The supplementary health market reacted to the video by Globo presenter Marcos Mion, which went viral on the internet this Wednesday (23), with about 12 million views, talking about the judgment of the STJ (Superior Court of Justice).
The court’s analysis, which was interrupted by a request for a view, addresses treatments guaranteed by health plans.
Mion made an appeal for his followers to say no to the exhaustive list, which, according to the ANS (National Supplementary Health Agency), is the current model and establishes which are the mandatory coverages to be offered by health plans, which can be expanded by beneficiary with additional payment.
In the other model, called exemplary, the list works as a minimal reference.
Former BBB Juliette Freire, who has about 40 million followers, also spoke out on the matter. “If it is considered exhaustive, the plans will have full power to refuse to meet these demands. This is very serious! This is a serious restriction of the right to health and society. We cannot be silent!”, wrote Juliette, endorsing Mion’s speech. , who in the video mentions the case of her autistic son and also that of other families.
The ANS says that “it regrets that erroneous information is being disseminated on the matter in the imminence of a trial of such importance.”
Alessandro Acayaba, president of Anab (National Association of Benefit Administrators) says that Mion made a passionate demonstration, but lacked technical knowledge, according to him.
“It has already been addressed to the ANS. His situation has already been addressed and resolved. His speech in relation to this makes no sense, but he encourages other people to continue with the understanding of this exemplary role”, says Acayaba.
In July last year, the regulatory agency added to the coverage of health plans unlimited sessions with psychologists, occupational therapists and speech therapists for the treatment of autism, in addition to the already guaranteed physiotherapy.
Representatives of the health plan market say that the exemplary model may end up causing an increase in health plan prices, because operators would lose the predictability of the tax role.
“There is a financial operation behind it, of income and expense. If you have an unlimited expense and everything you can, a blank check in the consumer’s hand, for the health plan operator to pay, you have to pass it on”, says Acayaba .
“With all due respect to Mion, I like him a lot, but he’s talking nonsense. He’s great as a presenter, but he’s not good as a health insurance commentator”, says the president of Anab.
Abramge (Brazilian Association of Health Plans) says that the “reinforcement of the understanding by the taxativity of the list is linked to legal certainty and predictability in health care for the set of beneficiaries”.
“Formulating the price of a product with no coverage limit, which includes any and all existing procedures, drugs and treatments, can make access to a health plan unfeasible and put the continuity of supplementary health in Brazil in check”, says Abramge in note.
Joana Cunha with andressa Motter and Ana Paula Branco
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