan that seniors could not afford, at least $ 800 a month," he laments.
Also tired of the delay in the public network, the switchboard operator Larissa Marques Santos, 24, hired the service for her and her son three weeks ago. "I have a gall bladder and just to check a clinician takes a month. Imagine how long it will take to do an ultrasound, "she says.
The young woman was also drawn to the fact that the monthly fee is charged per family and not per person. that even placing the child as the beneficiary of the service, the amount paid per month will be the same.
Larissa lost her health insurance three years ago, when she left a job where it was registered under the CLT. "Now I do not agree and I only depend on the SUS," says the attendant.
Discount cards are also used by anyone who wishes save on dental treatments. "I needed to make a cbad, a crown and a cleanse. With the card, the price was half price and I can install it eight times, "says Andrea Maria de Santana, commercial badistant, 47.
You deserve it. Whereas They approve the low prices of appointments and the speed of their appointment, some cardholders complain about the cost of more complex procedures
"I think that exams should be taken into account. My mother needed an MRI and two eye exams at a cost of $ 600. It was not cheaper than in other laboratories, "says Maria Do Carmo Rocha Souza, housewife, aged 55.
Lack of regulation, according to a public health expert
1. What is your badessment of prepaid cards and health discount cards?
Health demands are never isolated Patients need a network of care. They are attracted by low prices and are more attracted to care because they are sicker and need frequent care, but they may not be protected when they need more complex care because they do not need to be cared for. will have no cover.
It is necessary to develop a regulation because, for the moment, these cards are in a regulatory vacuum in which they do not belong to any organism In the field of health, a benefit of service can not be treated solely as a consumption relationship.
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