Supplemental care from a bioethical perspective.
OBJECTIVE
To describe and analyze, from the perspective of Intervention Bioethics, the legal, institutional and ethical contexts, the conflicts and regulations of supplemental health care in Brazil, since the approval of the regulatory law in 1998 until 2010.


METHODS
Qualitative research, using Intervention Bioethics as the theoretical reference. Bibliographical and documental study of the legislation, regulations and assistential framework, as well as interviews with members of the Supplemental Health Board.


RESULTS
There was improvement in the records and rules of action in private health companies, as well as flow of information, contractual and financial guarantees provided to consumers. Conflicts persist regarding access to services and procedures, price increases, policies on autonomy and medical fees. There is a dispute with the public sector regarding the network of health services, with rising costs and no improvement in quality of care.


CONCLUSIONS
Private participation in health demands comparative assessments and improvement of public-private care regulation, as well as promoting greater balance in the funding and reevaluation of the health care model.


CONCLUSIONS
It is necessary to review the regulatory framework considering the supplementary, complementary or duplicate characteristic of assistance, the social actors involved, bioethical and political issues regarding associations between Supplemental Health Care and the National Health System (SUS).
Programa de Pós-Graduação em Bioética, Universidade de Brasília, Brasília, DF, Brasil. Electronic address: pariziregina@gmail.com.
Regina Ribeiro Parizi
RR
Carvalho
Paulo Antônio de Carvalho
PA
Fortes
Volnei
V
Garrafa
D026688:Bioethical Issues; D001938:Brazil; D003695:Delivery of Health Care / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006291:Health Policy; D006801:Humans; D038622:Internationality; D017061:Prepaid Health Plans / Q000191:economics / Q000941:ethics* / Q000331:legislation & jurisprudence; D055818:Public-Private Sector Partnerships / Q000191:economics / Q000941:ethics* / Q000331:legislation & jurisprudence
Bioethics; Bioética; Participação público-privada; Public-private partnerships; Saúde suplementar; Supplemental health; Universalization of health; Universalização da saúde