Clipping of news on Brazilian Culture, Law and Citizenship
This article was translated by an automatic translation system, and was therefore not reviewed by people.
Alexandre Rodrigues and Carolina Dall'olio
These operators provide poor service to about 9 million users
About 9 million users of individual health insurance are currently serviced by operators considered unsatisfactory by the Agency of National Health Insurance (ANS), an agency responsible for regulating the sector. They represent 23% of the total. Are in the same situation another 1.379 million customers of plans dental (or 18%).
This group is attended by companies that had the Performance Index of Health Supplements (IDSS) ranging from 0 to 0.39 (on a scale of 0 to 1, the latter being the best level). The data are in the Qualification Program for Health Supplemental for 2008 and released yesterday by the NSA. According to the chief executive of the agency, Fausto Pereira dos Santos, are these operators will have a greater focus of the review.
Santos says that the factors weighed more for poor grades were a low cost carrier's ability to pay for services and mismanagement of assistance to users. Still, the overall assessment of the sector was positive, because 77% of beneficiaries are served by companies with index above 0.4. "We found that each year has increased the percentage of beneficiaries among operators better evaluated," says Santos, highlighting the concentration of users on average.
About 17.9 million beneficiaries of medical care, nearly 45.1% of the total, have contracts that were in the range between 0.6 and 0.79 of the IDSS. Only 104,087 people have plans with the top rating - from 0.8 to 1.
Daniela Trettel, a lawyer of the Brazilian Consumer Defense (Idec), welcomes the fact that the NSA have made the assessment and made the results available to the public. "People have to know what is the situation where the operators, not only in time to get insurance," he points out.
However, the lawyer criticizes the stance of ANS on the results. "The fact that 80% of mobile operators take less than 0.6 clearly shows that companies are in breach of the standards required by the NSA itself, since the agency used as criteria for assessing only the rules in force in the market," he says. "Therefore, the NSA would use this ranking to punish those who has low grades. But instead, the data were just released and nothing was done. "
Criteria
To score the companies, the NSA has used four criteria: the focus on health, economic and financial situation of the operator, the structure of service and customer satisfaction. Emphasis was given to the first two items, which account for 80% of the note. They measure, respectively, the quality of service and security service that the company offers to members - and it was precisely this second concern that health plans skidded more.
"In assessing the economic situation of the carrier, the NSA is pondering whether the company has sufficient financial reserves, if it breaks, continue paying suppliers and maintaining the service to policyholders until your customer is transferred to another operator," says Pedro Fazio, a consultant specializing in the health plan. "Therefore, if many companies are with low grades in this regard the situation is worrying."
For Santos, increased competition and facilities, such as the ability to contracts signed since 1999 to change the plan without grace (portability), can explain the movement towards better evaluation plans. But it also highlights the value of the index by operators as a marketing tool. "They saw that can be an important differential in the market and they had more concern about the ratings." The NSA does not rank.
WHAT TO DO
Assessment shows that most plans are down. For small and medium-sized firms, the situation worsens
So before hiring a health plan, although small and medium-sized generally offer cheaper plans, should not extend beyond the price to make a choice
Check the note that the NSA gives the company and check the existing claims against the operator in court (www.procon.sp.gov.br). Avoid headache before hiring plan
After signing the contract, the unhappy customer can even use portability to switch operators without complying with grace, but shall be subject to a set of rules that hinder the migration
You can only change on the anniversary of the plan and contracts of the same value
Source: Jornal da Tarde
This article was translated by an automatic translation system, and was therefore not reviewed by people.