Health-care system regulation in Brazil and in great Britain

Abstract

This chapter reviews research carried out since the start of the concept of healthcare regulation in Brazil and in the United Kingdom and how regulatory practices developed. The study focuses on economic regulation and the assessment of the quality of health-care services provided by the Brazilian private market and the British National Health Service. Beginning from a historical overview, the advent of regulatory authorities in both systems will be discussed, specially the Supplementary Health National Agency (a Brazilian agency which has the acronym in Portuguese of “ANS”). As to the UK, the research sets out to cover briefly the legal framework supporting the powers and duties of different bodies within the National Health Service (NHS), such as the Department of Health, Public Health England, Care Quality Commission, general practitioners, and foundation trusts as examples within the UK system. The Health Plan Market in Brazil will be analyzed before and after the introduction of regulation. Solvency and coverage issues, the reduction in the network of providers, abusive readjustments of premiums, and the unilateral annulment of contracts will also be reviewed. This chapter also will present Brazilian intervention methods (inspection regimes) used by the Brazilian regulatory agency for private health plan insurers and companies especially through ready reckoners. In Great Britain, the law underpinning the current public health-care system will be discussed, with some remarks on the new white paper “Equity and Excellence: Liberating the NHS (2010),” notably the topics related to economic regulation.