Determinants of catastrophic health expenditures in Brazil: the impact of the public system and private insurance
- Presenter:
Chair: Jon Christianson; Discussant: Jean Abraham Mon June 5, 2006 13:45-15:15 Room 309
Despite the fact that Brazil has a health system with universal access and care free of charge at point of delivery, several previous studies have shown that Brazil has a high number of households with large health expenditures. The primary objective of this research is to assess the effectiveness of the public health system and private health insurance in providing financial protection in health care to the Brazilian population.
This research utilizes data from a large national survey of households. The determinants of catastrophic health expenditures (CHE) were estimated by a probit regression with a Heckman selection adjustment, controlling for the need for health care.
According to our findings, the Brazilian health system provides a significant reduction (41%) in the probability that a household has CHE. On the other hand, private health insurance did not reduce out of pocket expenditures and, given that the premiums are quite expensive, made CHE more likely - by 37%.
Recommendations include further improvements in the quantity, accessibility, quality and reliability of public health providers and more extensive and appropriate provision of medicines by the public system. A tighter regulation of private health plans is also necessary, both on the high cost of the insurance premiums and on the restricted nature of the benefits.
