Clipping of news on Brazilian Culture, Law and Citizenship
05/06/2013
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Through bills and review the list of procedures, users extend coverage
RIO - Ensuring compliance and mandatory coverage of certain procedures by the plans and health insurance are battles that are being waged by users since the early 2000s, either by bills or by social pressure for inclusion in the list the National Health Agency (ANS). The latest victory, the free supply of collecting bags of feces and urine for ostomates, goes into effect on June 30. And later this month, the regulator conducts the fourth and final review meeting will be mandatory from 2014 for 47.9 million beneficiaries. The oral chemotherapy should be included among the treatments, benefiting patients today have to resort to SUS or pay up to R$ 18,000 per month
For 33 years, retired teacher Candida Carvalheira, 64, needs a collection bag stool, since an inflammatory disease made her lose the large intestine and rectum. She is one of about 34 000 people use collection bags in Brazil. Considering who uses any equipment that will supply required - bags, protective equipment, protective barriers skin - the number of beneficiaries by law and Resolution 325 12.738/2012 ANS reaches hundred thousand. The bags, which are disposable, they last for two to three days. Sold only in surgical sites, cost between R $ 10 and R $ 35. The monthly expense of the patient ranges from $ 300 to R $ 1,050.
- It is possible that the person pay a health plan and the time that you need to have to resort to SUS - says Candida, who is president of the Association of Ostomy (abrasion) and fight for the cause since 1980. - The day my insurer provide me, I open hand SUS. I think the measure can also help meet those who have no plan. In the beginning it will be difficult, but with the organization and cooperation of operators nobody will go without collecting bags.
Access to oral medication
According to Congresswoman Jandira Feghali (PCdoB-RJ), who in 2002 presented the project last year became the law of ostomates, the demand came from the patients' own movement in the early 2000s.
- The families paying for health insurance and there was no requirement for coverage. In general, it is something for ever and a very high expense. Since SUS covers, the plans must cover.
The Member is reporting to the Commission on Social Security and Family House, which analyzes the bill 3998/2012, by Senator Ana Amelia (PP-RS), so that patients in cancer treatment can have access to oral chemotherapy at home, paid for by health insurance. This possibility is being studied by the technical group of about 60 people who review the List of Procedures and Health Events ANS, which in 2014 will be part of the minimum coverage.
In 1998, when the law of plan
the health was established by determining what should have mandatory coverage, about 95% of the cancer treatments were intravenous. According to Luciana Holtz, President of the NGO Oncoguia today, about 40% of treatments are oral and in ten years is likely to be the majority. For her, the guarantee of the right pours the NHS, because when the plan denies the patient resorts to the public system.
- In the case of kidney cancer, practically there is only the option oral. Technology has changed and the patient no longer has access because he changed the form of government - says Tiago Matos, legal director of Oncoguia. - In the treatment is expensive, between £ 8000 and £ 18,000, is long term. If approved, will be the main gain from the law of health plans.
In 2001, with the emergence of oral drugs for chemotherapy, the physician João Paulo dos Reis Neto, the Capesesp, operator of the plane of the servers of the Ministry of Health created a program for chemotherapy household. Today, about 200 people use. And the financial impact, he says, is bearable:
- With about $ 0.99 per person, and we have 130 000 lives across the country, we cover the costs of those 200 people. A patient costs on average between £ 6000 and £ 7000. It is feasible, if well managed.
For Idec, list of procedures is illegal
According to the oncologist Rafael Kaliks, the high price of treatment is due to the fact that the new drug is not because it is oral.
- In the case of kidney cancer, there are four effective drugs. But only one is intravenous. It is a tragedy not to have access to all - says the doctor, who argues that the treatment offered has to be the best.
General Manager Regulatory Assistance ANS, the area responsible for updating the list of procedures, Martha Oliveira explains that the bills added to the exclusions of the law of the plans:
- We're in the middle of the revision of the list. In the case of ostomy, ANS detailed everything is included. Regarding oral chemotherapy, the group assesses whether this procedure should be included even without change in the law
The public consultation on decisions that must be open in June, will be available for 30 days. Among the evaluated procedures are different surgeries including video, new radiotherapy, expanding the indication procedures already included, in addition to demands for physiotherapy, nutrition and psychology.
The Brazilian Institute for Consumer Defense (IDEC) considers ileg
al have a roster with more exceptions than the coverage provided by the law of the plans, which are only ten, as treatments in testing and artificial insemination.
- The ANS is against the law for health plans and the Code of Consumer Protection. The list is not effective for ensuring the rights of consumers. It determines in part what is already guaranteed by law since 1998 - says Joana Cruz, lawyer Idec.
In a statement, the National Federation of Health Insurance (FenaSaúde) states argue that initiatives incorporation or exclusion of procedures are made by reviewing the list and not through the bill. As for oral chemotherapy, highlights that the issue is complex and requires evaluation. Regarding ostomy bags, says the member operators are organizing to enforce the law. The Brazilian Association of Medical Group (Abramge) points out that some operators have been providing collection bags. As for oral chemotherapy, only it will decide after project approval.
Source: The Globe - Online
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This article was translated by an automatic translation system, and was therefore not reviewed by people.