Government mulls opening healthcare data to encourage competition

Marcelo Queiroga — Foto: Cristiano Mariz/O Globo
Marcelo Queiroga — Foto: Cristiano Mariz/O Globo

The federal government is mulling over a provisional measure — a legal act that allows the president to enact an interim law prior to Congress voting — aiming at increasing competition in the health insurance market, by the creation of an “open health” system. It is inspired by the open banking platform — a system conceived by the Central Bank to give greater transparency to the banking sector.

Health Minister Marcelo Queiroga told Valor that the idea was formulated from conversations with Central Bank President Roberto Campos Neto and has already had the approval of President Jair Bolsonaro in recent weeks to implement the plan in the country.

The measure is still being developed in Brasília, but the main idea is that, similarly to what is being implemented in stages in Brazil with the banks, there will be greater transparency in the health insurance sector. A large, extensive national registry of data on patients and indicators on supplementary health would be created to be shared between operators and patients.

According to the Mr. Queiroga, the sharing of client data, through the “open health” platform, would allow an operator to offer a cheaper plan for a patient who uses few hospitals or healthcare services.

Government officials also explain that, in the future, the intention is to facilitate the portability of beneficiaries from one plan to another, which currently takes about 90 days.

Mr. Queiroga believes that if there is more competition and supply of health plans, Brazil’s public healthcare system (SUS) can stop being overloaded and part of its public migrate to the private sector.

The “open health” is inspired by a model adopted in the financial market in Australia and is inserted in the general guidelines approved by the National Council of Supplementary Health (Consu) at the end of last year. It is supposed to encourage a greater offer of health services, stimulate the appearance of more operators in the sector, and reduce the prices in this market in the future.

The Consu, in turn, is a collegiate body formed by ministers Queiroga, Paulo Guedes (Economy), Anderson Torres (Justice) and Ciro Nogueira (Chief of Staff).

In the evaluation of the health ministry, there is room for the entry of more companies in the supplementary health segment, because there were more than 2,000 health plan operators in the country at the beginning of the 2000’s, when the National Agency for Supplementary Health (ANS) was created.

Last Monday, Valor released a study conducted by CADE, the antitrust watchdog, which indicates that the number of health insurance companies dropped 47% between 2011 and 2020. This trend of market concentration over the last decade has been criticized by ministers.

President of the Brazilian Association of Health Plans (Abramge), Renato Casarotti says he has seen the Minister of Health mention many times the benefits of “open health” in public events in the sector. The entity, however, has not yet been called to a specific meeting on the matter.

“The idea is good, it is timely with the General Law of Data Protection, of information belonging to the beholder. The logic makes a lot of sense,” says Mr. Casarotti. “The important thing is to understand how this fits into the health sector, which is a little different from the banking sector.”

According to him, there are two main issues that tend to limit at some level the impacts of the federal government’s proposal. The first is that medical information about patients is still “very fragmented” in Brazil, without the existence of a single medical record.

“In the health sector, there is data with the doctors, hospitals, laboratories, operators, that still don’t talk to each other,” he said. “If the single medical record existed, then ‘open health’ would make perfect sense.”

Source: Valor international