02.01.02. The private health sector | Brazil

02.01.02. The private health sector | Brazil

30 Mar 2022

The private health sector has been an important part in the provision of care in Brazil and is spread across the country. The private healthcare sector connects with the public sector by providing services contracted-out by the SUS, out of pocket hospital, and ambulatory services, drugs, and through private health plans and insurance. Private healthcare services are financed both by the SUS and private sources. Data from the report “Fiscal Aspects of Health in Brazil” state that 55% of the total expenditure in health comes from private expenditure/sources and 45% comes from public expenditure/sources (Brazilian National Treasure, 2018; OPAS/OMS, 2019).

It is important point out that over 70% of the total population do not count on private insurances for their healthcare needs (>190 million people) (Brazilian Ministry of Health, 2013a). A survey conducted in 2018, commissioned by the Credit Protection Service (SPC Brasil) and by the National Confederation of Store Owners (CNDL), showed that, of the 70% who do not hold a health insurance, nearly 45% report to use SUS whenever they need it, while the remaining proportion reports to pay in cash for their healthcare whenever they need it (Agencia Brasil, 2018). Mostly due to the long waiting time for consultations, some people pay for it privately and then do the exams requested by the clinician through the public health system, for example. Also, most people get their vaccinations done through SUS, and may get their medication free of charge also out from the primary healthcare services (Agencia Brasil, 2018).

By the end of 2018, according to the National Regulatory Agency for Private Health Insurances and Plans (Agência Nacional de Saúde Suplementar – ANS), around 23.3% of the Brazilian population had a private health care insurance (National Regulatory Agency for Private Health Insurances and Plans, 2019b). Main users of private health plans are employees from public and private companies that offer private health coverage. The insurances vary in quality and amenities according to socioeconomic and occupational status of the demanders. Within one company, employees may have different levels of health care coverage depending on occupational hierarchy. Even though people with private health care insurance might benefit from more “premium” health plans, they often receive vaccines, high-cost, and complex services through SUS (Paim et al., 2011).


Agencia Brasil (EBC). (2018, November 5). Tragédia Mariana. Agência Brasil. http://agenciabrasil.ebc.com.br/geral/noticia/2018-11/tragedia-de-mariana-completa-3-anos-veja-linha-do-tempo

Brazilian Ministry of Health. (2013a). Pesquisa Nacional de Saúde 2013: Acesso e Uitlização dos Serviços de Saúde, Acidentes e Violências. https://biblioteca.ibge.gov.br/visualizacao/livros/liv94074.pdf

Brazilian National Treasure. (2018). Aspectos Fiscais da Saúde no Brasil. https://sisweb.tesouro.gov.br/apex/f?p=2501:9::::9:P9_ID_PUBLICACAO:28265

National Regulatory Agency for Private Health Insurances and Plans, M. (2019b). Caderno de Informação da Saúde Suplementar: Beneficiários, operadoras e planos. Março 2019. https://www.gov.br/ans/pt-br/arquivos/acesso-a-informacao/perfil-do-setor/dados-e-indicadores-do-setor/informacoes-gerais/total-cad-info-jun-2019.pdf

OPAS/OMS. (2019). OPAS/OMS Brasil—Países estão gastando mais em saúde, mas pessoas ainda pagam muitos serviços com dinheiro do próprio bolso. https://www.paho.org/pt/noticias/20-2-2019-paises-estao-gastando-mais-em-saude-mas-pessoas-ainda-pagam-muitos-servicos-com

Paim, J., Travassos, C., Almeida, C., Bahia, L., & Macinko, J. (2011). The Brazilian health system: History, advances, and challenges. The Lancet, 377(9779), 1778–1797. https://doi.org/10.1016/S0140-6736(11)60054-8