Lacking courage to change private health, says Einstein president
It is generally agreed that the cost of health in Brazil has reached an unsustainable level, say experts at the Health Forum EXAME.
São Paulo – A fundamental problem of private health in Brazil is the lack of courage to change and reduce costs. This was one of the conclusions of the debate “Private health: is it possible to satisfy all interests?”, Which took place during the EXAME Health Forum , held this Wednesday by EXAME.
Sidney Klajner, president of Albert Einstein Hospital, Irene Hahn, president of Qualirede, and Henrique Lian, director of institutional relations at Proteste, took part in the discussion. Each speaker gave a ten-minute presentation, and then there was a debate with questions on the topic.
It is generally agreed that the cost of health in Brazil has reached an unsustainable level. The result is that consumers are no longer able to pay for private health, and operators themselves find it difficult to offer the service.
“I think we all know what has to be done. But it lacks the courage to take the initial step, even if at first it brings a reduction in profits, ”said Sidney Klajner, president of Albert Einstein Hospital.
In his presentation, Klajner gave examples of how Albert Einstein has made this change. One of the actions was the implementation of a second opinion for indications of surgeries that use expensive items such as orthoses or prostheses.
“After we started doing this, 61% of the surgery indications were contraindicated in the second opinion. And our satisfaction survey showed over 90% satisfaction for both patients who had surgery and those who did not, which proves that the indications were correct, ”he said.
However, such actions move the pocketbook. “There is a perverse compensation system that rewards unnecessary examination and length of stay. At Einstein we already see a decrease in our revenue due to the reduction of hospitalization time ”, exemplified Klajner.
The lack of courage was also cited by Irene Hahn, president of Qualirede, a health insurance company. In his presentation, Hahn cited the difficulty that plan beneficiaries today have in finding a good doctor to solve their problem. Behind this difficulty is the lack of an assessment of the care provided by the doctors listed in the plans.
“It seems a sin to speak of health merit. Today I have data to say which cardiologists deliver the most value, for example. I can tell which people had many interventions after surgery, which had care for five cardiologists, but ended up having emergency surgery. And I can tell who made those calls. But the plans do not want to disclose that. God forbid, this team has the best result, ”he provokes.
For Hahn, this is an example of an attitude that can be implemented quickly and that would bring good results for the industry. “This competitiveness generates quality,” he argues.
Another point raised by Hahn is the need for offices and hospitals to use a unified management system, which would allow easier data crossing and lower costs. “If banks share tellers 24 hours, it’s time to share technology in healthcare because technology is key to change. Each office spends on management system and is not a little money. An alternative is to think about funding a system together, ”he suggests.
Henrique Lian, director of institutional relations at Proteste, an organization of European origin that acts in the defense of consumer rights, recalls: “we are all consumers”. The patient consumes the plan, which consumes the services of the hospital that consumes the services of a doctor. So if there are problems in the system, everyone suffers, he said.
However, even if all actors are engaged in seeking solutions to the problem, this is a complex issue, so solutions are not simple either, Lian says. “This is a theme that involves political and economic actions. But there is also a behavioral component, which is in the patient who goes to the hospital for whatever reason, as well as in the doctor who points out unnecessary procedures. There is no simple solution.”