Health, Health and Mental Health Plans: The Challenge of Care

for every Lesinio Rato

Health is not just the absence of disease. By definition, health is understood as physical, psychological and social well-being. Within this vision, health in Brazil has been ill for a long time and could worsen. The crisis in the sector is known to all of society. However, little has been said about the process that has particularly affected a large part of the population.

People who lose health insurancewho were previously paid by the companies they worked for, are unable to afford the new health insurance, with a few exceptions.

In this way, it would be up to the public health service, SUS, to take care of these people. Just like health plan operators, the SUS was obliged to conclude agreements with the private network of hospitals and clinics, thus helping patients who were previously served by the plans.

Private clinics are engaged in real administrative battles to bring high costs in line with stagnant revenues. The quality of their services is often compromised. Many public hospitals, which have specialized in several specialties, are struggling to perform medical procedures.

in Psychiatry This is particularly worrisome given the specificities of this specialty. The increasing demand for clients with mental disorders, the tendency toward chronic mental illness, the worrisome cases of chemical dependence, and the lack of services available to care for these clients are issues that society is aware of.

Modern psychiatry requires a multidisciplinary team in the relationship with the family and the patient, working frantically to achieve effective results. Only those who have lived 50 years after the development of psychotherapies understand the meaning of the multidisciplinary team.

In general, health plan operators cover psychiatric services and pay for the daily rate and medications. Procedures such as group therapy, individual or family therapy, nuclear meetings, etc. are not covered.

Multidisciplinary teams are concerned with turning people into people. The staff has a strictly economic view of psychiatry, without regard to the physical, psychological and social safety of the patient. Therefore, it is possible to predict the survival of low-cost psychiatric clinics.

All stakeholders (insureds, providers, and plans) are dissatisfied. Providers are subject to a routine of delayed payments for services provided, in addition to freezing their prices.

We recognize that there is an urgent need for a meeting of the parties (the psychiatric community, health plan operators, humanitarian aid, and service providers) so that together we can find a way out of specialization. Maintaining the quality of psychiatric services in this scenario, when there is no financial/economic partnership, is the challenge that psychiatry faces daily.

It is worth noting that in cities like Rio de Janeiro, Sao Paulo and others of similar size, the private sector provides psychological care to 70% of the population. It would be a disaster with unbearable consequences for the unified subscription system, and the elimination of the private sector.

Clinics, psychiatric hospitals and health services are struggling to adjust their procedures to maintain operations. Before bankruptcy, a sale becomes inevitable.

Brazil therefore faces the challenge of providing the dignified mental health care its population deserves.

*Licinio Rato is a psychiatrist and founding director of Casa de Saúde Saint Roman.