Complementary health care is experiencing a defining moment in Brazil. At the same time, the health plan’s more than 50 million beneficiaries face major modifications, unilateral cancellations, and difficulties obtaining basic treatments.
As head of the National Complementary Health Agency, I stated that the organization cannot be controlled by just one party. An economic-financial balance is necessary, but it must apply to both operators and consumers. Regulation that takes this issue into account is the only way to restore confidence to the sector and guarantee consumer rights.
In recent years, we have observed operators claiming losses, while at the same time posting strong financial results. Discourse on unsustainability has become a kind of automatic narrative, rarely accompanied by data justifying, for example, much higher inflation adjustments.
That’s why I advocated for greater transparency: the country needs a trustworthy indicator of medical inflation, clear criteria for adjustments and justifications that allow citizens to understand what they are paying for. Today, there is nothing.
The so-called medical inflation requires technical measurement, as is the case with common inflation. This indicator can be measured, for example, by IBGE or the Institute for Applied Economic Research (Ipea). Transparency is always the best way to organize business relationships. In this case, we are talking about the lives of millions of Brazilians.
Another crucial point is the practice of unilateral cancellation of collective contracts. It is unjustified for the elderly or people undergoing ongoing treatment to be surprised by decisions that interrupt their care. Cancellation due to risk selection is illegal. This is a perverted logic that distorts the principle of reciprocity and results in profound injustice. ANS is building the 2026-2028 regulatory agenda. I will advocate that this issue be confronted head-on and decisively.
We must also confront the paradox of individual plans. Although it is the safest method for the consumer – as it regulates modifications – it represents a small part of the market. Why do operators avoid offering it? What real barriers exist?
Modern regulation must investigate these responses in a technical way and open paths for dialogue, thus avoiding an environment in which the beneficiary is forced into false collective contracts, and where he is more vulnerable to arbitrary increases.
ANS will only do its part if it combines clear rules with effective supervision and a commitment to user protection, and to maintaining the economic and financial balance of contracts. This is not about antagonizing operators, but rather calling on all complementary health care actors to form a charter of responsibility.
A health plan is not just a product: it is a contract that people sign and must be fulfilled by both parties. ANS works to ensure the public interest and build systems that look at life as it is. We cannot ignore consumer confusion, anxiety and complaints.
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