According to ANS, in March 2023, Brazil registered more than 50 million health plan beneficiaries, representing 25% of the population. As for the rest, there is an overwhelming portion that relies exclusively on the public health system, the SUS, and a portion that has a permissive income for the alternatives that have appeared on the market in recent years, such as popular clinics.
These companies emerged from that Gap left by the SUS and the operators, under the promise of carrying out consultations, exams, and other health services at more affordable prices. Despite the breadth and benefits of the public system, it faces many difficulties, ranging from long waiting lines for appointments, the poor distribution of services, to the delays in procedures caused by the pandemic, among other things.
Popular clinics make it possible, for example, for people to access diagnostic methods that have a very large queue in the SUS and are not expensive, speeding up the start of treatment and alleviating the burden on the public system. The demand for consultation with specialists is also high due to the concentration of professionals in certain regions and the high demand of the population;
In addition, from the point of view of supplementary health, Crisis scenario of operators and the high adjustments that befall the beneficiaries also contribute to the increase in demand for these alternatives to private health, which is a trend in the current situation in Brazil as a whole.
In this scenario, there was also a lot of talk about discount or benefit cards. They allow access to a specific number of exams or appointments for a low price. As these cards are not regulated by the ANS, they are not required to have minimum coverage like health plan operators. This regulation on operators is one of the reasons that makes it difficult to offer cheaper plans. However, if the users of these cards face problems, they do not go to the ANS, but to consumer protection agencies and also to the courts.
Limitations of popular clinics in Brazil
Even if it is posed as a response to the crisis and a market trend, it must be understood that popular clinics also have their limitations. The idea of the popular clinic is not to replace current systems, but to consolidate itself as a complement that covers a portion and covers obvious deficiencies in access to health in Brazil.
Among these limitations, one of them is the absence of comprehensive care and its continuity, since these are services paid in a timely manner. Still, a number of people need to go to the SUS when there is a need for more complex treatments and, in some cases, the entire path of primary consultations must be redone on the public network. In this sense, some experts believe that these clinics should be subject to greater regulations.
In short, health is very complex and there is still no single solution that will solve the access problem, but some trends are evident. Popular clinics, although they have limitations, partially respond to this problem, partially relieving the SUS and optimizing with the speed of diagnosis and health promotion for the population.
As Retail Clinics in the North American context
From the point of view of the international context, it is worth mentioning the so-called Retail Clinics, or “retail clinics” in the North American market. They have certain similarities with popular clinics in Brazil: they are medical clinics located in large stores and pharmacies, offering care for a limited range of health problems, in addition to vaccines and preventive care. In general, the prices are fixed and transparent.
Um study from the RAND Corporation, a North American global political think tank, indicated that these Retail Clinics have been proposed as an alternative due to the high cost of emergency care for conditions that are not emergency. They estimated that up to 20% of those emergency department visits could take place at one of these clinics, which would lead to potential spending savings of close to $4.4 billion annually.
These clinics started in the 2000s and have been growing in the healthcare market under the proposition of convenience, accessibility, and price transparency. Furthermore, it was found that the most common audience in these establishments is that of young adults without a regular provider. Although they have their limitations, it is understood that the Retail Clinics they also provide benefits in terms of access to health, functioning as a provider for low-income patients and those without a primary care physician.
