Introduction to Agência Nacional de Saúde Suplementar (ANS)
ANS is an agency exclusive for the sector of health insurance and health plans, aiming to provide a better quality in the medical assistance of the insured peple.
Background
ANS is the Portuguese abbreviation for National Regulatory Agency for Private Health Insurance and Plans. It is the authority responsible for the health insurance sector in Brazil. Created in 2000, ANS aims to regulate a department of the Ministry of Health that until then had no specific regulation to follow.
The supplementary healthcare started to operate alongside with the public health system, consolidated with SUS, the Unified Health System. When SUS was created in the 1988 Constitution, health was legitimated as a right to the citizens, becoming a public asset.
Health plans were created with the foundation of the Santas Casas de Misericórdia, which are institutions connected to the Catholic Church that supports charitable and philanthropic activities. At the beginning, people with different illnesses were accepted as patients there, except the ones with infectious and contagious diseases.
The Santas Casas were the main places to offer health services since the times when Brazil was a Colony of Portugal, continuing through the time when it was an Empire, then when it became the Old Republic and finally until the Estado Novo regime, in the middle of last century.
In Brazil, the opportunities of exploring economically the healthcare sector appeared in the decade of 1930 and grew significantly in the decade of 1950, when the industrialization in the country actually started and industries were placed in the region of Grande ABC, in São Paulo state. By that time, private hospital institutions were consolidated as the main services provider of the emerging middle class.
Still in the 20th century, the Brazilian health system followed the path of other Latin American countries such as Mexico, Chile, Argentina and Uruguay and started to develop itself from the social security and pension funds. That was when the CAPs appeared.
CAPs, known as Caixas de Aposentadorias e Pensões, were the ones that took care of the pension funds of some sectors of the economy. Initially, they were used for workers of railroads. After some time, CAPs was substituted by IAPs, Institutes of Retirement and Pension Funds, and these were unified in the INPS , National Institute of Social Security, which originated Inamps, the National Institute of Medical Assistance of the Social Security, created in 1974.
Inamps provided medical assistance to the workers with employment ties that contributed to the social security. It preceded SUS, the Unified Health System.
Nowadays, the Brazilian sector of health plans and insurances is the second largest private health system in the world.
Services
ANS was created specifically to regulate the health insurance sector. Other sectors of insurance – such as automotive, residential, business – are all regulated by SUSEP, the Superintendence of Private Insurance. Between the responsibilities of ANS, are:
- Analysis of the market of supplementary health
- Functioning permission and prohibition of private insurance plans operators
- Maintenance and alteration of products registers
- Projects for improving health and prevention and control of risks and diseases
- Establishment of a list of minimum services that the health insurance must provide to the insured person, depending on the insurance plan made
- Establishment of the maximum time that insured people should wait until they are assisted.